Efficacy of mobilization with movement (MWM) for shoulder conditions : A systematic review and meta-analysis

Journal article


Satpute, Kiran, Reid, Susan Anne, Mitchell, Thomas, Mackay, Grant and Hall, Toby. (2021). Efficacy of mobilization with movement (MWM) for shoulder conditions : A systematic review and meta-analysis. The Journal of Manual and Manipulative Therapy. pp. 1-21. https://doi.org/10.1080/10669817.2021.1955181
AuthorsSatpute, Kiran, Reid, Susan Anne, Mitchell, Thomas, Mackay, Grant and Hall, Toby
Abstract

To assess the effects of mobilization with movement (MWM) on pain, range of motion (ROM), and disability in the management of shoulder musculoskeletal disorders. Methods: Six databases and Scopus, were searched for randomized control trials. The ROB 2.0 tool was used to determine risk-of-bias and GRADE used for quality of evidence. Meta-analyses were performed for the sub-category of frozen shoulder and shoulder pain with movement dysfunction to evaluate the effect of MWM in isolation or in addition to exercise therapy and/or electrotherapy when compared with other conservative interventions.Results: Out of 25 studies, 21 were included in eight separate meta-analyses for pain, ROM, and disability in the two sub-categories. For frozen shoulder, the addition of MWM significantly improved pain (SMD −1.23, 95% CI −1.96, −0.51)), flexion ROM (MD −11.73, 95% CI −17.83, −5.64), abduction ROM (mean difference −13.14, 95% CI −19.42, −6.87), and disability (SMD −1.50, 95% CI (−2.30, −0.7). For shoulder pain with movement dysfunction, the addition of MWM significantly improved pain (SMD −1.07, 95% CI −1.87, −0.26), flexion ROM (mean difference −18.48, 95% CI- 32.43, −4.54), abduction ROM (MD −32.46, 95% CI – 69.76, 4.84), and disability (SMD −0.88, 95% CI −2.18, 0.43). The majority of studies were found to have a high risk of bias. Discussion: MWM is associated with improved pain, mobility, and function in patients with a range of shoulder musculoskeletal disorders and the effects clinically meaningful. However, these findings need to be interpreted with caution due to the high levels of heterogeneity and risk of bias. Level of Evidence: Treatment, level 1a.

KeywordsMulligan’s mobilization with movement; manual therapy; systematic review; shoulder dysfunction
Year2021
JournalThe Journal of Manual and Manipulative Therapy
Journal citationpp. 1-21
PublisherTaylor and Francis Ltd.
ISSN1066-9817
Digital Object Identifier (DOI)https://doi.org/10.1080/10669817.2021.1955181
PubMed ID34334099
Scopus EID2-s2.0-85111936419
Research or scholarlyResearch
Page range1-21
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All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online01 Aug 2021
Publication process dates
Deposited18 Nov 2021
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