University of Brighton, Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne, BN20 7UR, UK.
University of Brighton, Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne, BN20 7UR, UK.
Musculoskelet Sci Pract. 2019 Feb;39:157-163. doi: 10.1016/j.msksp.2018.12.001. Epub 2018 Dec 11.
Musculoskeletal (MSK) conditions are very common and represent a major concern for the society and global health. The manual therapy technique Mulligan's Mobilisation with Movement (MWM) has shown promising results in treating a variety of MSK conditions. The aim of this review was to systematically review the literature to establish whether MWM treatment is effective for improving pain and function in patients with MSK conditions related to peripheral joints.
Seven electronic databases (MEDLINE (through Ovid), EMBASE (through ovid), CINAHL (through EBSCO), Cochrane (CENTRAL), Web of Science, SPORTDiscus (through EBSCO) AND PEDro) were searched up to November 2017 for randomized controlled trials (RCTs). The quality of the evidence was rated using the GRADE approach.
Seven published trials were identified in which all trials presented positive clinical outcome in pain and function of MWM. Moderate quality evidence was found for the effectiveness of MWM in pain and function in patients with chronic ankle instability (CAI) and hip osteoarthritis (OA). There was found low quality evidence for shoulder impingement syndrome (SIS) and low and very low quality evidence for lateral epicondylalgia.
Overall MWM interventions applied to peripheral joints seems to be superior to placebo and no intervention controls, but not in comparison with other medical or physiotherapy interventions. There is a need for more high quality trials that investigate the short and long-term effect of a series of MWM interventions.
肌肉骨骼(MSK)疾病非常常见,是社会和全球健康的主要关注点。手动治疗技术 Mulligan 的运动性关节松动术(MWM)已显示出在治疗各种 MSK 疾病方面有很好的效果。本综述的目的是系统地回顾文献,以确定 MWM 治疗是否对改善与外周关节相关的 MSK 疾病患者的疼痛和功能有效。
截至 2017 年 11 月,我们在七个电子数据库(MEDLINE(通过 Ovid)、EMBASE(通过 Ovid)、CINAHL(通过 EBSCO)、Cochrane(CENTRAL)、Web of Science、SPORTDiscus(通过 EBSCO)和 PEDro)中搜索了随机对照试验(RCT)。使用 GRADE 方法评估证据质量。
确定了 7 项已发表的试验,所有试验均显示 MWM 在疼痛和功能方面具有积极的临床结果。在慢性踝关节不稳定(CAI)和髋骨关节炎(OA)患者中,MWM 在疼痛和功能方面的有效性具有中等质量证据。在肩峰下撞击综合征(SIS)中发现低质量证据,在外上髁炎中发现低质量和极低质量证据。
总体而言,应用于外周关节的 MWM 干预似乎优于安慰剂和无干预对照,但与其他医学或物理治疗干预措施相比并非如此。需要更多高质量的试验来研究一系列 MWM 干预的短期和长期效果。