Çelik Derya, Van Der Veer Pınar, Tiryaki Pelin
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istinye University, Istanbul, Türkiye.
J Integr Complement Med. 2025 Feb;31(2):134-142. doi: 10.1089/jicm.2024.0200. Epub 2024 Aug 27.
Mulligan's mobilization with movement (MWM) is a manual therapy technique designed to address musculoskeletal pain and joint mobility. Despite immediate reported improvements by patients, the clinical significance of MWM compared with other interventions remains uncertain. To assess the clinical effectiveness of MWM for shoulder pathologies compared with other treatment methods. The databases PubMed, Web of Science, Cochrane Library, Scopus, and the Physiotherapy Evidence Database (PEDro) were searched up to June 2024. Inclusion criteria were limited to randomized controlled trials published in English and Turkish languages, focusing on the MWM technique for shoulder pathologies. Two independent reviewers evaluated methodological quality based on the PEDro scale. Outcome data were analyzed for pain, function, and range of motion (ROM) using SPSS Statistics 29.0. Twenty-seven studies (1157 participants) were included. MWM demonstrated statistical superiority in function (, 95% CI: [-18.33, -4.16], = 001) and shoulder flexion and abduction ROM compared with other mobilization techniques. There was a significant MD in pain intensity, which was -1.55 cm (95% CI: [-2.60, -0.51], = 0.00), with high heterogeneity ( = 93%), favoring MWM in comparison with control group. MWM was significantly better for shoulder abduction ROM in comparison with physical therapy interventions (, 95% CI: [1.98, 26.90], = 0.02) with high heterogeneity ( = 90%) and control group (SMD = 56.67, 95% CI: [7.71, 111.63], = 0.02) with high heterogeneity ( = 96%). However, clinical significance was not consistently achieved. Although some statistical significance was found when comparing MWM with other her treatment methods, it was observed that most of the statistically significant data did not reach clinical significance. Upon closer examination, outcome measures that showed clinical significance, either the interventions in the comparison group were inadequate, not evidence-based, or the improvements within the group were not logical.
穆利根动态松动术（MWM）是一种旨在解决肌肉骨骼疼痛和关节活动度问题的手法治疗技术。尽管患者报告有即时改善，但与其他干预措施相比，MWM的临床意义仍不明确。为评估与其他治疗方法相比，MWM对肩部疾病的临床疗效。检索了截至2024年6月的PubMed、科学网、考克兰图书馆、Scopus和物理治疗证据数据库（PEDro）。纳入标准仅限于以英文和土耳其语发表的随机对照试验，重点是针对肩部疾病的MWM技术。两名独立 reviewers 根据PEDro量表评估方法学质量。使用SPSS Statistics 29.0对疼痛、功能和活动范围（ROM）的结果数据进行分析。纳入了27项研究（1157名参与者）。与其他松动技术相比，MWM在功能方面（，95%CI：[-18.33，-4.16]， = 0.01）以及肩部屈曲和外展ROM方面显示出统计学优势。疼痛强度有显著的平均差值，为-1.55 cm（95%CI：[-2.60，-0.51]， = 0.00），异质性较高（ = 93%），与对照组相比更有利于MWM。与物理治疗干预措施相比（，95%CI：[1.98，26.90]， = 0.02），MWM在肩部外展ROM方面显著更好，异质性较高（ = 90%），与对照组相比（标准化均值差 = 56.67，95%CI：[7.71，111.63]， = 0.02），异质性较高（ = 96%）。然而，并未始终实现临床意义。尽管在将MWM与其他治疗方法比较时发现了一些统计学意义，但观察到大多数具有统计学意义的数据并未达到临床意义。仔细检查后发现，显示出临床意义的结果测量中，要么比较组的干预措施不足、缺乏循证依据，要么组内的改善不合理。
