The Effects of Mulligan's Mobilisation With Movement on Shoulder Pain and Dysfunction

Abstract

The aims of this thesis were to evaluate the immediate and long-term effects of Mobilisation-with-movement (MWM) in isolation and in conjunction with taping and therapeutic exercise for people with musculoskeletal shoulder pain. In addition, the thesis aimed to assess possible indicators of poor response to MWM to the shoulder. Shoulder pain is the third most common musculoskeletal problem with patients often experiencing persistent pain and dysfunction. For the majority, conservative treatment is initially recommended. Evidence supports the use of manual therapy (MT) as a beneficial component of a multimodal management approach but the literature describes a wide variety of MT interventions, often with poor descriptions of these interventions. Mulligan’s MT concept involves the application of a manual glide to a joint being actively moved to the point of pain onset. Mulligan called this Mobilisation-with-movement (MWM). There is evidence in the form of randomised controlled trials (RCT) supporting the immediate success of MWM for reducing pain and improving range of movement (ROM) in peripheral joints such as the ankle and elbow. Additionally, Mulligan suggests tape to augment the immediate effects of MWM. Few high-quality trials have investigated the application of MWMs for the treatment of musculoskeletal shoulder pain. Research investigating the effects of MWM in the treatment of musculoskeletal shoulder pain will guide conservative management choices.