Mulligan’s mobilisation with movement: a review of the tenets and prescription of MWMs

Introduction: Mulligan’s manual therapy technique at peripheral joints, namely
mobilisation with movement (MWM), has been well documented in research for
over a decade. The specific parameters of MWM prescription are relatively variable
and generally ill defined. The purpose of this review was to critically evaluate the
literature regarding MWM prescription at peripheral joints.
Methods: A search was conducted from 1990 to June 2007, to identify all studies
pertaining to MWM’s at peripheral joints, using the keywords mobilisation with
movement* OR mobilization with movement* OR MWM*; manual therapy AND
(mobilisation* OR mobilization); mulligan mobilisation* OR mulligan mobilization*
from the following databases: Cinahl, Medline and Amed via Ovid, Pubmed
and Medline via Ebsco Health Databases, Cochrane via Wiley and PEDro. Two
researchers independently reviewed all papers and cross-examined reference
lists for further potential studies. Tables were compiled to determine study content
and the specifics regarding MWM prescription; including tenets, technical, and
response parameters.
Results: Twenty-one studies, which have investigated MWM’s at peripheral joints,
were included for analysis. This review highlights that specific parameters identified
for MWM prescription (tenets, technical and response parameters), are variable
and in general inconsistently implemented and explained. The efficacy of MWM’s
at peripheral joints is well established for various joints and pathologies with 20 out
of 21 studies (95%) demonstrating positive effects overall.
Conclusions: A proposed algorithm has been formulated for the integration into
clinical practice to ensure necessary parameters are considered. It would be
advisable that future research has more robust methodology and investigates and/
or implements all necessary established parameters of MWM prescription.