Mulligan's Mobilization with Movement: A Systematic Review

Mulligan's manual therapy technique at peripheral joints, namely mobilization with movement (MWM), has been well documented in research. The efficacy of MWM has been established in the treatment of joint dysfunction and various pathologies. The purpose of this systematic review was to critically evaluate the literature regarding MWM at peripheral joints and determine the overall efficacy related to MWM prescription. Electronic databases (Cinahl, Medline and Amed via Ovid, Pubmed and Medline via Ebsco Health Databases, Cochrane via Wiley and PEDro) were searched up to August 2008 with no date restriction to identify all studies pertaining to MWM at peripheral joints. The keywords used were mobilisation with movement* OR mobilization with movement* OR MWM*; manual therapy AND (mobilisation* OR mobilization); mulligan mobilisation* OR mulligan mobilization*. Two researchers independently reviewed all papers and crossexamined reference lists for further potential studies. Methodological quality was assessed using the Downs and Black checklist, and tables were compiled to determine study characteristics. Twenty-one studies, which have investigated MWM at peripheral joints, were included for analysis. This review highlights that there is an overall moderate level of methodological quality (mean = 15 (/28), SD ± 4.54, range = 4—23 /28). The efficacy of MWM at peripheral joints is well established for various joints and pathologies with 24 out of 25 studies (96%) demonstrating positive effects. It would be advisable that future research have more robust methodology and investigate and/or implement all necessary established parameters of MWM prescription.