The effectiveness of Mulligan\u27s mobilisation with movement on peripheral joints in musculoskeletal impairments – literature review

Uvod: Mišično-kostna obolenja ali okvare perifernih sklepov lahko zdravimo z različnimi manualnimi postopki, eden izmed postopkov je mobilizacija z gibanjem po Mulliganu. Mobilizacija z gibanjem se izvaja med pacientovim aktivnim gibom, tako da terapevt uporablja zunanjo silo, ki ne sme biti boleča, z namenom zagotavljanja pravilne artrokinematike obravnavanega perifernega sklepa ali gibalnega segmenta. Namen: Namen diplomskega dela je na osnovi pregleda literature predstaviti učinke mobilizacije z gibanjem pri utesnitvenem sindromu ramenskega sklepa, lateralnem epikondilitisu, osteoartrozi kolka, osteoartrozi kolena, zvinu in kronični nestabilnosti gležnja. Metode dela: Literaturo, objavljeno med leti 2006 in 2021, smo iskali v podatkovnih zbirkah MEDLINE in CINAHL, Cochrane, Web of Science, SPORTDiscus, PEDro, PubMed in Google Scholar. Pregled je zajemal raziskave, v katerih so sodelovali pacienti z mišično-kostnimi obolenji na zgornjih ali spodnjih udih in so bili obravnavani z mobilizacijo z gibanjem po Mulliganu. Rezultati: V analizo je bilo vključenih 12 randomiziranih kontrolnih poskusov. V vseh so dokazali pozitiven učinek mobilizacije z gibanjem na izboljšanje funkcije in zmanjšanje bolečine. Dokazan je bil boljši učinek mobilizacije z gibanjem v primerjavi z nekaterimi drugimi postopki, in sicer z nihajnimi vajami v kombinaciji z vadbo za izboljšanje obsega gibljivosti in v primerjavi s transkutano električno živčno stimulacijo. Razprava in zaključek: Mobilizacija z gibanjem pri pacientih z različnimi mišično-kostnimi obolenji na perifernih sklepih je bila učinkovitejša kot zdravljenje s placebo učinkom, ali če pacienti niso prejemali nobene terapije. Vendar ne moremo potrditi, da je mobilizacija z gibanjem učinkovitejša v primerjavi z drugimi manualnimi postopki, kot so manipulacija, vadba za izboljšanje obsega gibljivosti ali zdravljenje s kortikosteroidnimi zdravili. Potrebno je nadaljnje raziskovanje za dokazovanje kratko- in dolgoročnih učinkov mobilizacije z gibanjem.Introduction: Musculoskeletal disorders of the peripheral joints can be treated with various manual proceduresone of these is mobilization with movement according to Mulligan. Mobilization with motion is performed while the patient active motion, so that the therapist applies an external force, which may not be painful, to ensure proper arthrokinematics of the peripheral joint or segment motion. Purpose: The purpose of the thesis is to present the effects of mobilization with motion in shoulder impingement syndrome, lateral epicondylitis, hip osteoarthritis, knee osteoarthritis, ankle sprains and chronic ankle instability. Methods: Literature published between 2006 and 2021 was searched in MEDLINE and CINAHL, Cochrane, Web of Science, SPORTDiscus, PEDro, PubMed and Google Scholar databases. The review included studies involving subjects with musculoskeletal disorders of the upper or lower limbs treated by Mulligan mobilization with movement. Results: Twelve randomized control trials were included in the analysis. They all showed the positive effect of mobilization with motion on improving function and reducing pain. A better effect of mobilization with motion was demonstrated in comparison with some other procedures, namely with pendular exercises combined with exercise to improve range of motion and transcutaneous electrical nerve stimulation. Discussion and conclusion: Mobilization with motion in patients with various musculoskeletal disorders at the peripheral joints was more effective than treatment with a placebo effect, or if patients were not receiving any therapy. However, we cannot confirm that mobilization with movement is more effective compared to other manual procedures such as manipulation, exercise to improve range of motion, or treatment with corticosteroid medications. Further research is needed to demonstrate the short- and long-term effects of mobilization with movement