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

ABSTRACT 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. Hing W, Bigelow R, Bremner T (2008): Mulligan’s mobilisation with movement: a review of the tenets and prescription of MWMs. New Zealand Journal of Physiotherapy 36(3): 144-164.