PMID- 36518834
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231113
IS  - 2159-2896 (Print)
IS  - 2159-2896 (Electronic)
IS  - 2159-2896 (Linking)
VI  - 17
IP  - 7
DP  - 2022
TI  - The Efficacy of the Mulligan Concept to Treat Meniscal Pathology: A Systematic 
      Review.
PG  - 1219-1235
LID - 10.26603/001c.55540 [doi]
AB  - BACKGROUND: Meniscal pathologies are common knee injuries and arthroscopic 
      surgery is the current accepted gold standard for treatment. However, there is 
      evidence to support the use of the Mulligan Concept (MC) Mobilization with 
      Movement (MWM) for meniscal pathologies including the 'Squeeze' technique, tibial 
      internal rotation (IR), and tibial external rotation (ER). HYPOTHESIS/PURPOSE: 
      The purpose of this systematic review was to critically appraise the literature 
      to investigate the effectiveness of MC MWMs for meniscal lesions on patient 
      reported pain, function, and multi-dimensional health status in patients with 
      clinically diagnosed meniscal pathologies. STUDY DESIGN: Systematic Review. 
      METHODS: A literature search was completed across multiple databases using 
      combinations of the words "knee, function, mobilization with movement, MWM, 
      mulligan concept, MC, meniscal pathology, meniscal derangement, and meniscal 
      tear." Studies written within the prior 10 years that examined MC MWM techniques 
      to treat knee meniscal injury were included. Articles that met the inclusion 
      criteria (used MC MWM 'Squeeze' technique, tibial IR, or tibial ER for treatment 
      of clinically diagnosed meniscal pathologies; Patient reported outcome [PRO] 
      measures had to be used in the assessment of knee pain or function) were analyzed 
      for quality. Randomized control trials were analyzed using the PEDro scale and 
      the Downs & Black (D&B) checklist, case series were analyzed using the Joanna 
      Briggs Institute (JBI) checklist, and case reports were analyzed using the CARES 
      checklist. RESULTS: Six articles met the inclusion criteria and were included in 
      this review, two randomized controlled studies, two case series, and two case 
      reports consisting of 72 subjects. All six papers included reports of 
      improvements in pain and function that were either statistically significant or 
      met the minimal clinically important difference (MCID). Five studies reported the 
      Disablement in the Physically Active (DPA) scale that also demonstrated 
      statistically significant differences or met the MCID. The MC MWM 'Squeeze' 
      technique, tibial IR, or tibial ER demonstrated the ability to reduce pain, 
      improve function, and improve patient perceived disability following treatment of 
      a clinically diagnosed meniscal pathology. These studies demonstrated short term 
      results lasting from one week to 21 weeks. CONCLUSION: Treatment interventions 
      incorporating MC MWM techniques demonstrated reduction of pain and improvement in 
      function in the short term in patients with clinically diagnosed meniscal 
      pathologies. LEVEL OF EVIDENCE: 2a.
FAU - Reep, Nathan C
AU  - Reep NC
AD  - Department of Movement Sciences University of Idaho.
FAU - Leverett, Sydney N
AU  - Leverett SN
AD  - Department of Movement Sciences University of Idaho.
FAU - Heywood, Rebecca M
AU  - Heywood RM
AD  - Department of Movement Sciences University of Idaho.
FAU - Baker, Russell T
AU  - Baker RT
AD  - Department of Movement Sciences University of Idaho.
AD  - WWAMI Medical Education University of Idaho.
FAU - Barnes, Darren L
AU  - Barnes DL
AD  - Department of Movement Sciences University of Idaho.
FAU - Cheatham, Scott W
AU  - Cheatham SW
AD  - Department of Kinesiology California State University Dominguez Hills.
LA  - eng
PT  - Journal Article
DEP - 20221201
PL  - United States
TA  - Int J Sports Phys Ther
JT  - International journal of sports physical therapy
JID - 101553140
PMC - PMC9718724
OTO - NOTNLM
OT  - Mobilization with Movement (MWM)
OT  - knee injury
OT  - lesion
OT  - manual therapy intervention
OT  - rehabilitation
COIS- All authors declare that they do not have any conflict of interests with any of 
      the topics discussed in this manuscript.
EDAT- 2022/12/16 06:00
MHDA- 2022/12/16 06:01
PMCR- 2022/12/01
CRDT- 2022/12/15 02:30
PHST- 2022/07/15 00:00 [received]
PHST- 2022/09/12 00:00 [accepted]
PHST- 2022/12/15 02:30 [entrez]
PHST- 2022/12/16 06:00 [pubmed]
PHST- 2022/12/16 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - 55540 [pii]
AID - 10.26603/001c.55540 [doi]
PST - epublish
SO  - Int J Sports Phys Ther. 2022 Dec 1;17(7):1219-1235. doi: 10.26603/001c.55540. 
      eCollection 2022.