Taping improves ROM effects of Mulligan’s Mobilisation-with-Movement

By Lucy Piper, Senior medwireNews Reporter

Combining the Mulligan's Mobilisation-with-Movement (MWM) technique for the shoulder with taping provides a sustained improvement in range of movement (ROM) for up to a week that is superior to that with MWM alone, researchers report.

However, improvements in pain severity were not maintained for more than 30 minutes after a single session of either intervention.

"This current study adds to the growing body of evidence demonstrating positive sustained effects of MWM in combination with tape, and may help direct treatment planning for patients with musculoskeletal shoulder complaints," say Bill Vicenzino (The University of Queensland, St Lucia, Australia) and colleagues.

As reported in Manual Therapy, 25 people aged over 18 years with pain in the antero-superior aspect of one shoulder for at least 4 weeks, and reduced shoulder elevation due to pain, were randomly assigned to receive a single session of MWM plus tape or MWM alone.

MWM involved a therapist applying a postero-lateral glide to the humeral head while the patient actively raised their arm in the plane of the scapula to the point of pain onset.

ROM, pressure pain threshold (PPT), and current pain severity (PVAS) were measured before and after treatment and at 30 minutes, 24 hours, and 1-week follow-up. After a 1-week washout period, the two groups switched interventions.

ROM in the patients receiving MWM plus tape showed a significant 19° improvement that was sustained over 1 week of follow-up. ROM also improved in those receiving MWM, by 12°, but this was not sustained for longer than 30 minutes after the intervention. At 1 week, there was a significant 16° difference in ROM between the two interventions.

PVAS improved with MWM plus tape, decreasing by 38 mm on a visual analogue scale of 0-100 mm, where 100 indicates greatest severity, but this was only sustained for up to 30 minutes post-intervention. PVAS in patients receiving MWM alone improved by 40 mm, but again only for up to 30 minutes.

The difference in PVAS between the two groups did not differ significantly at any time, and there was no significant improvement in PPT for either intervention at any follow-up after treatment.

"Given the positive effects of a single intervention of MWM-with-tape as identified in our study, there is a need to investigate the short- and long-term effects of a multimodal treatment of MWM-with-tape and exercise in people with musculoskeletal shoulder pain," say Vicenzino and co-workers.

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