The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis
Abstract Background Ankle sprains are common injuries that cause pain, swelling, and reduced range of motion (ROM), adversely affecting physical activity. In this study, we aim to review the effectiveness of mobilization with movement (MWM) in improving outcomes for patients with ankle sprains. Meth...
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BMC
2025-04-01
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| Series: | BMC Sports Science, Medicine and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s13102-025-01121-6 |
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| author | Mohamed M. ElMeligie Heba A. Abdeen Hady Atef Elena Marques-Sule Rania N. Karkosha |
| author_facet | Mohamed M. ElMeligie Heba A. Abdeen Hady Atef Elena Marques-Sule Rania N. Karkosha |
| author_sort | Mohamed M. ElMeligie |
| collection | DOAJ |
| description | Abstract Background Ankle sprains are common injuries that cause pain, swelling, and reduced range of motion (ROM), adversely affecting physical activity. In this study, we aim to review the effectiveness of mobilization with movement (MWM) in improving outcomes for patients with ankle sprains. Methods We conducted a search of PubMed, Cochrane Library, PEDro, Web of Science, and Scopus up to October 2023 for English trials comparing Mulligan MWM with other treatments. The Cochrane Risk of Bias tool (ROB 2) was used for quality assessment, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Heterogeneity was evaluated using Cochrane’s Q and I2 statistics. Results A total of 10 trials involving 419 patients (209 in the MWM group and 210 controls) were included. The overall risk of bias was low. MWM significantly reduced pain (MD = - 0.92; 95% CI:[- 1.37, - 0.46]; P < 0.0001) and improved ankle ROM (SMD = 1.65; 95% CI:[0.17, 3.14]; P = 0.03). MWM also demonstrated superior performance in the Star Excursion Balance Test (SEBT) (MD = 3.15; 95% CI:[1.44, 4.86]; P = 0.0003) and Y Balance Test (MD = 4.69; 95% CI:[1.67, 7.70]; P = 0.02). However, no significant differences were found in pain pressure threshold (SMD = - 0.10; 95% CI:[- 0.59, 0.39]; P = 0.7), stiffness perception (MD = 0.10; 95% CI:[- 0.64, 0.85]; P = 0.79), or peroneus longus latency time (MD = - 12.85; 95% CI:[- 22.08, - 3.63]; P = 0.006). The quality evaluation showed that the majority of RCTs revealed some concerns, except of two studies that established a low risk of bias. The GRADE assessment classified the overall evidence as low or very low, due to imprecision, risk of bias, and inconsistency. Conclusions MWM significantly reduced pain and improved ROM and WBLT scores in patients with ankle sprains. The MWM group also showed enhanced balance in the posterolateral SEBT compared to controls. |
| format | Article |
| id | doaj-art-e7aa256f22df41dc826158aa69c93fcb |
| institution | DOAJ |
| issn | 2052-1847 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Sports Science, Medicine and Rehabilitation |
| spelling | doaj-art-e7aa256f22df41dc826158aa69c93fcb2025-08-20T02:55:27ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472025-04-0117111510.1186/s13102-025-01121-6The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysisMohamed M. ElMeligie0Heba A. Abdeen1Hady Atef2Elena Marques-Sule3Rania N. Karkosha4Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Ahram Canadian UniversityPhysical Therapy Department for Cardiovascular, Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo UniversityPhysical Therapy Department for Cardiovascular, Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo UniversityPhysiotherapy in Motion, Multispeciality Research Group (Ptinmotion), University of ValenciaDepartment of Basic Sciences, Faculty of Physical Therapy, Cairo UniversityAbstract Background Ankle sprains are common injuries that cause pain, swelling, and reduced range of motion (ROM), adversely affecting physical activity. In this study, we aim to review the effectiveness of mobilization with movement (MWM) in improving outcomes for patients with ankle sprains. Methods We conducted a search of PubMed, Cochrane Library, PEDro, Web of Science, and Scopus up to October 2023 for English trials comparing Mulligan MWM with other treatments. The Cochrane Risk of Bias tool (ROB 2) was used for quality assessment, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Heterogeneity was evaluated using Cochrane’s Q and I2 statistics. Results A total of 10 trials involving 419 patients (209 in the MWM group and 210 controls) were included. The overall risk of bias was low. MWM significantly reduced pain (MD = - 0.92; 95% CI:[- 1.37, - 0.46]; P < 0.0001) and improved ankle ROM (SMD = 1.65; 95% CI:[0.17, 3.14]; P = 0.03). MWM also demonstrated superior performance in the Star Excursion Balance Test (SEBT) (MD = 3.15; 95% CI:[1.44, 4.86]; P = 0.0003) and Y Balance Test (MD = 4.69; 95% CI:[1.67, 7.70]; P = 0.02). However, no significant differences were found in pain pressure threshold (SMD = - 0.10; 95% CI:[- 0.59, 0.39]; P = 0.7), stiffness perception (MD = 0.10; 95% CI:[- 0.64, 0.85]; P = 0.79), or peroneus longus latency time (MD = - 12.85; 95% CI:[- 22.08, - 3.63]; P = 0.006). The quality evaluation showed that the majority of RCTs revealed some concerns, except of two studies that established a low risk of bias. The GRADE assessment classified the overall evidence as low or very low, due to imprecision, risk of bias, and inconsistency. Conclusions MWM significantly reduced pain and improved ROM and WBLT scores in patients with ankle sprains. The MWM group also showed enhanced balance in the posterolateral SEBT compared to controls.https://doi.org/10.1186/s13102-025-01121-6Mobilization with movementManual therapyMulligan tapingAnkle sprainsSystematic reviewMeta-analysis |
| spellingShingle | Mohamed M. ElMeligie Heba A. Abdeen Hady Atef Elena Marques-Sule Rania N. Karkosha The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis BMC Sports Science, Medicine and Rehabilitation Mobilization with movement Manual therapy Mulligan taping Ankle sprains Systematic review Meta-analysis |
| title | The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis |
| title_full | The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis |
| title_fullStr | The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis |
| title_full_unstemmed | The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis |
| title_short | The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis |
| title_sort | effectiveness of mulligan mobilization with movement mwm on outcomes of patients with ankle sprain a systematic review and meta analysis |
| topic | Mobilization with movement Manual therapy Mulligan taping Ankle sprains Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s13102-025-01121-6 |
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