About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
Efficacy of mulligan technique on sub-acromial space in patients with shoulder impingement syndrome
1
Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
2
Radiology Department, Faculty of Medicine, Menia University, Cairo, Egypt
Submission date: 2023-03-05
Acceptance date: 2023-07-21
Publication date: 2024-09-09
Corresponding author
Physiother Quart. 2024;32(3):7-14
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To estimate the effectiveness of the Mulligan technique for the shoulder complex on the subacromial space, shoulder ROM, pressure pain threshold, and function of the shoulder in the impingement syndrome patient.
Methods:
Thirty patients who suffered from shoulder impingement syndrome were at random allocated into two groups; the experimental group received shoulder complex mobilization with movement plus conventional therapy, and the control group received conventional treatment. All patients were examined by ultrasonography for subacromial space, shoulder range of motion using a digital goniometer, electronic algometry for pressure pain threshold, and the Quick DASH for a difficulty level involved in carrying out several physical activities.
Results:
In comparison to group B post-treatment, there were statistically significant improvements in the subacromial space (p > 0.004), flexion and abduction ROM, PPT of the biceps and supraspinatus (p > 0.001), and a significant reduction in the quick DASH (p > 0.001).
Conclusions:
Shoulder complex mobilization with movement plus conventional therapy improved subacromial space, shoulder ROM, pressure pain thresholds, and function more than conventional therapy alone in shoulder impingement syndrome patients.
To estimate the effectiveness of the Mulligan technique for the shoulder complex on the subacromial space, shoulder ROM, pressure pain threshold, and function of the shoulder in the impingement syndrome patient.
Methods:
Thirty patients who suffered from shoulder impingement syndrome were at random allocated into two groups; the experimental group received shoulder complex mobilization with movement plus conventional therapy, and the control group received conventional treatment. All patients were examined by ultrasonography for subacromial space, shoulder range of motion using a digital goniometer, electronic algometry for pressure pain threshold, and the Quick DASH for a difficulty level involved in carrying out several physical activities.
Results:
In comparison to group B post-treatment, there were statistically significant improvements in the subacromial space (p > 0.004), flexion and abduction ROM, PPT of the biceps and supraspinatus (p > 0.001), and a significant reduction in the quick DASH (p > 0.001).
Conclusions:
Shoulder complex mobilization with movement plus conventional therapy improved subacromial space, shoulder ROM, pressure pain thresholds, and function more than conventional therapy alone in shoulder impingement syndrome patients.
REFERENCES (30)
1.
Ajit D, Shika S. Effects of mobilization with movement (MWM) in shoulder impingement syndrome patients on acromiohumeral distance using ultrasonography. J Exerc Sci Physiother. 2016;12(2)28–35; doi: 10.18376/jesp/ 2016/v12/i2/111262.
2.
Creech JA, Silver S. Shoulder impingement syndrome.In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2023.
3.
de Witte PB, Nagels J, van Arkel ER, Visser CPJ, Nelissen RGHH, de Groot JH. Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM). BMC Musculoskelet Disord. 2011;12:282; doi: 10.1186/1471-2474-12-282.
4.
Delgado-Gil JA, Prado-Robles E, Rodrigues-de-Souza DP, Cleland JA, Fernández-de-las-Peñas C, Alburquerque- Sendín F. Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial. J Manipulative Physiol Ther. 2015;38(4):245–52; doi: 10.1016/j.jmpt.2014.12.008.
5.
Hing W, Hall T, Rivett D, Vicenzino B, Mulligan B. The Mulligan Concept of Manual Therapy. Textbook of Techniques. e-book. Elsevier Health Sciences; 2014:13.
6.
Ludewig PM, Lawrence RL. Mechanics of the scapula in shoulder function and dysfunction. In: Kibler WB, Sciascia AD (eds.) Disorders of the Scapula and Their Role in Shoulder Injury. A Clinical Guide to Evaluation Guide to Evaluation and Management. Cham: Springer International Publishing AG; 2017:7–23; doi: 10.1007/978-3-319-53584-5_2.
7.
Teece RM, Lunden JB, Lloyd AS, Kaiser AP, Cieminski CJ, Ludewig PM. Three-dimensional acromioclavicular joint motions during elevation of the arm. J Orthop Sports Phys Ther. 2008;38(4):181–90; doi: 10.2519/ jospt.2008.2386.
8.
Shamus E, Van Duijn AJ. Manual Therapy of the Extremities. Fort Myers: Jones and Bartlett Learning; 2016:4.
9.
McClure PW, Bialker J, Neff N, Williams G, Karduna A. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(9):832–48.
10.
Ludewig PM, Borstad JD. Effects of a home exercise programme on shoulder pain and functional status in construction workers. Occup Environ Med. 2003;60(11):841–9; doi: 10.1136/oem.60.11.841.
11.
Maenhout A, Van Eessel V, Van Dyck L, Vanraes A, Cools A. Quantifying acromiohumeral distance in overhead athletes with glenohumeral internal rotation loss and the influence of a stretching program. Am J Sports Med. 2012; 40(9):2105–12; doi: 10.1177/0363546512454530.
12.
Yu J. Comparison of reliabilities and validity between AR based motion capture system and physical therapist: preliminary study. Turk J Comput Mathem Educ. 2021;12(10):6779–85.
13.
Norkin CC, White DJ. Measurement of Joint Motion. A Guide to Goniometry. Philadelphia: FA Davis; 2016:18.
14.
El-Deen HB, Fahmy SE, Ali SA, El-Sayed WM. Polarized light versus light-emitting diode on healing of chronic diabetic foot ulcer. Romanian J Biophys. 2014;24(2):117–32.
15.
Finocchietti S, Graven-Nielsen T, Arendt-Nielsen L. Dynamic mechanical assessment of muscle hyperalgesia in humans: the dynamic algometer. Pain Res Manag. 2015;20(1):29–34; doi: 10.1155/2015/595203.
16.
Hidalgo-Lozano A, Fernández-de-las-Peñas C, Alonso- Blanco C, Ge H-Y, Arendt-Nielsen L, Arroyo-Morales M. Muscle trigger points and pressure pain hyperalgesia in the shoulder muscles in patients with unilateral shoulder impingement: a blinded, controlled study. Exp Brain Res. 2010;202(4):915–25; doi: 10.1007/s00221-010-2196-4.
17.
Salwa F, Khattab AS, Mohammed MM. Validity and reliability of the Arabic version of the quick-dash questionnaire for upper extremity disorders. Med J Cairo Univ. 2020;88:2037–43; doi: 10.21608/mjcu.2020.125145.
18.
Imaeda T, Toh S, Wada T, Uchiyama S, Okinaga S, Kusunose K, Sawaizumi T; Impairment Evaluation Committee, Japanese Society for Surgery of the Hand. Validation of the Japanese society for surgery of the hand version of the quick disability of the arm shoulder, and hand (QuickDASH-JSSH) questionnaire. J Orthop Sci. 2006;11(3):248–53; doi: 10.1007/s00776-006-1013 1.
19.
Sharma S, Sharma S, Sharma RK, Jain A. Exercise therapy plus manual therapy improves acromiohumeral distance measured by real-time ultrasound in overhead athletes with shoulder impingement syndrome. Adv Rehabil. 2022;36(3):1–10; doi: 10.5114/areh.2022.118934.
20.
Weon J-H, Oh J-S, Cynn H-S, Kim Y-W, Kwon O-Y, Yi C-H. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther. 2010;14(4):367–74; doi: 10.1016/j.jbmt.2009.06.006.
21.
Collins N, Teys P, Vicenzino B. The initial effects of a Mulligan’s mobilization with movement technique on dor-siflexion and pain in subacute ankle sprains. Manual Ther.2004;9(2):77–82; doi: 10.1016/S1356-689X(03)00101-2.
22.
Kamkar A, Irrgang JJ, Whitney SL. Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1993;17(5):212–24; doi: 10.2519/jospt.1993.17.5.212.
23.
Neumann DA. Kinesiology of The Musculoskeletal System. Foundations for Rehabilitation. e-book. Elsevier Health Sciences; 2016:3.
24.
Stathopoulos N, Dimitriadis Z, Koumantakis GA. Effectiveness of Mulligan’s mobilization with movement techniques on range of motion in peripheral joint pathologies: a systematic review with meta-analysis between 2008 and 2018. J Manipulative Physiol Ther. 2019;42(6):439– 49; doi: 10.1016/j.jmpt.2019.04.001.
25.
Fuentes Contreras JP. Hypoalgesic effects of interferential current therapy on pressure pain thresholds (PPT) in healthy subjects. Doctoral dissertation. University of Alberta; 2007.
26.
Menek B, Tarakci D, Algun ZC. The effect of Mulligan mobilization on pain and life quality of patients with rotator cuff syndrome: a randomized controlled trial. J Back Musculoskelet Rehabil. 2019;32(1):171–8; doi: 10.3233/ BMR-181230.
27.
Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (Quick- DASH). J Orthop Sports Phys Ther. 2014;44(1):30–9; doi: 10.2519/jospt.2014.4893.
28.
Miller RM, Popchak A, Vyas D, Tashman S, Irrgang JJ, Musahl V, Debski RE. Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg. 2016;25(4):641–9; doi: 10.1016/j.jse.2015. 08.048.
29.
Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence- based rehabilitation protocol. J Shoulder Elbow Surg. 2009;18(1):138–60; doi: 10.1016/j.jse.2015.08.048.
30.
Moezy A, Sepehrifar S, Dodaran MS. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial. Med J Islam Rep Iran. 2014;28:87.
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
