Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 954-965
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.954
Effectiveness of Maitland and Mulligan mobilization methods for adults with knee osteoarthritis: A systematic review and meta-analysis
Ling-Ling Li, Xin-Jie Hu, Yong-Hui Di, Wei Jiao
Ling-Ling Li, Xin-Jie Hu, Yong-Hui Di, Wei Jiao, Sport Medicine and Rehabilitation College, Beijing Sport University, Beijing 100084, China
Author contributions: Li LL and Hu XJ designed the research; Li LL, Hu XJ and Di YH performed the research; Li LL and Hu XJ contributed new reagents/analytic tools; Li LL and Di YH analyzed the data; Li LL and Hu XJ wrote the paper.
Supported by the National Key Research and Development Program of China, No. 2018YFF0301104.
Conflict-of-interest statement: Dr. Jiao reports grants from National Key Research and Development Program of China, during the conduct of the study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Jiao, PhD, Academic Fellow, Sport Medicine and Rehabilitation College, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing 100084, China. jiaowei01@vip.sina.com
Received: July 9, 2021
Peer-review started: July 9, 2021
First decision: October 22, 2021
Revised: November 4, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022
Processing time: 190 Days and 9.2 Hours
Abstract
BACKGROUND

As a serious global problem, knee osteoarthritis (KOA) often leads to pain and disability. Manual therapy is widely used as a kind of physical treatment for KOA.

AIM

To explore further the efficacy of Maitland and Mulligan mobilization methods for adults with KOA.

METHODS

We searched PubMed, the Cochrane Library, EMbase, Web of Science and Google Scholar from inception to September 20, 2020 to collect studies comparing Maitland and Mulligan mobilization methods in adults with KOA. The quality of the studies was assessed using the Physiotherapy Evidence Database Scale for randomized controlled trials. Data analyses were performed using Review Manager 5.0 software.

RESULTS

A total of 341 articles were screened from five electronic databases (PubMed, the Cochrane Library, EMbase, Web of Science and Google Scholar) after excluding duplicates. Ultimately, eight trials involving 471 subjects were included in present systematic review and meta-analysis. The mean PEDro scale score was 6.6. Mulligan mobilization was more effective in alleviating pain [standardized mean difference (SMD) = 0.60; 95% confidence interval (CI): 0.17 to 1.03, P = 0.007; I2 = 60%, P = 0.020) and improving Western Ontario and McMaster Universities function score (SMD = 7.41; 95%CI: 2.36 to 12.47, P = 0.004; I2 = 92%, P = 0.000). There was no difference in the effect of the two kinds of mobilization on improving the range of motion (SMD = 9.63; 95%CI: -1.23 to 20.48, P = 0.080; I2 = 97%, P = 0.000).

CONCLUSION

Mulligan mobilization technique is a promising intervention in alleviating pain and improving function score in KOA patients.

Keywords: Mulligan mobilization; Maitland mobilization; Manipulation; Manual therapy; Knee osteoarthritis; Meta-analysis

Core Tip: Manual therapy is widely used as a kind of physical treatment for knee osteoarthritis. Maitland and Mulligan mobilization are two types of manual therapy used in osteoarthritis treatment. There still was no systematic reviews and meta-analyses to compare the efficacy of different mobilization techniques, such as Maitland vs Mulligan mobilization. This study aims to explore further the efficacy of Maitland and Mulligan mobilization and fill the research gaps. Mulligan mobilization was found to be a promising alternative option for knee osteoarthritis treatment. Particularly, the Mulligan mobilization has been recommended to be applied in alleviating pain and improving Western Ontario and McMaster Universities function scores.