【論文摘要】The Immediate Effect of Multiple Sessions of Mobilization with Movement on Knee Osteoarthritis: A Systematic Review and Meta-analysis

【論文摘要】多次動態關節鬆動術治療對退化性膝關節炎的立即效果：系統性回顧與統合分析

蘇敏傑(Min-Jie Su)

《物理治療》 46卷2期 (2021/06) Pp. 108-109

https://doi.org/10.6215/FJPT.202106.O17

摘要

Background and Purpose: Mobilization with movement (MWM), also known as Mulligan's technique, is a class of manual therapy for management of musculoskeletal pain and restrictive joint motion, such as lateral epicondylalgia and adhesive capsulitis. MWM technique consists of a therapist-applied pain-free accessory gliding force combined with active movement. MWM technique is able to correct minor positional faults that lead to maltracking of the joint, resulting in symptoms such as pain or stiffness. The purpose of this study was to investigate the immediate effect of multiple treatment sessions of MWM technique compared with the control group or the other treatment group on knee osteoarthritis (OA). Methods: Three databases (Pubmed, ScienceDirect, and Google Scholar) were searched and articles were included if met the following criteria: (1) subjects were randomly assigned to one of the treatment groups; (2) subjects with identified knee OA and related knee pain; (3) the intervention group received MWM technique alone or MWM technique combined with other treatment which was the same as the control group; (4) the control group received no treatment, sham treatment, or other treatment which was part of the intervention group; (5) the other treatment group received other treatment which not contained MWM technique, such as modality treatment or other types of manual therapy; (6) outcome measures contained pain intensity of knee at rest, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index which is able to test pain, stiffness, and function of patients with knee OA, and knee flexion range of motion (ROM). Results: A total of 9 studies were included and analyzed. Immediately after multiple sessions of MWM treatment, there was significant improvement of pain intensity at rest (standardized mean difference [SMD] = -2.84, p ＜ 0.00001), WOMAC index (SMD = -2.22, p ＜ 0.0001), and knee flexion ROM (SMD = 1.43, p = 0.02) in the intervention group compared with the control group. Immediately after multiple sessions of MWM treatment, there was significant improvement of pain intensity at rest (SMD = -0.85, p ＜ 0.00001), WOMAC index (SMD = -0.85, p = 0.0004), and knee flexion ROM (SMD = 0.48, p = 0.03) in the intervention group compared with the other treatment group. Conclusion: This meta-analysis indicated that there was immediate effect of multiple sessions of MWM treatment on significantly decreasing pain intensity and increasing physical function and knee flexion ROM for patients with knee OA compared with both the control group and the other treatment group. Clinical Relevance: This meta-analysis suggests that multiple sessions of MWM treatment have immediate effect on decreasing pain intensity and increasing physical function and knee flexion ROM for patients with knee OA.