Shoulder pain is common and often slow to resolve despite treatment. We assessed the efficacy of Mobilization With Movement (MWM) in chronic shoulder pain. A systematic review was conducted. Five electronic databases, including MEDLINE, were searched from inception to August 2, 2024. Only controlled trials comparing MWM to conservative interventions, sham mobilization, or no-intervention control in adults aged 18 − 65 years with chronic shoulder pain (mean duration ≥ 3 months) were included. The outcomes were patient-reported pain (primary), patient-reported disability, quality of life, and range of motion (ROM). Random effects meta-analyses were performed. Risk of bias was assessed using the Physiotherapy Evidence Database scale. Twenty-nine trials of adhesive capsulitis (AC) and six trials of subacromial pain syndrome (SAPS) were included. All active comparators were types of mobilization. AC analysis: MWM was significantly superior to other types of mobilization immediately post-therapy for improving pain (SMD = 1.03, 95% CI 0.59–1.46, n = 960), disability (SMD = 0.82, 95% CI 0.17–1.48, n = 361), external rotation ROM (SMD = 0.77, 95% CI 0.33–1.20, n = 992), and flexion ROM (SMD = 0.83, 95% CI 0.13–1.53, n = 727). Subgroup analyses demonstrated a significant superiority of MWM over Muscle Energy Techniques for reducing pain (SMD = 2.22, 95% CI 0.60–3.84, n = 271), and over Maitland mobilization for improving external rotation ROM (SMD = 0.74, 95% CI 0.38–1.09, n = 356). No significant differences were detected at 2–10-week follow-ups (n = 69–110). MWM was significantly superior to no-intervention control for pain, disability, and ROM immediately post-therapy. SAPS analysis: Although pain and ROM improvements were observed compared with no-intervention control, no significant differences were found versus sham mobilization. Quality of life was not assessed in any included trial. Risk of bias was moderate/high for AC trials and low/moderate for SAPS trials. In chronic AC, MWM resulted in significant improvements in pain, disability, and ROM immediately post-therapy. Follow-up data were too limited to draw firm conclusions. For chronic SAPS, there is insufficient evidence to support or refute an effect of MWM. CRD42018109380.
Storås et al. (Fri,) studied this question.