Effectiveness of Mobilisation with Movement (MWM) along with Usual Care for Knee Osteoarthritis: A Randomised Clinical Trial

Introduction Knee osteoarthritis (OA) is a degenerative joint disorder involving progressive cartilage loss, subchondral bone changes, and periarticular tissue involvement. It is a major cause of pain, stiffness, and reduced mobility, particularly in weight-bearing joints. Mobilisation with Movement (MWM), a Mulligan Concept manual therapy, aims to correct minor joint positional faults during active movement, potentially reducing pain and restoring function. This study examined the effectiveness of MWM with usual physiotherapy care compared with usual care alone in individuals with knee OA. Methods and analysis A single-blind randomised controlled trial was conducted from June to August 2025 at the Musculoskeletal Physiotherapy Unit, Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh. Fifty adults aged 40–65 years with radiographically confirmed knee OA (Kellgren–Lawrence grade ≥2) were allocated to MWM plus usual care (n=25) or usual care alone (n=25). Both groups received 30-minute sessions, three times weekly for six weeks. Outcomes included pain (Numeric Pain Rating Scale, NPRS), active and passive knee range of motion (ROM), and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC). The primary outcome was pain intensity (NPRS). Secondary outcomes included knee ROM and WOMAC scores. Results Both groups improved significantly (p<0.001), but the MWM group achieved greater pain reduction (median NPRS change –4.0 vs –2.0; p<0.001), larger ROM gains, and greater WOMAC score improvements (mean change –19.2 vs –10.8; p<0.001). Conclusions MWM combined with usual care produced superior improvements in pain, ROM, and function versus usual care alone, supporting its integration into physiotherapy protocols for knee OA.