| Bennell et al.3636 Bennell K, Wee E, Coburn S, Green S, Harris A, Staples M, et al. Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial. BMJ. 2010;340:c2756.
|
Total (n=120)
(experimental group - EG, (n=59), and control group - CG (n=61)); 22 weeks follow-up (EG n=59 and CG n=61) |
Chronic injury of the rotator cuff |
Soft tissue massage; glenohumeral JM (anteroposterior and inferior sliding);
Thoracic and cervical mobilization (grade IV); scapular rehabilitation; postural taping shoulder and scapula; home exercises |
Placebo ultrasound, light application of non-therapeutic gel on the shoulder |
Shoulder pain and disability; pain intensity at rest and movement; global perception; quality of life; shoulder isometric strength; adherence to treatment |
SPADI;
NS;
Likert Scale;
SF-36 e AQoL;
Nicholas Manual Muscle tester;
Records of the number of physical therapy visits |
There was no difference between groups on pain and disability of shoulder, on pain at rest and movement, both groups showed significant improvement; the participants in active group showed greater satisfaction with treatment, despite non-significant difference between groups. The active group showed a significant improvement in SPADI than placebo group after 22 weeks, although there was no difference between groups for pain reduction or percentage of participants who reported treatment success. The active group obtained better muscle strength, less interference in activities and better quality of life |
A standardized program of manual therapy and home exercises did not present immediate benefits for pain and function compared to a placebo group. However, greater improvements were observed in shoulder function and strength at 22-week follow-up, suggesting that benefits with active treatment take time to manifest |
| Beselga et al.3838 Beselga C, Neto F, Alburquerque-Sendín F, Hall T, Oliveira-Campelo N. Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: a randomised controlled trial. Man Ther. 2016;22:80-5.
|
Total (n=40)
EG n=20 and CG n=20 |
Hip OA |
JM with flexion and internal hip rotation (Mulligan technique) |
Simulated therapy of mobilization technique with hip movement |
Pain intensity at rest;
ROM of hip flexion and internal rotation;
functionality. |
NS;
Universal goniometer;
Timed up and go test;
30s Chair Stand; SPWT |
In the EG, there was pain intensity reduction, increased hip flexion and internal rotation, and functional tests also improved with a relevant clinical effect. There were no significant changes in any outcome in CG |
Pain intensity, hip flexion ROM and physical performance improve immediately after the application of JM with movement in patients with hip OA. The immediate changes observed were clinically relevant. |
| Crossley et al.3939 Crossley KM, Vicenzino B, Lentzos J, Schache AG, Pandy M, Ozturk H, et al. Exercise, education, manual-therapy and taping compared to education for patello-femoral osteoarthritis: a blinded, randomised clinical trial. Osteoarthritis Cartilage. 2015;23(9):1457-64.
|
Total (n=92)
(experimental
group EG (n=39) and CG (n=42); 9 months follow-up EG (n=35) and CG (n=34)) |
Patellofemoral OA |
Functional recovery and strengthening exercises for quadriceps and hip muscles; patellar bandage; patellofemoral, tibiofemoral JM (without specifications) and soft tissue; education in OA |
Education in OA |
Global perception;
Movement pain intensity;
Activities of daily living;
Adverse events and use of drugs |
Likert scale; VAS;
KOOS-ADL;
Physiotherapy attendance, home exercises, description of adverse events and the medicines used |
The EG reported a higher percentage of the item "greater improvement" of the general clinical signs on the Likert scale and greater reduction of pain when compared to CG. There was no significant effect on ADLs. After 9 months, there was no significant effect on self-reported pain |
After 3 months of treatment, the EG presented a superior result in global perception of clinical change and pain when compared to CG. However, after 6 months, there was no maintenance of the effects observed previously either in physical function and/or other positive effects. |
| Farooq et al.4242 Farooq MN, Mohseni-Bandpei MA, Gilani SA, Ashfaq M, Mahmood Q. The effects of neck mobilization in patients with chronic neck pain: A randomized controlled trial. J Bodyw Mov Ther. 2018;22(1):24-31.
|
Total (n=68)
EG (n=34) and CG (n=34) |
Chronic neck pain |
Physiotherapy (Infrared, TUS, TENS, isometric exercises for neck);
Cervical mobilization (Maitland posteroanterior oscillatory mobilization), participant education, home exercises |
Physiotherapy participant education, home exercises |
Cervical pain intensity at rest;
Neck disability level;
Cervical ROM; cervical muscular endurance;
Analgesic intake during treatment |
VAS;
NDI;
Universal goniometer;
Muscle endurance tests |
There was a greater significant reduction of pain and disability in EG when compared to control group, as well as an increase in the resistance of cervical muscles and cervical ROM compared with CG. All outcomes had significant improvement in both groups. However, a larger increase was observed in the EG. |
The combination of cervical mobilization with physical therapy is more effective in reducing pain, disability, muscular resistance and ROM in patients with chronic mechanical neck pain compared to the group treated only with
physiotherapy |
| Horst et al.48 |
Total (n=72)
EG (n=36) and CG (n=36; 3 months follow-up EG (n=33) and CG (n=33) |
Frozen Shoulder |
Activity-oriented therapy (strengthening of shoulder muscles, several verbal commands for specific movements of the shoulder and scapula), aerobic training, cryotherapy, laser therapy and exercise with elastic bands |
Structural oriented therapy (PNF, verbal feedback, passive anteroposterior humerus and scapula JM, separation training and joint approach), aerobic training, cryotherapy, laser therapy and exercise with elastic bands |
Pain intensity at rest;
Upper limbs functionality;
ROM;
Muscle strength |
McGill Pain Questionnaire;
Upper Extremity Motor Activity Log modified;
Goniometer;
Daniels and Worthingham muscle test |
The activity-oriented group achieved significant increases in functional performance and activities of daily living compared to control group after 10 days of therapy and in the follow-up of three months |
An activity-oriented therapy program has longer benefits than targeted structural therapy |
| Mayor et al.4343 Mayor EE, Pérez GL, Martín YP, del Barco ÁA, Fuertes RR, Requejo CS, et al. Ensayo clínico aleatorizado en pacientes con cervicalgia mecánica en atención primaria: terapia manual frente a electroestimulación nerviosa transcutánea. Aten Primaria. 2008;40(7):337-43.
|
Total (n=90)
EG (n=45) and CG (n= 42) |
Mechanical neck pain |
Manual therapy (cervical mobilizations (technique site not specified), neuromuscular techniques, stretches and invasive treatments of trigger points), home exercises and postural guidelines |
TENS (F: 80 Hz, T: ≤ 150 µs, adjustable intensity), home exercises and postural guidelines |
Pain intensity at rest;
Neck disability level;
Quality of life;
Depression and anxiety;
Drug use (active principle and periodicity);
Expectation of treatment;
Adverse events |
VAS;
NDI;
SF-12;
GHQ-28;
Records (drugs prescribed by physicians, periodicity of consumption, adherence to recommended postural care and recommended exercise) |
There was a significant difference in reduction of pain intensity in both groups |
Treatment with TENS and manual therapy produces a significant reduction in pain intensity, and there are no differences between these treatment groups |
| Richer, Marchand and Descarreaux1515 Richer N, Marchand AA, Descarreaux M. Management of chronic lateral epicondylitis with manual therapy and local cryostimulation: a pilot study. J Chiropr Med. 2017;16(4):279-88.
|
Total (n=37)
EG (n=19) and CG (n=18), 3 months follow-up EG (n=15) and CG (n=12) |
Chronic lateral epicondylitis |
Anteroposterior elbow mobilization
(Mill manipulation described by James Cyriax), cryostimulation with cryospray at the trigger point |
Ischemic pressure at the myofascial trigger point |
Pain intensity at rest; gripping force without pain; functional outcomes (disability and pain) |
VAS; Hand dynamometer; PRTEE |
Significant reduction of pain and functional index were observed in both groups post intervention evaluation and were maintained at follow-up. |
Based on preliminary data from this study, the combination of cryostimulation treatment and manual therapy does not provide short- and long-term benefits. The manual myofascial point treatment and mobilization techniques provided positive results in chronic lateral epicondylitis. |
| Shashua et al.4040 Shashua A, Flechter S, Avidan L, Ofir D, Melayev A, Kalichman L. The effect of additional ankle and midfoot mobilizations on plantar fasciitis: a randomized controlled trial. J Orthop Sports Phys Ther. 2015;45(4):265-72.
|
Total (n=50)
EG (n=25) and CG (n=25); 6 months follow-up EG (n=23) and CG (n=23) |
Plantar fasciitis |
TUS, stretching and anteroposterior talocrural JM |
TUS and stretching |
Pain intensity at rest;
Dorsiflexion ROM;
Lower limbs functionality;
PPT |
NS;
Inclinometer;
LEFS;
Pressure algometer |
No significant differences were found between groups in any outcome. Both groups showed a difference in pain intensity and lower limb function. Both groups increased dorsiflexion ROM, but there was no difference between groups |
The addition of ankle and foot JM with the aim of improving dorsiflexion ROM is no more effective than the TUS treatment and stretching only. The association between limitation of dorsiflexion and plantar fasciitis probably occurs because of soft tissue limitation and not from the joint |
| Snodgrass et al.4141 Snodgrass SJ, Rivett DA, Sterling M, Vicenzino B. Dose optimization for spinal treatment effectiveness: a randomized controlled trial investigating the effects of high and low mobilization forces in patients with neck pain. J Orthop Sports Phys Ther. 2014;44(3):141-52.
|
Total (n=64)
EG high force mobilization (n=21), low force mobilization (n=22), CG (n=21); 4 days follow-up EG: high force mobilization (n=20) and low force mobilization (n=22), CG (n=20) |
Neck pain |
Postero-anterior JM (grade III) in cervical spine C7 vertebra with force of 30 N or 90 N |
Laser treatment turned off |
PPT (spinous process of the cervical vertebra, upper trapezius muscle right, median right nerve trunk in the elbow);
Pain intensity at rest;
Cervical ROM;
Cervical stiffness;
Neck disability level |
Algometer;
VAS;
Cervical ROM instrument;
Custom device;
NDI |
At follow-up, the 90 N group had lower pain than 30 N group and lower cervical stiffness than the control group. There was no significant difference between the groups in LDP and WMD after treatment or at follow-up |
A specific dose of JM in terms of applied force seems necessary to reduce stiffness and potentially pain in patients with chronic neck pain. The changes were not observed immediately after the mobilization, suggesting that their effects are not directly mechanical |
| Sterling et al.4949 Sterling M, Pedler A, Chan C, Puglisi M, Vuvan V, Vicenzino B. Cervical lateral glide increases nociceptive flexion reflex threshold but not pressure or thermal pain thresholds in chronic whiplash associated disorders: a pilot randomised controlled trial. Man Ther. 2010;15(2):149-53.
|
Total (n=34) EG (n=19) and CG (n=15) |
Chronic whiplash associated disorders |
Cervical lateral glide at the C5-C6 level |
Manual contact |
Pain and disability in cervical spine;
Emotional distress;
Pressure pain threshold;
Thermal pain threshold;
NFR; pain associated to NFR test |
NDI;
GHQ-28;
Algometer;
Thermotest
system;
EMG;
VAS |
|
Manual cervical lateral glide technique has the ability to modulate spinal hyperexcitability in patients with chronic whiplash injury in short term. However, manual cervical lateral glide is not recommended until its long-term effects are discovered and whether they are equivalent to reduced pain and cervical inability |
| Tavares et al.3737 Tavares FA, Chaves TC, Silva ED, Guerreiro GD, Gonçalves JF, Albuquerque AA. Immediate effects of joint mobilization compared to sham and control intervention for pain intensity and disability in chronic low back pain patients: randomized controlled clinical trial. Rev Dor. 2017;18(1):2-7.
|
Total (n=60)
EG (n=20), placebo group (n=20), and CG (n=20) |
Chronic low back pain |
Posteroanterior central JM grade II (for 30 seconds on each lumbar vertebra L5 to S1) |
Placebo: reproduced the same positioning of the hands used in the EG without rhythmic oscillations and with the hands at rest;
CG: without intervention |
Pain intensity at rest;
Low back pain-related incapacity;
Pain-related catastrophizing |
NS;
ODI;
PCS |
|
JM was effective in improving disability, pain intensity and pre and post-intervention catastrophizing. In comparison of the effects between intervention groups, a reduction on pain intensity was observed in mobilization and placebo groups in relation to CG, suggesting a placebo effect associated to mobilization |
| Villafañe et al.4545 Villafañe JH, Langford D, Alguacil-Diego IM, Fernández-Carnero J. Management of trapeziometacarpal osteoarthritis pain and dysfunction using mobilization with movement technique in combination with kinesiology tape: a case report. J Chir Med. 2013;12(2):79-86.
|
Total (n=29)
EG (n=18) and CG (n=18; 1 week follow-up EG (n=14) and CG (n=15); 2 weeks follow-up EG (n=14) and CG (n=15) |
Secondary thumb carpometacarpal OA |
Grade III Kaltenborn JM (anteroposterior glide with carpometacarpal joint traction) |
TUS in non-therapeutic doses |
Pressure pain threshold;
Pinch and grip force |
Algometer;
Pinch dynamometer,
Hand dynamometer |
|
Kaltenborn JM reduced pain in carpometacarpal joint and the scaphoid bone area. Thus, mobilization can be effective in reducing pain and potentially improving function in OA |
| Villafañe et al.4444 Villafañe JH, Silva GB, Fernandez-Carnero J. Effect of thumb joint mobilization on pressure pain threshold in elderly patients with thumb carpometacarpal osteoarthritis. J Manipulative Physiol Ther. 2012;35(2):110-20.
|
Total (n=28)
EG (n=14) and CG (n=14); 1 week follow-up (EG (n=14) and CG (n=14); 2 weeks follow-up EG (n=14) and CG (n=14) |
Thumb carpometacarpal OA |
Maitland postero-anterior trapeziometacarpal JM |
TUS in non-therapeutic doses |
|
Algometer;
Pinch dynamometer,
Hand dynamometer |
|
Accessory passive mobilization increases PPT at carpometacarpal joint of thumb. However, therapy does not increase motor function in patients with thumb carpometacarpal OA |
| Villafañe et al.4747 Villafañe JH, Cleland JA, Fernandez-De-Las-Peñas C. Bilateral sensory effects of unilateral passive accessory mobilization in patients with thumb carpometacarpal osteoarthritis. J Manipulative Physiol Ther. 2013;36(4):232-7.
|
Total (n=28)
EG (n=14) and CG (n=14); 1 week follow-up EG (n=14) and CG (n=14); 2 weeks follow-up EG (n=14) and CG (n=14) |
Thumb carpometacarpal OA |
Carpometacarpal JM with anteroposterior slide |
Simulated technique and TUS in thumb region |
PPT in carpometacarpal joint, in scaphoid and hamato bones;
Pinch and grip force;
*asymptomatic limb |
Algometer; Pinch dynamometer,
Hand dynamometer |
|
The application of unilateral accessory passive mobilization directed to the symptomatic carpometacarpal joint provided an increase in PPT 2 weeks after treatment; however, the differences were small and of limited clinical value. No contralateral motor effects were observed |
