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Background <p>Shoulder pain is common and often slow to resolve despite treatment. We assessed the efficacy of Mobilization With Movement (MWM) in chronic shoulder pain.</p> Methods <p>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&#xa0;years with chronic shoulder pain (mean duration ≥ 3&#xa0;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.</p> Results <p>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, <i>n</i> = 960), disability (SMD = 0.82, 95% CI 0.17–1.48, <i>n</i> = 361), external rotation ROM (SMD = 0.77, 95% CI 0.33–1.20, <i>n</i> = 992), and flexion ROM (SMD = 0.83, 95% CI 0.13–1.53, <i>n</i> = 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, <i>n</i> = 271), and over Maitland mobilization for improving external rotation ROM (SMD = 0.74, 95% CI 0.38–1.09, <i>n</i> = 356). No significant differences were detected at 2–10-week follow-ups (<i>n</i> = 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.</p> Conclusions <p>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.</p> PROSPERO registration <p>CRD42018109380.</p>

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Efficacy of mobilization with movement in chronic shoulder pain: a systematic review and meta-analysis of controlled trials

  • 期刊论文

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  • 发表日期：

    2026年3月20日

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  • Arnstein Storås,
  • Fabian Lillebostad,
  • Sturla Haslerud,
  • Jan Magnus Bjordal,
  • Ernesto Cesar Pinto Leal-Junior,
  • Mark I. Johnson,
  • Martin Bjørn Stausholm

摘要

Background

Shoulder pain is common and often slow to resolve despite treatment. We assessed the efficacy of Mobilization With Movement (MWM) in chronic shoulder pain.

Methods

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.

Results

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.

Conclusions

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.

PROSPERO registration

CRD42018109380.