A Really Effective MWM for Knee OA
Reference:Takasaki H, Hall T, Jull G. Immediate and short-term effects of Mulligan’s mobilization with movement on knee pain and disability associated with knee osteoarthritis–a prospective case series. Physiother Theory Pract. 2013 Feb;29(2):87-95.
The evidence supporting the efficacy of Mulligan’s mobilizations with movement (MWM) is growing and here is the latest one that every PT must be aware of and apply clinically.
Patients with symptomatic knee OA with an average age of 71, received four treatment sessions of MWMs within a 2 week period along with a home program.
The patients had significant improvements in knee ROM, pain and functional scores after only 2 weeks with the greatest benefit occurring immediately following the first session of knee MWMs.
With the patient in supine lying flex and extend the knee and note the most symptomatic direction and note pain level.
Re-evaluate active assisted knee flexion / extension in supine by applying
Option 1: A lateral glide to the tibia while stabilizing the femur close to the joint line (aka Lateral glide)
Option 2: A lateral glide with medial rotation
Option 3: A lateral glide with lateral rotation
Option 4: A medial glide
The patient is asked to report which option provides the most symptomatic relief during knee flexion/extension. Of the 4 options, the most beneficial glide direction is then chosen as the treatment of choice.
The most effective glide is then applied in weight bearing with the effected knee on a chair. The MWM is repeated 10 times with 3 sets. Self MWMs are performed every 3 hours, 2 sets of 10 …as per image on the right –>
Posted on: September 26, 2013