Effect of Mobilization With Movement in Patients With Rotator Cuff Lesions

Condition(s) studied

Investigational drug(s) / intervention(s)

Mulligan mobilization: Participants assigned to the Mobilization with Movement (MWM) group will receive manual therapy based on the Mulligan concept. The intervention will consist of the application of sustained, pain-free accessory mobilization to the glenohumeral joint combined with active physiological shoulder movements, primarily in shoulder flexion and abduction. The direction and grade of mobilization will be individually determined according to the patient's symptoms and movement restrictions, ensuring that all movements are performed within a pain-free range. MWM interventions will be administered by a trained physiotherapist following a standardized treatment protocol. Each treatment session will last approximately 20-30 minutes and will be applied multiple times per week throughout the intervention period. The primary goal of the intervention is to improve joint mechanics, reduce pain, and enhance proprioceptive input by facilitating normal, pain-free movement patterns.

Conventional Physiotherapy: Participants allocated to the conventional physiotherapy group will receive a standard rehabilitation program commonly used for rotator cuff lesions. The intervention will include therapeutic exercises targeting shoulder range of motion, strengthening of the rotator cuff and scapular stabilizing muscles, and stretching exercises for periarticular soft tissues. Physical therapy modalities such as heat or ultrasound may be applied as needed for pain management. This intervention will be delivered by a physiotherapist according to established clinical guidelines. Mobilization with Movement or other Mulligan-based manual therapy techniques will not be included in this group.

Study summary

This randomized controlled trial aims to investigate the effects of Mobilization with Movement (MWM) on pain and functional status in individuals with rotator cuff lesions. Rotator cuff pathology is a common cause of shoulder pain and functional limitation, and impairments in proprioception may further compromise shoulder motor control and recovery.

Eligible participants with rotator cuff lesions will be randomly allocated into three groups: (1) Mobilization with Movement (MWM), (2) conventional physiotherapy, and (3) control group. All participants will be evaluated before and after the intervention period. Outcome measures will include shoulder-related functional disability assessed by the QuickDASH questionnaire, pain intensity, and shoulder joint position sense evaluated using an active repositioning test with a laser pointer during shoulder flexion.

The study is designed to determine whether MWM provides additional benefits over conventional treatment or task oriented training intervention in improving pain, function, and proprioceptive accuracy. The findings are expected to contribute to evidence-based conservative rehabilitation strategies for patients with rotator cuff lesions.

Eligibility

Primary outcome measure(s)

• Quick Disabilities of the Arm, Shoulder and Hand questionnaire. — Baseline (pre-intervention) and at the end of the 8-week intervention period.
  Upper Extremity Functional Disability, Higher scores better outcomes

Trial sites (1)

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