Effectiveness of Mulligan’s Mobilization with Movement techniques on pain and disability of peripheral joints: a systematic review with meta-analysis between 2008 to 2017

Abstract

The systematic review titled “Effectiveness of Mulligan’s Mobilization with Movement techniques on pain and disability of peripheral joints: A systematic review with meta-analysis between 2008 to 2017 concluded that Mulligan’s techniques provide short term pain relief in the peripheral joints [1]. The article is accepted for publication and is currently in press. This systematic review is of great interest for the readers and we congratulate the authors for the excellent contribution. While the review is of very high quality, we write this letter about our published study which appears eligible for inclusion in the systematic review [2], but not considered.

The inclusion criteria of the review are the randomized controlled trials investigating the effectiveness of Mulligans techniques in the peripheral joints on the outcomes of pain or disability [1]. The study by Neelapala et al., investigated the effects of Mulligans’ posterolateral glide in painful shoulders [2] and is available in the data bases PEDro, Scopus and CINAHL. The study delivered Mulligan’s posterolateral glide along with active shoulder movement in accordance with the recommended procedures [2, 3] and reported pain scores before and after the intervention [2]. Thus, the study by Neelapala et al. fits with inclusion criteria of the systematic review with respect to population, intervention, and outcomes of interest.

In addition, the inclusion of high-quality studies could further enhance the strength of the systematic review. The study by Neelapala et al., scores 8/10 on PEDro scale, suggestive of a high methodological quality. In view of the higher quality score when compared to a few other studies in the review we wonder about the possible reasons for not considering our study. Furthermore, we expected our paper could have been excluded after the full text review of the emerged articles. But we were surprised as there was no mention of our paper in the “Figure 1.” which mentioned reasons for other excluded articles [1]. We believe understanding the specific methodologic reasons for excluding our study would help us improve the quality of our further research.

The systematic review provides important information about the effectiveness of Mulligan’s techniques. However, further clarification about the study selection process is warranted. We suspect that our study could have not emerged as the title mentions Mulligan’s posterolateral glide [1]. However, a well conducted systematic review must develop search strategies to identify the available literature on the topic [4].

Conflict of interest: None declared.

Citation

Effectiveness of Mulligan’s Mobilization with Movement techniques on pain and disability of peripheral joints: a systematic review with meta-analysis between 2008 to 2017