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The efficacy of Mulligan mobilization and corticosteroid injection on pain, functionality, and proprioception in rotator cuff tears: a randomized controlled trial [with consumer summary]
Menek B, Menek MY
Journal of Hand Therapy 2025 Jul-Sep;38(3):410-417
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Treatment of rotator cuff (RTC) tears commonly involves manual therapy, exercise, and injection methods. These treatments are typically administered together as components of a physical therapy intervention. However, it is not known which intervention is more effective. PURPOSE: The objective of this study was to examine the impact of mobilization with movement (MWM) mobilization, a technique from Mulligan approaches, and corticosteroid (CS) injection on pain, functionality, and proprioception in cases of RTC tears. STUDY DESIGN: This was a single-blinded randomized clinical trial. METHODS: Participants with RTC tears (n = 60) were divided into Mulligan mobilization (MM) and CS groups. The participants in the MM group performed mobilization with movement and a conventional exercise program; the CS group received a CS injection in addition to conventional exercises. The Visual Analog Scale, The Disabilities of the Arm, Shoulder, and Hand questionnaire, active range of motion (AROM), and joint position sense (JPS) were evaluated. The outcomes were analyzed using effect size, minimum clinically important difference, minimal detectable change, Wilcoxon test, and Mann-Whitney U test. RESULTS: Both groups significantly improved in all measured outcomes at 3 weeks. The MM group showed significantly better (p < 0.05, Cohen d range 0.82 to 3.2) results in pain, AROM (Flexion, abduction, extension, external rotation, internal rotation), and proprioception (30 degrees and 60 degrees of flexion and abduction). Between-group differences in AROM were also clinically meaningful as they exceeded their MDC90 and minimum clinically important difference values. CONCLUSIONS: Although both of these treatment methods may be successful in the short-term management of chronic RTC, the MM approach combined with conventional exercises seems to be a more effective approach for improving shoulder pain, function, and proprioception in this patient population. CLINICAL TRIAL NUMBER: NCT05933382

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