https://doi.org/10.4081/ejtm.2022.10504

The cognitive-behavioral aspects of the Mulligan concept of manual therapy: A systematic review

Vol. 32 No. 2 (2022)
Submitted: 10 April 2022
Accepted: 5 May 2022
Published: 19 May 2022
Mulligan concept, sustained natural apophyseal glides (SNAGs), low back pain, cognitive behavioral treatment
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Authors

Dimitrios Athanasiadis
Physical Therapy at Vocational Training Institute of Kavala, Greece.
Yannis Dionyssiotis
https://orcid.org/0000-0001-6962-1583
Spinal Cord Injury Rehabilitation Clinic, University of Patras, Rio Patras, Greece.
Julian Krumov
Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria.
Vasil Obretenov
Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria.
Kiril Panayotov
Faculty of Public Health, Angel Kanchev University of Ruse, Bulgaria.
Jannis Papathanasiou
giannipap@yahoo.co.uk
https://orcid.org/0000-0003-2557-5508
Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria; Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, DSci.”, Medical University of Sofia, Bulgaria.

Low back pain (LBP) is a common clinical problem imposing a prominent socio-economic burden. The purpose of this systematic review was to investigate the biopsychosocial effects of the Mulligan Concept (MC) of manual therapy (MT) when applied to patient's with LBP. Three researchers independently evaluated the literature quality, and completed a review on five online databases (Medline, Cochrane Library, Science Direct, ProQuest and Google Scholar) for articles published from January 1st 2010 to November 20th 2021, using a combination of free words, Wildcards and Medical Subject Headings (MESH) terms: " Mulligan mobilization " AND " back pain " OR " SNAGs." In total, 62 studies were selected for full-text reading, from which finally 6 studies were included in the present review. The results revealed that the studies where the MC of MT was applied to treat LBP mainly lacked concern regarding the effect that the intervention has on the cognitive and behavioural parameters. The ones that introduced measure outcomes for at least some parts of the cognitive behavioural components, showed that the MC has a positive effect, even though without a long-term follow-up assessment. This review summarized that the evidence of the MC on cognitive behavioural (CB) aspects of patients with LBP is controversial and scarce.

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Crossref
Scopus
Google Scholar
Europe PMC
Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021 Jul 3; 398(10294):78-92. DOI: https://doi.org/10.1016/S0140-6736(21)00733-9
Wang L, Ye H, Li Z, Lu C, Ye J, Liao M, Chen X. Epidemiological trends of low back pain at the global regional, and national levels. Eur Spine J. 2022 Apr;31(4):953-962. DOI: https://doi.org/10.1007/s00586-022-07133-x
Foster NE, Thompson KA, Baxter GD, Allen JM. Management of nonspecific low back pain by physiotherapists in Britain and Ireland. A descriptive questionnaire of current clinical practice. Spine (Phila Pa 1976). 1999 Jul 1;24(13):1332-42. DOI: https://doi.org/10.1097/00007632-199907010-00011
Hing W, Hall T, Mulligan B. The Mulligan concept of manual therapy - 2nd edition 2019; 2019.
Mulligan BR. Manual therapy – ‘NAGS’, ‘SNAGS’, ‘MWMs’ etc. 6.ed. Wellington: Plane View Services; 2010.
Konstantinou K, Foster N, Rushton A, Baxter D. The use and reported effects of mobilization with movement techniques in low back pain management; a cross-sectional descriptive survey of physiotherapists in Britain. Man Ther. 2002 Nov; 7(4):206-14. DOI: https://doi.org/10.1054/math.2002.0469
May J, Krzyzanowicz R, Nasypany A, Seegmiller J. Mulligan Concept Use and Clinical Profile From the Perspective of American Certified Mulligan Practitioners. J Sport Rehabil. 2015 Nov; 24(4):337-41. DOI: https://doi.org/10.1123/jsr.2014-0178
O'Sullivan K, Dankaerts W, O'Sullivan L, O'Sullivan PB. Cognitive Functional Therapy for Disabling Nonspecific Chronic Low Back Pain: Multiple Case-Cohort Study. Phys Ther. 2015 Nov; 95(11):1478-88. DOI: https://doi.org/10.2522/ptj.20140406
Hanscom DA, Brox JI, Bunnage R. Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview. Global Spine J. 2015 Dec; 5(6):496-504. DOI: https://doi.org/10.1055/s-0035-1567836
Vibe Fersum K, O'Sullivan P, Skouen JS, Smith A, Kvåle A. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013 Jul; 17(6):916-28. DOI: https://doi.org/10.1002/j.1532-2149.2012.00252.x
Sveinsdottir V, Eriksen HR, Reme SE. Assessing the role of cognitive behavioral therapy in the management of chronic nonspecific back pain. J Pain Res. 2012; 5:371-80. DOI: https://doi.org/10.2147/JPR.S25330
Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018 Jul; 48(7):519-522. DOI: https://doi.org/10.2519/jospt.2018.0610
Baker RT, Nasypany A, Seegmiller JG, Baker, JG. The mulligan concept: mobilizations with movement. Int J Athl Ther Train. 2013; 18(1), 30-34. DOI: https://doi.org/10.1123/ijatt.18.1.30
Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. DOI: https://doi.org/10.1016/j.math.2006.07.012
Pourahmadi MR, Mohsenifar H, Dariush M, Aftabi A, Amiri A. Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review. Clin Rehabil. 2018 Oct; 32(10):1289-1298. DOI: https://doi.org/10.1177/0269215518778321
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021 Mar 29; 372: n160. DOI: https://doi.org/10.1136/bmj.n160
Furlan AD, Malmivaara A, Chou R, Maher CG, Deyo RA, Schoene M, Bronfort G, van Tulder MW, Editorial Board of the Cochrane Back, Neck Group. 2015 Updated Method Guideline for Systematic Reviews in the Cochrane Back and Neck Group. Spine (Phila Pa 1976). 2015 Nov; 40(21):1660-73. DOI: https://doi.org/10.1097/BRS.0000000000001061
van Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine (Phila Pa 1976). 2003 Jun 15; 28(12):1290-9. DOI: https://doi.org/10.1097/01.BRS.0000065484.95996.AF
O’Connor D, Green S, Higgins JPT. Defining the review question and developing criteria for including studies. In: Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. [Updated March 2011]: The Cochrane Collaboration, 2011. Available at: www.cochrane.handbook.org. (Accessed: March 28, 2022).
Rumrill PD Jr, Fitzgerald SM. Using narrative literature reviews to build a scientific knowledge base. Work. 2001; 16(2):165-170.
Nascimento DP, Costa LOP, Gonzalez GZ, Maher CG, Moseley AM. Abstracts of low back pain trials are poorly reported, contain spin of information and are inconsistent with the full text: An overview study. Arch Phys Med Rehabil. 2019 Jun 14;1976-1985.e18. DOI: https://doi.org/10.1016/j.apmr.2019.03.024
Turner L, Shamseer L, Altman DG, Weeks L, Peters J, Kober T, Dias S, Schulz KF, Plint AC, Moher D. Consolidated standards of reporting trials (CONSORT) and the completeness of reporting of randomised controlled trials (RCTs) published in medical journals. Cochrane Database Syst Rev. 2012 Nov 14;11(11):MR000030. DOI: https://doi.org/10.1002/14651858.MR000030.pub2
Bello B, Danazumi MS, Kaka B. Comparative Effectiveness of 2 Manual Therapy Techniques in the Management of Lumbar Radiculopathy: A Randomized Clinical Trial. J Chiropr Med. 2019 Dec;18(4):253-260. DOI: https://doi.org/10.1016/j.jcm.2019.10.006
Ali MN, Sethi K, Noohu MM. Comparison of two mobilization techniques in management of chronic non-specific low back pain. J Bodyw Mov Ther. 2019 Oct;23(4):918-923. DOI: https://doi.org/10.1016/j.jbmt.2019.02.020
Satpute K, Hall T, Bisen R, Lokhande P. The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial. Arch Phys Med Rehabil. 2019 May; 100(5):828-836. DOI: https://doi.org/10.1016/j.apmr.2018.11.004
Hussien HM, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan Concept Lumbar SNAG on Chronic Nonspecific Low Back Pain. J Chiropr Med. 2017 Jun; 16(2):94-102. DOI: https://doi.org/10.1016/j.jcm.2017.01.003
Ahmed N, Khan Z, Chawla C. Comparison of Mulligan’s spinal mobilization with limb movement (SMWLM) and neural tissue mobilization for the treatment of lumbar disc herniation: a randomized clinical trial. J Nov Physiother. 2016 Apr;6(2): e144. DOI: https://doi.org/10.4172/2165-7025.1000304
Hidalgo B, Pitance L, Hall T, Detrembleur C, Nielens H. Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial. J Manipulative Physiol Ther. Jul-Aug 2015;38(6):365-74. DOI: https://doi.org/10.1016/j.jmpt.2015.06.013
Green BN, Johnson CD, Adams A.Writing narrative literature reviews for peer-reviewed journals: secrets of the trade.J Chiropr Med. 2006 Autumn; 5(3):101-17. DOI: https://doi.org/10.1016/S0899-3467(07)60142-6
Hidalgo B. Evidence based orthopaedic manual therapy for patients with nonspecific low back pain: An integrative approach. J Back Musculoskelet Rehabil. 2016 Apr 27; 29(2):231-239. DOI: https://doi.org/10.3233/BMR-150619
Bialosky JE, Bishop MD, George SZ, Robinson ME. Placebo response to manual therapy: something out of nothing? J Man Manip Ther. 2011 Feb; 19(1):11-9. DOI: https://doi.org/10.1179/2042618610Y.0000000001
Costa N, Hodges PW, Ferreira ML, Makovey J, Setchell J. What Triggers an LBP Flare? A Content Analysis of Individuals' Perspectives. Pain Med. 2020 Jan 1;21(1):13-20. DOI: https://doi.org/10.1093/pm/pnz021
Dixon WG, Beukenhorst AL, Yimer BB, Cook L, Gasparrini A, El-Hay T, Hellman B, James B, Vicedo-Cabrera AM, Maclure M, Silva R, Ainsworth J, Pisaniello HL, House T, Lunt M, Gamble C, Sanders C, Schultz DM, Sergeant JC, McBeth J. How the weather affects the pain of citizen scientists using a smartphone app. NPJ Digit Med. 2019 Oct 24; 2:105. DOI: https://doi.org/10.1038/s41746-019-0180-3
Caneiro JP, Roos EM, Barton CJ, O'Sullivan K, Kent P, Lin I, Choong P, Crossley KM, Hartvigsen J, Smith AJ, O'Sullivan P. It is time to move beyond 'body region silos' to manage musculoskeletal pain: five actions to change clinical practice. Br J Sports Med. 2020 Apr;54(8):438-439. DOI: https://doi.org/10.1136/bjsports-2018-100488
Vibe Fersum K, Smith A, Kvåle A, Skouen JS, O'Sullivan P. Cognitive functional therapy in patients with non-specific chronic low back pain-a randomized controlled trial 3-year follow-up. Eur J Pain. 2019 Sep;23(8):1416-1424. DOI: https://doi.org/10.1002/ejp.1399
Louw A, Farrell K, Landers M, Barclay M, Goodman E, Gillund J, McCaffrey S, Timmerman L. The effect of manual therapy and neuroplasticity education on chronic low back pain: a randomized clinical trial. J Man Manip Ther. 2017 Dec;25(5):227-234. DOI: https://doi.org/10.1080/10669817.2016.1231860
Galan-Martin MA, Montero-Cuadrado F, Lluch-Girbes E, Coca-López MC, Mayo-Iscar A, Cuesta-Vargas A. Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial. J Clin Med. 2020 Apr 22;9(4):1201. DOI: https://doi.org/10.3390/jcm9041201
Belache FTC, Souza CP, Fernandez J, Castro J, Ferreira PDS, Rosa ERS, Araújo NCG, Reis FJJ, Almeida RS, Nogueira LAC, Correia LCL, Meziat-Filho N. Trial Protocol: Cognitive functional therapy compared with combined manual therapy and motor control exercise for people with non-specific chronic low back pain: protocol for a randomised, controlled trial. J Physiother. 2018 Jul;64(3):192. DOI: https://doi.org/10.1016/j.jphys.2018.02.018
Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. Am Psychol. Feb-Mar 2014;69(2):153-66. DOI: https://doi.org/10.1037/a0035747
Yates M, Shastri-Hurst N. The Oswestry disability index. Occup Med. 2017; 67(3): 241-242. DOI: https://doi.org/10.1093/occmed/kqw051
Vianin M. Psychometric properties and clinical usefulness of the Oswestry Disability Index. J Chiropr Med. 2008 Dec;7(4):161-3. DOI: https://doi.org/10.1016/j.jcm.2008.07.001
Walsh TL, Hanscom B, Lurie JD, Weinstein JN. Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary? The responsiveness of the Oswestry Disability Index, MODEMS, and the SF-36. Spine (Phila Pa 1976). 2003 Mar 15;28(6):607-15. DOI: https://doi.org/10.1097/01.BRS.0000050654.97387.DF
Repo JP, Ponkilainen VT, Häkkinen AH, Ylinen J, Bergman P, Kyrölä K. Assessment of Construct Validity of the Oswestry Disability Index and the Scoliosis Research Society-30 Questionnaire (SRS-30) in Patients With Degenerative Spinal Disease. Spine Deform. 2019 Nov;7(6):929-936. DOI: https://doi.org/10.1016/j.jspd.2019.04.008

How to Cite

Athanasiadis, D. ., Dionyssiotis, Y. ., Krumov , J. ., Obretenov , V. ., Panayotov, K. ., & Papathanasiou, J. (2022). The cognitive-behavioral aspects of the Mulligan concept of manual therapy: A systematic review. European Journal of Translational Myology, 32(2). https://doi.org/10.4081/ejtm.2022.10504

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