Mobilisation with movement: a step towards understanding the importance of peripheral mechanoreceptors

Abstract

Mobilisation with movement (MWM) is a form of manual therapy treatment that has been gaining popularity among physiotherapists due to their reported instant improvements in pain-free range of motion and pain alleviation. Several theories have been proposed in an attempt to explain the mechanisms of action of these procedures. Irrespective of the alternate explanations for the mechanisms of action, clinical studies provide reasonable support for some of the MWM techniques. This paper attempts to review key aspects of the mechanisms of action proposed in the literature and further explore the possible effects of MWM on articular and periarticular mechanoreceptors. The clinical implication of this knowledge is also illustrated in order to alert clinicians about specific aspects of these procedures.

Keywords:

• MWM
• mobilisations
• manual therapy
• mechanoreceptors
• mobilisation with movement
• Mulligan

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Rafael baeske, MSc Manual Therapy, is a private physiotherapy practitioner, and he is an invited lecturer for postgraduate courses in musculoskeletal physiotherapy. He is mainly interested in understanding the mechanisms of action of musculoskeletal physiotherapy interventions, especially joint-based techniques. He has participated in studies investigating the effects of passive intervertebral mobilisation on pain pressure threshold; the effects of a contralateral cervical glide on the ulnar nerve neurodynamics and vibration threshold; the use of ultrasound for piriformis, a validation study in normal subjects; the effects of a cervical sustained natural apophyseal glide on pain pressure threshold and sympathetic nervous system activity. More recently, he has written a book chapter about mechanoreceptors.