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@article{206560,
        author = {Nidhi Shetty and Rushikesh Patil and Aishwarya Shinde and Tanvi Bhujbal and Shantanu Kshirsagar and Siddhi Patrekar and Sakshi Desai},
        title = {EFFECTS OF MULLIGAN MOBILIZATION ON NEUROMECHANICAL CHANGES, WEIGHT-BEARING FUNCTION AND CLINICAL OUTCOMES IN KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {13},
        number = {2},
        pages = {2216-2227},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=206560},
        abstract = {Knee osteoarthritis (KOA) is a leading cause of chronic pain, muscle weakness, and functional decline in adults. Mulligan's mobilization with movement (MWM) is a manual therapy technique that combines a sustained accessory glide with active physiological movement, and has been proposed to reduce pain, correct altered joint arthrokinematics, and restore neuromuscular control during weight-bearing activity. This systematic review aimed to evaluate the effects of Mulligan mobilization on neuromechanical changes, weight-bearing function, and clinical outcomes in individuals with knee osteoarthritis. A comprehensive literature search was conducted using PubMed, Google Scholar, Scopus, ScienceDirect, Web of Science, PEDro, and ClinicalTrials.gov for studies published between 2010 and 2026. Only randomized controlled trials and cross-sectional studies were eligible for inclusion. Risk of bias was assessed using the Revised Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and the Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional studies. A total of 10 studies (6 randomized controlled trials and 4 cross-sectional studies) met the eligibility criteria and were included in this review. The included randomized controlled trials showed that Mulligan MWM, whether delivered alone, combined with isometric or proprioceptive exercise, or compared against Maitland mobilization, produced consistent short-term improvements in pain, quadriceps strength, functional mobility, and disability scores in individuals with knee osteoarthritis. The cross-sectional studies demonstrated that weight-bearing asymmetry, trunk movement asymmetry, reduced quadriceps rate of force development, and diminished weight-bearing quadriceps strength are clinically important neuromechanical impairments associated with pain and disability in knee osteoarthritis, providing a mechanistic rationale for weight-bearing manual therapy. Most randomized controlled trials were judged to raise 'some concerns' on the RoB 2 tool, chiefly due to the inherent difficulty of blinding participants and treating therapists to a manual therapy intervention, while the cross-sectional studies demonstrated generally good methodological quality on the AXIS tool, with the principal limitations relating to sample representativeness and non-response bias. This review concludes that Mulligan mobilization is a safe and clinically useful adjunct for improving pain, neuromuscular activation, weight-bearing symmetry, and functional performance in knee osteoarthritis, and that the observed neuromechanical impairments in this population including weight-bearing and trunk movement asymmetry and reduced quadriceps force generation support its proposed mechanism of action. Larger, long-term, high-quality randomized controlled trials incorporating objective biomechanical outcome measures are needed to confirm these findings and to establish standardized treatment protocols.},
        keywords = {Mulligan mobilization; mobilization with movement; knee osteoarthritis; weight-bearing asymmetry; neuromechanics; systematic review.},
        month = {July},
        }