The immediate and sustained effects of mobilisations with movement on the hip range of motion and power and shoulder range of motion and strength

Abstract

Introduction. The purpose of this study was to determine the effect of a mobilisation with movement (MWM) and self-applied mobilisation with movement (SMWM) treatment on hip extension ROM (°), jump height (cm) and power (N) output and shoulder ROM (°) and strength [Peak Torque per Body Weight (%) and Time to Peak Torque (ms)]. Studies have demonstrated that MWM treatment has an effect on shoulder IR ROM and isometric strength, however no previous study has determined the effect of a MWM and SMWM treatment on shoulder rotational ROM or isokinetic strength. While MWMs have been shown to significantly increase functional hip IR ROM, no previous research has explored the effects of MWM or SMWM treatment on hip extension. Previous studies have documented an increase in isometric muscle strength following hip mobilisations, however no research to date has explored the effects of MWM and SMWM treatment on hip power. Similarly, previous studies demonstrated an increase in isometric muscle strength following shoulder mobilisations, however no research to date has explored the effects of MWM and SMWM treatment on isokinetic shoulder rotational strength.

Methods. The first study investigated the effect of a single MWM and SMWM treatment bout on the hip joint (n=60), where the treatment effects where examined immediately, 24hrs and 48hrs post. The participants had a restricted hip extension ROM (<20°). Baseline hip extension ROM (°) and hip power [jump height (cm) and power (N)] measures were obtained with a mobile phone inclinometer and a force plate. The participants were stratified and randomly allocated into groups; therapist applied MWM (n=20), self-applied MWM (n=20) or the control (n=20). The participants received treatment on the hip joint based on their respective group. Participants only received a single treatment application (3 sets of 10 repetitions). Outcome measures were reassessed immediately, 24hrs and 48hrs following the treatment application. The second study investigated the treatment effects of a single MWM and SMWM treatment bout immediately, 24hrs and 48hrs post treatment on the shoulder joint (n=73). Participants had a restricted shoulder IR ROM (<60°). Baseline shoulder IR ROM (°) and strength measures [Peak Torque per Body Weight (%) and Time to Peak Torque (ms)] were obtained using an inclinometer and an isokinetic Biodex Machine respectively. The participants were stratified and randomly allocated into groups; therapist applied MWM (n=19), self-applied MWM (n=21) or the control (n=22). The participants received treatment on the shoulder joint based on their respective group. Participants only received a single treatment application (3 sets of 10 repetitions). Outcome measures were reassessed immediately, 24hrs and 48hrs following the treatment application. The third study investigated the effects of multiple MWM and SMWM treatment applications immediately and up to 7 days post treatment (n=27). Participants had a restricted shoulder IR ROM (<60°). Baseline shoulder IR ROM (°) and strength measures [Peak Torque per Body Weight (%) and Time to Peak Torque (ms)] were obtained using an inclinometer and an isokinetic Biodex Machine respectively. The participants were stratified and randomly allocated into groups; therapist applied MWM (n=9), self-applied MWM (n=9) or the control (n=9). The participants received treatment on the shoulder joint based on their respective group. Participants received 3 treatment applications (3 sets of 10 repetitions in each treatment application) over a period of a week. Outcome measures were reassessed immediately, 48hrs and 7 days following the final treatment. The data was analysed using the SPSS statistics package, the between group differences were compared using a split plot ANOVA with the post-hoc analysis and the paired t-test was utilised to identify within group changes.

Results. In study one, a split plot ANOVA revealed no significant between group effects for hip ROM or hip power immediately, 24hrs or 48hrs post treatment when compared to the baseline measurement. In study two, a split plot ANOVA revealed a significant between group effect (F=5.09 [df=2, SE=47], p=0.01), demonstrating a significant increase in the MWM and SMWM groups immediately (MWM=11°,SMWM=10°), 24 hours (MWM=8°,SMWM=8°) and 48 hours (MWM=7°,SMWM=6°) post treatment when compared to the baseline measurement. In study three, a split plot ANOVA revealed a significant between groups effects (F=8.4 [df=2, SE=27], p=0.01), demonstrating a significant statistical difference in the MWM and SMWM groups immediately (MWM=14°,SMWM=13°), 48 hours (MWM=13°,SMWM=15°) and 7 days (MWM=18°,SMWM=14°) post treatment when compared to the baseline measurement. No significant between group effect was found for shoulder ER ROM and strength measures for both SMWM and MWM in study two and three.

Conclusion. A single application of MWM and SMWM techniques did not significantly effect hip ROM, jump height or power output. A single application of MWM and SMWM treatment is equally effective at increasing shoulder IR ROM immediately and up to 48h post treatment application. Multiple MWM and SMWM treatments are effective in increasing shoulder IR ROM immediately and up to 7 days following the treatment application, furthermore it results in a greater ROM increase when compared to a single treatment application. The application of MWM or SMWM treatments has no negative impact on shoulder strength or shoulder ER ROM.