Abstract
Dear Editor,
In reply to the letter about our study “Effectiveness of Mulligan’s Mobilization with Movement techniques on pain and disability of peripheral joints: a systematic review and meta-analysis between 2008 to 2017” [1] recently accepted for publication in ‘Physiotherapy’. The reason for this letter was to question why the study by Neelapala et al. [2] was not included in our systematic review and meta-analysis.
First of all, we would like to thank the authors of this study [2] for their interest in sending their positive feedback and questions about our study. Although we recognize that the study by Neelapala et al. is an excellent work with a significant contribution to our knowledge regarding the effectiveness of mobilization with movement on painful conditions of peripheral joints, it could not be included in our systematic review.
In our manuscript, we mention that a PICO question was used for selecting the articles referencing to the table of Appendix A. The table of the Appendix A mentions that studies were included if the control intervention was: “no treatment, placebo (sham) treatment, passive treatment or another manual therapy intervention”. The study by Neelapala et al. used an active treatment (active exercises of the involved shoulder) for the control group (active control group) with exercises that were different in number and movement direction to the exercises performed in conjunction with the MWM technique (posterolateral glide) in the intervention group. Therefore, this study is associated with a slightly different research question and could not be included in our systematic review. Furthermore, this study is not mentioned in the excluded studies (Figure 1) because it was not excluded during the ‘Eligibility’ phase, but earlier during the ‘Screening’ phase (n = 1096) after reading the title/abstract of the study.
It also has to be clarified that as “The random assignment of subjects to one or another of two groups (differing only by the intervention to be studied)” [3] is commonly considered, 2 studies delivering equal amounts of co-interventions were included in our systematic review (the rationale for this decision is explained in the 3rd paragraph of the Discussion section of our paper), as those 2 studies delivered the same exercise program (equal amount and type of exercise interventions) to their control and intervention groups [4, 5] and therefore the effect of those would have been almost equal between groups.
We recognize the validity and importance of this study [2] and we strongly believe that it will be a point of discussion in future systematic reviews.
Citation
Response to letter to the editor re “Effectiveness of Mulligan’s Mobilization with Movement techniques on pain and disability of peripheral joints: a systematic review with meta-analysis between 2008–2017”