To date, no research has been published examining the immediate effects of MWM as part of ACL treatment, specifically regarding its role as an adjunct in gaining ROM and facilitating quadriceps activation.
The primary goal of this research was to assess the efficacy of MWM in achieving these key objectives during the preliminary treatment sessions.
The secondary purpose was to determine whether ACL-injured knees respond more favorably to a specific direction of MWM. This knowledge would enhance the practitioner’s ability to select the most appropriate MWM technique, potentially increasing patient trust in the therapist—a factor that has been demonstrated to be crucial for long-term treatment effectiveness.
Retrospective data collection from medical records of the initial treatment of forty ACL patients seeking treatment in 2024 at an orthopedic outpatient clinic, where they were treated by one of four physiotherapists based on their preference. All physiotherapists have been using MWM for over 20 years.
During the initial assessment, range of motion (ROM) was evaluated both in non-weight-bearing (NWB) and weight-bearing (WB) positions. Quadriceps activation was assessed by having the patient perform a static quadriceps contraction with a towel placed under the knee. If a limitation of ROM, or failure to activate the quadriceps was identified, the patient's response to MWM was assessed using either internal (IR) or external rotation (ER), chosen at random. If the patient responded positively to both directions, a shared decision was made based on the patient’s preferred direction. The patient was then instructed to use this preferred direction for self-treatment. If there were no contraindications, taping was applied similarly.
ACL-deficient knees show a favorable response to knee ER MWM. This direction has been associated with improved significantly better outcomes in both ROM and quadriceps activation as well as patient satisfaction.
Rotation MWM, and especially ER MWM, has been found to be an effective method for improving two major objectives in the early stages of ACL rehabilitation. As a non-painful treatment technique, MWM may help reduce patient anxiety associated with more painful interventions, potentially making it a preferred choice for patients.
ER MWM should be the initial assessment for symptom modification in ACL-related dysfunction. Once a positive response is achieved, the technique is taught to the patient for self-administration, promoting autonomy and self-efficacy.
Mobilizations With Movement
Symptom-modification
