Mulligan Mobilization Technique and Proprioceptive Exercises in Knee Osteoarthritis Rehabilitation: A Scoping Review

Abstract

Background: Knee osteoarthritis (KOA) is a leading cause of chronic pain and disability, and growing interest has emerged in manual therapy and sensorimotor training as adjuncts to standard physiotherapy. Mulligan Mobilization with Movement (MWM/MMT) and proprioceptive training target complementary biomechanical and neuromuscular deficits, yet evidence regarding their individual and combined effects remains fragmented. Objective: To map and synthesize available research on the application, outcomes, and limitations of MWM/MMT and proprioceptive training in adults with KOA across conservative rehabilitation settings. Methods: A scoping review was conducted following the Arksey–O’Malley framework and PRISMA-ScR guidelines. Searches of PubMed, MEDLINE, PEDro, CINAHL, Scopus, Google Scholar, and ScienceDirect (2014–March 2025) identified randomized trials, controlled studies, systematic reviews, meta-analyses, guidelines, and protocols. Two reviewers independently screened and charted data, with narrative thematic synthesis used to organize findings. Results: Forty-three studies met inclusion criteria. Both MWM/MMT and proprioceptive training demonstrated consistent short-term improvements in pain, physical function, proprioceptive acuity, balance, and range of motion. Comparative trials showed similar effectiveness to other manual therapies and combined or multimodal interventions often produced additive benefits. Evidence gaps included heterogeneous protocols, small samples, short follow-ups, and limited evaluation of combined approaches. Conclusion: MWM/MMT and proprioceptive training are promising adjuncts to physiotherapy for KOA, but high-quality long-term trials are urgently needed.