{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:34:34Z","timestamp":1793892874465,"version":"4.8.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HSS Journal\u00ae: The Musculoskeletal Journal of Hospital for Special Surgery"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Post-traumatic stiffness is a pathological condition that results from injury and the soft tissue response, leading to reduced or lost joint motion and functional impairments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This pilot study aimed to compare the efficacy of Kaltenborn mobilization and Mulligan Mobilization with movement (MWM) in managing post-traumatic elbow stiffness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A 6-month prospective non-randomized comparative interventional pilot study was conducted at Independent University Hospital, Faisalabad, Pakistan. Forty-five participants were equally divided into 3 groups: Group A (Active range of motion [A-RoM] + actinotherapy), Group B (Kaltenborn Grade III glides + actinotherapy), and Group C (MWM with sustained end-range glides + actinotherapy). Baseline assessments included demographics, elbow RoM (flexion, extension, pronation, supination), manual muscle testing, Mayo Elbow Performance Score, and Numeric Pain Rating Scale. This study was registered in the Clinical Trials Registry of Australia and New Zealand (ACTRN12625000820404). Post-intervention analysis using paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and 2-way analysis of variance was conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The interventions in Group C were associated with the greatest improvements in RoM, strength, and pain relief compared to A-RoM exercises and Kaltenborn mobilization. Kaltenborn mobilization resulted in significant clinical improvement, whereas A-RoM exercises did not show any difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings of this pilot study suggest that MWM may address biomechanical dysfunctions more effectively than Kaltenborn mobilization in patients with post-traumatic elbow stiffness. Further study is needed to confirm that MWM should be integrated into standard post-traumatic elbow rehabilitation protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, Therapeutic Study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15563316261475265","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:56:08Z","timestamp":1787118968000},"page":"544-552","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence-Based Clinical Comparison of Mulligan\u2019s Mobilization With Movement and Kaltenborn Mobilization in Elbow Recovery: A Pilot Study"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7932-3084","authenticated-orcid":false,"given":"Mehlaqa","family":"Waseem","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Allied Health Sciences, Independent University Hospital, Faisalabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Fatima","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Allied Health Sciences, Independent University Hospital, Faisalabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-3455","authenticated-orcid":false,"given":"Arslan","family":"Iftikhar","sequence":"additional","affiliation":[{"name":"Department of Physiology, GCUF, Faisalabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Pereira GF Balu AR Flamant EM Fletcher AN Kurkowski SC Ruch DS. Elbow stiffness. Orthop Trauma. 2024:1233-1241. https:\/\/doi.org\/10.1007\/978-3-031-30518-4_100","DOI":"10.1007\/978-3-031-30518-4_100"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Nimura A Shimura H Hoshika S Fukai A Akita K. Elbow anatomy in perspective of joint capsule and surrounding aponeuroses: a narrative review. JSES Int. 2024;8(3):654-660. https:\/\/doi.org\/10.1016\/j.jseint.2024.01.006","DOI":"10.1016\/j.jseint.2024.01.006"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Bi W Lu Y Kang Y Ji Y Xu J Guo B. Hinged external fixation combined with open debridement for post-traumatic elbow stiffness: a systematic review and meta-analysis. Indian J Orthop. 2024;58(3):231-241. https:\/\/doi.org\/10.1007\/s43465-023-01087-y","DOI":"10.1007\/s43465-023-01087-y"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"Sun Z Li J Cui H Ruan H Wang W Fan C. A new pathologic classification for elbow stiffness based on our experience in 216 patients. J Shoulder Elbow Surg. 2020;29(3):e75-e86. https:\/\/doi.org\/10.1016\/j.jse.2019.08.001","DOI":"10.1016\/j.jse.2019.08.001"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Akhtar A Hughes B Watts AC. The post-traumatic stiff elbow: a review. J Clin Orthop Trauma. 2021;19:125-131. https:\/\/doi.org\/10.1016\/j.jcot.2021.05.006","DOI":"10.1016\/j.jcot.2021.05.006"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Siemensma MF van Es EM van Bergen CJ Colaris JW Eygendaal D van der Windt AE. Management of post-traumatic elbow stiffness in paediatric and adult patients: an update. Orthop Trauma. 2024;38(4):228-237. https:\/\/doi.org\/10.1016\/j.mporth.2024.06.001","DOI":"10.1016\/j.mporth.2024.06.001"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Veltman ES Doornberg JN Eygendaal D van den Bekerom MP. Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients. Arch Orthop Trauma Surg. 2015;135:613-617. https:\/\/doi.org\/10.1007\/s00402-015-2199-5","DOI":"10.1007\/s00402-015-2199-5"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Zhang D Nazarian A Rodriguez EK. Post-traumatic elbow stiffness: pathogenesis and current treatments. Shoulder Elbow. 2020;12(1):38-45. https:\/\/doi.org\/10.1177\/1758573218793903","DOI":"10.1177\/1758573218793903"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","unstructured":"B\u00e4cker HC Freibott CE Swart E Perka C Jobin CM Rosenwasser MP. A novel treatment for prevention of post-traumatic elbow stiffness using onaBotulinum toxin type A: a prospective placebo controlled randomized trial. Acta Orthop Belg. 2021;87(3):509-520. https:\/\/doi.org\/10.52628\/87.3.17","DOI":"10.52628\/87.3.17"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","unstructured":"Umar M Anwar A Khan N Marryam M Rashid H. Effectiveness of Kaltenborn mobilization versus muscle energy technique on shoulder range of motion in adhesive capsulitis. J Rawalpindi Med Coll. 2023;27(3):1959. https:\/\/doi.org\/10.37939\/jrmc.v27i3.1959","DOI":"10.37939\/jrmc.v27i3.1959"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4324\/9781003524212-16"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Rusanov A Vitomska M. The role of mobilization techniques in the physical therapy of patients with adhesive capsulitis of the shoulder joint. Art Med. 2022;24(4):181-186. https:\/\/doi.org\/10.21802\/artm.2022.4.24.181","DOI":"10.21802\/artm.2022.4.24.18"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","unstructured":"McDowell JM Johnson GM Hetherington BH. Mulligan concept manual therapy: standardizing annotation. Man Ther. 2014;19(5):499-503. https:\/\/doi.org\/10.1016\/j.math.2013.12.006","DOI":"10.1016\/j.math.2013.12.006"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","unstructured":"Savva C Karagiannis C Korakakis V Efstathiou M. The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review. J Man Manip Ther. 2021;29(5):276-287. https:\/\/doi.org\/10.1080\/10669817.2021.1904348","DOI":"10.1080\/10669817.2021.1904348"},{"key":"e_1_3_2_16_2","doi-asserted-by":"crossref","unstructured":"Kawa M Muszynska E Kowza-Dzwonkowska M. Evaluation of analgesic effectiveness of infrared radiation and interference currents in degenerative diseases. Balt J Health Phys Act. 2014;6(4):5. https:\/\/doi.org\/10.2478\/bjha-2014-0026","DOI":"10.2478\/bjha-2014-0026"},{"key":"e_1_3_2_17_2","volume-title":"Therapeutic exercise: foundations and techniques","author":"Kisner C","year":"2017","unstructured":"Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. Fa Davis; 2017."},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","unstructured":"Ragav S Singh A. Comparison of effectiveness of mulligan \u2018MWM\u2019technique versus kaltenborn mobilization technique on pain and end range of motion in patients with adhesive capsulitis of shoulder joint: a randomized controlled trial. . J Exerc Sci Physiother. 2019;15(1):1-9. https:\/\/doi.org\/10.18376\/jesp\/2019\/v15\/i1\/111313","DOI":"10.18376\/jesp\/2019\/v15\/i1\/111313"},{"key":"e_1_3_2_19_2","doi-asserted-by":"crossref","unstructured":"Fernandes A Shah L Mohan A. Effectiveness of Kaltenborn mobilization technique versus Mulligan\u2019s MWM in patients with adhesive capsulitis of shoulder. Indian J Physiother Occup Ther. 2020;14(3):18-24. https:\/\/doi.org\/10.37506\/ijpot.v14i3.9661","DOI":"10.37506\/ijpot.v14i3.9661"},{"key":"e_1_3_2_20_2","volume-title":"StatPearls","author":"Gandbhir VN","year":"2020","unstructured":"Gandbhir VN, Cunha B. Goniometer. In: StatPearls. StatPearls Publishing; 2020."},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","unstructured":"Anggiat L Altavas AJ Budhyanti W. Joint mobilization: theory and evidence review. Int J Sport Exerc Health Res. 2020;4(2):86-90. http:\/\/repository.uki.ac.id\/id\/eprint\/3142","DOI":"10.31254\/sportmed.4211"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","unstructured":"Bielewicz J Daniluk B Kamieniak P. VAS and NRS same or different? Are visual analog scale values and numerical rating scale equally viable tools for assessing patients after microdiscectomy? Pain Res Manag. 2022;2022:5337483. https:\/\/doi.org\/10.1155\/2022\/5337483","DOI":"10.1155\/2022\/5337483"},{"key":"e_1_3_2_23_2","doi-asserted-by":"crossref","unstructured":"Engelke J Walde MV Schnetzke M Gr\u00fctzner P-A Nolte P-C. High correlation of the subjective elbow value with Mayo Elbow Performance Score and Oxford Elbow Score in patients with elbow dislocation. JSES Int. 2023;7(5):868-871. https:\/\/doi.org\/10.1016\/j.jseint.2023.04.010","DOI":"10.1016\/j.jseint.2023.04.010"},{"key":"e_1_3_2_24_2","doi-asserted-by":"crossref","unstructured":"Chiragh S Shakil-ur-Rehman S Ikram M. Short-term effects of mobilization with movement vs. Sham techniques in patients with rotator cuff impingement: a randomized controlled trial. Pak J Rehabil. 2025;14(1):6-15. https:\/\/doi.org\/10.36283\/pjr.zu.14.1\/003","DOI":"10.36283\/\/pjr.zu.14.1\/003"},{"key":"e_1_3_2_25_2","doi-asserted-by":"crossref","unstructured":"Premkumar M Sureshkumar A Kavitha S. Effect of mulligan mobilization with ultrasound VS conventional rehabilitation for grade II supraspinatus tendinitis\u2013Quasi experimental study. J Orthop Rep. 2024;3(3):100321. https:\/\/doi.org\/10.1016\/j.jorep.2024.100321","DOI":"10.1016\/j.jorep.2024.100321"},{"key":"e_1_3_2_26_2","doi-asserted-by":"crossref","unstructured":"Lee H Seo D. Short-term effects of Kaltenborn-Evjenth functional glide on pain ROM and function in patients with breast cancer. Phys Ther Rehabil Sci. 2024;13(3):354-367. https:\/\/doi.org\/10.14474\/ptrs.2024.13.3.354","DOI":"10.14474\/ptrs.2024.13.3.354"},{"key":"e_1_3_2_27_2","doi-asserted-by":"crossref","unstructured":"Sharma A Sharma N Chahal A. Impact of virtual reality on pain ROM muscle strength and quality of life among breast cancer patients: an integrative review of literature. Pain Manag Nurs. 2024;25(5):538-548. https:\/\/doi.org\/10.1016\/j.pmn.2024.04.015","DOI":"10.1016\/j.pmn.2024.04.015"},{"key":"e_1_3_2_28_2","article-title":"Comparative study of ART and joint mobilization in middle aged females having chronic neck pain","author":"Verma A","unstructured":"Verma A. Comparative study of ART and joint mobilization in middle aged females having chronic neck pain. Int J Life Sci Biotechnol Pharma Res. 2024;13(1):1\u20137.","journal-title":"Int J Life Sci Biotechnol Pharma Res"},{"key":"e_1_3_2_29_2","doi-asserted-by":"crossref","unstructured":"Siegel P Smith S Stark E Burns C Dionne TP. A scoping review on active vs. passive range of motion approaches to treat heterotopic ossification at the elbow. Front Rehabil Sci. 2024;5:1327417. https:\/\/doi.org\/10.3389\/fresc.2024.1327417","DOI":"10.3389\/fresc.2024.1327417"},{"key":"e_1_3_2_30_2","doi-asserted-by":"crossref","unstructured":"Suresh V Venkatesan P Babu K. Effect of proprioceptive neuromuscular facilitation and cranio-cervical flexor training on pain and function in chronic mechanical neck pain: a randomized clinical trial. Physiother Res Int. 2024;29(1):e2058. https:\/\/doi.org\/10.1002\/pri.2058","DOI":"10.1002\/pri.2058"},{"key":"e_1_3_2_31_2","doi-asserted-by":"crossref","unstructured":"Dalvi S Shinde S Mishra SD. Effect of mobilization with movement on the glenohumeral joint positional fault in subacromial impingement. Cureus. 2024;16(6): 62576. https:\/\/doi.org\/10.7759\/cureus.62576","DOI":"10.7759\/cureus.62576"},{"key":"e_1_3_2_32_2","doi-asserted-by":"crossref","unstructured":"Dutta A Chadi K Kalita A Baruah TS. A comparative study to determine the effects of maitland mobilization vs. Mulligan mobilization with movement (MWM) with retro-walking in osteoarthritis. Int J Life Sci Pharma Res. 2022;12(1):L118-L125. http:\/\/doi.org\/10.22376\/ijpbs\/lpr.2022.12.1.L118-125","DOI":"10.22376\/ijpbs\/lpr.2022.12.1.L118-125"}],"container-title":["HSS Journal\u00ae: The Musculoskeletal Journal of Hospital for Special Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15563316261475265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15563316261475265","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15563316261475265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:17:02Z","timestamp":1793891822000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15563316261475265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["10.1177\/15563316261475265"],"URL":"https:\/\/doi.org\/10.1177\/15563316261475265","relation":{},"ISSN":["1556-3316","1556-3324"],"issn-type":[{"value":"1556-3316","type":"print"},{"value":"1556-3324","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}