Perceived Effectiveness and Safety of the Mulligan Technique in the Management of Shoulder Impingement Syndrome: A Cross-Sectional Study Among Physiotherapists in Al Khums, Libya

الملخص

Shoulder impingement syndrome (SIS) is a prevalent musculoskeletal disorder that impairs functional mobility and quality of life. The Mulligan technique, particularly Mobilization with Movement (MWM), has gained popularity as a manual therapy intervention for treating SIS. However, limited regional evidence exists regarding its clinical effectiveness and safety in routine practice. This study aimed to evaluate the perceptions of physiotherapists in Al Khums, Libya, regarding the effectiveness and safety of the Mulligan technique in the management of shoulder impingement. A descriptive cross-sectional study was conducted using a structured questionnaire distributed to 85 physiotherapists across nine clinical centers in Al Khums between December 2024 and March 2025. The questionnaire assessed usage patterns, experience levels, perceived improvements in pain and range of motion (ROM), and opinions on the technique's safety and efficacy. Among the respondents, 76.5% reported using the Mulligan technique. A majority observed moderate to significant improvements in both pain (41%–80%) and ROM. Notably, 95.4% of participants deemed the technique effective, and an equal proportion considered it safe. A smaller percentage expressed uncertainty, primarily attributed to limited clinical experience. The findings suggest a high level of clinical acceptance and confidence in the Mulligan technique among physiotherapists in Al Khums. The technique is perceived as both effective and safe for managing SIS. However, variation in practitioner experience highlights the need for structured training and future comparative studies to validate long-term outcomes and optimize application protocols.