The Effect of Mulligan's Mobilization with Movement Versus Dry Needling on Pain,Function,and Range of Motion Among Athletes with Hip Adductor Related Groin Pain and Dysfunction

The Effect of Mulligan's Mobilization with Movement Versus Dry Needling on Pain, Function, and Range of Motion Among Athletes with Hip Adductor Related Groin Pain and Dysfunction

This study aims to highlight and investigate the effectiveness of two common management practices in physiotherapy, dry needling intervention as a soft tissue technique and Mulligan mobilization with movements MWM as a joint technique, on pain, function, and range of motion among athletes with hip adductor-related groin pain and dysfunction.

Study Overview

• Status: Completed
• Conditions: Groin Pain; Groin Injury; Hip Adduction Strength
• Intervention / Treatment: Other: Mulligan's Mobilization with Movement and Dry Needling; Other: Dry Needling (DN)

Detailed Description

Background:

Injuries are considered a common challenge in the sports field, 31% of the injuries are muscular, especially in the lower extremities. Injuries in the groin area are a major and serious problem because they are common, lead to prolonged symptoms, and had a high recurrence rate.

Study objective:

This study aims to highlight and investigate the effectiveness of two common management practices in physiotherapy, dry needling DN intervention as a soft tissue technique and Mulligan mobilization with movements MWM as a joint technique.

Methods:

A convenience sampling of thirty football players who were diagnosed with hip adductor-related groin pain and dysfunction were recruited from different cities in the west bank who participated in this randomized clinical trial, the participants were randomly divided into two groups, the dry needling group (15), and dry needling combined with Mulligan mobilization MWM (15).

Numiric Pain Rating Scale (NPRS), Five-Second Copenhagen Squeeze test, Hip Abduction Range of Motion, Adductor Squeeze Test, Flexion Abduction External Rotation Test (FABER), Y Balance Test, and The Copenhagen Hip and Groin Outcome Score (HAGOS) were used as outcome measures (NPRS and 5-second squeeze test performed each session for the two groups).

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Palestinian Territory, occupied
  • Ramallah, Palestinian Territory, occupied, P125
    • Ayman Daragmah

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Athletes suffered from unilateral adductor-related groin pain, grades 1 and 2.
2. Acute, subacute, or chronic athletes with hip adductor-related groin pain and dysfunction.
3. Groin pain during or after activities.
4. Pain at palpation of the adductors and their origin.
5. Pain on resistance against adduction.
6. Aged 15- 35 years old.

Exclusion criteria:

Patients with other causes of groin pain such as:

1. Lymphadenitis.
2. Prostatitis, Urinary infections, Malignancy.
3. Spinal pathology.
4. Hip joint osteoarthritis.
5. Inguinal-related or Iliopsoas-related groin pain.
6. Femoral or Inguinal hernia.
7. Referral pain and adductor strain grade 3.
8. Current use of medication.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Mulligan's Mobilization with Movement and Dry Needling; the intervention group 1 was treated using Mulligan Mobilization with Movements and Dry Needling (DN&MWM) for soft tissue trigger points, (N=15).	Other: Mulligan's Mobilization with Movement and Dry Needling; the intervention group 1 was treated using Mulligan Mobilization with Movements and Dry Needling (DN&MWM) for soft tissue trigger points, (N=15). The treatment duration was 6 sessions, 3 sessions per week ( day after day).
Active Comparator: Dry Needling; the intervention group 2 was treated using Dry Needling (DN) for soft tissue trigger points, (N=15).	Other: Dry Needling (DN); The intervention group 2 was treated using Dry Needling (DN) for soft tissue trigger points, (N=15). The treatment duration was 6 sessions, 3 sessions per week ( day after day).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sheet of Demographic Data	Demographic, personal data, and injury history were obtained at baseline from the patient interview and recorded on a data collection sheet	pre and 1 day post treatment
Numeric Pain Rating Scale NPRS	The Numeric Pain Rating Scale (NPRS) is valid and reliable, a self-assessing questionnaire , used to assess the severity of pain. 0- 10 scale where 0 represents "no pain" and 10 representing "unbearable pain." Each participant was asked to indicate the pain level before and after treatment.	pre and 1 day post treatment
Y-Balance Test YBT	The Y balance test was developed from the star excursion balance test (SEBT) and assesses performance during single-leg balance with reaching in the 3 directions: anterior, posteromedial, and posterolateral. the patient stands on one leg while reaching out in 3 different directions with the other lower extremity.	pre and 1 day post treatment
FABER Test	To assess the adductor muscle tightness and shortening due to injury. FABER test is used as a provocation special test but has also been used as a measurement of combined hip range of motion, also useful tools for the hip examination, particularly for anterior hip or groin pain. The patient lies supine on the examination table. The hip and knee of the tested leg are flexed, abducted, and externally rotated, as the foot of the tested leg is placed on the contralateral thigh just proximal to the knee. While stabilizing the pelvis on the contralateral side, gentle pressure is applied downwards on the knee of the tested leg, also measuring the distance from the lateral condyle of the knee to the surface of the examination table for both affected and none affected knees.	pre and 1 day post treatment
Five Seconds Copenhagen Squeeze Test	The therapist placed his arms between the athlete's knees and asked the athlete to squeeze the legs as hard as possible for five seconds, then, scored any pain in the groin area on a scale of 0 to 10 NPRS Scale	pre and 1 day post treatment

Collaborators and Investigators

• Sponsor: Al-Quds University
• Investigators: Principal Investigator: Daragmah, Master degree, Al-Quds University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2020
• Primary Completion (Actual): March 15, 2021
• Study Completion (Actual): August 17, 2021

Study Registration Dates

• First Submitted: January 20, 2025
• First Submitted That Met QC Criteria: February 18, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 18, 2025
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Athletes; groin pain; hip adductor; athletes with groin pain; athletes with hip dysfunction
• Other Study ID Numbers: 118/REC/2020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No