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CHAPTER OBJECTIVES

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Chapter Objectives

At the conclusion of this chapter, the reader will be able to:

  • Identify the history and key contributing factors in the development of the Mulligan concept approach to orthopaedic manual physical therapy (OMPT).

  • Understand the theoretical underpinnings that are believed to be responsible for the clinical effectiveness of the Mulligan concept.

  • Describe the clinical features that may be used to confirm the efficacy of mobilization with movement (MWM) techniques.

  • Articulate and implement the clinical practice guidelines for the use of MWM.

  • Develop introductory level proficiency in the performance of spinal and peripheral MWM techniques.

  • Describe how the concepts and techniques within the Mulligan concept can be integrated into a comprehensive examination and intervention scheme.

  • Identify and discuss the current best evidence related to this approach.

  • Discuss the characteristics that differentiate this approach from other manual and nonmanual therapy strategies.

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HISTORICAL PERSPECTIVES

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Personal Background

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The Mulligan concept approach to orthopaedic manual physical therapy (OMPT) was conceived by a New Zealand physiotherapist by the name of Brian R. Mulligan. Mulligan qualified as a physiotherapist in 1954 and achieved his Diploma in Manipulative Therapy in 1974. In 1996 he was made an Honorary Fellow of the New Zealand Society of Physiotherapists for his contribution to physiotherapy. Some of Mulligan's other honors include being a life member of the New Zealand Manipulative Physiotherapists Association (1988); life member of the New Zealand College of Physiotherapy (1998); honorary teaching fellow at the University of Otago, Department of Physiotherapy (2003); fellow of the American Academy of Orthopaedic Manual Physical Therapists (2004); and recipient of the International Service Award from the World Confederation of Physical Therapy (2007).

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In addition to maintaining active clinical practice, Brian Mulligan has been teaching manual therapy in New Zealand since 1970 and internationally since 1972. He first began teaching in the United States in 1979. He is the author of numerous journal articles that have appeared in the New Zealand Journal of Physiotherapy as well as other international publications (Fig. 10–1).

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FIGURE 10–1

B.R. Mulligan's biographical timeline.

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Mulligan credits Freddy M. Kaltenborn of Norway (see Chapter 6) as being his primary mentor in the area of practical learning. Upon this foundation, Mulligan's clinical observations, born out of inquisition and experimentation, have led to an entirely new approach to OMPT. To meet the increasing international demand from therapists wishing to learn the Mulligan concept and to ensure high standards of instruction, Mulligan established the Mulligan Concept Teachers Association (MCTA) in 1993. In addition to instruction, the MCTA is dedicated to the generation of funding and promotion of research related to the validity of these concepts and the clinical efficacy of these techniques. MCTA instructors are accessible at www.bmulligan.com and www.na-mcta.com.

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