Effects of Mulligan Mobilization With Movement Versus Kinesiotaping and Placebo on Knee Function and Injury -Related Outcomes in Basketball Players: A Parallel -Group Randomized Controlled Trial
Phase: NA
Conditions: Knee Injuries, Sport Injury, Knee Injuries
Sponsor: University Aleksander Moisiu Durres

Official Title  
Effects of Mulligan Mobilization with movement 
versus Kinesiotaping and Placebo on knee function 
and injury -related Outcomes in Basketball 
Players: A parallel-group Randomized Controlled 
Trial 
 
 
 
 
 
NCT Number: 
 
 
 
 
 
 
 
 
 
Date 10 December 2024 
 
 

4. Study Protocol with SAP and ICF  
1. Subtitles Study Protocol  
Title of the Study: Effects of Mulligan Mobilization with movement versus Kinesiotaping and 
Placebo on knee function and injury -Related Outcomes in Basketball Players: A parallel-group 
randomized controlled trial. 
Protocol Version & Date: (Version 1.0, Date 10/12/2024). 
Principal Investigator: Selda Sokoli, University of Sports, Tirana. 
Introduction 
Basketball is a contact sport that requires rapid and high-intensity movements such as jumping, 
changing direction, turning, landing, running (Sokoli, S. V., et al., 2024), Rubin, E. B., et al., 
2021; Hannington, M. et al., 2022; Chang, L. L. Y., 2020). These maneuvers result in 
musculoskeletal injuries (Tummala, S. V., et al., 2022) and the highest frequency of knee 
injuries (Tummala, S. V., et al., 2022). Previous studies have shown the tendency to injure 
athletes in contact sports such as basketball (Qëndro et al., 2024). Young basketball players are 
influenced by the effects of continuous mechanical stress, rapid biological growth, sports 
overload, and neuromuscular development, which increases the risk of overuse injury 
(Zoellner, A., & Whatman, C.,2025) while limiting sports activities and functional limitations. 
In order to determine the impact of sports overuse injury, the sports population uses a 
measuring tool called the OSTRC Overuse Injury Questionnaire (Owoeye, O.B.A. et al., 2018). 
This is a standard questionnaire from the Oslo Sports Trauma Research Centre (Weiss, K. J., 
et al., 2017) to help identify injuries, especially in young athletes with symptoms. In many 
cases, in young athletes, not only are symptom monitoring, neuromuscular control, and 
dynamic stability evaluated, but also functional capacity. KOS-ADLS sports activity scale 
assesses the functional capacity of young basketball players in relation to the specific 
requirements of basketball (Nyland, J. et al. 2025). There are many conservative 
physiotherapeutic interventions to improve the functioning of young basketball players. 
Mulligan's technique is based on joint mobilization combined with active physiological 
movements and acts to interact with the physiological kinematics of joint movements and 
neurophysiological mechanisms of pain (ElMeligie, M. M., et al., 2025; Veizaj, S. S., et al., 
2024). Randomized studies to assess the effect of Mulligan's MWM technique, versus 
Kinesiotaping and placebo, are limited, especially studies that are applied to young basketball 
players. The lack of evidence from randomized studies also has to do with the assessment of 
the injury rate in young athletes, on the one hand, and the assessment of the level of activity 
and sports functionality, on the other. Although a good part of the research is focused on 
rehabilitation through conservative management of sports injury in young basketball players 
(Sos-Tirado, M. et al., 2024). This randomized study aimed to evaluate the effect of the 
Mulligan MWM technique, the Kinesiotaping technique, and a placebo intervention in young 
U16-U20 basketball players on reducing symptoms of knee injuries and improving 
functionality and sports levels. This study hypothesized that the Mulligan group would have a 
more significant improvement in the KOS-SAS and OSRTC scores. 

Objectives 
The primary objective is to compare the effect of Mulligan, Kinesiotaping and Placebo in 
improving the functionality and scale of sports activity in U16-U20 basketball players. 
The secondary objective is to evaluate the effect of the Mulligan, Kinesiotaping, and Placebo 
intervention in decreasing the level of overuse injuries in U16-U20 basketball players. 
The third objective is whether each of the techniques, Mulligan, Kinesiotaping, and Placebo, 
has an impact on the relationship between decreasing the rate of OSTRC overuse injury and 
increasing the ADLS functional scale and SAS sports activity scale in U16-U20 basketball 
players. 
Study Design 
This study was designed as a parallel group randomized controlled clinical trial with three 
intervention arms: Mulligan Mobilization with movement MWM, Kinesiotaping, and Placebo 
with repeated measurements at baseline, 1 hour, and 2 weeks after treatment. 
Participants  
Inclusion Criteria: 
✓ Male and female genders 
✓ Have a minimum of 2 years of sports experience 
✓ Presence of knee injury 
✓ Active participation in sport. 
Exclusion Criteria:  
✓ Knee surgery 
✓ Knee instability 
✓ Neurological disorders 
✓ Not approve of the application of the Mulligan method 
Recruitment Method 
The basketball players were recruited from local sports clubs through referrals and 
collaborations from the club coaches. 
Interventions / Procedures 
Mulligan Group Experimental 
For all participants who applied, regardless of the type of knee injury, Mulligan Mobilization 
with movement MWM in the squat position was used manually to maintain the homogeneity 
of the treatment. The intervention included tibial glide by the therapist while the basketball 
players actively performed the mobilization without pain. The athletes underwent the technique 
2 sessions per week for 2 weeks. Each session lasted 5 min, and the technique was applied by 
a Physiotherapist who had the Mulligan technique certificate. 
Kinesiotaping Active Comparator Group 
Kinesiotaping was also used in a model regardless of the injury of athletes. Initially, the 
measurement was made from the medial and lateral condyles of the knee by placing a y-taping 
from the tibial tuberosity towards the femoral condyles, and another taping was placed 
horizontally over the patella. It was applied 2 times a week for 2 weeks for 5 minutes 
Placebo Comparator Group  

In this group, participants received a sham intervention to mimic the treatment without 
therapeutic effect twice a week for 2 weeks, for 5 minutes. 
Outcome Measures 
Primary Outcomes:KOS-ADLS: The Activities of Daily Living Scale (ADLS) subscale of the 
Knee Outcome Survey evaluates symptoms and functional limitations during daily activities. 
Scores range from 0 to 100, with higher scores indicating better function. 
 The Sports Activity Scale (SAS) subscale of the Knee Outcome Survey evaluates knee 
function during sports and higher-level activities. Scores range from 0 to 100, with higher 
scores indicating better sports-related function.  
Secondary outcomes The OSTRC Overuse Injury Questionnaire is a validated self-report tool 
used to monitor the severity and impact of overuse-related musculoskeletal problems. It 
assesses the consequences of knee-related problems on sports participation, training volume, 
performance, and symptom severity. Each question is scored on a graded response scale, and a 
severity score is calculated, with higher scores indicating greater symptom burden and 
functional impairment. 
Timeline / Schedule of Assessments 
Outcome 
/Assessment 
Baseline 
pre 
treatment  
1 hour post treatment 2 
weeks 
post 
treatment 
KOS-ADLS ; ADLS  * 
* 
* 
SAS 
* 
* 
* 
OSTRC 
* 
* 
`* 
Sample Size & Justification 
The simple size (N=60) was determined based on the available number of eligible 
participants during the period of study. A post-hoc power analysis was conducted for the 
ADLS outcome using mixed ANOVA. The time × group interaction yielded η²p = 0.816 
(Cohen’s f = 2.11), indicating a very high statistical power (1.0) for detecting the observed 
effect. 
Ethics and Regulatory Approvals 
Ethics Committee Approval. This study has been reviewed and approved by the University of 
Sports of Tirana. Ethics Committee for scientific research. 
Approval Reference Number: Prot. Nr. 3736/2 
Approval Date: 10/12/2024. 
 
Confidentiality Measures 
All participant data will be treated with strict confidentiality. Personal identifiers have been 
replaced with coded identification numbers. Data are stored and are only accessible by the 

study researchers. Any publication or presentation of study results will report only aggregated 
data, ensuring that individual participants cannot be identified. 
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2. Subtitles Informed Consent Form Adults ≥ 18 years old 
________________________
_________________________  
REPUBLIC OF ALBANIA  
UNIVERSITY OF SPORTS OF TIRANA 
FACULTY OF PHYSICAL ACTIVITY AND RECREATION 
DEPARTMENT OF MOVEMENT AND HEALTH 
 
Letter of acceptance to participate in the study: 'The impact of the Mulligan Technique 
on knee problems in basketball in Albania.' 
 
For participants over the age of 18 
I declare that the testing and physiotherapeutic intervention of this Scientific Study have been 
explained to me in detail by the study leaders in the information meeting held by them. Also, 
for every question I have asked, I have received a quick and clear answer from them. 
During the meeting, I was informed about the conditions set for being part of the study, about 
my right not to participate in the study, and about the right to withdraw from it at any time. 
The positive and negative (side) effects of all examinations that will be performed during the 
study have been explained to me in detail. In this way, I have managed to understand the 
benefits of my participation in this Scientific Study not only for me personally but also for 
other sports. I know that I can ask at any time about any uncertainties that I may have in the 
future, during the different stages of its development. 
I have been assured that: 
1. I will be cared for at every stage of the study by specialized medical and physiotherapy 
personnel. 
2. My confidentiality will be maintained. 
3. No information that will be distributed or published will reveal my personal identity. 
4. No information will be distributed or published without my consent and only if it is permitted 
by legal provisions. 
In this way, I agree to participate in this study  
 
First Name Last Name 
 
 
Signature (if you are 18 years old or older) 
 
Note: The person who can be contacted for this study is Msc. Selda Sokoli, at this phone number: 355692199179 and with this electronic 
address (e-mail): seldaveizaj@gmail.com 
 

3. Subtitles Parental Consent Form Adults ≥ 18 years old 
________________________
_________________________  
REPUBLIC OF ALBANIA 
UNIVERSITY OF SPORTS OF TIRANA 
FACULTY OF PHYSICAL ACTIVITY AND RECREATION 
DEPARTMENT OF MOVEMENT AND HEALTH 
 
Parental consent form 
 
 (To be used for parents of participating children under 18 years of age, excluding students) 
 
Study Title: 'The Impact of the Mulligan Technique on Knee Problems in Basketball in 
Albania', 
 
For questions regarding the research project, please contact: 
 
Scientific Researcher: Selda SOKOLI seldaveizaj@gmail.com  
Scientific Leader: Prof.Asc.Dr.Klotilda VRENJO 
 
Description  
This project will include all basketball athletes starting from the age of 14 to 22 years old. The 
athletes will undergo orthopedic assessment tests for hidden or active knee problems. Circuit 
tests will be conducted, and athletes with problems will be grouped, and a non-invasive 
physiotherapeutic treatment technique (Mulligan technique, Kinesiotaping, and placebo 
intervention) will be developed for them. The time it will take athletes to answer the 
questionnaire will not exceed 5 minutes, testing 5 minutes, and intervention 5 minutes. The 
confidentiality of basketball athletes will be maintained regarding individual data. 
 
Risks 
During the implementation of this study, participants will not have any physical injury, pain, 
or disability. The duration from testing, questionnaire, to physiotherapy intervention will not 
be a limitation in terms of training time. 
Confidentiality 
I pledge that all individual data of each participant will be kept confidential. All data that will 
be collected will be stored only by me, Selda Sokoli, the Scientific Researcher of this study. In 
studies where only measurement and non-identifying data will be used. This data will be stored 
by me, Selda Sokoli, until 2028, and then will be deleted. 
 

Right to withdraw 
 
Participation in this study is voluntary, and each participant may choose to withdraw from the 
study at any time. Each participant has the right to withdraw consent and discontinue 
participation in the study without prejudice. 
 
Voluntary Consent 
(The following consent statement must be included) 
1. I have read the above information and agree that my child may participate in this study. 
2. I understand that all aspects of this project will be conducted in strict confidence and in a 
manner in which my child’s rights as a human participant are protected. 
3. I have been informed in advance of what the task(s) will be and what procedures will be 
followed. 
4. I have been allowed to ask questions, and my questions have been answered satisfactorily. 
5. I am aware that I have the right to withdraw consent and discontinue my child’s participation 
at any time, without prejudice. 
6. My child may also withdraw his/her consent at any time. 
7. My signature below may be taken as confirmation of all of the above, prior to participation. 
 
Child's name: _________________________________________  
 
Parent's name: ______________________________________________________________ 
 
 
Parent's signature:_________________________________________________________ 
 
 
 
Date ______________