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 
 
 

1. 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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