Background: Subacromial impingement syndrome (SIS) is considered the most prevailing cause of shoulder pain. Although Mulligan's technique may be useful in treating shoulder impingement, its significance in areas of range of movement (ROM), pain, and function is still debated. Objective: To systematically review and summarize the best evidence on treating subacromial impingement syndrome using mobilization with movement. Patients and Methods: Databases Cochrane Library Web search, PEDro and PubMed were searched for RCTs published in English language from inception to September 2019, updated later to 7th of July 2021. Reference lists of relevant publications were also screened. Two reviewers separately identified relevant papers based on the inclusion criteria. The identified papers by both authors were obtained in full text. To evaluate methodological quality and risk of bias, the Cochrane risk of bias tool was used. We used the random-effects model in all analyses for meta-analyses. Results: A total of 11 RCTs with a total number of 358 adults with subacromial shoulder pain were included. They examined the effect of mobilization with movement (MWM) combined with exercise with or without taping against rotator cuff strengthening, ROM exercises, isometric strengthening, shoulder joint mobilization, and sham techniques. Meta-analysis was done comparing MWM against exercise and found a significant difference in VAS and a non-significant difference in SPADI. Conclusion: Shoulder mobilization with movement combined with a supervised exercise program (ROM, and functional limitations) has a better impact on pain than exercise alone or sham in short-term with similar improvement to exercise in the long-term.

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Background: Work-related injuries to the thumb area have become a well-recognized problem of physical therapists that use various manual techniques in the treatment of patients with musculoskeletal disorders, which can lead to a change in the conduct of treatment technique, changes in the choice of treatment technique, reduction in working hours. , Reduction in the number of patients treated. Objective: To determine the prevalence of thumb problem in physical therapists of Alexandria-Egypt. Study Design: a descriptive, cross-sectional study in a clinical setting Material & Methods: A cross-sectional study was conducted at different physical therapy clinical setups of Alexandria-Egypt. To collect data from the concerned participants, 100 questionnaires were distributed using convenience sampling. All participants responded positively, in which 65 were male and 35 were female. Visual analog scale (VAS) was used to measure the pain. Quick DASH to measure functional disability, Pinch gague to measure thumb power. SPSS version 20 was used for data analysis. Results: Results showed that 48(48%) subjects have thumb pain while 52(52%) do not experience thumb pain. Onehundred physical therapists participated in this study. They recruited from different hospitals and health care institutions in Alexandria-Egypt , age of the study group was 29.82 ± 3.02 years with a minimum of 27 years and a maximum of 42 years. Conclusion: The prevalence of thumb problems in physical therapist of Alexandria-Egypt appears to be high and can be of sufficient severity to impact on careers.