Effects of lower body quadrant neural mobilization in healthy and low back pain populations: A systematic review and meta-analysis. (February 2017) - Neto, Tiago
Abstract: Background: Neural mobilization (NM) is widely used to assess and treat several neuromuscular disorders. However, information regarding the NM effects targeting the lower body quadrant is scarce. Objectives: To determine the effects of NM techniques targeting the lower body quadrant in healthy and low back pain (LBP) populations. Design: Systematic review with meta-analysis. Method: Randomized controlled trials were included if any form of NM was applied to the lower body quadrant. Pain, disability, and lower limb flexibility were the main outcomes. PEDro scale was used to assess methodological quality. Results: Forty-five studies were selected for full-text analysis, and ten were included in the meta-analysis, involving 502 participants. Overall, studies presented fair to good quality, with a mean PEDro score of 6.3 (from 4 to 8). Five studies used healthy participants, and five targeted people with LBP. A moderate effect size (g = 0.73, 95% CI: 0.48–0.98) was determined, favoring the use of NM to increase flexibility in healthy adults. Larger effect sizes were found for the effect of NM in pain reduction (g = 0.82, 95% CI 0.56–1.08) and disability improvement (g = 1.59, 95% CI: 1.14–2.03), in people with LBP. Conclusion: Evidence suggests that there are positive effects from the application of NM to the lower body quadrant. Specifically, NM shows moderate effects on flexibility in healthy participants, and large effects on pain and disability in people with LBP. Nevertheless, more studies with high methodological quality are necessary to support these conclusions. Highlights: NM increases joint flexibility of healthy adults. In people with low back pain NM promotes pain relief and disability improvements. The duration, and number of sessions, of NM show a large heterogeneity.