Effect of Slump Stretching with Static Spinal Exercise for the Management of Non Radicular Low Back Pain among Non Active Sports Persons

Does the efficacy of neurodynamic treatments depend on the presence and type of criteria used to define neural mechanosensitivity in spinally-referred leg pain? A systematic review and meta-analysis

“…The type of neural mobilisation technique and dosage varied amongst groups. The techniques used included slump (Ali et al 2015 ; Cleland et al 2006 ; Jain et al 2012 ; Jeong et al 2016 ; Karthikeyan, Jothikaran & Kiran 2014 ; Kirthika et al 2016 ; Malik, Kataria & Sachdev 2012 ; Nagrale et al 2012 ; Patel 2014 ; Rezk-Allah, Shehata & Gharib 2011 ; Tambekar et al 2015 ; Waleed 2015 ), SLR (Adel 2011 ; Ahmed et al 2013 ; Kaur & Sharma 2011 ; Malik et al 2012 ; Rezk-Allah et al 2011 ; Waleed 2015 ), bent leg raise mobilisation (Dwornik et al 2009 ; Patel 2014 ; Tambekar et al 2015 ) and neural mobilisations in side lying (Colakovic & Avdic 2013 ; Ferreira et al 2016 ; Lee & Kim 2017 ). One study reported a neural slider technique of the sciatic nerve involving the hip, knee and foot (Plaza-Manzano et al 2020 ).…”

“…The neural mobilisation interventions were a standalone treatment in six studies (Dwornik et al 2009 ; Kaur & Sharma 2011 ; Lee & Kim 2017 ; Patel 2014 ; Tambekar et al 2015 ; Waleed 2015 ) and were combined with exercise programmes in 15 studies (Adel 2011 ; Ahmed et al 2013 ; Ali et al 2015 ; Cleland et al 2006 ; Colakovic & Avdic 2013 ; Ferreira et al 2016 ; Jain et al 2012 ; Jeong et al 2016 ; Karthikeyan et al 2014 ; Kirthika et al 2016 ; Malik et al 2012 ; Nagrale et al 2012 ; Plaza-Manzano et al 2020 ; Rezk-Allah et al 2011 ; Sharma & Sheth 2017 ). The control groups were diverse, including lumbar stabilisation, lumbar mobility exercises, hamstring stretching, advice, physical modalities or a combination treatment.…”

“…Sixteen studies (Adel 2011 ; Ahmed et al 2013 ; Ali et al 2015 ; Cleland et al 2006 ; Colakovic & Avdic 2013 ; Dwornik et al 2009 ; Jain et al 2012 ; Jeong et al 2016 ; Karthikeyan et al 2014 ; Kirthika et al 2016 ; Lee & Kim 2017 ; Malik et al 2012 ; Nagrale et al 2012 ; Patel 2014 ; Plaza-Manzano et al 2020 ; Tambekar et al 2015 ) were attributed to the NM unclear subgroup. Of those, eight studies (Ahmed et al 2013 ; Colakovic & Avdic 2013 ; Jeong et al 2016 ; Karthikeyan et al 2014 ; Malik et al 2012 ; Patel 2014 ; Plaza-Manzano et al 2020 ; Tambekar et al 2015 ) used pain provocation within a certain range of motion (15–75 degrees hip flexion) as a criterion for NM. Three studies (Adel 2011 ; Cleland et al 2006 ; Nagrale et al 2012 ) used pain provocation as a criterion without reporting whether structural differentiation was applied.…”

“…In 16 studies, the presence of NM remained unclear (total sample size = 693) (Adel 2011 ; Ahmed et al 2013 ; Ali et al 2015 ; Cleland et al 2006 ; Colakovic & Avdic 2013 ; Dwornik et al 2009 ; Jain et al 2012 ; Jeong et al 2016 ; Karthikeyan et al 2014 ; Kirthika et al 2016 ; Lee & Kim 2017 ; Malik et al 2012 ; Nagrale et al 2012 ; Patel 2014 ; Plaza-Manzano et al 2020 ; Tambekar et al 2015 ). Of these, seven studies (Ali et al 2015 ; Cleland et al 2006 ; Dwornik et al 2009 ; Jain et al 2012 ; Jeong et al 2016 ; Kirthika et al 2016 ; Nagrale et al 2012 ) provided neural mobilisation in a slump position and reported greater improvements in pain and disability for neural mobilisation compared to control interventions.…”

“…The findings revealed that SLR and slump mobilisations are equally effective in reducing pain. Karthikeyan et al ( 2014 ) compared joint mobilisation plus static spinal exercise to slump mobilisation. The study concluded both interventions to be beneficial for pain and disability but no significant between-group differences were reported.…”