THE EFFECTIVENESS OF NEURAL MOBILIZATION FOR NEUROMUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Review written by Shruti Nambiar info

BACKGROUND & OBJECTIVE

Several musculoskeletal conditions with a neuropathic component such as low back-related leg pain, neck-related arm pain, lateral epicondylalgia and carpal tunnel (CTS) can present with pain and disability. The effectiveness of neural mobilization (NM) for these conditions remains unclear. This study focused on assessing the effectiveness of NM on neuromusculoskeletal conditons using pain, disability and function as the primary outcome measures.

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METHODS

This systematic review only included randomized control trials (RCTs) that assessed the effect of NM on participants > 18 years of age having musculoskeletal conditions with neural tissue dysfunction. Interventions used in the included studies for NM were active exercises or passive techniques, sliding/tensioning techniques, cervical lateral glides or lumbar foraminal opening. The included studies were critically appraised using Meta Analysis of Statistic Assessment and Review Instrument (MAStARI).Risk of bias os study of appraisal was assessed independently using GRADE guidelines. Meta-analysis was conducted for nerve-related low back pain (N-LBP; Outcome measures - Modified Oswestry Disability Index [MODI], Visual Analog scale [VAS]/ Numeric Pain Rating scale [NPRS]), nerve-related neck and arm pain (N-NAP;Outcome measures - VAS) and CTS (Outcome measures - VAS Phalen's test, Grip strenght, 2-point discrimination and DASH Questionnaire).

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RESULTS

Forty studies were included in this review (n=1759), of which 17 had a low risk of bias.

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