Spinal manipulation and spinal mobilization on extensor strength and proprioception in patients with chronic low back pain: a scoping review

Background

Spinal manipulation (SMA) and spinal mobilization (SMO) are commonly utilized treatments for chronic low back pain (CLBP)

Objective

To summarize the evidence describing the effects of SMA and SMO on trunk proprioception and the lumbar paravertebral muscle strength in patients with chronic low back pain (CLBP)

Methods

A search was conducted in five databases and four sources of gray literature. The inclusion criteria were: individuals aged between 18 and 65 years with chronic low back pain (CLBP), of both sexes; no restrictions on publication period or language; studies employing spinal manipulation (SMA) or spinal mobilization (SMO) interventions; inclusion of a comparator group such as control, placebo, or other base therapies; and measurement of at least one of the following outcomes: paravertebral muscle strength, trunk proprioception, or postural control

Results

Initially, 8187 references were identified through database searches. Among these, the review included seven randomized clinical trials, two non-randomized clinical trials, and two crossover clinical trials; no reviews were found meeting the inclusion criteria. After screening and selection, a total of 11 studies were included in the review, comprising 8 studies investigating spinal manipulation (SMA) and 3 studies investigating spinal mobilization (SMO).

Conclusion

In patients with CLBP, SMA did not demonstrate a significant effect on proprioception but showed a notable effect on the maximum contraction of the lumbar multifidus muscle. Conversely, SMO exhibited beneficial effects on both proprioception and the generation of muscle strength in trunk extensors among patients with CLBP.

Trial registration

Open Science Framework (OSF) osf.io/b5fym.