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Pourahmadi M, Hesarikia H, Keshtkar A, et al. Effectiveness of Slump Stretching on Low Back Pain: A Systematic Review and Meta-analysis. Pain Med. 2018 Dec 24. pii: 5260828. doi: 10.1093/pm/pny208. (Systematic review)
Abstract

Background: The slump test is a type of neurodynamic test that is believed to evaluate the mechanosensitivity of the neuromeningeal structures within the vertebral canal. The objective of this review was to investigate the effectiveness of slump stretching on back pain and disability in patients with low back pain (LBP).

Methods: We searched eight electronic databases (PubMed/Medline, Scopus, Ovid, CINAHL, Embase, PEDro, Google Scholar, CENTRAL). The publication language was restricted to English, and we searched the full time period available for each database, up to October 2017. Our primary outcomes were pain and disability, and the secondary outcome was range of motion (ROM).

Results: We identified 12 eligible studies with 515 LBP patients. All included studies reported short-term follow-up. A large effect size (standardized mean difference [SMD] = -2.15, 95% confidence interval [CI] = -3.35 to -0.95) and significant effect were determined, favoring the use of slump stretching to decrease pain in patients with LBP. In addition, large effect sizes and significant results were also found for the effect of slump stretching on disability improvement (SMD = -8.03, 95% CI = -11.59 to -4.47) in the LBP population. A qualitative synthesis of results showed that slump stretching can significantly increase straight leg raise and active knee extension ROM.

Conclusions: There is very low to moderate quality of evidence that slump stretching may have positive effects on pain in people with LBP. However, the quality of evidence for the benefits of slump stretching on disability was very low. Finally, it appears that patients with nonradicular LBP may benefit most from slump stretching compared with other types of LBP.

Ratings
Discipline Area Score
Physician 5 / 7
Rehab Clinician (OT/PT) 5 / 7
Comments from MORE raters

Physician rater

There are many interventions for Low Back Pain, but the incidence of the symptoms and diseases on that level are also many. There is not a only specific therapy that can be useful for all the kinds of pathologies. Many patients need individual intervention. Good use of methodology in the article.

Physician rater

This is more relevant to Ortho/physiotherapy than to rheumatology.

Rehab Clinician (OT/PT) rater

The findings from this study are important especially when one considers the widespread use of slump stretching. There was very low to moderate quality of evidence that slump stretching may have positive effects on pain in people with LBP. However, the quality of evidence for the benefits of slump stretching on disability was very low. Also it appears that patients with nonradicular LBP may benefit most from slump stretching compared with other types of LBP. In addition, it was shown that a qualitative synthesis of results showed that slump stretching can significantly increase straight leg raise and active knee extension ROM.

Rehab Clinician (OT/PT) rater

Using slump mobilization to treat low back pain has been a frequent clinical approach over the last 20 years. This review examines the efficacy of said technique, but is limited (as many review are) by the inclusion of poor quality studies. The mechanism by which slump mobilization is (or isn't) useful is largely conjectural, but the authors recognize this and provide a summary of the literature upon which the treatment rational is based. Clinicians utilizing this treatment approach would benefit by reading this study.

Rehab Clinician (OT/PT) rater

As a PT specializing in orthopaedics and sports, I find these results are what I would have expected. The study will be helpful to me is that it provides evidence when I am asked to give an opinion or advice to clients and colleagues.
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