Effects of neural mobilization in the treatment of chronic low back pain: a systematic review
Efectos de la movilización neural en el tratamiento del dolor lumbar crónico: una revisión sistemática
Suelen Carla Souza de Faria, Renato Carvalho Vilella, Laiz Helena de Castro Toledo Guimaraes, Luciana Crepaldi Lunkes
Abstract
Introduction: Low back pain appears in approximately two thirds of the population at some point in life and when it exceeds more than 12 weeks, it evolves to chronic low back pain. Chronic low back pain is considered one of the most common causes of disability and absence from work. A therapeutic technique that can be used as a treatment for chronic low back pain is neural mobilization, capable of restoring compromised neurological structures, restoring movement by improving the elasticity of neural tissue and adjacent tissues.
Objective: To verify the effects of neural mobilization in patients with chronic low back pain.
Material and methods: All articles were carefully evaluated in order to obtain concrete and reliable information. The databases used were Google Scholar, Scielo, Medline and PubMed due to the methodological quality and articles in the area of interest. The keywords “low back pain”, “chronic low back pain”, “neural mobilization” and “physiotherapeutic intervention” were combined in the most diverse possibilities, in English and Spanish translations.
Results: 86 articles were found, nine of which were included in this review. They had a score ≥ 5 on the PEDro Scale, which methodologically qualifies the articles. After analyzing the results obtained through the selected articles, all the data collected, as well as their respective results, were described in a table that contains data from the articles.
Conclusions: Neural mobilization reduces pain and improves the extensibility of tissues, causing a reduction in painful sensation and increased flexibility. Therefore, it is necessary to continue research in order to verify new results obtained through this type of intervention.
Keywords
Resumen
Introducción: La lumbalgia aparece en aproximadamente dos tercios de la población en algún momento de la vida y cuando supera las 12 semanas evoluciona a lumbalgia crónica. El dolor lumbar crónico se considera una de las causas más comunes de incapacidad y ausencia laboral. Una técnica terapéutica que se puede utilizar como tratamiento para el dolor lumbar crónico es la movilización neural, capaz de restaurar las estructuras neurológicas comprometidas, restaurando el movimiento al mejorar la elasticidad del tejido neural y los tejidos adyacentes.
Objetivo: Verificar los efectos de la movilización neural en pacientes con dolor lumbar crónico.
Material y métodos: Todos los artículos fueron cuidadosamente evaluados para obtener información concreta y confiable. Las bases de datos utilizadas fueron Google Scholar, Scielo, Medline y PubMed debido a la calidad metodológica y artículos del área de interés. Las palabras clave “lumbalgia”, “lumbalgia crónica”, “movilización neural” e “intervención fisioterapéutica” se combinaron en las más diversas posibilidades, en las traducciones al inglés y al español.
Resultados: Se encontraron 86 artículos, nueve de los cuales fueron incluidos en esta revisión. Tuvieron puntaje ≥ 5 en la Escala PEDro, que califica metodológicamente los artículos. Luego de analizar los resultados obtenidos a través de los artículos seleccionados, todos los datos recolectados, así como sus respectivos resultados, fueron descritos en una tabla que contiene los datos de los artículos.
Conclusiones: La movilización neural reduce el dolor y mejora la extensibilidad de los tejidos, provocando una reducción de la sensación dolorosa y un aumento de la flexibilidad. Por lo tanto, es necesario continuar con la investigación para verificar nuevos resultados obtenidos a través de este tipo de intervención.
Palabras clave
References
1. Bade M, Cobo-Estevez M, Neeley D, Pandya J, Gunderson T, Cook C. Effects of manual therapy and exercise targeting the hips in patients with low-back pain-A randomized controlled trial. J Eval Clin Pract. 2017;23(4):734-40. doi: 10.1111/jep.12705.
2. Lee SY, Cho NH, Jung YO, Seo YI, Kim HA. Prevalence and Risk Factors for Lumbar Spondylosis and Its Association with Low Back Pain among Rural Korean Residents. J Korean Neurosurg Soc. 2017;60(1):67-74. doi: 10.3340/jkns.2016.0505.007.
3. Kamalikhah T, Morowatisharifabad MA, Rezaei-Moghaddam F, Ghasemi M, Gholami-Fesharaki M, Goklani S. Alexander Technique Training Coupled With an Integrative Model of Behavioral Prediction in Teachers With Low Back Pain. Iran Red Crescent Med J. 2016;18(9):e31218. doi: 10.5812/ircmj.31218.
4. Campos-Fumero A, Delclos GL, Douphrate DI, Felknor SA, Vargas-Prada S, Serra C, et al. Low back pain among office workers in three Spanish-speaking countries: findings from the CUPID study. Inj Prev. 2017;23(3):158-64. doi: 10.1136/injuryprev-2016-042091.
5. Trocoli TO, Botelho RV. Prevalence of anxiety, depression and kinesiophobia in patients with low back pain and their association with the symptoms of low back spinal pain. Rev Bras Reumatol. 2016:S0482-5004(16)00023-1. doi: 10.1016/j.rbr.2015.09.009.
6. Salvetti Mde G, Pimenta CA, Braga PE, Corrêa CF. [Disability related to chronic low back pain: prevalence and associated factors]. Rev Esc Enferm USP. 2012;46 Spec No:16-23. doi: 10.1590/s0080-62342012000700003.
7. Lizier DT, Perez UM, Sakata RK. Exercícios para tratamento da lombalgia inespecífica. Rev Bras Anestesiol. 2012;62(6):838-46. doi: 10.1590/S0034-70942012000600008.
8. Ferreira AM, Santana JV. Análise do efeito da mobilização neural na dor lombar em pacientes com hérnia de disco. Rev Mult Psic. 2017;11(38):824-34. doi: 10.14295/idonline.v11i38.956.
9. Leite NS. Importância clínica da Mobilização Neural em pacientes com lombociatalgia. Fisioterapia Brasil. 2017;16(1):824-34. doi: 10.33233/fb.v16i1.299.
10. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1.
11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
12. Junior PAA, Schons DG. Os efeitos da mobilização neural em pacientes com lombociatalgia. Rev Fisioter S Func. 2015;4(2):14-20.
13. Schmit EFD, Brito DJ, Nóbrega RS, Araújo-Neto AS, Andrade RP, Ferreira AJJ, et al. Efeitos da fisioterapia na força, atividade mioelétrica e dor, em lombálgicos crônicos. ConScientiae Saúde. 2016;15(2):183-90. doi: 10.5585/ConsSaude.v15n2.6174.
14. Arêas FZS, Pelai BE, Pires FP, Bortolazzo LG, Rodrigues MB, Bigaton RD. Efeito da mobilização das raízes nervosas lombares sobre a força e
flexibilidade dos músculos do membro inferior. ConScientiae Saúde. 2017;16(4):433-40. doi: 10.5585/conssaude.v16n4.7824.
15. Machado GF, Bigolin SE. Estudo comparativo de casos entre a mobilização neural e um programa de alongamento muscular em lombálgicos crônicos. Fisioter Mov. 2010;23(4):545-54. doi: 10.1590/S0103-51502010000400005.
16. Ali M, Rehman USS, Ahmad S, Farooq NM. Effectiveness of slump neural mobilization technique for the management of chronic radicular low back pain. Rawal Med J. 2015;40(2):41-3.
17. Borges RSM, Santana GS, Brito PAM. Aplicação de um protocolo de tratamento fisioterapêutico em pacientes com sintoma de dor lombar. FisioSale. 2019;1(1):1-23.
18. Paeslandim NMR, Matos LKBL. The effect of manual therapy on lumbar disc protrusion. MTP & Rehab J. 2014;12(1):208-15. doi: 10.17784/mtprehabjournal.2014.12.192.
19. Neto T, Freitas SR, Marques M, Gomes L, Andrade R, Oliveira R. Effects of lower body quadrant neural mobilization in healthy and low back pain populations: A systematic review and meta-analysis. Musculoskelet Sci Pract. 2017;27:14-22. doi: 10.1016/j.msksp.2016.11.014.
20. Kurt V, Aras O, Buker N. Comparison of conservative treatment with and without neural mobilization for patients with low back pain: A prospective, randomized clinical trial. J Back Musculoskelet Rehabil. 2020;33(6):969-75. doi: 10.3233/BMR-181241.
21. Ramos M, Cruz HAC, Laurentino FM, Ashmawi AH, Santos MF, Chacur M. Efeito da mobilização neural em indivíduos com dor lombar crônica. BrJP. 2020;3(3):205-12. doi: 10.5935/2595-0118.20200041.
22. Monerrat E, Nunes-Júnior CP, Silva SLA, Barbosa GL, Pereira SJ. Efeito da mobilização neural na melhora da dor e incapacidade funcional da hérnia de disco lombar subaguda. Fisioterapia Brasil. 2012;13(1):13-9.
23. Haeffner R, Sarquis LMM, Haas GFS, Heck RM, Jardim VMR. Prevalência de lombalgia e fatores associados em trabalhadores de uma empresa agropecuária do Sul do Brasil. Rev Brasil Med Trab. 2015;13(1)35-42.
24. Sardá JJ, Nicholas KM, Pimenta MAC, Asghari A. Preditores biopsicossociais de dor, incapacidade e depressão em pacientes brasileiros com dor crônica. Rev Dor. 2012;13(2):111-8. doi: 10.1590/S1806-00132012000200003.
Submitted date:
04/26/2022
Reviewed date:
06/30/2022
Accepted date:
07/16/2022
Publication date:
07/16/2022