Effectiveness of slump stretching on low back pain: A systematic review and meta-analysis

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 ¼ �2.15, 95% confidence interval CI ¼ �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 ¼ �8.03, 95% CI ¼ �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. © 2018 American Academy of Pain Medicine. All rights reserved