Effects of Mulligan sustained natural apophyseal glide mobilizations on pain, mobility, and lumbar-related disability in chronic non-specific low back pain: A systematic review and meta-analysis.

Study Summary

17 randomized controlled trials (RCTs), including 716 adults with chronic nonspecific low back pain, were included in this systematic review and meta-analysis comparing Mulligan sustained natural apophyseal glides (SNAGs) alone or combined with other physiotherapy interventions, with sham mobilizations, conventional physiotherapy, or other active treatments. Pooled outcomes included pain intensity, lumbar flexion and extension range of motion (ROM), and functional disability. SNAGs significantly reduced pain and disability and improved lumbar extension compared with control interventions, although improvements in lumbar flexion were not statistically significant. These findings suggested that SNAGs may provide short-term benefits as part of multimodal rehabilitation, although substantial heterogeneity and limited long-term evidence warranted cautious interpretation.