A Systematic Review and Meta-Analysis of the Effectiveness of Mulligan Mobilization with Movement on Pain, Range of Motion, Function, and Flexibility in Patients with Sciatica

BackgroundThe Mulligan techniques address lumbar disc lesions and related dysfunctions. However, the current body of evidence of its effectiveness remains limited.AimsTo assess the effectiveness of the Mulligan concept on pain alleviation, range of motion, function, and flexibility in patients with sciatica.MethodsThis meta-analysis included randomized controlled trials that applied Mulligan techniques to patients with sciatica and assessed outcomes such as pain, range of motion, function, or flexibility. We searched six electronic databases to identify the relevant trials. The methodological quality of the studies was evaluated using the Cochrane risk of bias assessment.ResultsA total of 21 randomized controlled trials (RCTs) were included in this study. Three primary Mulligan techniques were performed: spinal mobilization with leg movement (SMWLM), bent leg raise (BLR), and traction straight leg raise (TSLR). In this review, seven trials exhibited a high to moderate risk of bias, while the remaining trials demonstrated a low risk of bias. The analysis revealed that SMWLG could be beneficial in improving pain (standardized mean difference [SMD] = -0.58, 95% confidence interval [CI] = -0.82 to -0.33, p < .001) and function (SMD = -1.02, 95% CI = -1.87 to -0.17, p = .02). Additionally, BLR showed potential benefits in improving flexibility, particularly when combined with standard treatment (SMD = 0.59, 95% CI = 0.30 to 0.88, p < .001).ConclusionsSMWLG demonstrates greater improvements in pain and function compared to other Mulligan techniques in patients with sciatica. However, the limited number of trials and the overall low quality of the existing literature highlight the need for future high-quality research that encompasses all related Mulligan techniques.