Spinal manipulation or mobilization for lumbar disc herniation with radiculopathy : a protocol for a systematic review and meta-analysis

Introduction: The purpose of this study is to conduct a systematic review and meta-analysis into the effects of spinal manipulation or mobilization for Lumbar Disc Herniation with Radiculopathy (LDHR). Methods: An electronic database search of titles and abstracts of articles published in English will be conducted in the following databases: PEDro (Physiotherapy Evidence Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Science Direct, Google Scholar, and The Cochrane Library. The specific search strategies will be dependent on the particular database being searched and hand searches of the reference lists of the included articles will also be performed. Studies will be included if they reported an acceptable comparison group, and also reported at least one of the main clinically relevant outcome measures for LDHR. Two independent reviewers will screen the identified records, and all disagreements will be resolved. The internal and external validities of the included studies will be assessed using the PEDro scale and the External Validity Assessment Tool (EVAT) respectively. The clinical relevance and risk of bias of the studies will be determined using the 5-Criteria developed by the Cochrane Back Review Group and the Cochrane Risk of Bias Assessment Tool respectively. Studies will be pooled into meta-analysis where appropriate using RevMan software and the outcomes will be reported using the PRISMA guidelines. Discussion: This review will summarize the current evidence about the effects of spinal manipulation or mobilization compared with other interventions in the management of individuals with Lumbar Disc Herniation with Radiculopathy (LDHR). A meta-analysis will also be conducted where appropriate in this review to compare the effects of spinal manipulation or mobilization with other interventions with a view to finding out which technique is better in the management of individuals with LDHR. Review Registration: This review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019131292). Keywords: Spinal manipulation; spinal mobilization; lumbar disc herniation; systematic review; meta-analysi