Mapping the use of spinal manual therapy on the lumbo-pelvic area for lower extremity isolated pain: A scoping review

BackgroundSpinal manual therapy is frequently employed to alleviate pain and improve function. Although traditionally applied to spinal disorders, its use for lower extremity isolated pain has been reported, within the framework of regional interdependence. However, the clinical rationale for selecting specific techniques remains insufficiently explored.ObjectiveOur scoping review aimed to systematically investigate and summarize the types of lower extremity conditions addressed using spinal manual therapy applied to the lumbo-pelvic area, the types of interventions used (manipulation, mobilization, soft-tissue techniques and others), and the clinical assessments and outcomes reported.MethodsA comprehensive search of PubMed/MEDLINE, Scopus, ProQuest, PEDro and SPORTDiscus was conducted, covering all study designs. The modified 11-item Consensus on Exercise Reporting Template checklist was used to evaluate the replicability and reporting of spinal manual therapy techniques. Data were systematically categorized, and frequency analyses were performed to identify trends in intervention types and assessment methods.ResultsFifty-one studies were included. Knee-related conditions were the most frequently addressed (62.7%), and manipulation was the most commonly reported spinal manual therapy (SMT) technique (82.4%). Pain, muscle strength and function were among the most frequently assessed outcomes. None of the studies met all modified Consensus on Exercise Reporting Template (mCERT) reporting criteria.ConclusionThe review identified various techniques, particularly for knee-related conditions. However, intervention descriptions were often insufficient to ensure reproducibility. Future research should provide replicable descriptions of spinal manual therapy techniques applied to the lumbo-pelvic area and investigate their effects on clinically relevant outcomes in specific lower extremity conditions.