Effect of Lumbar Mobilization on Erector Spinae Activity: Protocol for Systematic Review and Meta-Analysis

This study was designed to determine the effect of lumbar joint mobilization techniques on muscle activity of the erector spinae (ES) muscles in healthy individuals. Previous reviews on the effect of lumbar mobilization on muscle activity have focused mainly on patients with lower-back pain and lower-back dysfunction; few studies have been conducted on healthy people. The study protocol was designed, and will be conducted and reported, using the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P). Electronic databases such as the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Web of Science, CINAHL, Pedro, ClinicalTrials.gov and gray literature will be searched from inception to April 1, 2024. Randomized controlled trials (RCTs) that included subjects with healthy people (aged 18–65 years) receiving lumbar mobilization versus another intervention (exercise), manipulation (high-velocity low amplitude, etc.) and a non-exposed control group will be included. Outcomes will be presented as weighted or standardized mean differences, with 95% confidence intervals. If the heterogeneity test is not significant, the Mantel–Haenszel method will be applied as the fixed-effects model. If statistical heterogeneity is observed (I2 ≥ 50% or P < 0.1), the random effects model will be selected. If the heterogeneity is large, qualitative summaries will be created instead, without meta-analysis. This study will explore whether lumbar mobilization applied to the lower back increases or decreases ES activity.