Abstract
Central sensitisation is a potential mechanism contributing to persistent and widespread pain across multiple clinical conditions. Systemic Manual Therapy Halili (SMT Halili) is a structured manual therapy approach organised into coded local, regional, and proposed systemic protocols. However, its evidence has not previously been synthesised across body regions or critically examined in relation to contemporary central sensitisation research. This narrative evidence synthesis and mapping review aimed to describe the clinical, conceptual, and methodological development of SMT Halili, examine patterns across its published applications, and identify priorities for future research. Twelve publications directly related to SMT Halili were mapped and considered alongside contextual literature on central sensitisation, nociplastic pain, assessment methods, and chronic pain conditions. The SMT literature included retrospective clinical studies, case reports, focused reviews, a theoretical model, and methodological publications concerning the Patient Identified Problem scale and the Halili Physical Therapy Statistical Analysis Tool. Applications were identified across low back, knee, shoulder, hip, pelvic, facial, respiratory, and post-COVID presentations. Most clinical publications reported improvement in regional complaints and broader patient-identified problems following combinations of local, regional, visceral, drainage, autonomic, and proposed desensitisation protocols. However, the predominance of retrospective designs, absence of randomised comparator groups, heterogeneity of interventions, limited long-term follow-up, and indirect assessment of central sensitisation restrict causal interpretation. Current evidence therefore supports SMT Halili as a structured clinical and research framework with preliminary findings across several presentations, but it does not establish SMT as an effective treatment for central sensitisation. Prospective controlled studies, independent replication, predefined protocols, multidimensional sensory assessment, and standardised outcome reporting are required.