Objective Oxidative stress plays an important role in neuropathic pain. Spinal manipulative therapy (SMT) can exert beneficial effects in pain outcomes in humans and animal models. SMT can also modulate oxidative stress markers in both humans and animals. We aimed to determine the effect of Impulse®-assisted SMT (ISMT) on nociception and oxidative stress biomarkers in the spinal cord and sciatic nerve of rats with neuropathic pain (NP). Methods NP was induced by chronic constriction injury (CCI) of the sciatic nerve. Animals were randomly assigned to naive, sham (rats with sciatic nerve exposure but without ligatures) and CCI, with and without ISMT. ISMT was applied onto the skin area corresponding to the spinous process of L4-L5, 3 times/week, for 2 weeks. Mechanical threshold, latency to paw withdrawal to thermal stimulus and oxidative stress biomarkers in spinal cord and sciatic nerve were the main outcomes evaluated. Results ISMT significantly increased mechanical threshold and withdrawal latency after CCI. In the spinal cord, ISMT prevented the increase of pro-oxidative superoxide anion generation and hydrogen peroxide levels. Lipid hydroperoxide levels both in the spinal cord and in the sciatic nerve were attenuated by ISMT. Total antioxidant capacity increased in the spinal cord and sciatic nerve of CCI rats with and without ISMT. CCI and ISMT did not significantly change the total thiol content of the spinal cord. Conclusions Our findings suggest reduced oxidative stress in the spinal cord and/or nerve may be an important mechanism underlying a therapeutic effect of SMT to manage NP non-pharmacologically.
Introduction: Cervical joint dysfunction may interfere with the sensorimotor afferent response, interfering with neck neck Joint Position Sense error (JPS). Objective: The aim of this study was to evaluate the influence of Cervical Spine Manipulation (CSM) on neck JPS error in patients with chronic neck pain. Method: 21 patients with chronic neck pain were divided into 2 groups: Spinal Manipulation Group (MG) or Sham Group (SG) who received 4 sessions of CSM and Sham CSM respectively. JPS was assessed in three different time frames: 1) pre-intervention; 2) Right after the first intervention (post-intervention 1); and 3) After a chronic intervention (post-intervention 2). The outcome measured in this study was the head reposition accuracy test with the Revel's Test. Results: The JPS showed no significant differences between pre-and post-intervention 1 and 2 for any of the assessed groups. Conclusion: We conclude that, for this sample, neither the CSM nor the Sham CSM statistically changed the JPS error for neither groups. We believe that the changes in JPS after CSM were concealed because the ability of other sensory system information to compensate for inadequacies in any other component. Therefore, more studies have to be done with a stronger methodological rigor, clinical prediction rule for spinal manipulation, bigger sample and a blind assessment.
Background: Neck pain is one of the major problems managed by chiropractors, therefore its common the use of spinal manipulation to manage this problem. Objective: To evaluate the influence of Cervical Spine Manipulation (CSM) in the Neck Disability Index (NDI) of patients with chronic neck pain compared to a manipulative sham group. Method: 15 patients with chronic neck pain, were randomly assigned into one of two groups. Experimental Group (EG), with 8 patients, mean age of 30.6(13.7) years and Sham Group (SG), with 7 patients, mean age of 38.9(17.0) years. All the patients signed a Voluntary Informed Consent Document, approved by the university’s research ethics committee (n°555.015). The NDI was used to evaluate the outcome. The EG intervention was the CSM, performed 4 times, along a mean of 39.2 days. The SG was subjected to a similar cervical manipulative sensory experience, also performed 4 times, along a mean of 30.6 days. Paired and unpaired Student’s t-test was used to assess intra and inter group differences, respectively. Results: Statistically significant differences (p=0.000) were found for NDI between the pre and post-treatment evaluations of both the EG (26.3(5.0) % pre; 10.9(7.1) % post) and the SG (30.1(3.7) % pre; 18.4(5.3) % post). There were no significant differences for NDI in the pre-treatment between groups (p=0.122), however statistically significant differences were found in the post-treatment between the EG and the SG (p=0.039). Conclusion: The result shows that after the treatment period both groups showed improvement for NDI, however the CSM in the EG resulted in an improved outcome in the treatment of patients with chronic neck pain.
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