A structured review of spinal stiffness as a kinesiological outcome of manipulation: Its measurement and utility in diagnosis, prognosis and treatment decision-making

Snodgrass, Suzanne J.; Haskins, Robin; Rivett, Darren A.

doi:10.1016/j.jelekin.2012.04.015

Cited by 26 publications

(29 citation statements)

References 114 publications

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“…The sparse and conflicting evidence for spinal stiffness changes following manual therapy suggests that further research is needed, particularly to determine the relationship between spinal stiffness and pain. 53 …”

Section: Spinal Stiffnessmentioning

confidence: 99%

“…The first cycle of applied force was discarded, 44,50 and stiffness was defined as the slope of the linear portion of the force-displacement curve averaged over cycles 2 through 5 (N/mm). 53,57 The linear portion was determined by viewing the force-displacement curves across the sample and selecting a linear range ap-propriate for all spinal levels measured. Spinal stiffness differs between spinal levels, 7,57,69 and thus the linear portion of the curve varied slightly between spinal levels.…”

mentioning

confidence: 99%

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Dose Optimization for Spinal Treatment Effectiveness: A Randomized Controlled Trial Investigating the Effects of High and Low Mobilization Forces in Patients With Neck Pain

Snodgrass

Rivett²,

Sterling³

et al. 2014

J Orthop Sports Phys Ther

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Section: Spinal Stiffnessmentioning

confidence: 99%

mentioning

confidence: 99%

Dose Optimization for Spinal Treatment Effectiveness: A Randomized Controlled Trial Investigating the Effects of High and Low Mobilization Forces in Patients With Neck Pain

Snodgrass

Rivett²,

Sterling³

et al. 2014

J Orthop Sports Phys Ther

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“…The association between LBP and spinal stiffness is complex [26, 27]. Shirley and Lee (1993) applied oscillating posterior-anterior (PA) pressures to L3 and L4 and found patients with LBP had a higher spinal stiffness than those were asymptomatic [28].…”

Section: Introductionmentioning

confidence: 99%

Association of lumbar spine stiffness and flexion-relaxation phenomenon with patient-reported outcomes in adults with chronic low back pain – a single-arm clinical trial investigating the effects of thrust spinal manipulation

Xia

Long

Vining

et al. 2017

BMC Complement Altern Med

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BackgroundSpinal manipulation (SM) is used commonly for treating low back pain (LBP). Spinal stiffness is routinely assessed by clinicians performing SM. Flexion-relaxation ratio (FRR) was shown to distinguish between LBP and healthy populations. The primary objective of this study was to examine the association of these two physiological variables with patient-reported pain intensity and disability in adults with chronic LBP (>12 weeks) receiving SM.MethodsA single-arm trial provided 12 sessions of side-lying thrust SM in the lumbosacral region over 6 weeks. Inclusion criteria included 21–65 years old, Roland-Morris Disability Questionnaire (RMDQ) score ≥ 6 and numerical pain rating score ≥ 2. Spinal stiffness and FRR were assessed pre-treatment at baseline, after 2 weeks and after 6 weeks of treatment. Lumbar spine global stiffness (GS) were calculated from the force-displacement curves obtained using i) hand palpation, ii) a hand-held device, and iii) an automated indenter device. Lumbar FRR was assessed during trunk flexion-extension using surface electromyography. The primary outcomes were RMDQ and pain intensity measured by visual analog scale (VAS). Mixed-effects regression models were used to analyze the data.ResultsThe mean age of the 82 participants was 45 years; 48% were female; and 84% reported LBP >1 year. The mean (standard deviation) baseline pain intensity and RMDQ were 46.1 (18.1) and 9.5 (4.3), respectively. The mean reduction (95% confidence interval) after 6 weeks in pain intensity and RMDQ were 20.1 mm (14.1 to 26.1) and 4.8 (3.7 to 5.8). There was a small change over time in the palpatory GS but not in the hand-held or automated GS, nor in FRR. The addition of each physiologic variable did not affect the model-estimated changes in VAS or RMDQ over time. There was no association seen between physiological variables and LBP intensity. Higher levels of hand-held GS at L3 and automated GS were significantly associated with higher levels of RMDQ (p = 0.02 and 0.03, respectively) and lower levels of flexion and extension FRR were significantly associated with higher levels of RMDQ (p = 0.02 and 0.008, respectively) across the 3 assessment time points.ConclusionsImprovement in pain and disability observed in study participants with chronic LBP was not associated with the measured GS or FRR.Trial registration NCT01670292 on clinicaltrials.gov, August 2, 2012

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“…This may be repeated with adjacent segments to evaluate the relative stiffness of different spinal regions. Because manual segmental spinal stiffness assessment (MSSA) has unacceptable intra-or interrater reliability [10,11], however, various spinal stiffness-testing devices have been invented although they were used mainly for clinical research [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Value of Assessing Lumbar Posteroanterior Segmental Stiffness: A Narrative Review of Manual and Instrumented Methods

Wong

Kawchuk

2016

PM&R

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A structured review of spinal stiffness as a kinesiological outcome of manipulation: Its measurement and utility in diagnosis, prognosis and treatment decision-making

Cited by 26 publications

References 114 publications

Dose Optimization for Spinal Treatment Effectiveness: A Randomized Controlled Trial Investigating the Effects of High and Low Mobilization Forces in Patients With Neck Pain

Dose Optimization for Spinal Treatment Effectiveness: A Randomized Controlled Trial Investigating the Effects of High and Low Mobilization Forces in Patients With Neck Pain

Association of lumbar spine stiffness and flexion-relaxation phenomenon with patient-reported outcomes in adults with chronic low back pain – a single-arm clinical trial investigating the effects of thrust spinal manipulation

The Clinical Value of Assessing Lumbar Posteroanterior Segmental Stiffness: A Narrative Review of Manual and Instrumented Methods

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