Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects

Bicalho, Eduardo; Setti, João Antônio Palma; Macagnan, Jones; Cano, José Luis Rivas; Manffra, Elisängela Ferretti

doi:10.1016/j.math.2010.03.012

Cited by 75 publications

(61 citation statements)

References 44 publications

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“…7,28,45,55,69,88,90 Nevertheless, the C1-2 articulation has been found to have a high frequency of symptomatic involvement in patients with neck pain and headaches. 41,42,54,100 Previous studies have demonstrated that 39° to 45° of the total cervical ROM occurs at the C1-2 articulation, 1,27,41,71,77 and that only 4° to 8° of rotation occurs at each motion segment from C2-3 to C6-7.…”

Section: T T Conclusionmentioning

confidence: 99%

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Dunning¹,

Cleland²,

Waldrop³

et al. 2012

J Orthop Sports Phys Ther

131

110

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A pproximately 54% of individuals have experienced neck pain within the last 6 months, 24 and the incidence of neck pain may be increasing. 76 The economic burden associated with the management of patients with neck pain is high, second only to low back pain in annual workers' compensation costs in the United States. 98Two recent clinical prediction rules 17,21,22,81 have been developed in an attempt to guide treatment selection for patients with neck pain. However, one has yet to be validated and only identifies those patients with neck pain likely to benefit from cervical traction, 81 and the other, which attempted to identify those patients with neck pain likely to benefit from thoracic manipulation and a general cervical range-of-motion (ROM) exer- T T METHODS:Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). T T RESULTS:One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively. T T CONCLUSION:The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain. T T LEVEL OF EVIDENCE:Therapy, level 1b.

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Section: T T Conclusionmentioning

confidence: 99%

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Dunning¹,

Cleland²,

Waldrop³

et al. 2012

J Orthop Sports Phys Ther

131

110

View full text Add to dashboard Cite

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“…For that, the volunteers started off from the standing position with their feet separated in the shoulder distance, and were asked to perform a bending of the torso for 3 seconds, keeping their knees extended, keeping the maximum flexion for 3 seconds (relaxation), and return to the initial position in 3 seconds (extension). The verbal command was used with the help of a timer to control the movement 5,17 . Three cycles were carried out with 1 minute of rest between them.…”

Section: Methodsmentioning

confidence: 99%

“…Some studies have reported positive results from spinal manipulation such as improving joint mobility, decreasing pain and muscle spasms 2,4,5 . The physiological mechanisms responsible for these effects are not yet fully clear 2,3,6 , but are related to the inhibition of the electrical activity of paravertebral muscles.…”

Section: Introductionmentioning

confidence: 99%

“…Works that have studied the immediate effects of the manipulation in subjects with low back pain, observed a decrease of electromyographic activity when the individual is in full flexion of the trunk immediately after the intervention 5,10 . These studies researched only the immediate effects of vertebral manipulation and how long they could endure is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Duração dos efeitos de uma manipulação vertebral sobre a intensidade da dor e atividade eletromiográfica dos paravertebrais de indivíduos com lombalgia crônica mecânica

et al. 2016

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RESUMO O objetivo desta pesquisa foi avaliar os efeitos de uma intervenção manipulativa sobre a atividade eletromiográfica dos músculos paraverterbais e a intensidade da dor na coluna lombar imediatamente e 30 minutos após sua realização em indivíduos com dor lombar crônica mecânica. Foram avaliados 38 indivíduos, distribuídos aleatoriamente em dois grupos: o que recebeu a técnica de manipulação vertebral global (n=20) e o controle (n=18), que permanecia em decúbito lateral por dez segundos sobre cada lado do corpo. O sinal eletromiográfico dos paravertebrais ao nível L4-L5 direito e esquerdo foi coletado durante três ciclos do movimento de flexão-relaxamento-extensão do tronco. Nos intervalos entre os ciclos, os participantes relataram a intensidade de dor através da Escala Visual Analógica (EVA 100 mm). Foi observada redução significativa na intensidade da dor no grupo que recebeu a manipulação, ao contrário do grupo controle, em que a pontuação na EVA aumentou. O tamanho do efeito na intensidade da dor foi de 1,0 e 0,9 logo após a manipulação e 30 minutos depois. A razão de flexão/relaxamento (RFR) aumentou no grupo que foi submetido à manipulação, mas permaneceu inalterada no grupo controle. A RFR exibiu tamanhos de 0,6 e 0,5 entre os grupos nas duas avaliações. Foi possível constatar efeitos da manipulação nessas duas variáveis e sua continuidade no intervalo observado, concluindo-se que eles perduram pelo menos durante esse tempo.

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“…Within the last few years, immediate effects of thrust and non-thrust manipulation have been shown to: improve proprioception, 1 standing balance, 2 reduce pain, 3,4 increase nociceptive flexion reflex threshold, 5 thermal pain sensitivity (temporal summation), 6 provide a widespread hypoalgesic effect, 7 improve range of motion, 4,8 alter EMG signals, 9 and modify sensorimotor integration. 10 In fairness, the studies represented here were both mechanistic-and clinically-oriented.…”

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confidence: 99%

Immediate effects from manual therapy: much ado about nothing?

Cook

2011

Journal of Manual & Manipulative Therapy

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Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects

Cited by 75 publications

References 44 publications

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Duração dos efeitos de uma manipulação vertebral sobre a intensidade da dor e atividade eletromiográfica dos paravertebrais de indivíduos com lombalgia crônica mecânica

Immediate effects from manual therapy: much ado about nothing?

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