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Results for “Manipulation, Spinal”

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At least 1,117 records · Page 62Linked to original sources
PubMed1998

An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation.

OBJECTIVE: To investigate a proposed model in which manipulative therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect by activating a descending pain inhibitory system. The a priori hypothesis tested was that manipulative therapy produces mechanical hypoalgesia and sympathoexcitation beyond that produced by placebo or control. Furthermore, these effects would be correlated, thus supporting the proposed model. DESIGN: A randomized, double-blind, placebo-controlled, repeated-measures study of the initial effect of treatment. SETTING: Clinical neurophysiology laboratory. SUBJECTS: Twenty-four subjects (13 women and 11 men; mean age, 49 yr) with chronic lateral epicondylalgia (average duration, 6.2 months). INTERVENTION: Cervical spine lateral glide oscillatory manipulation, placebo and control. OUTCOME MEASURES: Pressure pain threshold, thermal pain threshold, pain-free grip strength test, upper limb tension test 2b, skin conductance, pileous and glabrous skin temperature and blood flux. RESULTS: Treatment produced hypoalgesic and sympathoexcitatory changes significantly greater than those of placebo and control (p < .03). Confirmatory factor-analysis modeling, which was performed on the pain-related measures and the indicators of sympathetic nervous system function, demonstrated a significant correlation (r = .82) between the latencies of manipulation-induced hypoalgesia and sympathoexcitation. The Lagrange Multiplier test and Wald test indicated that the two latent factors parsimoniously and appropriately represented their observed variables. CONCLUSION: Manual therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect beyond that of placebo or control. The strong correlation between hypoalgesic and sympathoexcitatory effects suggests that a central control mechanism might be activated by manipulative therapy.

Adult↗
PubMedDate not supplied

Number of sampling movements and manual stiffness judgments.

OBJECTIVE: It has been suggested that when using posteroanterior pressure to assess the stiffness of the spine, no more than two or three oscillations should be used. This study sought to examine this clinical impression by investigating the effect of the number of sampling movements on stiffness perception. DESIGN: Perceptual study using a mechanical device to provide stiffness stimuli, with university staff and students as judges. SETTING: University psychophysics laboratory. INTERVENTIONS: In part 1, subjects were directed to sample the stimuli a prescribed number of times (either 1, 2, 3, 4 or 5 pushes), whereas in part 2, subjects were free to choose the number of sampling movements. MAIN OUTCOME MEASURE: Measures of interstimulus discriminability and bias. RESULTS: An inverted-U relationship between the number of directed sampling movements and stiffness discriminability was found, with three cycles providing best discriminability. When subjects were given a choice, most chose to use three cycles. The number of sampling movements had no effect on bias. CONCLUSION: This study confirms the hypothesis under investigation and suggests that therapists will be maximally sensitive when using three testing cycles of posteroanterior pressure to assess stiffness.

Adult↗
PubMedDate not supplied

The effect of upper cervical or sacroiliac manipulation on hip flexion range of motion.

OBJECTIVES: To compare the effectiveness of an upper cervical manipulation and a manipulation of the sacroiliac joint for increasing hip range of motion. DESIGN: Clinical cohort study. SETTING: Macquarie University Centre for Chiropractic Outpatient Clinic. SAMPLE: Fifty-two randomly chosen university students aged 18 to 34 yr. METHOD: A reliable hand-held dynamometer was used to determine the end point of range of motion before and after the application of a treatment. Three groups of subjects were created: cervical manipulation, sacroiliac manipulation and sham/placebo. Range of motion of the hip in flexion (SLR) was used as the independent variable. RESULTS: The two manipulative treatments resulted in increased flexion range of motion at the hip. Statistical analysis revealed that only the upper cervical manipulation procedure increased hip flexion range of motion significantly. CONCLUSION: The results suggest that manual therapy of the neck may affect hip range of motion in normal adults. Findings such as these may indicate the existence of a link between the cervical spine and the lower extremity.

Adolescent↗
PubMed1999

Manipulation of the cervical spine: risks and benefits.

Manipulation of the cervical spine (MCS) is used in the treatment of people with neck pain and muscle-tension headache. The purposes of this article are to review previously reported cases in which injuries were attributed to MCS, to identify cases of injury involving treatment by physical therapists, and to describe the risks and benefits of MCS. One hundred seventy-seven published cases of injury reported in 116 articles were reviewed. The cases were published between 1925 and 1997. The most frequently reported injuries involved arterial dissection or spasm, and lesions of the brain stem. Death occurred in 32 (18%) of the cases. Physical therapists were involved in less than 2% of the cases, and no deaths have been attributed to MCS provided by physical therapists. Although the risk of injury associated with MCS appears to be small, this type of therapy has the potential to expose patients to vertebral artery damage that can be avoided with the use of mobilization (nonthrust passive movements). The literature does not demonstrate that the benefits of MCS outweigh the risks. Several recommendations for future studies and for the practice of MCS are discussed.

Cervical Vertebrae↗