Richard Roy | Université du Québec à Montréal (original) (raw)

Papers by Richard Roy

Research paper thumbnail of Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain

Journal of Manipulative and Physiological Therapeutics, May 1, 2009

The purpose of this study was to examine heart rate variability (HRV) in the presence or the abse... more The purpose of this study was to examine heart rate variability (HRV) in the presence or the absence of pain in the lower back, while receiving one chiropractic treatment at L5 from either a manually assisted mechanical force (Activator) or a traditional diversified technique spinal manipulation. A total of 51 participants were randomly assigned to a control (n = 11), 2 treatment, or 2 sham groups (n = 10 per group). Participants underwent an 8-minute acclimatizing period. The HRV tachygram (RR interval) data were recorded directly into a Suunto watch (model T6; FitzWright Company Ltd, Langley, British Columbia, Canada). We analyzed the 5-minute pretreatment and posttreatment intervals. The spectral analysis of the tachygram was performed with Kubios software. All groups decreased in value except the control group that reacted in the opposite direction, when comparing the pretests and posttests for the high-frequency component. The very low frequency increased in all groups except the control group. The low frequency decreased in all groups except the sham pain-free group. The low frequency-high frequency ratio decreased in the treatment pain group by 0.46 and in the sham pain-free group by 0.26. The low frequency-high frequency ratio increase was 0.13 for the sham pain group, 0.04 for the control group, and 0.34 for the treatment pain-free group. The mean RR increased by 11.89 milliseconds in the sham pain-free group, 18.65 milliseconds in the treatment pain group, and 13.14 milliseconds in the control group. The mean RR decreased in the treatment pain-free group by 1.75 milliseconds and by 0.01 milliseconds in the sham pain group. Adjusting the lumbar vertebrae affected the lumbar parasympathetic nervous system output for this group of participants. Adaptation in the parasympathetic output, reflected by changes in high frequency, low frequency, and very low frequency, may be independent of type of adjustment. Therefore, the group differences found in the modulation of the HRV would seem to be related to the presence or absence of pain. The autonomic nervous system response may be specific and sensitive to its effectors organ.

Research paper thumbnail of Comparing Outcome Measures in Lumbar Spine Manipulations: Dynamic X-Rays and Oswestry Index

Spine Research, 2016

Control group A total of ten participants, four females and six males, were recruited in early Ju... more Control group A total of ten participants, four females and six males, were recruited in early June 2008 from a chiropractic clinic located at 7655 Newman Boulevard, LaSalle, Quebec. The inclusion criterion was that all participants were receiving maintenance chiropractic care and would not have any treatment during the two-week span of the research project. All participants were examined, x-rayed, and evaluated for all the same outcome measures.

Research paper thumbnail of Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series

Journal of chiropractic medicine, 2015

The purpose of this study is to describe chiropractic treatment of 14 patients who presented with... more The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients' pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms.

Research paper thumbnail of Intra and Inter Examiner Reliability Study for the Characteristics of Evaluation of the SA201

Journal of Spine, 2015

Introduction: There is no published account of the reliability of the percussion technology on hu... more Introduction: There is no published account of the reliability of the percussion technology on human participants. Our goal was to measure the reliability of the instrument's analysis protocol on an inert substance and on human participants with expert and novice evaluators. Method: 15 participants were evaluated by six evaluators, three experienced and three novices. Results: No participants were excluded from the analysis, based on the NDI, ODI and BMI. Even if the global result from the durometer testing were surprising in their range, the effect size score for the pre and post value on the durometer indicate very good reliability. Conclusion: The intra-evaluator reliability is very good when testing on the durometer but less predominant when evaluating the participant. In addition a novice chiropractor can use the instrument with a certain degree of ability that will develop over time if he uses this technology on a regular basis.

Research paper thumbnail of Neuroimmunologie : études cliniques pour mesurer l'effet de l'ajustement chiropratique sur la température cutanée, la variabilité du rythme cardiaque et les cytokines (protéine réactive-C et interleukine-6)

L'objet de cette thèse est l'évaluation de l'effet du traitement chiropratique sur de... more L'objet de cette thèse est l'évaluation de l'effet du traitement chiropratique sur des variables physiologiques. Il y a peu d'information sur l'effet du traitement chiropratique sur la température cutanée paraspinale. De plus, il y a peu d'information sur la technologie de thermométrie utilisée pour faire ces évaluations. Plusieurs recherches ont été effectuées pour mesurer l'effet des traitements chiropratiques cervicaux ct dorsaux sur la variabilité du rythme cardiaque, mais il n'y a aucune étude qui mesure les effets des traitements chiropratiques lombaires. La littérature fournit peu de documentation sur l'effet des traitements chiropratiques sur les hormones pro-inflammatoires. Il n'y a aucune information sur l'effet des traitements chiropratiques sur l'interleukine-6 et la protéine réactive C. Les hypothèses visaient à mesurer s'il y a des effets produits par des traitements chiropratiques sur les variables énumérées ci-haut ...

Research paper thumbnail of Roy RA, Boucher JP and Comtois AS. Effects of a manually-assisted mechanical force on cutaneous temperature. J Manipulative Physiol Ther 2008;31:230-236)

Journal of Manipulative and Physiological Therapeutics

Research paper thumbnail of Heart Rate Variability Modulation Produced by a Chiropractic Lumbar Adjustment

Medicine & Science in Sports & Exercise, 2008

Research paper thumbnail of Validity of Infrared Thermal Measurements of Segmental Paraspinal Skin Surface Temperature

Journal of Manipulative and Physiological Therapeutics, 2006

Objective: The purpose of this study was to evaluate the validity of thermal measurements by infr... more Objective: The purpose of this study was to evaluate the validity of thermal measurements by infrared camera thermometry. Methods: Seventeen subjects underwent a 30-minute acclimatizing period in a controlled environment room. Thermal recordings were executed at the levels of C4 and L4. Fifteen recordings per segment were acquired in an alternating mode that always started at L4. Each subject was required to participate on 5 occasions. The exclusion criteria for the subjects included the following: no inflammatory disease or fever, no consumption of beverages containing caffeine, and no participation in physical activity 2 hours before the recording session; female subjects could not be menstruating on a day of recording. Results: A total of 2550 recordings for the cervical area and the lumbar area was recorded. Strong significant correlations were found for the left (r = .77) and right (r = .71) lumbar sections ( P b .0001) whereas weaker significant correlations were observed for the left (r = .56) and right (r = .63) cervical areas ( P b .0001). The limits of agreement (Bland-Altman) showed good relationships but poor interchangeability. Conclusions: In this study, the infrared cameras showed that they were valid tools in a controlled environment; however, the technique for the cervical measurements needs to be reassessed. (J Manipulative Physiol Ther 2006;29:150-155)

Research paper thumbnail of Paraspinal Cutaneous Temperature Modification After Spinal Manipulation at L5

Journal of Manipulative and Physiological Therapeutics, 2010

The purpose of this study was to investigate local paraspinal cutaneous temperature (CT) modifica... more The purpose of this study was to investigate local paraspinal cutaneous temperature (CT) modifications after spinal manipulative therapy at L5. Twenty subjects with acute low back symptoms were randomly assigned to either a treatment or a sham group (n = 10 per group). Subjects underwent an 8-minute acclimatizing period. Temperature was measured bilaterally with infrared cameras at the L5 level. In the treatment group, a traditional chiropractic manipulation (lumbar roll technique with a pisiform contact on the ipsilateral mamillary of L5) was delivered, whereas with the sham group, the same technique was used, but no thrust was applied. Cutaneous temperature control measurements were taken 2 minutes before (t(-2)) and immediately after the intervention (t(0)) and at 1, 3, 5, and 10 minutes postintervention (t(1), t(3), t(5), and t(10), respectively). At t(0), CT in the treatment group on the treatment side (ipsilateral side) warmed up by 0.2 degrees F, whereas in the sham group, there were no significant temperature modifications on either side. At t(3) relative to t(0), CT in the treatment group on the treatment side warmed by approximately 0.6 degrees F, whereas the contralateral side (nontreatment side) cooled. In the treatment group, significant differences were noted between sides (F = 13.36, P = .002, P = .932) and sides x times (F = 2.97, P = .016, P = .838). The effects of a lumbar spine manipulation appear noticeable by changes in paraspinal CT measurements at the level of L5. However, the meaning and mechanisms of CT modifications at L5 are still being investigated.

Research paper thumbnail of Effects of a Manually Assisted Mechanical Force on Cutaneous Temperature

Journal of Manipulative and Physiological Therapeutics, 2008

Objective: Digitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous... more Objective: Digitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous temperature (CT). This project ascertains the effect of a manually assisted mechanical force producing a chiropractic adjustment in the lumbar spine after the Activator Methods Chiropractic Technique on CT during 2 different time recording periods (TRPs). Methods: Sixty-six healthy subjects (36 women and 30 men) without acute low back conditions or symptoms were recruited. Subjects were randomly divided into 2 groups based on the length of the acclimatization period (8 or 30 minutes; TRP 8 and TRP 30 , respectively). In turn, each recording period group was divided into 3 subgroups (n = 11 per subgroup): treatment, sham, and control subgroups. Bilateral DIST was conducted at L-4 (TRP 30 ) and L-5 (TRP 8 ) using infrared cameras (Subluxation Station Insight 7000; Chiropractic Leadership Alliance, Mahwah, NJ). Results: Before treatment (t −0.5 ), the TRP 8 CT was significantly different between the ipsilateral and the contralateral sides for all subgroups. At 10 minutes (t 10 ) after intervention, CT increased significantly (P b .05) for the treatment group but not for the sham and control groups. In contrast, there were no significant differences in the TRP 30 CT before treatment between the ipsilateral and the contralateral sides; but at t 10 , CT was significantly (P b .05) greater for all 3 subgroups compared with preintervention CT. Conclusion: Contacting the skin with the instrument with (treatment group TRP 30 ) or without (sham group TRP 30 ) a thrust with a sustained pressure stronger than the loading principle taught in the Activator Methods Chiropractic Technique protocol or a thrust respecting the standard loading principle (treatment group TRP 8 ) of the instrument produced a CT cooling immediately after the adjustment. Furthermore, we observed that when contacting the skin with the instrument with a thrust respecting the standard loading principle (treatment group TRP 8 ) of the instrument, it produced a secondary cooling at t 5 followed by a rewarming at t 10 . Finally, contacting the skin with the instrument without a thrust and respecting the standard loading principle (sham TRP 8 ) of the instrument did not produce a CT change. (J Manipulative Physiol Ther 2008;31:230-236)

Research paper thumbnail of Consistency of Cutaneous Thermal Scanning Measures Using Prone and Standing Protocols: A Pilot Study

Journal of Manipulative and Physiological Therapeutics, 2010

The goal of this pilot study was to measure paraspinal cutaneous temperature (PCT) in the prone v... more The goal of this pilot study was to measure paraspinal cutaneous temperature (PCT) in the prone vs standing position. Ten symptom-free participants were evaluated. Paraspinal cutaneous temperature was recorded. Subjects were acclimated to the treatment room in a prone position for 8 minutes before the PCT was measured. After the prone PCT reading, patients stood. A standing PCT measurement was then taken. Paraspinal cutaneous temperature was marginally warmer when subjects were standing vs prone (PCT difference, 0.25 degrees C +/- 0.64 degrees C and 0.62 degrees C +/- 0.67 degrees C for left and right sides, respectively). The right and left side differential was the same in the prone and standing positions. There was a positive Pearson correlation (0.802-0.803; P < .000) between the standing and prone positions for both left and right sides. There are no differences between the prone or standing PCT measures if symptom-free subjects are given 8 minutes to acclimate before recording PCT measures.

Research paper thumbnail of Digitized Infrared Segmental Thermometry: Time Requirements for Stable Recordings

Journal of Manipulative and Physiological Therapeutics, 2006

Objectives: Digitized infrared segmental thermometry (DIST) is a method for measuring and recordi... more Objectives: Digitized infrared segmental thermometry (DIST) is a method for measuring and recording skin surface body temperatures. The project evaluated the required length of time for patients to acclimatize their core body temperature to ambient conditions to obtain stable DIST readings. Methods: Seventeen subjects were allowed a 20-minute acclimatizing period in a temperature-controlled room. The bilateral DIST temperature was measured with thermistors in combination with infrared cameras (IRCs) at the C4 and L4 levels. All IRC temperatures were recorded after a 20-minute stabilization period. The room temperature and relative humidity were recorded throughout all trials. The acclimatization trend was computed from the 20-to 24-minute period for the IRCs, and the acclimatization trend was computed continuously for a total of 30 minutes (at 2-minute intervals) for 5 days. Results: We discovered a stabilization trend in the early trial stages, with the thermistor recordings between 8 and 16 minutes. The IRC trend was also conclusive for the core temperature requirements. Conclusions: This study determined a core body temperature acclimatization trend tested among patients using thermistor recordings in a controlled environment. Based on these findings, we recommend acclimatization in a temperature-and humidity-controlled environment for a minimum 8-minute period, followed by an 8-minute maximum recording period with the patient in a prone position to obtain accurate DIST recordings. (J Manipulative Physiol Ther 2006;29:468.e1-468.e10)

Research paper thumbnail of Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain? The Importance of Controlling for Respiration Rate Changes

Journal of Manipulative and Physiological Therapeutics, 2010

Research paper thumbnail of Comparison of Paraspinal Cutaneous Temperature Measurements Between Subjects With and Without Chronic Low Back Pain

Journal of Manipulative and Physiological Therapeutics, 2013

Objective: The purpose of this study was to evaluate the effects of chiropractic manipulative tre... more Objective: The purpose of this study was to evaluate the effects of chiropractic manipulative treatment on paraspinal cutaneous temperature (PCT) for subjects with chronic low back pain and compare these PCT findings to subjects without chronic low back pain. Methods: Two groups were created, a symptomatic treatment group (subjects with chronic low back pain, n = 11, 7 males, 4 females) and an asymptomatic, nontreatment group (asymptomatic subjects, n = 10, 6 males, 4 females). Outcomes included the modified Oswestry questionnaire and PCT measurements in the prone position after an 8minute acclimation period. The treatment group received 9 chiropractic spinal instrument-based manipulative treatments over 2 weeks. Reevaluation was done 2 weeks after the initial evaluation for both groups. Results: The preintervention Oswestry results (29.8% ± 11.8%) for the treatment group were higher than the asymptomatic group (10.2% ± 10.6%). The postintervention Oswestry results for the treatment group were 14.20 % ± 11.5%. The resulting Cohen's effect size of the spinal manipulation on the Oswestry evaluation is 0.58. The preintervention PCT showed higher temperature for the nontreatment group compared with the treatment group. Comparing the levels associated with low back pain, the nontreatment group PCT was stable, varying from 0.01°C to 0.02°C, whereas the treatment group PCT varied from 0.10°C to 0.18°C. The treatment group postintervention PCT showed an increase in temperature after the 9 visits; however, this did not reach the values of the asymptomatic group. Conclusion: The PCT readings for subjects with chronic low back pain were lower than the asymptomatic, nontreatment group. The PCT temperature of the treatment group increased after 9 treatments. (J Manipulative Physiol Ther 2013;36:44-50)

Research paper thumbnail of Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain

Journal of Chiropractic Medicine, 2010

Objective: Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been e... more Objective: Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been evaluated in response to a short course of lumbar spinal manipulation. The purpose of this study is to observe the responses of inflammatory markers (IL-6 and CRP) after a series of 9 chiropractic spinal manipulations. Methods: Twenty-one participants were assigned to a treatment or a control group. Only the treatment group received 9 chiropractic interventions. Pre-and postintervention measures were recorded for blood samples for detection of proinflammatory cytokines IL-6 and CRP. Results: Mediators of inflammation (IL-6 and high-sensitivity CRP) were modified by the intervention received in the treatment group, and the effect size demonstrated a tendency toward the control group values. Conclusion: A total of 9 chiropractic lower back manipulations caused the mediators of inflammation to present a normalization response in individuals suffering from chronic low back pain.

Research paper thumbnail of Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain

Journal of Manipulative and Physiological Therapeutics, May 1, 2009

The purpose of this study was to examine heart rate variability (HRV) in the presence or the abse... more The purpose of this study was to examine heart rate variability (HRV) in the presence or the absence of pain in the lower back, while receiving one chiropractic treatment at L5 from either a manually assisted mechanical force (Activator) or a traditional diversified technique spinal manipulation. A total of 51 participants were randomly assigned to a control (n = 11), 2 treatment, or 2 sham groups (n = 10 per group). Participants underwent an 8-minute acclimatizing period. The HRV tachygram (RR interval) data were recorded directly into a Suunto watch (model T6; FitzWright Company Ltd, Langley, British Columbia, Canada). We analyzed the 5-minute pretreatment and posttreatment intervals. The spectral analysis of the tachygram was performed with Kubios software. All groups decreased in value except the control group that reacted in the opposite direction, when comparing the pretests and posttests for the high-frequency component. The very low frequency increased in all groups except the control group. The low frequency decreased in all groups except the sham pain-free group. The low frequency-high frequency ratio decreased in the treatment pain group by 0.46 and in the sham pain-free group by 0.26. The low frequency-high frequency ratio increase was 0.13 for the sham pain group, 0.04 for the control group, and 0.34 for the treatment pain-free group. The mean RR increased by 11.89 milliseconds in the sham pain-free group, 18.65 milliseconds in the treatment pain group, and 13.14 milliseconds in the control group. The mean RR decreased in the treatment pain-free group by 1.75 milliseconds and by 0.01 milliseconds in the sham pain group. Adjusting the lumbar vertebrae affected the lumbar parasympathetic nervous system output for this group of participants. Adaptation in the parasympathetic output, reflected by changes in high frequency, low frequency, and very low frequency, may be independent of type of adjustment. Therefore, the group differences found in the modulation of the HRV would seem to be related to the presence or absence of pain. The autonomic nervous system response may be specific and sensitive to its effectors organ.

Research paper thumbnail of Comparing Outcome Measures in Lumbar Spine Manipulations: Dynamic X-Rays and Oswestry Index

Spine Research, 2016

Control group A total of ten participants, four females and six males, were recruited in early Ju... more Control group A total of ten participants, four females and six males, were recruited in early June 2008 from a chiropractic clinic located at 7655 Newman Boulevard, LaSalle, Quebec. The inclusion criterion was that all participants were receiving maintenance chiropractic care and would not have any treatment during the two-week span of the research project. All participants were examined, x-rayed, and evaluated for all the same outcome measures.

Research paper thumbnail of Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series

Journal of chiropractic medicine, 2015

The purpose of this study is to describe chiropractic treatment of 14 patients who presented with... more The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients' pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms.

Research paper thumbnail of Intra and Inter Examiner Reliability Study for the Characteristics of Evaluation of the SA201

Journal of Spine, 2015

Introduction: There is no published account of the reliability of the percussion technology on hu... more Introduction: There is no published account of the reliability of the percussion technology on human participants. Our goal was to measure the reliability of the instrument's analysis protocol on an inert substance and on human participants with expert and novice evaluators. Method: 15 participants were evaluated by six evaluators, three experienced and three novices. Results: No participants were excluded from the analysis, based on the NDI, ODI and BMI. Even if the global result from the durometer testing were surprising in their range, the effect size score for the pre and post value on the durometer indicate very good reliability. Conclusion: The intra-evaluator reliability is very good when testing on the durometer but less predominant when evaluating the participant. In addition a novice chiropractor can use the instrument with a certain degree of ability that will develop over time if he uses this technology on a regular basis.

Research paper thumbnail of Neuroimmunologie : études cliniques pour mesurer l'effet de l'ajustement chiropratique sur la température cutanée, la variabilité du rythme cardiaque et les cytokines (protéine réactive-C et interleukine-6)

L'objet de cette thèse est l'évaluation de l'effet du traitement chiropratique sur de... more L'objet de cette thèse est l'évaluation de l'effet du traitement chiropratique sur des variables physiologiques. Il y a peu d'information sur l'effet du traitement chiropratique sur la température cutanée paraspinale. De plus, il y a peu d'information sur la technologie de thermométrie utilisée pour faire ces évaluations. Plusieurs recherches ont été effectuées pour mesurer l'effet des traitements chiropratiques cervicaux ct dorsaux sur la variabilité du rythme cardiaque, mais il n'y a aucune étude qui mesure les effets des traitements chiropratiques lombaires. La littérature fournit peu de documentation sur l'effet des traitements chiropratiques sur les hormones pro-inflammatoires. Il n'y a aucune information sur l'effet des traitements chiropratiques sur l'interleukine-6 et la protéine réactive C. Les hypothèses visaient à mesurer s'il y a des effets produits par des traitements chiropratiques sur les variables énumérées ci-haut ...

Research paper thumbnail of Roy RA, Boucher JP and Comtois AS. Effects of a manually-assisted mechanical force on cutaneous temperature. J Manipulative Physiol Ther 2008;31:230-236)

Journal of Manipulative and Physiological Therapeutics

Research paper thumbnail of Heart Rate Variability Modulation Produced by a Chiropractic Lumbar Adjustment

Medicine & Science in Sports & Exercise, 2008

Research paper thumbnail of Validity of Infrared Thermal Measurements of Segmental Paraspinal Skin Surface Temperature

Journal of Manipulative and Physiological Therapeutics, 2006

Objective: The purpose of this study was to evaluate the validity of thermal measurements by infr... more Objective: The purpose of this study was to evaluate the validity of thermal measurements by infrared camera thermometry. Methods: Seventeen subjects underwent a 30-minute acclimatizing period in a controlled environment room. Thermal recordings were executed at the levels of C4 and L4. Fifteen recordings per segment were acquired in an alternating mode that always started at L4. Each subject was required to participate on 5 occasions. The exclusion criteria for the subjects included the following: no inflammatory disease or fever, no consumption of beverages containing caffeine, and no participation in physical activity 2 hours before the recording session; female subjects could not be menstruating on a day of recording. Results: A total of 2550 recordings for the cervical area and the lumbar area was recorded. Strong significant correlations were found for the left (r = .77) and right (r = .71) lumbar sections ( P b .0001) whereas weaker significant correlations were observed for the left (r = .56) and right (r = .63) cervical areas ( P b .0001). The limits of agreement (Bland-Altman) showed good relationships but poor interchangeability. Conclusions: In this study, the infrared cameras showed that they were valid tools in a controlled environment; however, the technique for the cervical measurements needs to be reassessed. (J Manipulative Physiol Ther 2006;29:150-155)

Research paper thumbnail of Paraspinal Cutaneous Temperature Modification After Spinal Manipulation at L5

Journal of Manipulative and Physiological Therapeutics, 2010

The purpose of this study was to investigate local paraspinal cutaneous temperature (CT) modifica... more The purpose of this study was to investigate local paraspinal cutaneous temperature (CT) modifications after spinal manipulative therapy at L5. Twenty subjects with acute low back symptoms were randomly assigned to either a treatment or a sham group (n = 10 per group). Subjects underwent an 8-minute acclimatizing period. Temperature was measured bilaterally with infrared cameras at the L5 level. In the treatment group, a traditional chiropractic manipulation (lumbar roll technique with a pisiform contact on the ipsilateral mamillary of L5) was delivered, whereas with the sham group, the same technique was used, but no thrust was applied. Cutaneous temperature control measurements were taken 2 minutes before (t(-2)) and immediately after the intervention (t(0)) and at 1, 3, 5, and 10 minutes postintervention (t(1), t(3), t(5), and t(10), respectively). At t(0), CT in the treatment group on the treatment side (ipsilateral side) warmed up by 0.2 degrees F, whereas in the sham group, there were no significant temperature modifications on either side. At t(3) relative to t(0), CT in the treatment group on the treatment side warmed by approximately 0.6 degrees F, whereas the contralateral side (nontreatment side) cooled. In the treatment group, significant differences were noted between sides (F = 13.36, P = .002, P = .932) and sides x times (F = 2.97, P = .016, P = .838). The effects of a lumbar spine manipulation appear noticeable by changes in paraspinal CT measurements at the level of L5. However, the meaning and mechanisms of CT modifications at L5 are still being investigated.

Research paper thumbnail of Effects of a Manually Assisted Mechanical Force on Cutaneous Temperature

Journal of Manipulative and Physiological Therapeutics, 2008

Objective: Digitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous... more Objective: Digitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous temperature (CT). This project ascertains the effect of a manually assisted mechanical force producing a chiropractic adjustment in the lumbar spine after the Activator Methods Chiropractic Technique on CT during 2 different time recording periods (TRPs). Methods: Sixty-six healthy subjects (36 women and 30 men) without acute low back conditions or symptoms were recruited. Subjects were randomly divided into 2 groups based on the length of the acclimatization period (8 or 30 minutes; TRP 8 and TRP 30 , respectively). In turn, each recording period group was divided into 3 subgroups (n = 11 per subgroup): treatment, sham, and control subgroups. Bilateral DIST was conducted at L-4 (TRP 30 ) and L-5 (TRP 8 ) using infrared cameras (Subluxation Station Insight 7000; Chiropractic Leadership Alliance, Mahwah, NJ). Results: Before treatment (t −0.5 ), the TRP 8 CT was significantly different between the ipsilateral and the contralateral sides for all subgroups. At 10 minutes (t 10 ) after intervention, CT increased significantly (P b .05) for the treatment group but not for the sham and control groups. In contrast, there were no significant differences in the TRP 30 CT before treatment between the ipsilateral and the contralateral sides; but at t 10 , CT was significantly (P b .05) greater for all 3 subgroups compared with preintervention CT. Conclusion: Contacting the skin with the instrument with (treatment group TRP 30 ) or without (sham group TRP 30 ) a thrust with a sustained pressure stronger than the loading principle taught in the Activator Methods Chiropractic Technique protocol or a thrust respecting the standard loading principle (treatment group TRP 8 ) of the instrument produced a CT cooling immediately after the adjustment. Furthermore, we observed that when contacting the skin with the instrument with a thrust respecting the standard loading principle (treatment group TRP 8 ) of the instrument, it produced a secondary cooling at t 5 followed by a rewarming at t 10 . Finally, contacting the skin with the instrument without a thrust and respecting the standard loading principle (sham TRP 8 ) of the instrument did not produce a CT change. (J Manipulative Physiol Ther 2008;31:230-236)

Research paper thumbnail of Consistency of Cutaneous Thermal Scanning Measures Using Prone and Standing Protocols: A Pilot Study

Journal of Manipulative and Physiological Therapeutics, 2010

The goal of this pilot study was to measure paraspinal cutaneous temperature (PCT) in the prone v... more The goal of this pilot study was to measure paraspinal cutaneous temperature (PCT) in the prone vs standing position. Ten symptom-free participants were evaluated. Paraspinal cutaneous temperature was recorded. Subjects were acclimated to the treatment room in a prone position for 8 minutes before the PCT was measured. After the prone PCT reading, patients stood. A standing PCT measurement was then taken. Paraspinal cutaneous temperature was marginally warmer when subjects were standing vs prone (PCT difference, 0.25 degrees C +/- 0.64 degrees C and 0.62 degrees C +/- 0.67 degrees C for left and right sides, respectively). The right and left side differential was the same in the prone and standing positions. There was a positive Pearson correlation (0.802-0.803; P < .000) between the standing and prone positions for both left and right sides. There are no differences between the prone or standing PCT measures if symptom-free subjects are given 8 minutes to acclimate before recording PCT measures.

Research paper thumbnail of Digitized Infrared Segmental Thermometry: Time Requirements for Stable Recordings

Journal of Manipulative and Physiological Therapeutics, 2006

Objectives: Digitized infrared segmental thermometry (DIST) is a method for measuring and recordi... more Objectives: Digitized infrared segmental thermometry (DIST) is a method for measuring and recording skin surface body temperatures. The project evaluated the required length of time for patients to acclimatize their core body temperature to ambient conditions to obtain stable DIST readings. Methods: Seventeen subjects were allowed a 20-minute acclimatizing period in a temperature-controlled room. The bilateral DIST temperature was measured with thermistors in combination with infrared cameras (IRCs) at the C4 and L4 levels. All IRC temperatures were recorded after a 20-minute stabilization period. The room temperature and relative humidity were recorded throughout all trials. The acclimatization trend was computed from the 20-to 24-minute period for the IRCs, and the acclimatization trend was computed continuously for a total of 30 minutes (at 2-minute intervals) for 5 days. Results: We discovered a stabilization trend in the early trial stages, with the thermistor recordings between 8 and 16 minutes. The IRC trend was also conclusive for the core temperature requirements. Conclusions: This study determined a core body temperature acclimatization trend tested among patients using thermistor recordings in a controlled environment. Based on these findings, we recommend acclimatization in a temperature-and humidity-controlled environment for a minimum 8-minute period, followed by an 8-minute maximum recording period with the patient in a prone position to obtain accurate DIST recordings. (J Manipulative Physiol Ther 2006;29:468.e1-468.e10)

Research paper thumbnail of Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain? The Importance of Controlling for Respiration Rate Changes

Journal of Manipulative and Physiological Therapeutics, 2010

Research paper thumbnail of Comparison of Paraspinal Cutaneous Temperature Measurements Between Subjects With and Without Chronic Low Back Pain

Journal of Manipulative and Physiological Therapeutics, 2013

Objective: The purpose of this study was to evaluate the effects of chiropractic manipulative tre... more Objective: The purpose of this study was to evaluate the effects of chiropractic manipulative treatment on paraspinal cutaneous temperature (PCT) for subjects with chronic low back pain and compare these PCT findings to subjects without chronic low back pain. Methods: Two groups were created, a symptomatic treatment group (subjects with chronic low back pain, n = 11, 7 males, 4 females) and an asymptomatic, nontreatment group (asymptomatic subjects, n = 10, 6 males, 4 females). Outcomes included the modified Oswestry questionnaire and PCT measurements in the prone position after an 8minute acclimation period. The treatment group received 9 chiropractic spinal instrument-based manipulative treatments over 2 weeks. Reevaluation was done 2 weeks after the initial evaluation for both groups. Results: The preintervention Oswestry results (29.8% ± 11.8%) for the treatment group were higher than the asymptomatic group (10.2% ± 10.6%). The postintervention Oswestry results for the treatment group were 14.20 % ± 11.5%. The resulting Cohen's effect size of the spinal manipulation on the Oswestry evaluation is 0.58. The preintervention PCT showed higher temperature for the nontreatment group compared with the treatment group. Comparing the levels associated with low back pain, the nontreatment group PCT was stable, varying from 0.01°C to 0.02°C, whereas the treatment group PCT varied from 0.10°C to 0.18°C. The treatment group postintervention PCT showed an increase in temperature after the 9 visits; however, this did not reach the values of the asymptomatic group. Conclusion: The PCT readings for subjects with chronic low back pain were lower than the asymptomatic, nontreatment group. The PCT temperature of the treatment group increased after 9 treatments. (J Manipulative Physiol Ther 2013;36:44-50)

Research paper thumbnail of Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain

Journal of Chiropractic Medicine, 2010

Objective: Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been e... more Objective: Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been evaluated in response to a short course of lumbar spinal manipulation. The purpose of this study is to observe the responses of inflammatory markers (IL-6 and CRP) after a series of 9 chiropractic spinal manipulations. Methods: Twenty-one participants were assigned to a treatment or a control group. Only the treatment group received 9 chiropractic interventions. Pre-and postintervention measures were recorded for blood samples for detection of proinflammatory cytokines IL-6 and CRP. Results: Mediators of inflammation (IL-6 and high-sensitivity CRP) were modified by the intervention received in the treatment group, and the effect size demonstrated a tendency toward the control group values. Conclusion: A total of 9 chiropractic lower back manipulations caused the mediators of inflammation to present a normalization response in individuals suffering from chronic low back pain.