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The effects of a single session of spinal manipulation on strength and cortical drive in athletes
European journal of applied physiology, 2018
The primary purpose of this study was to investigate whether a single session of spinal manipulation (SM) increases strength and cortical drive in the lower limb (soleus muscle) of elite Taekwondo athletes. Soleus-evoked V-waves, H-reflex and maximum voluntary contraction (MVC) of the plantar flexors were recorded from 11 elite Taekwondo athletes using a randomized controlled crossover design. Interventions were either SM or passive movement control. Outcomes were assessed at pre-intervention and at three post-intervention time periods (immediate post, post 30 min and post 60 min). A multifactorial repeated measures ANOVA was conducted to assess within and between group differences. Time and session were used as factors. A post hoc analysis was carried out, when an interactive effect was present. Significance was set at p ≤ 0.05. SM increased MVC force [F(3,30) = 5.95, p < 0.01], and V-waves [F(3,30) = 4.25, p = 0.01] over time compared to the control intervention. Between group ...
Objectives: To analyse the acute effects of spinal manipulation on neuromuscular function in asymptomatic individuals. Design: Randomised controlled, cross-over trial. Settings: Spinal manipulation (SM) is used as therapeutic modality for various neuromuscular disorders and also in sport with asymptomatic individuals to improve range of motion and/or facilitate motor control. Experimental evidence of its effectiveness is lacking. Participants: 27 asymptomatic participants (15 males and 12 females) [age (mean ± standard deviation) 24 ± 3 years] were exposed to three separate treatments in random order: 1) Spinal Manipulation of the lumbar spine (MAN); 2) Stretching of the Lumbar spine (STR); 3) sham manipulation (SHA). Main outcome measures: Before (PRE), after (POST) and 15 min after (15_MIN) each treatment, the participants were asked to perform three tasks always in the same order: 1) force fluctuation task; 2) Modified S€ orensen's test; 3) sit and reach. Surface EMG was recorded from Gastrocnemius medialis and Erector Spinae muscles using linear arrays during task 1 and 2. Results: MAN was not shown to determine improvements superior to other treatments in the control of force output and sEMG parameters. Conclusions: Studies with larger populations are needed in order to ascertain the effectiveness of SM on neuromuscular function.
Chiropractic & Manual Therapies, 2019
Introduction: The effectiveness of spinal manipulative therapy (SMT) for improving athletic performance in healthy athletes is unclear. Assessing the effect of SMT on other performance outcomes in asymptomatic populations may provide insight into the management of athletes where direct evidence may not be available. Our objective was to systematically review the literature on the effect of SMT on performance-related outcomes in asymptomatic adults. Methods: MEDLINE, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials were systematically searched from 1990 to March 23, 2018. Inclusion criteria was any study examining a performance-related outcome of SMT in asymptomatic adults. Methodological quality was assessed using the SIGN criteria. Studies with a low risk of bias were considered scientifically admissible for a best evidence synthesis. We calculated the between group mean change and 95% confidence intervals. Results: Of 1415 articles screened, 20 studies had low risk of bias, seven were randomized crossover trials, 10 were randomized controlled trials (RCT) and three were RCT pilot trials. Four studies showed SMT had no effect on physiological parameters at rest or during exercise. There was no effect of SMT on scapular kinematics or transversus abdominus thickness. Three studies identified changes in muscle activation of the upper or lower limb, compared to two that did not. Five studies showed changes in range of motion (ROM). One study showed an increase lumbar proprioception and two identified changes in baropodometric variables after SMT. Sport-specific studies show no effect of SMT except for a small increase in basketball free-throw accuracy. Conclusion: The preponderance of evidence suggests that SMT in comparison to sham or other interventions does not enhance performance-based outcomes in asymptomatic adult population. All studies are exploratory with immediate effects. In the few studies suggesting a positive immediate effect, the importance of such change is uncertain. Further high-quality performance specific studies are required to confirm these preliminary findings.
Spinal Manipulative Therapy and Sports Performance Enhancement: A Systematic Review
Journal of Manipulative and Physiological Therapeutics, 2017
Objective: The purpose of this study was to review the literature regarding the relationship between spinal manipulative therapy (SMT) and sports performance. Methods: PubMed and Embase databases were searched for original studies published up to July 2016. Inclusion criteria were if SMT has been applied to athletes and if any sports performance-related outcome was measured. Results: Of the 581 potential studies, 7 clinical trials were selected. Most studies had adequate quality (≥6/11) when assessed by the PEDro scale. None of those studies assessed performance at an event or competition. Four studies revealed improvement in a sports performance test after SMT. Meta-analysis could not be performed because of the wide differences in methodologies, design, and outcomes measured. Spinal manipulative therapy influences a wide range of neurophysiological parameters that could be associated with sports performance. Of the 3 studies where SMT did not improve test performance, 2 used SMT not for therapeutic correction of a dysfunctional vertebral joint but to an arbitrary previously set joint. Conclusions: Although 4 of 7 studies showed that SMT improved sports performance tests, the evidence is still weak to support its use. Spinal manipulative therapy may be a promising approach for performance enhancement that should be investigated with more consistent methodologic designs.
Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles
Brain Sciences, 2016
This study investigates whether spinal manipulation leads to changes in motor control by measuring the recruitment pattern of motor units in both an upper and lower limb muscle and to see whether such changes may at least in part occur at the cortical level by recording movement related cortical potential (MRCP) amplitudes. In experiment one, transcranial magnetic stimulation input-output (TMS I/O) curves for an upper limb muscle (abductor pollicus brevis; APB) were recorded, along with F waves before and after either spinal manipulation or a control intervention for the same subjects on two different days. During two separate days, lower limb TMS I/O curves and MRCPs were recorded from tibialis anterior muscle (TA) pre and post spinal manipulation. Dependent measures were compared with repeated measures analysis of variance, with p set at 0.05. Spinal manipulation resulted in a 54.5% ± 93.1% increase in maximum motor evoked potential (MEPmax) for APB and a 44.6% ± 69.6% increase in MEPmax for TA. For the MRCP data following spinal manipulation there were significant difference for amplitude of early bereitschafts-potential (EBP), late bereitschafts potential (LBP) and also for peak negativity (PN). The results of this study show that spinal manipulation leads to changes in cortical excitability, as measured by significantly larger MEPmax for TMS induced input-output curves for both an upper and lower limb muscle, and with larger amplitudes of MRCP component post manipulation. No changes in spinal measures (i.e., F wave amplitudes or persistence) were observed, and no changes were shown following the control condition. These results are consistent with previous findings that have suggested increases in strength following spinal manipulation were due to descending cortical drive and could not be explained by changes at the level of the spinal cord. Spinal manipulation may therefore be indicated for the patients who have lost tonus of their muscle and/or are recovering from muscle degrading dysfunctions such as stroke or orthopaedic operations and/or may also be of interest to sports performers. These findings should be followed up in the relevant populations.
International Journal for Research in Applied Science & Engineering Technology (IJRASET), 2022
The amount of research behind spinal manipulation is growing, however, very little attention has been paid to the possible impacts SM has on athletes-or furthermore strength athletes. The central research question is "What impact does spinal manipulation have on strength athletes?". The objective of this research question is to guide the exploration and observation of how spinal manipulation impacts the performance of strength athletes. This was achieved via an international research survey. A null and alternative hypothesis was established. Each question was designed to measure how effective SM was on strength performance. There were 5 questions in total that covered the most prominent results in the literature; recovery, technique, R.O.M, pain, strength. Each question required an answer between 1-10, determining how effective the participant felt SM was regarding that specific topic, and each participant's survey would be submitted out of 50, covering 5 questions worth 1/10 each. 69 participants (n=69; ±0.10-10%) enrolled in the research article, 81.2% male, 18.8% female and between the age of 21-55. The null hypothesis was successfully rejected with 95% of the sample population scoring a sample mean value (33.7, 95% CI 31.2-36.3) >25 (over 50%), meeting the critical value inclusion criteria of 5% (P = 0.05); concluding it statistically significant with 95% confidence Interval, a 2.6 margin of error and a SD of 10.8. That is a 67% result in favour to SM being effective for strength performance. In conclusion: the data shows that spinal manipulation is an effective treatment to improve overall performance in strength athletes, this includes pain modulation, ROM, technique, strength and recovery improvements.
The Neuromuscular Response to Spinal Manipulation in the Presence of Pain
Journal of manipulative and physiological therapeutics, 2016
The purpose of this study was to evaluate differences in muscle activity in participants with and without low back pain during a side-lying lumbar diversified spinal manipulation. Surface and indwelling electromyography at eight muscle locations were recorded during lumbar side-lying manipulations in 20 asymptomatic participants and 20 participants with low back pain. The number of muscle responses and muscle activity onset delays in relation to the manipulation impulse were compared in the 2 pain groups using mixed linear regressions. Effect sizes for all comparisons were calculated using Cohen's d. Muscle responses occurred in 61.6% ± 23.6% of the EMG locations in the asymptomatic group and 52.8% ± 26.3% of the symptomatic group. The difference was not statistically significant but there was a small effect of pain (d = 0.350). Muscle activity onset delays were longer for the symptomatic group at every EMG location except the right side indwelling L5 electrode, and a small effe...
Gait & posture, 2018
This study investigated the effects of a single exercise session using a device developed for postural muscle training on the function of postural muscles in healthy, pain free individuals. During standardised rapid arm movements, timing of onset of electromyography (EMG) was measured using intramuscular and surface recordings of the transversus abdominis (TrA), obliquus internus abdominis (OI), obliquus externus abdominis (OE), lumbar multifidus (LM) and lumbar erector spinae (LES) muscles. A single exercise session with the device led to significantly (main effect of time: P = 0.03) earlier LES EMG onset in advance of the postural perturbation induced by rapid forward arm movements from -1 ms (SD: 32 ms) at baseline to -11 ms (SD: 27 ms) post-exercise and -16 ms (SD: 22 ms) at 10-min Wash-Out after the FRED exercise bout. The timing of EMG onset of the other trunk muscles was not affected by the single bout of exercise. A significant correlation was found between background activi...
Journal of Manipulative and Physiological Therapeutics, 2000
Objective: The objective of this study was to determine whether mechanical force, manually-assisted (MFMA) spinal manipulative therapy (SMT) affects paraspinal muscle strength as assessed through use of surface electromyography (sEMG). Design: Prospective clinical trial comparing sEMG output in 1 active treatment group and 2 control groups. Setting: Outpatient chiropractic clinic, Phoenix, AZ. Subjects: Forty subjects with low back pain (LBP) participated in the study. Twenty patients with LBP (9 females and 11 males with a mean age of 35 years and 51 years, respectively) and 20 age-and sex-matched sham-SMT/control LBP subjects (10 females and 10 males with a mean age of 40 years and 52 years, respectively) were assessed. Methods: Twenty consecutive patients with LBP (SMT treatment group) performed maximum voluntary contraction (MVC) isometric trunk extensions while lying prone on a treatment table. Surface, linear-enveloped sEMG was recorded from the erector spinae musculature at L3 and L5 during a trunk extension procedure. Patients were then assessed through use of the Activator Methods Chiropractic Technique protocol, during which time they were treated through use of MFMA SMT. The MFMA SMT treatment was followed by a dynamic stiffness and algometry assessment, after which a second or post-MVC isometric trunk extension and sEMG assessment were performed. Another 20 consecutive subjects with LBP were assigned to one of two other groups, a sham-SMT group and a control group. The sham-SMT group underwent the same experimental protocol with the exception that the subjects received a sham-MFMA SMT and dynamic stiffness assessment. The control group subjects received no SMT treatment, stiffness assessment , or algometry assessment intervention. Within-group analysis of MVC sEMG output (pre-SMT vs post-SMT sEMG output) and across-group analysis of MVC sEMG output ratio (post-SMT sEMG/pre-SMT sEMG output) during MVC was performed through use of a paired observations t test (POTT) and a robust analysis of variance (RANOVA), respectively. Main Outcome Measures: Surface, linear-enveloped EMG recordings during isometric MVC trunk extension were used as the primary outcome measure. Results: Nineteen of the 20 patients in the SMT treatment group showed a positive increase in sEMG output during MVC (range,-9.7% to 66.8%) after the active MFMA SMT treatment and stiffness assessment. The SMT treatment group showed a significant (POTT, P < .001) increase in erector spinae muscle sEMG output (21% increase in comparison with pre-SMT levels) during MVC isometric trunk extension trials. There were no significant changes in pre-SMT vs post-SMT MVC sEMG output for the sham-SMT (5.8% increase) and control (3.9% increase) groups. Moreover, the sEMG output ratio of the SMT treatment group was significantly greater (robust analysis of variance, P = .05) than either that of the sham-SMT group or that of the control group. Conclusions: The results of this preliminary clinical trial demonstrated that MFMA SMT results in a significant increase in sEMG erector spinae isometric MVC muscle output. These findings indicate that altered muscle function may be a potential short-term therapeutic effect of MFMA SMT, and they form a basis for a randomized, controlled clinical trial to further investigate acute and long-term changes in low back function.
Journal of Manipulative and Physiological Therapeutics, 2013
Objective: It is believed that systematic modulation of spinal manipulative therapy (SMT) parameters should yield varying levels of physiological responses and eventually a range of clinical responses. However, investigation of SMT dose-physiological response relationship is recent and has mostly been conducted using animal or cadaveric models. The main objective of the present study is to investigate SMT dose-physiological response relation in humans by determining how different levels of force can modify electromyographic (EMG) responses to spinal manipulation. Methods: Twenty-six participants were subjected to 2 trials of 4 different SMT force-time profiles using a servocontrolled linear actuator motor. Normalized EMG activity of paraspinal muscles (left and right muscles at level T6 and T8) was recorded during and after SMT, and EMG values were compared across the varying levels of force. Results: Increasing the level of force yielded an increase in paraspinal muscle EMG activity during the thrust phase of SMT but also in the two 250-millisecond time windows after the spinal manipulation impulse. These muscle activations quickly attenuated (500 milliseconds after spinal manipulation impulse). Conclusion: The study confirmed the presence of a local paraspinal EMG response after SMT and highlighted the linear relationship between the SMT peak force and paraspinal muscle activation.