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Altered Central Integration of Dual Somatosensory InputAfter Cervical Spine Manipulation

By |October 9, 2015|Chiropractic Care, Spinal Manipulation, Subluxation|

Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2010 (Mar);   33 (3):   178–188 ~ FULL TEXT

Heidi Haavik Taylor, PhD, BSc, Bernadette Murphy, PhD, DC

Director of Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.
heidi.taylor@nzchiro.co.nz


OBJECTIVE:   The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a session of spinal manipulation of dysfunctional cervical joints.

METHOD:   Dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was used in 13 subjects with a history of reoccurring neck stiffness and/or neck pain but no acute symptoms at the time of the study. Somatosensory evoked potentials were recorded after median and ulnar nerve stimulation at the wrist (1 millisecond square wave pulse, 2.47 Hz, 1 x motor threshold). The SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves.

RESULTS:   There was a significant decrease in the MU/M + U ratio for the cortical P22-N30 SEP component after chiropractic manipulation of the cervical spine. The P22-N30 cortical ratio change appears to be due to an increased ability to suppress the dual input as there was also a significant decrease in the amplitude of the MU recordings for the same cortical SEP peak (P22-N30) after the manipulations. No changes were observed after a control intervention.

There are more articles like this @ our:

What is the Chiropractic Subluxation Page and the:

Chronic Neck Pain and Chiropractic Page

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Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically?

By |September 1, 2015|Chiropractic Care, Low Back Pain, Spinal Manipulation|

Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls?

The Chiro.Org Blog


SOURCE:   Spine 2015 (Sep 1);   40 (17):   1329–1337 ~ FULL TEXT

Wong, Arnold Y. L. PT, MPhil, PhD; Parent, Eric C. PT, PhD;
Dhillon, Sukhvinder S. MB, ChB, CCST; Prasad, Narasimha PhD;
Kawchuk, Gregory N. DC, PhD

Department of Rehabilitation Sciences,
The Hong Kong Polytechnic University,
Kowloon, Hong Kong

Department of Physical Therapy,
University of Alberta,
Alberta, Canada


FROM: University of Alberta ~ 8-31-2015

Researchers at the University of Alberta have found that spinal manipulation—applying force to move joints to treat pain, a technique most often used by chiropractors and physical therapists — does indeed have immediate benefits for some patients with low-back pain but does not work for others with low-back pain. And though on the surface this latest conflict might appear to muddy the waters further, the results point to the complexity of low-back pain and the need to treat patients differently, says lead author Greg Kawchuk.

“This study shows that, just like some people respond differently to a specific medication, there are different groups of people who respond differently to spinal manipulation.”

In a non-randomized control study, individuals with low-back pain received spinal manipulation during two treatment sessions that spanned a week. Participants reported their pain levels and disability levels after spinal manipulation, and researchers used ultrasound, MRI and other diagnostics to measure changes in each participant’s back, including muscle activity, properties within the intervertebral discs, and spinal stiffness.

A control group of participants with low-back pain underwent similar clinical examinations but did not receive spinal manipulation. A third group — those who did not have low-back pain symptoms — were also evaluated.

The people who responded to spinal manipulation reported less pain right away and showed improvement in back muscle thickness, disc diffusion and spinal stiffness. Those changes were great enough to exceed or equal the measures in the control groups and stayed that way for the week of treatment, the research team found.
A patient receives spinal manipulation treatment.

Kawchuk, who practised as a chiropractor before going on to obtain his PhD in biomechanics and bioengineering, said the results do not advocate one way or another for spinal manipulation but help explain why there has been so much conflicting data about its merits.

“Clearly there are some people with a specific type of back pain who are responding to this treatment and there are some people with another type of back pain who do not. But if you don’t know that and you mix those two groups together, you get an artificial average that doesn’t mean anything,” Kawchuk explained.

The research team is still fine-tuning how to distinguish who is a responder or non-responder before spinal manipulation is given; however, this study shows it can be used to identify an effective treatment course.

“Spinal manipulation acts so rapidly in responders that it could be used as a screening tool to help get the right treatment to the right patient at the right time.”

The study did not investigate the long-term effects of spinal manipulation, but this is next on the list for the researchers.

STUDY DESIGN:   Nonrandomized controlled study.

OBJECTIVE:   To determine whether patients with low back pain (LBP) who respond to spinal manipulative therapy (SMT) differ biomechanically from nonresponders, untreated controls or asymptomatic controls.

SUMMARY OF BACKGROUND DATA:   Some but not all patients with LBP report improvement in function after SMT. When compared with nonresponders, studies suggest that SMT responders demonstrate significant changes in spinal stiffness, muscle contraction, and disc diffusion. Unfortunately, the significance of these observations remains uncertain given methodological differences between studies including a lack of controls.

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Low Back Pain and Chiropractic Page

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Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness and Impaired Head Repositioning of Suspected Cervical Origin

By |March 22, 2015|Spinal Manipulation, Vertigo|

Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness and Impaired Head Repositioning of Suspected Cervical Origin:
A Pilot Study

The Chiro.Org Blog


SOURCE:   Man Ther 2000 (Aug);   5 (3):   151–157

Heikkila H, Johansson M, Wenngren BI

Department of Otorhinolaryngology,
Northern Sweden University Hospital,
Umea, Sweden.
hannu.heikkila@psychiat.umu.se


In a single-subject experiment undertaken on 14 consecutive patients, the effects of acupuncture, cervical manipulation, no therapy, and NSAID-percutan application on kinesthetic sensibility, dizziness/vertigo and pain were studied in patients with dizziness/vertigo of suspected cervical origin. The ability to perceive position of the head with respect to the trunk was studied. The effects of different forms of therapy-and none-on dizziness and neck pain were compared, using a 100 mm visual analogue scale (VAS). Active head relocation by subjects with dizziness was significantly less precise than in the control group. Manipulation was the only treatment to diminish the duration of dizziness/vertigo complaints during the past 7 days and increased the cervical range of motion.

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Vertigo, Balance and Chiropractic Page

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Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-type Headache: A Randomized, Controlled Clinical Trial

By |March 21, 2015|Headache, Spinal Manipulation|

Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-type Headache: A Randomized, Controlled Clinical Trial

The Chiro.Org Blog


SOURCE:   J Chiropr Med. 2014 (Mar);   13 (1):   4—13

Espí-López Gemma V., PhD, PT, and Gómez-Conesa Antonia, PhD, PT

Professor, Physiotherapy Department,
University of Valencia, Spain


OBJECTIVE:   The purpose of this study was to evaluate the efficacy of manipulative and manual therapy treatments with regard to pain perception and neck mobility in patients with tension-type headache.

METHODS:   A randomized clinical trial was conducted on 84 adults diagnosed with tension-type headache. Eighty-four subjects were enrolled in this study: 68 women and 16 men. Mean age was 39.76 years, ranging from 18 to 65 years. A total of 57.1% were diagnosed with chronic tension-type headache and 42.9% with tension-type headache. Participants were divided into 3 treatment groups (manual therapy, manipulative therapy, a combination of manual and manipulative therapy) and a control group. Four treatment sessions were administered during 4 weeks, with posttreatment assessment and follow-up at 1 month. Cervical ranges of motion pain perception, and frequency and intensity of headaches were assessed.

RESULTS:   All 3 treatment groups showed significant improvements in the different dimensions of pain perception. Manual therapy and manipulative treatment improved some cervical ranges of motion. Headache frequency was reduced with manipulative treatment (P < .008). Combined treatment reported improvement after the treatment (P < .000) and at follow-up (P < .002). Pain intensity improved after the treatment and at follow-up with manipulative therapy (P < .01) and combined treatment (P < .01).

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Headache and Chiropractic Page

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Spinal Manipulative Therapy and Somatosensory Activation

By |March 13, 2015|Spinal Manipulation, Subluxation|

Spinal Manipulative Therapy and
Somatosensory Activation

The Chiro.Org Blog


SOURCE:   J Electromyogr Kinesiol. 2012 (Oct);   22 (5):   785–794

Joel G Pickar, DC PhD and Philip S Bolton, DC PhD

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
Davenport, IA, USA.
pickar_j@palmer.edu


Manually-applied movement and mobilization of body parts as a healing activity has been used for centuries. A relatively high velocity, low amplitude force applied to the vertebral column with therapeutic intent, referred to as spinal manipulative therapy (SMT), is one such activity. It is most commonly used by chiropractors, but other healthcare practitioners including osteopaths and physiotherapists also perform SMT. The mechanisms responsible for the therapeutic effects of SMT remain unclear. Early theories proposed that the nervous system mediates the effects of SMT. The goal of this article is to briefly update our knowledge regarding several physical characteristics of an applied SMT, and review what is known about the signaling characteristics of sensory neurons innervating the vertebral column in response to spinal manipulation. Based upon the experimental literature, we propose that SMT may produce a sustained change in the synaptic efficacy of central neurons by evoking a high frequency, bursting discharge from several types of dynamically-sensitive, mechanosensitive paraspinal primary afferent neurons.


From the FULL TEXT Article:

INTRODUCTION

Manually-applied movement and mobilisation of body parts as a healing activity has been used for centuries (Wiese & Callender, 2005). A relatively high velocity, low amplitude force applied to the vertebral column with therapeutic intent, referred to as spinal manipulative therapy (SMT), is one such activity. It is most commonly used by chiropractors, but other healthcare practitioners including osteopaths and physiotherapists use it as well. Although SMT has been advocated for a wide range of health problems (Ernst & Gilbey, 2010), currently available best evidence suggests it has a therapeutic effect on people suffering some forms of acute neck and back pain particularly when it is used in combination with other therapies (Brønfort et al, 2004; Brønfort et al, 2010; Dagenais et al, 2010; Miller et al 2010; Walker et al 2010; Lau et al 2011). Its effect on chronic low back pain is less clear (Rubinstein et al 2011; Walker et al 2010).

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What is the Chiropractic Subluxation? Page

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Spinal Pain in Adolescents

By |February 2, 2015|Pediatrics, Spinal Joint Pain, Spinal Manipulation|

Spinal Pain in Adolescents: Prevalence, Incidence, and Course: A School-based Two-year Prospective Cohort Study in 1,300 Danes Aged 11-13

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2014 (May 29);   15:   187 ~ FULL TEXT

Ellen Aartun, Jan Hartvigsen, Niels Wedderkopp,
and Lise Hestbaek

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Odense, Denmark


BACKGROUND:   The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain).

METHODS:   This study was a school-based prospective cohort study. All 5th and 6th grade students (11-13 years) at 14 schools in the Region of Southern Denmark were invited to participate (N=1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time.

RESULTS:   The lifetime prevalence of spinal pain was 86% and 89% at baseline and follow-up, respectively. A group of 13.6% (95% CI: 11.8, 15.6) at baseline and 19.5% (95% CI: 17.1, 22.0) at follow-up reported that they had pain frequently. The frequency of pain was strongly associated with the intensity of pain, i.e., the majority of the participants reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period.

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Pediatrics Page

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