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Kovanur Sampath K, Tumilty S, Wooten L, Belcher S, Farrell G, Gisselman AS. Effectiveness of spinal manipulation in influencing the autonomic nervous system - a systematic review and meta-analysis. J Man Manip Ther 2024; 32:10-27. [PMID: 38044657 PMCID: PMC10795624 DOI: 10.1080/10669817.2023.2285196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Spinal manipulation (SM) has been hypothesized to influence the autonomic nervous system (ANS). Further, it has been proposed that the effects may vary depending on the segment manipulated. The aim of this systematic review was to synthesize the current level of evidence for SM in influencing the ANS in healthy and/or symptomatic population. METHODS Various databases (n = 8) were searched (inception till May 2023) and 14 trials (n = 618 participants) were included in the review. Two authors independently screened, extracted and assessed the risk of bias in included studies. The data were synthesized using standard mean differences and meta-analysis for the primary outcome measures. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of the body of evidence for each outcome of interest. RESULTS Overall, there was low quality evidence that SM did not influence any measure of ANS including heart rate variability (HRV), oxy-hemoglobin, blood pressure, epinephrine and nor-epinephrine. However, there was low quality evidence that cervical spine manipulation may influence high frequency parameter of HRV, indicating its influence on the parasympathetic nervous system. CONCLUSION When compared with control or sham interventions, SM did not alter the ANS. Due to invalid methodologies and the low quality of included studies, findings must be interpreted with great caution. Future studies are needed which employ rigorous data collection processes to verify the true physiological implications of SM on ANS.
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Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology, Te Pukenga, Hamilton, New Zealand
- Faculty of Health, Bruce ACT, University of Canberra, Australia
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Liana Wooten
- Physical Therapy Program – Phoenix, Department of Rehabilitation Sciences, School of Medicine, Tufts University, Phoenix, United States of America
| | - Suzie Belcher
- Centre for Health and Social Practice, Waikato Institute of Technology, Te Pukenga, Hamilton, New Zealand
| | - Gerard Farrell
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Angela Spontelli Gisselman
- Physical Therapy Program – Phoenix, Department of Rehabilitation Sciences, School of Medicine, Tufts University, Phoenix, United States of America
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Fernández-Seguín LM, Peinado-Asensio M, Díaz-Mancha JA, Cortés-Vega MD, Heredia-Rizo AM. Short-Term Effect of Spinal Manipulation on the Magnitude of Exophoria in Adults Who Are Asymptomatic: A Randomized Controlled Trial. Phys Ther 2023; 103:pzad069. [PMID: 37347984 DOI: 10.1093/ptj/pzad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/21/2023] [Accepted: 04/20/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE This study aimed to assess the immediate and short-term effects of cervical spinal manipulation (SM), compared with a placebo, on the magnitude of near and distance exophoria in adults with asymptomatic exophoria. METHODS In this single-blind, randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria confirmed with the prism alternating cover test (PACT) were allocated to a single intervention session using a high-velocity, low-amplitude cervical SM technique or a sham intervention (manual contact under the head). Outcomes were the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency at near (40 cm) or distance (4 m) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up. RESULTS From May to September 2021, 44 volunteers (23 women), with a mean age of 35 (SD = 9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time × group interaction for exophoria at near vision, but not at distance fixation. The SM group showed a significant decrease of near exophoria compared with the control group at the 1-week follow-up (mean difference = -1.09 prism diopters; 95% CI = -0.20 to -1.98 prism diopters). CONCLUSION The use of cervical SM therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with the placebo, in young adults who are asymptomatic. However, these effects were not observed at distance fixation and should be considered cautiously due to the pre-post design with a single intervention session and the short-term follow-up. IMPACT The findings suggest short-term benefits of SM therapy can manage undiagnosed ocular convergence disorders, although changes were not clinically relevant.
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Affiliation(s)
- Lourdes Mª Fernández-Seguín
- Department of Physiotherapy , Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | | | - Juan Antonio Díaz-Mancha
- Department of Physiotherapy , Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - María-Dolores Cortés-Vega
- Department of Physiotherapy , Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Alberto M Heredia-Rizo
- Department of Physiotherapy , Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville (IBIS), Seville, Spain
- Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Seville, Spain
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Rogan S, Taeymans J, Berger I, Baur H. [Manual spinal therapy techniques to stimulate the autonomic nervous system: a scoping review]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2023; 37:67-78. [PMID: 37216936 DOI: 10.1055/a-1958-2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Physical interventions or manual therapeutic techniques (MTTe) such as mobilisation, manipulation or soft tissue techniques not only have an influence on the target tissue with improvement of metabolism or reduction of hypertonic muscles. They are also used for balance regulation in central nervous changes of the autonomic nervous system (ANS). To date, there is a lack of empirical evidence on impact mechanisms and target locations of MTTe on the ANS. This scoping review aims to provide an overview of the evidence on the application of MTTe at diverse levels of the spine with a view to the ANS. METHOD A systematic literature search was conducted on CENTRAL, Google Scholar, Osteopathic Research Web, PEDro and PubMed. The scope and content of the literature were documented. The results of the included and referenced studies were summarised in a narrative approach with the focus being on the most significant clinical aspects. RESULTS MTTe was described as manipulations, mobilisations, myofascial techniques and cervical traction. In 27 out of 35 studies, therapeutic treatments were carried out on healthy volunteers. Ten studies analysed immediate effects in patients, while two studies were designed as longitudinal studies in patients with hypertension. Over a period of four to eight weeks, the frequency of intervention was between one and three MTTe sessions a week. CONCLUSION The study results proved to be heterogeneous. For this reason, it is not possible to draw definitive, explicit and generally valid statements regarding the type and intensity as well as the segmental level at which MTTe should be applied in order to trigger specific positive ANS response mechanisms. Consequently, longitudinal studies with follow-up are recommended for future studies. In addition, comprehensive effects of MTTe should be evaluated in groups of patients with different characteristics.
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Affiliation(s)
- Slavko Rogan
- Gesundheit, Berner Fachhochschule, Bern, SWITZERLAND
| | - Jan Taeymans
- Gesundheit, Berner Fachhochschule, Bern, SWITZERLAND
| | - Ina Berger
- FHG - Zentrum für Gesundheitsberuf Tirol, innsbruck, AUSTRIA
| | - Heiner Baur
- Gesundheit, Berner Fachhochschule, Bern, SWITZERLAND
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Romanchuk O. Comparative features of the immediate impact of manual therapy traction manipulations on the cardiorespiratory system of men and women. PHYSICAL REHABILITATION AND RECREATIONAL HEALTH TECHNOLOGIES 2022; 7:130-142. [DOI: https:/doi.org/10.15391/prrht.2022-7(4).24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Purpose: the aim of this study was to determine the principal differences of changes in the cardiorespiratory system activity under the influence of traction manipulations in the thoracic spine of men and women. Material & Methods: the 26 adults were involved in the study, including 18 women aged 39.6±12.1 years and 8 men aged 36.3±8.3 years. All patients were diagnosed with osteochondrosis of the thoracic spine, which was confirmed by radiographic examination. The study of the cardiorespiratory system was conducted in the first procedure of SMT before and after the use of traction manipulations directly in the physician office. The integrated method of studying the cardiorespiratory system defined as spiroarteriocardiorhythmography (SACR) was used. It simultaneously records the heart rate, rhythms of systolic and diastolic pressure at each heartbeat and respiratory rhythms, which provides significant time savings to determine the functional state of the heart, vessels and respiration, as well as to identify the important parameters of their interaction. Results: characterizing the changes in the cardiorespiratory system as a whole under the influence of traction manipulations on the thoracic spine, it should be noted that men and women had some significant unidirectional changes in HR (min–1), CO (dm3), CI (dm3/m2), IH (n. u.), which are determined primarily by the decrease in HR (min–1) under the influence of traction manipulations. As to the men, the significant effects were more related to the impact on the contractile function of the heart, which was confirmed by the improvement of the electrical systole of the ventricles (QTC, s), the increase in the activity of the effects of the parasympathetic branch of the ANS on the cardiac rhythm (HF, ms2) and a certain increase in the stroke index within the normative values (SI, cm3/m2), then to the women the significant effects were more related to the influence on the breathing pattern and vascular tone. Thus, characteristic and positive effects in women can be considered a decrease in the variability of diastolic blood pressure in the very-low-frequency range (VLFDBP, mmHg2), which is combined with a decrease in the total power of diastolic pressure variability (TPDBP, mmHg2) and an increase in the total peripheral vascular resistance (GPVR, dyn/s/cm−5). Conclusions: summarizing the results of the impact of traction manipulations in the thoracic spine on the cardiorespiratory system of men and women, it can be stated that their effect is different and has features associated with the use of different mechanisms. For men, the predominant effect is on the heart contractile function, and for women it is on the respiratory system and autonomous regulation of vascular tone.
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Chang S, Maddox J, Berg E, Kim K, Messier S, Swanson L, Dobrusin R, Stein AB, Nakken GN, Noble J, Nydam R. Evaluating for a correlation between osteopathic examination and ultrasonography on thoracic spine asymmetry. J Osteopath Med 2021; 122:31-43. [PMID: 34643344 DOI: 10.1515/jom-2021-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT The thoracic spine is a common area of focus in osteopathic manipulative medicine (OMM) for a variety of conditions. Thoracic spine somatic dysfunction diagnosis is achieved by palpating for asymmetry at the tips of the transverse processes (TPs). Previous studies reveal that instead of following the rule of threes, the TPs of a given thoracic vertebra generally align with the spinous process (SP) of the vertebra above. Ultrasonography has been widely utilized as a diagnostic tool to monitor musculoskeletal conditions; it does not utilize ionizing radiation, and it has comparable results to gold-standard modalities. In the case of thoracic somatic dysfunction, ultrasound (US) can be utilized to determine the location of each vertebral TP and its relationship with the SP. Previous studies have investigated the correlation between OMM and ultrasonography of the cervical, lumbar, and sacral regions. However, there has been no study yet that has compared osteopathic structural examination with ultrasonographic examination of the thoracic vertebral region. OBJECTIVES To examine the relationship between osteopathic palpation and ultrasonographic measurements of the thoracic spine by creating a study design that utilizes interexaminer agreement and correlation. METHODS The ClinicalTrials.gov study identifier is NCT04823637. Subjects were student volunteers recruited from the Midwestern University (MWU)-Glendale campus. A nontoxic, nonpermanent marker was utilized to mark bony landmarks on the skin. Two neuromusculoskeletal board-certified physicians (OMM1, OMM2) separately performed structural exams by palpating T2-T5 TPs to determine vertebral rotation. Two sonographers (US1, US2) separately scanned and measured the distance from the tip of the SP to the adjacent TPs of the vertebral segment below. Demographic variables were summarized with mean and standard deviation. Interexaminer agreement was assessed with percent agreement, Cohen's Kappa, and Fleiss' Kappa. Correlation was measured by Spearman's rank correlation coefficient. Recruitment and protocols were approved by the MWU Institutional Review Board (IRB). RESULTS US had fair interexaminer agreement for the overall most prominent segmental rotation of the T3-T5 thoracic spine, with Cohen's Kappa at 0.27 (0.09, 0.45), and a total agreement percentage at 51.5%. Osteopathic palpation revealed low interexaminer agreement for the overall most prominent vertebral rotation, with Cohen's Kappa at 0.05 (0.0, 0.27), and 31.8%. Segment-specific vertebral analysis revealed slight agreement between US examiners, with a correlation coefficient of 0.23, whereas all other pairwise comparisons showed low agreement and correlation. At T4, US had slight interexaminer agreement with 0.24 correlation coefficient, and osteopathic palpation showed low interexaminer (OMM1 vs. OMM2) agreement (0.17 correlation coefficient). At T5, there was moderate agreement between the two sonographers with 0.44 (0.27, 0.60) and 63.6%, with a correlation coefficient of 0.57, and slight agreement between OMM1 and OMM2 with 0.12 (0.0, 0.28) and 42.4%, with 0.23 correlation coefficient. CONCLUSIONS This preliminary study of an asymptomatic population revealed that there is a low-to-moderate interexaminer reliability between sonographers, low-to-slight interexaminer reliability between osteopathic physicians, and low interexaminer reliability between OMM palpatory examination and ultrasonographic evaluation of the thoracic spine.
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Affiliation(s)
- Shirley Chang
- Department of Osteopathic Manipulative Medicine, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Jason Maddox
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Erich Berg
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Karen Kim
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Scott Messier
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Loren Swanson
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Richard Dobrusin
- Department of Osteopathic Manipulative Medicine, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Amy B Stein
- Office of Research and Sponsored Programs, Midwesetern University, Glendale, AZ, USA
| | - G Nathan Nakken
- Department of Osteopathic Manipulative Medicine, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Jeannine Noble
- Department of Anatomy, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Randall Nydam
- Department of Anatomy, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
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Kovanur Sampath K, Mani R, Katare R, Neale J, Cotter J, Tumilty S. Thoracic Spinal Manipulation Effect on Neuroendocrine Response in People With Achilles Tendinopathy: A Randomized Crossover Trial. J Manipulative Physiol Ther 2021; 44:420-431. [PMID: 34376321 DOI: 10.1016/j.jmpt.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/13/2020] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The purpose of the present study was to determine the neuroendocrine response after a thoracic spinal manipulation in people with Achilles tendinopathy. METHODS This was a randomized 2-sequence, 2-period crossover trial. A total of 24 participants, mean (standard deviation) age of 48 (7) years, with a diagnosis of Achilles tendinopathy (>3 mo) were randomly assigned into sequence 1 (sham intervention and then thoracic spinal manipulation) or sequence 2 (thoracic spinal manipulation and then sham intervention). The trial was conducted at a university laboratory with a washout period of 1 week. The primary outcome measure was the testosterone/cortisol (T/C) ratio (salivary samples). The secondary outcome measures included heart rate variability (measured with electrocardiography) and total oxygenation index (nmol/L) of calf muscle and Achilles tendon (measured with near-infrared spectroscopy). A 2-way mixed-model analysis of variance was performed. The statistic of interest was the condition by time interaction. RESULTS A statistically significant condition by time interaction was found for the T/C ratio (mean difference: -0.16; confidence interval: -0.33 to 0.006; interaction: P < .05) and the total oxygenation index (mean difference: 1.35; confidence interval: -1.3 to 4.1; interaction: P < .05) of calf muscle but not for Achilles tendon (P = .6); however, no difference was found for heart rate variability (P = .5). CONCLUSION In people with Achilles tendinopathy, thoracic spinal manipulation resulted in immediate increase in the total oxygenation index in the calf muscle followed by an increase in the T/C ratio 6 hours post-intervention.
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Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Rajesh Katare
- Department of Physiology-Heart Otago, University of Otago, Dunedin, New Zealand
| | - Joshua Neale
- Department of Physiology-Heart Otago, University of Otago, Dunedin, New Zealand
| | - James Cotter
- School of Physical Education, Sport and Exercise Science, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Rodrigues PTV, Corrêa LA, Reis FJJ, Meziat-Filho NA, Silva BM, Nogueira LAC. One Session of Spinal Manipulation Improves the Cardiac Autonomic Control in Patients with Musculoskeletal Pain: A Randomized Placebo-Controlled Trial. Spine (Phila Pa 1976) 2021; 46:915-922. [PMID: 33496535 DOI: 10.1097/brs.0000000000003962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Three-arm, parallel, randomized, placebo-controlled, assessor-blinded trial. OBJECTIVE To compare the immediate effect of manual therapy at the upper thoracic spine on the cardiovascular autonomic control of patients with musculoskeletal pain. SUMMARY OF BACKGROUND DATA Musculoskeletal pain increases the risk of cardiovascular events. Thus, manual therapy applied to the upper thoracic region is likely efficient to improve the cardiac autonomic control. METHODS The study included 59 patients with musculoskeletal pain enrolled at an outpatient clinic. Participants were randomly assigned to spinal manipulation (n = 19), myofascial manipulation (n = 20), or placebo (n = 20) administered to the upper thoracic region. Resting heart rate variability provided indexes of the cardiac autonomic control, and the blood pressure response to the cold pressor test as a proxy of the sympathetic responsiveness to a stressor stimulus. RESULTS Groups were similar for baseline variables except for blood pressure. Two-way repeated-measures one-way analysis of covariance (ANCOVA) revealed that only spinal manipulation induced immediate increase of the square root of the mean squared differences of successive RR intervals (RMSSD), absolute (ms2), and normalized units (n.u.) of the high-frequency power (HF) as compared with pre-intervention evaluation, indicating an improvement in the parasympathetic activity to the heart. Normalized units of low-frequency power (LF) and the LF/HF ratio reduced after the spinal manipulation solely, suggesting a reduction of the sympathetic activity to the heart. There were no significant differences in the blood pressure responsiveness among the three treatments. There were no adverse events. CONCLUSION In patients with musculoskeletal pain, spinal manipulation on the upper thoracic spine led to an immediate improvement in the resting cardiac autonomic control without an effect on the blood pressure responsiveness to a sympathoexcitatory stimulus. Myofascial manipulation or placebo did not change cardiovascular autonomic control.Level of Evidence: 2.
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Affiliation(s)
| | - Leticia Amaral Corrêa
- Rehabilitation Science Postgraduation Progam, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | - Ney Armando Meziat-Filho
- Rehabilitation Science Postgraduation Progam, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Bruno Moreira Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduation Progam, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Department of Physical Therapy, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil
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Picchiottino M, Honoré M, Leboeuf-Yde C, Gagey O, Cottin F, Hallman DM. The effect of a single spinal manipulation on cardiovascular autonomic activity and the relationship to pressure pain threshold: a randomized, cross-over, sham-controlled trial. Chiropr Man Therap 2020; 28:7. [PMID: 31988711 PMCID: PMC6971986 DOI: 10.1186/s12998-019-0293-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023] Open
Abstract
Background The autonomic nervous system interacts with the pain system. Knowledge on the effects of high velocity low amplitude spinal manipulations (SM) on autonomic activity and experimentally induced pain is limited. In particular, the effects of SM on autonomic activity and pain beyond the immediate post intervention period as well as the relationship between these two outcomes are understudied. Thus, new research is needed to provide further insight on this issue. Objectives The aim was to assess the effect of a single SM (i.e. SM vs. sham) on cardiovascular autonomic activity. Also, we assessed the relationship between cardiovascular autonomic activity and level of pain threshold after the interventions. Method We conducted a randomized, cross-over, sham-controlled trial on healthy first-year chiropractic students comprising two experimental sessions separated by 48 h. During each session, subjects received, in a random order, either a thoracic SM or a sham manipulation. Cardiovascular autonomic activity was assessed using heart rate and systolic blood pressure variabilities. Pain sensitivity was assessed using pressure pain threshold. Measurements were performed at baseline and repeated three times (every 12 min) during the post intervention period. Participants and outcome assessors were blinded. The effect of the SM was tested with linear mixed models. The relationship between autonomic outcomes and pressure pain threshold was tested with bivariate correlations. Results Fifty-one participants were included, forty-one were finally analyzed. We found no statistically significant difference between SM and sham in cardiovascular autonomic activity post intervention. Similarly, we found no post-intervention relationship between cardiovascular autonomic activity and pressure pain threshold. Conclusion Our results suggest that a single SM of the thoracic spine has no specific effect on cardiovascular autonomic activity. Also, we found no relationship between cardiovascular autonomic activity and pressure pain threshold after the SM. Further experimental research should consider the use of several markers of autonomic activity and a more comprehensive pain assessment. Trial registration N° NCT03273868. Registered September 6, 2017.
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Affiliation(s)
- Mathieu Picchiottino
- Université Paris-Saclay CIAMS, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Institut Franco-européen de Chiropraxie (IFEC), Ivry-sur-Seine, Toulouse, France
| | - Margaux Honoré
- Université Paris-Saclay CIAMS, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Institut Franco-européen de Chiropraxie (IFEC), Ivry-sur-Seine, Toulouse, France
| | - Charlotte Leboeuf-Yde
- Université Paris-Saclay CIAMS, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Institut Franco-européen de Chiropraxie (IFEC), Ivry-sur-Seine, Toulouse, France
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Olivier Gagey
- Université Paris-Saclay CIAMS, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - François Cottin
- Université Paris-Saclay CIAMS, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - David M. Hallman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
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