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Maldonado MD, Parkinson SD, Story MR, Haussler KK. The Effect of Chiropractic Treatment on Limb Lameness and Concurrent Axial Skeleton Pain and Dysfunction in Horses. Animals (Basel) 2022; 12:ani12202845. [PMID: 36290230 PMCID: PMC9597761 DOI: 10.3390/ani12202845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022] Open
Abstract
Chiropractic care is a common treatment modality used in equine practice to manage back pain and stiffness but has limited evidence for treating lameness. The objective of this blinded, controlled clinical trial was to evaluate the effect of chiropractic treatment on chronic lameness and concurrent axial skeleton pain and dysfunction. Two groups of horses with multiple limb lameness (polo) or isolated hind limb lameness (Quarter Horses) were enrolled. Outcome measures included subjective and objective measures of lameness, spinal pain and stiffness, epaxial muscle hypertonicity, and mechanical nociceptive thresholds collected on days 0, 14, and 28. Chiropractic treatment was applied on days 0, 7, 14, and 21. No treatment was applied to control horses. Data was analyzed by a mixed model fit separately for each response variable (p < 0.05) and was examined within each group of horses individually. Significant treatment effects were noted in subjective measures of hind limb and whole-body lameness scores and vertebral stiffness. Limited or inconsistent therapeutic effects were noted in objective lameness scores and other measures of axial skeleton pain and dysfunction. The lack of pathoanatomical diagnoses, multilimb lameness, and lack of validated outcome measures likely had negative impacts on the results.
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Affiliation(s)
- Mikaela D. Maldonado
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Samantha D. Parkinson
- Department of Veterinary Preventative Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Melinda R. Story
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Kevin K. Haussler
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
- Correspondence:
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Walter LA, Blake LP, Gallot YS, Arends CJ, Sozio RS, Onifer SM, Bohnert KR. Effect of Denervation on XBP1 in Skeletal Muscle and the Neuromuscular Junction. Int J Mol Sci 2021; 23:ijms23010169. [PMID: 35008595 PMCID: PMC8745577 DOI: 10.3390/ijms23010169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 12/30/2022] Open
Abstract
Denervation of skeletal muscle is a debilitating consequence of injury of the peripheral nervous system, causing skeletal muscle to experience robust atrophy. However, the molecular mechanisms controlling the wasting of skeletal muscle due to denervation are not well understood. Here, we demonstrate that transection of the sciatic nerve in Sprague–Dawley rats induced robust skeletal muscle atrophy, with little effect on the neuromuscular junction (NMJ). Moreover, the following study indicates that all three arms of the unfolded protein response (UPR) are activated in denervated skeletal muscle. Specifically, ATF4 and ATF6 are elevated in the cytoplasm of skeletal muscle, while XBP1 is elevated in the nuclei of skeletal muscle. Moreover, XBP1 is expressed in the nuclei surrounding the NMJ. Altogether, these results endorse a potential role of the UPR and, specifically, XBP1 in the maintenance of both skeletal muscle and the NMJ following sciatic nerve transection. Further investigations into a potential therapeutic role concerning these mechanisms are needed.
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Affiliation(s)
- Lisa A. Walter
- Department of Kinesiology, St. Ambrose University, Davenport, IA 52803, USA; (L.A.W.); (L.P.B.)
| | - Lauren P. Blake
- Department of Kinesiology, St. Ambrose University, Davenport, IA 52803, USA; (L.A.W.); (L.P.B.)
| | - Yann S. Gallot
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025 Evry, France;
| | - Charles J. Arends
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA 52803, USA; (C.J.A.); (R.S.S.); (S.M.O.)
| | - Randall S. Sozio
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA 52803, USA; (C.J.A.); (R.S.S.); (S.M.O.)
| | - Stephen M. Onifer
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA 52803, USA; (C.J.A.); (R.S.S.); (S.M.O.)
| | - Kyle R. Bohnert
- Department of Kinesiology, St. Ambrose University, Davenport, IA 52803, USA; (L.A.W.); (L.P.B.)
- Correspondence: ; Tel.: +1-563-333-5743
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Han L, Zhao P, Han X, Wei J, Wang F, Li Y, Guo GJ. Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats. Chin J Integr Med 2021; 28:518-523. [PMID: 34586558 DOI: 10.1007/s11655-021-3276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2019] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare the analgesic effects of two types of spinal manipulation (SM) in acute lumbar radiculopathy (ALR) model rats induced by self-transplantation of autologous nucleus pulposus (ANP), and clarify the therapeutic mechanism. METHODS Totally 108 male Sprague-Dawley rats were randomly divided into 6 groups by a random number table (18 rats in each group), including a blank group with no interference, a sham operation group with a surgery by making a local soft tissue incision on the left side of L5-6 vertebral segment, a model group with ALR of L5 extraforaminal nerve by ANP self-transplantation without other interference, a sham manipulation (SMA) group with simulating physical rotation, as well as a mobilization (MOB) group with simulating low-velocity and variable-amplitude rotation and a manipulation (MAN) group with simulating high-velocity and low-amplitude rotation. The interventions in SMA, MOB, and MAN groups started 1 day after modeling followed by another 5 treatments at days 3, 5, 8, 10 and 12. Rats in the other 3 groups did not receive any special intervention. Behavioral pain tests of 50% mechanical pain withdrawal threshold (50% PWT) and paw withdrawal latency (PWL) were conducted 1 day before operation followed by another 10 tests on days 1-7, 10, 12 and 14. Immunohistochemical expression of nitric oxide synthase (NOS) was investigated on days 5 and 12 after operation. RESULTS After 3 experimental SM interventions, 50% PWT and PWL were higher in the MAN group than the SMA group on days 6 and 7, and higher on days 10, 12 and 14 postoperatively (P<0.05 or P<0.01), while the same indices were significantly higher in the MOB group than MAN group on days 1-4 (P<0.05 or P<0.01). The expression of NOS was lower in the MAN and MOB groups than SMA group on day 12 postoperatively (P<0.01). CONCLUSIONS Both manipulation and mobilization produced better results than sham interference in relieving pain by reducing neuroinflammation possibly. At the early period, compared with manipulation, mobilization presented less sensitive response to pain until later visit. SM may inhibit the overexpression of NOS, thereby alleviating severe radiculopathy.
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Affiliation(s)
- Lei Han
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China
| | - Ping Zhao
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China.
| | - Xue Han
- Department of Bone and Joint Imaging Diagnosis, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Jie Wei
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China
| | - Fei Wang
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China
| | - Yi Li
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China
| | - Guang-Jin Guo
- Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing, 100142, China
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Gevers-Montoro C, Provencher B, Descarreaux M, Ortega de Mues A, Piché M. Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain. Eur J Pain 2021; 25:1429-1448. [PMID: 33786932 DOI: 10.1002/ejp.1773] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/05/2021] [Accepted: 03/27/2021] [Indexed: 12/19/2022]
Abstract
Together, neck pain and back pain are the first cause of disability worldwide, accounting for more than 10% of the total years lived with disability. In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. Basic studies have examined the influence of chiropractic spinal manipulation (SM) on a variety of peripheral, spinal and supraspinal mechanisms involved in spine pain. While spinal cord mechanisms of pain inhibition contribute at least partly to the pain-relieving effects of chiropractic treatments, the evidence is weaker regarding peripheral and supraspinal mechanisms, which are important components of acute and chronic pain. This narrative review highlights the most relevant mechanisms of pain relief by SM and provides a perspective for future research on SM and spine pain, including the validation of placebo interventions that control for placebo effects and other non-specific effects that may be induced by SM. SIGNIFICANCE: Spinal manipulation inhibits back and neck pain partly through spinal segmental mechanisms and potentially through peripheral mechanisms regulating inflammatory responses. Other mechanisms remain to be clarified. Controls and placebo interventions need to be improved in order to clarify the contribution of specific and non-specific effects to pain relief by spinal manipulative therapy.
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Affiliation(s)
- Carlos Gevers-Montoro
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Madrid College of Chiropractic - RCU María Cristina, Madrid, Spain
| | - Benjamin Provencher
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Martin Descarreaux
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,GRAN Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | - Mathieu Piché
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Hinkeldey N, Okamoto C, Khan J. Spinal Manipulation and Select Manual Therapies: Current Perspectives. Phys Med Rehabil Clin N Am 2020; 31:593-608. [PMID: 32981581 DOI: 10.1016/j.pmr.2020.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Touch is fundamental to the doctor-patient relationship. Touch can produce neuromodulatory effects that mitigate pain and put patients at ease. Touch begins with a confident handshake and continues throughout the physical examination. Touching patients where they hurt is a clear indication that a provider understands their complaint. Touch often continues as a function of treatment. This article updates evidence surrounding human touch and addresses mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial, treatment plans with dose-response evidence, and the impact of manual therapy on the health care system.
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Affiliation(s)
- Nathan Hinkeldey
- VA Central Iowa Health Care System, 3600 30th Street, Des Moines, IA 50310, USA; Palmer College of Chiropractic, 1000 Brady Street, Davenport, IA 52803, USA.
| | - Casey Okamoto
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN 55417, USA; Department of Rehabilitation Medicine, 500 Boynton Health Service Bridge, Minneapolis, MN 55455, USA
| | - Jamal Khan
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN 55417, USA; Department of Rehabilitation Medicine, 500 Boynton Health Service Bridge, Minneapolis, MN 55455, USA
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Vining R, Long CR, Minkalis A, Gudavalli MR, Xia T, Walter J, Coulter I, Goertz CM. Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med 2020; 26:592-601. [PMID: 32543211 DOI: 10.1089/acm.2020.0107] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives: To investigate whether chiropractic care influences strength, balance, and/or endurance in active-duty United States military personnel with low back pain (LBP). Design: This study employed a prospective randomized controlled trial using a pragmatic treatment approach. Participants were randomly allocated to 4 weeks of chiropractic care or to a wait-list control. Interventions: Chiropractic care consisted of spinal manipulation, education, advice, and reassurance. Settings/Location: Naval Air Technical Training Center branch clinic at the Naval Hospital Pensacola Florida. Subjects: One hundred ten active-duty military personnel 18-40 years of age with self-reported LBP. Outcome measures: Isometric pulling strength from a semisquat position was the primary outcome. Secondary outcomes were single-leg balance with eyes open and eyes closed, and trunk muscle endurance using the Biering-Sorensen test. Patient-reported outcomes such as pain severity and disability were also measured. Outcomes were measured at baseline and 4 weeks. Linear mixed-effects regression models over baseline and 4 weeks were used for analysis. Results: Participants had mean age of 30 years (18-40), 17% were female, 33% were non-white, and 86% reported chronic LBP. Mean maximum pulling strength in the chiropractic group increased by 5.08 kgs and decreased by 7.43 kgs in the wait-list group, with a statistically significant difference in mean change between groups (p = 0.003). Statistically significant differences in mean change between groups were also observed in trunk muscle endurance (13.9 sec, p = 0.002) and balance with eyes closed (0.47 sec, p = 0.01), but not in balance with eyes open (1.19 sec, p = 0.43). Differences in mean change between groups were statistically significant in favor of chiropractic for LBP-related disability, pain intensity and interference, and fear-avoidance behavior. Conclusions: Active-duty military personnel receiving chiropractic care exhibited improved strength and endurance, as well as reduced LBP intensity and disability, compared with a wait-list control.
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Affiliation(s)
- Robert Vining
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Cynthia R Long
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Amy Minkalis
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - M Ram Gudavalli
- College of Chiropractic Medicine, Keiser University, West Palm Beach, FL, USA
| | - Ting Xia
- Mechanical Engineering Department, Northern Illinois University, DeKalb, IL, USA
| | - Joan Walter
- Samueli Integrative Health Programs, H&S Ventures, Alexandria, VA, USA
| | | | - Christine M Goertz
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
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Role for Endocannabinoids in Spinal Manipulative Therapy Analgesia? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2878352. [PMID: 31379956 PMCID: PMC6662436 DOI: 10.1155/2019/2878352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/23/2019] [Accepted: 06/26/2019] [Indexed: 11/24/2022]
Abstract
Chronic pain is quite prevalent and causes significant disabilities and socioeconomic burdens. Spinal manipulative therapy and other manipulative therapies are used to manage chronic pain. There is a critical knowledge gap about mechanisms and sites of action in spinal manipulative therapy pain relief, especially the short-term analgesia that occurs following a treatment. Endocannabinoids are an activity-dependent neurotransmitter system that acts as a short-term synaptic circuit breaker. This review describes both clinical research and basic research evidence suggesting that endocannabinoids contribute to short-term manipulative therapy analgesia. Determining endocannabinoids involvement in spinal manipulative therapy will improve its clinical efficacy when results from basic science and clinical research are translated.
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