Neurophysiologic Effects of Spinal Manipulation.

• Autor(a) principal: Nuno Filipe Pinho Nogueira
• Data de Publicação: 2019
• Idioma: eng
• Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Texto Completo: https://hdl.handle.net/10216/121620
• topic: Ciências da saúde; Health sciences

Objective: To compare the effects of manual and instrument-assisted cervical manipulation in different neurophysiologic parameters in asymptomatic subjects and in subjects with mechanical neck pain, and to verify wether these effects are related with the metameric level of the manipuation.Methods: Three double blind randomized placebo control trials were conducted. Two studies compared the immediate effects of manual and instrument-assisted manipulation in the Autonomous Nervous System activity, pressure pain thresholds and perception, electromyographic activity, stiffness, tone and muscle elasticity of upper trapezius and biceps brachii, bilaterally, in asymptmatic subjects. In the 3rd study, the effects of 3 sessions of manual and instrument-assisted cervical manipulation on pre-selected vertebral level were evaluated in the same muscle-related variables, as in previous studies, and, also in pain, disability and perception of change, in subjects with mechanical neck pain. Results: In asymptomatic subjects, both manual and instrument-assisted manipulation increased pressure pain thresholds in the various muscles evaluated without changes in the muscle parameters and in sympathetic nervous system activity, the latter compared to placebo. In subjects with neck pain, 3 sessions of manual manipulation improved pain, disability and perception of change. The immediate decrease in the electromyographic activity of upper trapezius, bilaterally, was significantly higher in the manual manipulation group.Conclusion: Manual and instrument-assisted manipulation produced similar effects and not only related to the metameric spinal level, in asymptomatic subjects, however, only the manual manipulation applied at a pre-selected vertebral level produced changes in subjects with neck pain.