Abstract:
BACKGROUND:While there is growing evidence for the efficacy of SM to treat LBP, little is known on the mechanisms and physiologic effects of these treatments. Accordingly, the purpose of this study was to determine whether SM alters the amplitude of the motor evoked potential (MEP) or the short-latency stretch reflex of the erector spinae muscles, and whether these physiologic responses depend on whether SM causes an audible joint sound. METHODS:We used transcranial magnetic stimulation to elicit MEPs and electromechanical tapping to elicit short-latency stretch reflexes in 10 patients with chronic LBP and 10 asymptomatic controls. Neurophysiologic outcomes were measured before and after SM. Changes in MEP and stretch reflex amplitude were examined based on patient grouping (LBP vs. controls), and whether SM caused an audible joint sound. RESULTS:SM did not alter the erector spinae MEP amplitude in patients with LBP (0.80±0.33 vs. 0.80±0.30 μV) or in asymptomatic controls (0.56±0.09 vs. 0.57±0.06 μV). Similarly, SM did not alter the erector spinae stretch reflex amplitude in patients with LBP (0.66±0.12 vs. 0.66±0.15 μV) or in asymptomatic controls (0.60±0.09 vs. 0.55±0.08 μV). Interestingly, study participants exhibiting an audible response exhibited a 20% decrease in the stretch reflex (p<0.05). CONCLUSIONS:These findings suggest that a single SM treatment does not systematically alter corticospinal or stretch reflex excitability of the erector spinae muscles (when assessed~10-minutes following SM); however, they do indicate that the stretch reflex is attenuated when SM causes an audible response. This finding provides insight into the mechanisms of SM, and suggests that SM that produces an audible response may mechanistically act to decrease the sensitivity of the muscle spindles and/or the various segmental sites of the Ia reflex pathway.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Clark BC,Goss DA Jr,Walkowski S,Hoffman RL,Ross A,Thomas JSdoi
10.1186/1471-2474-12-170subject
Has Abstractpub_date
2011-07-22 00:00:00pages
170issn
1471-2474pii
1471-2474-12-170journal_volume
12pub_type
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