• Lo CN
• Ng J
• Au CK
• Lim ECW

• Affiliation / Hong Kong Polytechnic University. Department of Rehabilitation Sciences
• Affiliation / Singapore General Hospital
• Affiliation / Singapore Institute of Technology. Cluster of Health and Social Sciences
• Affiliation(G) / Hong Kong
• Affiliation(G) / Singapore
• Manipulation, Spinal
• Muscle Strength
• Review Literature as Topic
• Systematic Reviews as Topic

OBJECTIVE: The purpose of this study was to systematically review the effects of spinal manipulation on muscular strength in healthy individuals and conduct a meta-analysis to appraise the quality of evidence.

METHODS: Articles were searched and retrieved from MEDLINE, EMBASE, CINAHL, Cochrane Library, PubMed, Academic Search Premier, SPORTDiscus, and AMED. Searches were conducted in September 2017 without a limit on the starting period. The Physiotherapy Evidence Database scale was used to appraise the quality of the included studies. Data from eligible articles were pooled, and meta-analyses were conducted. The quality of evidence was appraised by the Grading of Recommendations, Assessment, Development and Evaluations approach. The registration number for the review on PROSPERO is CRD42017075215.

RESULTS: A total of 911 records were screened, and 3 randomized controlled trials were eligible to be included in this review. There was a significant pooled standardized mean difference in isometric strength (0.93, 95% confidence interval [CI], 0.17-1.68; P = .02) between the experimental and control groups, with a moderate level of heterogeneity.

CONCLUSION: This review suggests that spinal manipulative therapy augments the percentage of change in isometric strength gain among healthy participants when compared to no intervention or sham manipulation. However, the heterogeneity of pooled studies in this review suggests that the results should be interpreted with caution.

Author keywords: Manipulation, Spinal, Muscle Strength, Spine

Author affiliations: CNL: Cluster of Health and Social Sciences, Singapore Institute of Technology, Singapore; Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong; JNG, CKA: Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong; ECWL: Cluster of Health and Social Sciences, Singapore Institute of Technology, Singapore; Physiotherapy Department, Singapore General Hospital, Singapore

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