Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 25248
  Title Motor neuron excitability attenuation as a sequel to lumbosacral manipulation in subacute low back pain patients and asymptomatic adults: A cross-sectional H-reflex study
Journal J Manipulative Physiol Ther. 2018 Jun;41(5):363-371
Peer Review Yes
Publication Type Article

Objective: The purpose of the study was to compare a time series of tibial nerve H-reflex trials between patients with subacute low back pain (LBP) and asymptomatic adults using pre and post high-velocity, low-amplitude (HVLA) spinal manipulation (SM) and control procedures.

Methods: Asymptomatic adults (n = 66) and patients with subacute LBP (n = 45) were randomized into 3 lumbosacral procedures: side-posture positioning, joint preloading with no thrust, and HVLA SM. A time series of 40 Hmax/Mmax ratios at a rate of 0.1 Hz were recorded in blocks of 10 trials at baseline and after the lumbosacral procedures at time points corresponding to immediately after, 5 minutes after, and 10 minutes after the procedure. Descriptive time series analysis techniques included time plots, outlier detection, and autocorrelation functions. A mixed analysis of variance model (group × procedure × time) was used to compare the effects of lumbosacral procedures on Hmax/Mmax ratios between the patients with subacute LBP and asymptomatic participants.

Results: The time series analysis and the significant lumbosacral × time interaction term (P < .05) indicated that inhibition of the Hmax/Mmax ratios at the 10-second postlumbosacral procedure time point was greatest after the HVLA SM procedure. The effects of lumbosacral procedures on Hmax/Mmax ratios were similar between patients with subacute LBP and asymptomatic participants.

Conclusions: Although nonspecific effects of movement or position artifacts on the Hmax/Mmax ratio were present, a reliable and valid attenuation of the Hmax/Mmax ratio occurred as a specific aspect of HVLA SM in both asymptomatic adults and patients with subacute LBP.

Author keywords: Low Back Pain, Mechanical, Lumbar Manipulation, H-Reflex, Gastrocnemius Muscle

Author affiliations:  JDD: Clinical Neurosciences Institute, Palmer College of Chiropractic Florida, Port Orange, Florida; JRB, PD: Research Department, New York Chiropractic College, Seneca Falls, New Yor

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link and select a publisher from PubMed's LinkOut feature.


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