Acute Effects of Manual vs Instrument-assisted Single Cervical Manipulation on Electromyographic Activity and Sympathetic Nervous System
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 75
- Primary Endpoint
- Change of electromyographic activity of biceps brachii after spinal manipulation
Study Overview
Brief Summary
This study evaluates the effects of manual and instrument-assisted cervical manipulation on electromyographic activity and sympathetic nervous system. Subjects were divided in four groups, one group was submitted to a manual cervical manipulation, other group was submitted to an instrument-assisted cervical manipulation, other group was submitted to a sham manipulation and another group served as control.
Detailed Description
The manual manipulation was applied over C3/C4, as the participants were positioned in supine with the cervical spine in a neutral position. Slight ipsilateral side flexion and contralateral rotation were introduced until tension was perceived in the tissues at the contact point. A high-velocity, low-amplitude thrust manipulation was directed upward and medially in the direction of the subject's contralateral eye.
The instrument-assisted manipulation was applied using a handheld Activator IV Adjusting Instrument. Contacts were made firm enough to prevent slipping of the rubber tip but not so firm as to load the spring, in consistence with customary clinical use of the instrument. The spring was then loaded by means of the instrument's trigger mechanism, and the impulse was delivered in an anterosuperior direction, over the posterolateral aspect of the vertebra on the right lamina-pedicle junction of C3.
The sham manipulation to the right C3/C4 segment was administered using the same 'set-up' as for the manual manipulation; however, once the barrier was engaged, the head was re-positioned to neutral with no thrust applied. The control group individuals were positioned supine for the same twenty minutes as the other groups and they received no manual contact.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Masking Description
Electromyographic signal and skin conductance were assessed by blinded assessors before and immediately after the intervention. The participants were not aware of their assigned group.
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Asymptomatic individuals
- •Age above 18 years.
Exclusion Criteria
- •Presence of cervical pain
- •History of surgery and/neck trauma
- •Osteoporosis
- •Current use of anticoagulant therapy
- •Presence of dizziness and/or vertigo
- •Pregnancy
- •Any other contra-indication to spinal manipulation.
Arms & Interventions
Manual Manipulation
A single manual manipulation was applied to C3/C4 level, on the right side.
Intervention: Manual Manipulation (Other)
Instrument-assisted Manipulation
A single instrument-assisted manipulation was applied to C3/C4 level, on the right side.
Intervention: Instrument-assisted Manipulation (Other)
Placebo
A placebo manipulation was applied on C3/C4 level, on the right side. The neck of th subject was placed in the pre manipulative position but no thrust was made. Then, the cervical was replaced in neutral position.
Intervention: Placebo (Other)
Control
No contact was given to the subject.
Outcomes
Primary Outcomes
Change of electromyographic activity of biceps brachii after spinal manipulation
Time Frame: 10 minutes post intervention
The effect on basal electromyographic activity of biceps brachii was compared between manual manipulation, instrument-assisted manipulation, placebo and control. Muscle activity was evaluated before and 10 minutes after each intervention.
Sympathetic Nervous System activity through change in skin conductance values
Time Frame: 10 minutes post intervention
The effect on sympathetic nervous system was compared between manual manipulation, instrument-assisted manipulation, placebo and control. The endodermic activity amplifier Galvanic Skin Response (GSR100C) was used to collect the skin conductance values.
Change of electromyographic activity of upper trapezius after spinal manipulation
Time Frame: 10 minutes post intervention
The effect on basal electromyographic activity of upper trapezius was compared between manual manipulation, instrument-assisted manipulation, placebo and control. Muscle activity was evaluated before and 10 minutes after each intervention.
Secondary Outcomes
No secondary outcomes reported
Investigators
Nuno Filipe Pinho Nogueira
Principal Investigator
Escola Superior de Tecnologia da Saúde do Porto