The Effects of Spinal Manipulation on Central Nervous System Activity Measured by Reflexive Calf Muscle Recruitment
- Conditions
- Subluxation of Joint of Lumbar Spine
- Interventions
- Procedure: Max Voluntary Isometric ContractionProcedure: SM+MVICProcedure: Spinal Manipulation
- Registration Number
- NCT02848456
- Lead Sponsor
- Grant Sanders
- Brief Summary
This study investigated the effects of spinal manipulation on central nervous system activity. The presence of postactivation potentiation, an increase in muscular force production following prior muscular contractions, was measured with electromyography and the muscular force production during electrically-induced calf muscle reflexes. It was hypothesized that significantly greater potentiation would be stimulated by a calf muscle contraction with spinal manipulation delivered immediately beforehand than the potentiation arising from the contraction only.
- Detailed Description
A randomized, controlled, single-blind crossover study design was utilized, and the three independent variables were spinal manipulative therapy (SMT), a 10 second plantar flexion maximal voluntary isometric contraction (MVIC) or SMT immediately preceding the MVIC (SMT + MVIC). The treatment order was randomized for each of the three sessions before the tibial nerve Hmax/Mmax stimulation protocol.
Each of the four dependent variables were evoked during the tibial nerve H-reflex stimulation protocol at the conclusion of each session, and included the Hmax/Mmax ratio (%) of the gastrocnemius and soleus muscles and the isometric twitch torque occurring at Hmax and at Mmax. Hmax, the highest H-reflex amplitude, is an indication of the greatest possible reflex activation; as such, it is an estimate of the number of motor neurons a subject is capable of activating in a given state. Further increases in the stimulation intensity cause the subsequent M-wave to reach its highest amplitude, Mmax. Mmax is a compound muscle action potential (CMAP) which represents full muscle activation. Specific to the current investigation, Mmax indicated activation of the total volume of the gastrocnemius/soleus motor neuron (MN) pool.
Given that Hmax is an inference of the number of MNs being recruited, and Mmax constitutes the entire motor neuron pool, the proportion of the entire MN pool capable of being recruited can be estimated with the Hmax/Mmax ratio. The Hmax/Mmax ratio was determined by division of the EMG peak-to-peak amplitudes (mV) evoked at Hmax by the preceding Mmax EMG peak-to-peak amplitudes. Differences in each of the four dependent variables (Hmax/Mmax ratios of the gastrocnemius and soleus and the peak twitch torques evoked at Hmax and Mmax) following each treatment form of SMT, MVIC or SMT+MVIC delivered during the three data collection sessions on three separate days were determined with a two-way (treatment × time point) repeated measures ANOVA. Percent changes from baseline were also calculated for each of the dependent variables, and the same type of ANOVA was used to determine differences in the within-subjects effects of each treatment.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 20
- At least one year of resistance training experience and current completion of at least three training sessions per week
- Males needed to be able to back squat a minimum load of 1.5 x body weight
- Females needed to be able to back squat 1 x body weight
- Any pain in the lower back, abdomen or legs and/or surgeries performed in these regions
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Max Voluntary Isometric Contraction MVIC Max Voluntary Isometric Contraction In a repeated measures, crossover design, all subjects received one of three randomized treatments during three separate sessions: SM; a 10 second plantar flexion maximal voluntary isometric contraction (MVIC) or the manipulation immediately preceding the contraction (SM+MVIC). SM+MVIC SM+MVIC In a repeated measures, crossover design, all subjects received one of three randomized treatments during three separate sessions: SM; a 10 second plantar flexion maximal voluntary isometric contraction (MVIC) or the manipulation immediately preceding the contraction (SM+MVIC). Spinal Manipulation SM Spinal Manipulation In a repeated measures, crossover design, all subjects received one of three randomized treatments during three separate sessions: SM; a 10 second plantar flexion maximal voluntary isometric contraction (MVIC) or the manipulation immediately preceding the contraction (SM+MVIC).
- Primary Outcome Measures
Name Time Method Changes in H-reflex amplitudes of the gastrocnemius and soleus muscles compared to baseline Data were collected at 17 time points during a 20-minute tibial nerve electrical stimulation protocol post-treatment: 20 seconds, 40 seconds, 1:00, 2:00, 3:00, 4:00, 5:00, 6:00, 7:00, 8:00, 9:00, 10:00, 12:00, 14:00, 16:00, 18:00 and 20:00 minutes Peak-to-peak EMG amplitudes (mV) at Hmax of the gastrocnemius and soleus were recorded before and immediately following the three separate treatments
Changes in isometric twitch torques of the gastrocnemius and soleus muscles compared to baseline Data were collected at 17 time points during a 20-minute tibial nerve electrical stimulation protocol post-treatment: 10 seconds, 30 seconds, 50 seconds, 1:30, 2:30, 3:30, 4:30, 5:30, 6:30, 7:30, 8:30, 9:30, 11:00, 13:00, 15:00, 17:00 and 19:00 minutes Twitch torques (Nm) of the gastrocnemius and soleus at Mmax were recorded before and immediately following the three separate treatments
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
College of Education, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY
🇺🇸Lexington, Kentucky, United States