Altered Sensorimotor Integration With Cervical Spine Manipulation
Received 6 October 2007; received in revised form 29 October 2007
Abstract
Objective
This study investigates changes in the intrinsic inhibitory and facilitatory interactions within the sensorimotor cortex subsequent to a single session of cervical spine manipulation using single- and paired-pulse transcranial magnetic stimulation protocols.
Method
Twelve subjects with a history of reoccurring neck pain participated in this study. Short interval intracortical inhibition, short interval intracortical facilitation (SICF), motor evoked potentials, and cortical silent periods (CSPs) were recorded from the abductor pollicis brevis and the extensor indices proprios muscles of the dominant limb after single- and paired-pulse transcranial magnetic stimulation of the contralateral motor cortex. The experimental measures were recorded before and after spinal manipulation of dysfunctional cervical joints, and on a different day after passive head movement. To assess spinal excitability, F wave persistence and amplitudes were recorded after median nerve stimulation at the wrist.
Results
After cervical manipulations, there was an increase in SICF, a decrease in short interval intracortical inhibition, and a shortening of the CSP in abductor pollicis brevis. The opposite effect was observed in extensor indices proprios, with a decrease in SICF and a lengthening of the CSP. No motor evoked potentials or F wave response alterations were observed, and no changes were observed after the control condition.
Conclusion
Spinal manipulation of dysfunctional cervical joints may alter specific central corticomotor facilitatory and inhibitory neural processing and cortical motor control of 2 upper limb muscles in a muscle-specific manner. This suggests that spinal manipulation may alter sensorimotor integration. These findings may help elucidate mechanisms responsible for the effective relief of pain and restoration of functional ability documented after spinal manipulation.
aDirector of Research, New Zealand College of Chiropractic, Auckland, New Zealand
bPostgraduate and MSc-Exercise Rehabilitation Coordinator and Director, Department of Sport and Exercise Science, Human Neurophysiology and Rehabilitation Laboratory, University of Auckland, Auckland, New Zealand
cDepartment/Institution work should be attributed to Human Neurophysiology and Rehabilitation Laboratory, Department of Sport and Exercise Science, University of Auckland.
Submit requests for reprints to: Heidi Haavik Taylor, BSc(Chiro), PhD, Director of Research, Department of Sport and Exercise Science, Human Neurophysiology and Rehabilitation Laboratory, Tamaki Campus, University of Auckland, Auckland, New Zealand.
ABSTRACT