Journal of Manipulative and Physiological Therapeutics
Volume 35, Issue 2 , Pages 86-93, February 2012

The Effect of Lumbosacral Manipulation on Corticospinal and Spinal Reflex Excitability on Asymptomatic Participants

  • Gary Fryer, PhD, BSc (Osteo), ND

      Affiliations

    • Senior Lecturer, Osteopathic Unit, School of Biomedical and Clinical Sciences; and Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
    • Research Associate Professor, A.T. Still Research Institute, Kirksville, MO
    • Corresponding Author InformationSubmit request for reprints to: Gary Fryer, PhD, BSc (Osteo), ND, Victoria University, School of Biomedical and Clinical Sciences and Institute of Sport, Exercise and Active Living, 301 Flinders Lane, Melbourne, Victoria 3000, Australia
    • ,
  • Alan J. Pearce, PhD, BSc (Spt Sci) Hons, Grad Dip

      Affiliations

    • Senior Lecturer, Motor Control, Motor Control TMS Laboratory, School of Sport and Exercise Science, Victoria University, Melbourne, Australia

Received 29 June 2011; received in revised form 21 July 2011; accepted 19 August 2011. published online 31 October 2011.

Abstract 

Objective

The aim of the study was to examine the effects of a high-velocity, low-amplitude (HVLA) manipulation to the lumbosacral joint on corticospinal excitability, as measured by motor evoked potentials (MEPs) using transcranial magnetic stimulation, and spinal reflex excitability, as measured by the Hoffman reflex (H-reflex).

Methods

In a randomized, controlled, crossover design, 14 asymptomatic volunteers (mean age, 23 ± 5.4 years; 10 men; 4 women) were measured for MEPs and H-reflexes immediately before and after a randomly allocated intervention. The interventions consisted of HVLA applied bilaterally to the lumbosacral joint and a control intervention. Participants returned a week later, and the same procedures were performed using the other intervention. Data for H-reflex and MEP amplitudes were normalized to the M-wave maximum amplitude and analyzed using 2-way analysis of variance with repeated measures.

Results

A significant interaction of treatment by time was found for MEP (F1,13 = 4.87, P = .04), and post hoc analyses showed that the MEP/M-wave maximum ratio decreased significantly in the HVLA treatment (P = .02; effect size, 0.68). For H-reflex, there was a significant effect of time (F1,13 = 8.186, P = .01) and treatment and time interaction (F1,13 = 9.05, P = .01), with post hoc analyses showing that H-reflexes were significantly reduced after the HVLA manipulation (P = .004; effect size, 0.94). There were no significant changes in MEP latency or silent period duration.

Conclusion

An HVLA manipulation applied to the lumbosacral joint produced a significant decrease in corticospinal and spinal reflex excitability, and no significant change occurred after the control intervention. The changes in H-reflexes were larger than those in MEPs, suggesting a greater degree of inhibition at the level of the spinal cord.

Key Indexing Terms: Manipulation, Spinal, H-Reflex, Motor Evoked Potentials

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PII: S0161-4754(11)00228-4

doi:10.1016/j.jmpt.2011.09.010

Journal of Manipulative and Physiological Therapeutics
Volume 35, Issue 2 , Pages 86-93, February 2012

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