The objective of the present study is to compare the neuromechanical responses to spinal manipulation and spinal mobilization in participants with chronic nonspecific middle back pain.
Although evidences suggest a similar effectiveness of spinal manipulation and spinal mobilization, there is no study that compares the neuromechanical effects of these manual therapies in a experimental context and with the standardization of both interventions. Therefore, the objective of the present study is to compare the neuromechanical responses to spinal manipulation (low-amplitude and high-velocity dynamic thrust) and spinal mobilization (repetitions of a low-amplitude and low-velocity nonthrust movement) in participants with and without chronic nonspecific back pain.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
26
A high-velocity and low-amplitude thrust delivered posteroanteriorly to a thoracic vertebra
Three repetitions of a low-velocity and low-amplitude nonthrust movement delivered posteroanteriorly to a thoracic vertebra
Université du Québec à Trois-Rivières
Trois-Rivières, Quebec, Canada
Global Spinal Stiffness
Global stiffness was defined as the slope of the straight-line best fitting the force-displacement data between 10 and 45 N
Time frame: two-minutes before spinal manipulation delivery up to two-minutes after
Terminal Spinal Stiffness
Terminal stiffness was defined as the ratio of the variation of force and displacement between 10 and 45 N
Time frame: two-minutes before spinal mobilization delivery up to two-minutes after
Pressure Provoked Pain
Pressure provoked pain intensity was assessed immediately after each spinal stiffness assessment using a 0 to 100 visual analog pain scale minimum value=0, maximum value=100. 0 is no pain while 100 is the worse outcome
Time frame: immediately after the therapeutic modality application
Muscular Response, Superior Level Ratio
To assess the muscular response during therapeutic modalities, the resulting bipolar sEMG signals were first digitally band-pass filtered using a frequency bandwidth of 20-450 Hz (2nd order Butterworth filter). For SMa, the peak root mean square (RMS) value was computed for each electrode using a 250 ms window (125 ms before and 125 ms after the peak force). The RMS values obtained for each electrode were then normalized (nRMS) to the respective RMS value calculated during the sEMG normalization trial.
Time frame: During the spinal manipulation and mobilization
Muscular Response, Inferior Level Ratio, Normalized RMS
To assess the muscular response during therapeutic modalities, the resulting bipolar sEMG signals were first digitally band-pass filtered using a frequency bandwidth of 20-450 Hz (2nd order Butterworth filter). For SMa, the peak root mean square (RMS) value was computed for each electrode using a 250 ms window (125 ms before and 125 ms after the peak force). The RMS values obtained for each electrode were then normalized (nRMS) to the respective RMS value calculated during the sEMG normalization trial.
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Time frame: During the spinal manipulation and mobilization