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    Immediate effects of cervical spine manipulation compared with muscle energy technique on neck muscle activity and range of motion in asymptomatic participants : a randomized study
    (Elsevier BV, 2022-07) King, Sasha Lee; Docrat, Aadil; Abdul-Rasheed, Ashura
    Objective: The purpose of this study was to investigate the immediate effects of cervical spine manipulation (SM) compared with muscle energy technique (MET) on neck muscle activity and range of motion in asymptomatic people. Methods: A randomized parallel-group study was conducted at a chiropractic teaching clinic in Durban, South Africa. Fifty asymptomatic participants between 18 and 35 years of age were randomly assigned into group 1 or group 2. Group 1 received cervical SM, and group 2 received MET. Participants were blinded to group allocation only. Baseline and post-test measurements consisted of resting upper trapezius and posterior cervical muscle activity and cervical spine range of motion (ROM) in lateral flexion and extension. Results: A significant difference was found in cervical ROM within groups (P < .001), with no significant difference observed between the 2 groups. The right posterior cervical muscles showed a significant difference in group 1 only (P = .012). No significant muscle activity changes occurred in group 2. Resting muscle activity measures showed no statistically significant changes between groups. Conclusion: A single application of SM and MET to the cervical spine immediately increased cervical ROM. Neither cervical SM nor MET changed resting posterior cervical and upper trapezius muscle activity.
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    The effect of sacroiliac joint manipulation on gluteus maximus muscle activity in asymptomatic participants
    (2020-06-10) Worth, Kevin; Kretzmann, Heidi
    Purpose: The effects of spinal manipulation are well documented; however there is a gap in the current literature regarding the exact mechanisms underlying the effectiveness of spinal manipulation. Further evidence is required to improve the understanding of the neurophysiological effects of spinal manipulative therapy and its effect on muscle activity. The objectives of this study were to investigate the effects of sacroiliac joint manipulation on gluteus maximus muscle activity in an asymptomatic sample group when compared to a placebo group Methods: A randomized, controlled, pre-test, post-test repeated measures design allowed for 28 participants, aged 18-40 years old, with sacroiliac joint dysfunction to be allocated into either a sacroiliac joint manipulation or a placebo group. Muscle activity of the gluteus maximus was measured before intervention and again 10 minutes post intervention. IBM SPSS was used to analyse the data with significance set at (p=0.05). Repeated measures ANOVA testing was used to determine the significance within and between groups. Results: There was evidence of an improvement in the intervention compared with the placebo group from pre to post for outcomes of Channel A mean and maximum values, and for Channel B maximum values. In the other measures there was a trend observed but insufficient evidence to conclude that it was a real effect. The partial eta squared values were relatively small for these non-significant effects and medium to large for the significant effects. Conclusion: Analysis of the results revealed that there was evidence of an improvement in the intervention group when compared with the placebo group in some of the outcomes measured while other outcomes measured trended towards an improvement but lacked a sufficiently large sample size to conclude that it was a statistically significant effect.
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    The effect of spinal manipulation on biceps brachii muscle activity
    (2016) Victor, Aldo; Matkovich, Grant
    Background The electromyographic response post-spinal manipulation may support the elucidation of the underlying neurophysiological mechanism of spinal manipulation on motor activity as well as on arthrogenic muscle inhibition. The literature shows conflicting evidence regarding the excitatory or inhibitory nature of the reflexive electromyographic response and the excitability of the homonymous motor neuron pool post-spinal manipulation. The current study investigated whether the electromyographic response post-spinal manipulation is affected by a facilitated golgi tendon organ Ib inhibitory di-synaptic spinal reflex as part of the convergent input on the homonymous motor neuron pool excitability. Objectives The objectives of this placebo-controlled, single-blinded, repeated measures design were: 1) to determine electrical activity and muscle force of the biceps brachii muscle immediately before and after an Activator Adjusting II Instrument placebo spinal manipulation, 2) to determine electrical activity and muscle force of the biceps brachii muscle immediately before and after a C5/C6 spinal manipulation, 3) to compare the electrical activity and muscle force of the biceps brachii muscle between the control and intervention groups pre- and post-test. Method Each participant performed three sets of modified stretching of the biceps brachii muscle with two minute rest intervals between each set in a single appointment, of which at a standardized fourth second during each set an intervention was applied to the ipsilateral C5/C6 segment. The first intervention (AAI 1) entailed the application of an Activator II Adjustment Instrument placebo spinal manipulation; the second intervention (AAI 2) entailed the application of an Activator II Adjustment Instrument placebo spinal manipulation; and the third intervention (SMT) entailed the application of spinal manipulation. One-second electromyography (EMG) segments were taken during the force plateau of each set; the EMG signal was processed through Root Mean Square (RMS) analysis and the muscle force data were obtained by using the Biopac - MP 150 Data Acquisition system and AcqKnowledge analysis software. Results The objective data analysis revealed a noteworthy scientific finding of a medical anomalous inverse relationship between the muscle force and EMG RMS immediately post-spinal manipulation. The immediate post-SMT intervention revealed an increase in the biceps brachii muscle force by 4.76 % and a decrease in the biceps EMG RMS by 9.03 % with a summation of percentage difference between the muscle force and EMG RMS of 13.79 %. The immediate post-placebo AAI 1 intervention showed a decrease in the biceps EMG RMS by 1.86 % and a decrease in the biceps brachii muscle force by 0.85 % with a summation of percentage difference between the muscle force and EMG RMS of 1.01 %. The immediate post-placebo AAI 2 intervention showed a decrease in the biceps EMG RMS by 0.05 % and a decrease in the biceps brachii muscle force by 1.97 % with a summation of percentage difference between the muscle force and EMG RMS of 1.92 %. Conclusion Further research is warranted to add statistical significance to the inverse relationship between muscle force and EMG RMS observed immediately post-spinal manipulation. This knowledge obtained, may have clinical relevance for rehabilitation practitioners and physical therapists by providing evidence based support for the suggestion that optimal management of patients with muscle weakness suspected to be of arthrogenic nature could include the application of spinal manipulation to the segmentally innervated facet joints before traditional strength training is initiated.
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    The effect of ankle joint manipulation on peroneal and soleus muscle activity in chronic ankle instability syndrome
    (2016) Dicks, Jason; O'Connor, Laura; Puckree, Threethambal
    Purpose: Ankle sprains are amongst the most common injury sustained by athletes and the general public. When an ankle is repeatedly sprained it results in chronic ankle instability syndrome (CAIS). This repeated trauma results in disruption of the afferent nerve supply from the injured joint, which affects the motor neuron pool excitability of the peroneal and soleus muscles resulting in arthogenic muscle inhibition (AMI). Traditional treatment for CAIS focuses on rehabilitation of the affected muscles via strength and proprioceptive training. Recent literature has shown that the addition of ankle joint manipulation resulted in improved clinical outcomes in the treatment of CAIS. The mechanism on how joint manipulation affects AMI is under-investigated especially in extremity joints. Thus this study aimed to determine the immediate effect of ankle joint manipulation on peroneal and soleus muscle activity, by assessing surface electromyography (sEMG) H/M ratio to detect a change in the proportion of the total motor neuron pool being recruited, in participants with CAIS. Methods: The study utilised a quantitative, experimental, pre-test post-test study design. Forty two participants with grade I and II CAIS, aged 18-45 years, were randomly allocated into one of three groups. Group one received a single talocrural joint long axis distraction manipulation, group two received a sham manipulation and group three was the control receiving no intervention. sEMG H/M ratio measurements were taken before and immediately after the intervention using a Biopac wireless emg system. Results: The groups were comparable at baseline for age, gender, body mass index and H/M ratio measurements for the soleus and peroneal muscles (p < 0.050). Intra-group analysis of the soleus muscle H/M ratio showed no statistically significant change over time for the manipulation (p = 0.975) and sham (p = 0.056) groups, with the control group showing a statistically significant (p = 0.019) decrease in the H/M ratio. For the peroneal muscle no statistically significant (p > 0.050) differences were observed in any of the three groups. Inter-group analysis of the soleus muscle H/M ratio measurements showed no statistically significant differences between the three groups (p = 0.470; F = 1.010) over time, with Tukey’s HSD post-hoc test revealing a statistically significant (p = 0.028) difference being observed between the sham and control groups in terms of post soleus muscle H/M ratio measurements. Conclusion: This study failed to show that ankle joint manipulation affects the soleus and peroneal muscles in terms of H/M ratio measurements in participants with CAIS. There may have been a trend of an effect of the sham and manipulation interventions counteracting the muscle fatigue experienced in the control group, however further investigation is required.