The Effects of Spinal Manipulation on Central Nervous System Activity Measured by Reflexive Calf Muscle Recruitment
NCT ID: NCT02848456
Last Updated: 2017-04-19
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
20 participants
Study Classification
INTERVENTIONAL
Study Start Date
2014-08-31
Study Completion Date
2014-10-31
Brief Summary
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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.
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Detailed Description
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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.
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.
Conditions
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Subluxation of Joint of Lumbar Spine
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
FACTORIAL
Primary Study Purpose
BASIC_SCIENCE
Blinding Strategy
SINGLE
Participants
Study Groups
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Spinal Manipulation SM
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).
Group Type
ACTIVE_COMPARATOR
Spinal Manipulation
Intervention Type
PROCEDURE
Manual, side-posture, high-velocity low-amplitude spinal manipulation targeting the lower lumbar spine and sacroiliac joints
Max Voluntary Isometric Contraction 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).
Group Type
ACTIVE_COMPARATOR
Max Voluntary Isometric Contraction
Intervention Type
PROCEDURE
A 10 second plantar flexion maximal voluntary isometric contraction
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).
Group Type
ACTIVE_COMPARATOR
SM+MVIC
Intervention Type
PROCEDURE
The spinal manipulation immediately preceding the maximal voluntary isometric contraction
Interventions
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Spinal Manipulation
Manual, side-posture, high-velocity low-amplitude spinal manipulation targeting the lower lumbar spine and sacroiliac joints
Intervention Type
PROCEDURE
Max Voluntary Isometric Contraction
A 10 second plantar flexion maximal voluntary isometric contraction
Intervention Type
PROCEDURE
SM+MVIC
The spinal manipulation immediately preceding the maximal voluntary isometric contraction
Intervention Type
PROCEDURE
Eligibility Criteria
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Inclusion Criteria
* 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
* 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
Exclusion Criteria
* Any pain in the lower back, abdomen or legs and/or surgeries performed in these regions
Minimum Eligible Age
20 Years
Maximum Eligible Age
35 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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University of Kentucky
OTHER
Sponsor Role
collaborator
Grant Sanders
OTHER
Sponsor Role
lead
Responsible Party
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Grant Sanders
Principal Investigator
Responsibility Role
SPONSOR_INVESTIGATOR
Principal Investigators
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Grant D Sanders, D.C., Ph.D.
Role: PRINCIPAL_INVESTIGATOR
College of Education, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY
James W Yates, Ph.D.
Role: STUDY_CHAIR
College of Education, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY
Locations
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College of Education, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY
Lexington, Kentucky, United States
Site Status
Countries
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United States
References
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Other Identifiers
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14-0507-F6A
Identifier Type: -
Identifier Source: org_study_id
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