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lumbar thrust manipulation

Aaron A Puhl, Christine J Reinhart, Jon B Doan, Howard Vernon
BACKGROUND CONTEXT: Spinal manipulative therapy (SMT) has been attributed with substantial non-specific effects. Accurate assessment of the non-specific effects of SMT relies on high-quality studies with low risk of bias that compare with appropriate placebos. PURPOSE: This review aims to characterize the types and qualities of placebo control procedures used in controlled trials of manually applied, lumbar and pelvic (LP)-SMT, and to evaluate the assessment of subject blinding and expectations...
November 22, 2016: Spine Journal: Official Journal of the North American Spine Society
Christopher H Wise, Ronald J Schenk, Jill Black Lattanzi
BACKGROUND: Despite emerging evidence to support the use of high velocity thrust manipulation in the management of lumbar spinal conditions, utilization of thrust manipulation among clinicians remains relatively low. One reason for the underutilization of these procedures may be related to disparity in training in the performance of these techniques at the professional and post professional levels. PURPOSE: To assess the effect of using a new model of active learning on participant confidence in the performance of spinal thrust manipulation and the implications for its use in the professional and post-professional training of physical therapists...
July 2016: Journal of Manual & Manipulative Therapy
Michael O'Donnell, Jo Armour Smith, Alex Abzug, Kornelia Kulig
BACKGROUND: Spinal manipulation is an effective intervention for low back pain, yet there is little consistency in how this skill is taught. OBJECTIVES: The purpose of this study was to identify what educators and clinicians believe are important characteristics of the patient and operator position prior to side-lying lumbar manipulation and the patient position and operator motion during the manipulative thrust. DESIGN: A multi-disciplinary correspondence-based Delphi method...
September 2016: Manual Therapy
Stuart J Currie, Casey A Myers, Ashok Krishnamurthy, Brian A Enebo, Bradley S Davidson
OBJECTIVE: The purpose of this study was to determine electromyographic threshold parameters that most reliably characterize the muscular response to spinal manipulation and compare 2 methods that detect muscle activity onset delay: the double-threshold method and cross-correlation method. METHODS: Surface and indwelling electromyography were recorded during lumbar side-lying manipulations in 17 asymptomatic participants. Muscle activity onset delays in relation to the thrusting force were compared across methods and muscles using a generalized linear model...
May 2016: Journal of Manipulative and Physiological Therapeutics
Zachary Walston, Dale Yake
Study Design Case series. Background Low back pain (LBP) is an increasing problem in health care. The evidence for the use of spinal manipulative therapy to treat pediatric patients with LBP is minimal. The treatment of pediatrics with manual therapy, particularly spinal manipulation, is controversial within the medical community, primarily with respect to adverse events. The purpose of this case series was to illustrate the feasibility and safety of lumbar manipulation plus exercise in the adolescent population with mechanical LBP...
May 2016: Journal of Orthopaedic and Sports Physical Therapy
William R Reed, Cynthia R Long, Gregory N Kawchuk, Randall S Sozio, Joel G Pickar
STUDY DESIGN: Electrophysiological recordings were obtained from proprioceptors in deep lumbar paraspinal muscles of anesthetized cats during high velocity low amplitude spinal manipulation (HVLA-SM). OBJECTIVE: To determine how thrust direction of an HVLA-SM affects neural input from back musculature. SUMMARY OF BACKGROUND DATA: A clinician's ability to apply the thrust of an HVLA-SM in a specified direction is considered an important component of its optimal delivery...
December 5, 2015: Spine
Ting Xia, Cynthia R Long, Maruti R Gudavalli, David G Wilder, Robert D Vining, Robert M Rowell, William R Reed, James W DeVocht, Christine M Goertz, Edward F Owens, William C Meeker
STUDY DESIGN: A three-arm controlled trial with adaptive allocation. OBJECTIVES: The aim of this study was to compare short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults with subacute or chronic low back pain (LBP) over 2 weeks. SUMMARY OF BACKGROUND DATA: SM has been recommended in recently published clinical guidelines for LBP management. Previous studies suggest that thrust and nonthrust SM procedures, though distinctly different in joint loading characteristics, have similar effects on patients with LBP...
June 2016: Spine
Edward F Owens, Ronald S Hosek, Stephanie G B Sullivan, Brent S Russell, Linda E Mullin, Lydia L Dever
OBJECTIVE: We developed an adjusting bench with a force plate supporting the lumbar portion to measure loads transmitted during lumbar manual adjustment. It will be used to provide force-feedback to enhance student learning in technique labs. The study goal is to define the learning target loads and speeds, with instructors as expert models. METHODS: A total of 11 faculty members experienced in teaching Gonstead technique methods performed 81 simulated adjustments on a mannequin on the force plate...
March 2016: Journal of Chiropractic Education
William R Reed, Joel G Pickar
STUDY DESIGN: In vivo cat model study. OBJECTIVE: To determine whether intervertebral facet joint fixation and segmental thrust level alter paraspinal muscle spindle activity during simulated spinal manipulation. SUMMARY OF BACKGROUND DATA: Intervertebral motion is commonly assessed by manual therapy practitioners during clinical evaluation and treatment. Mechanoreceptor activity elicited during spinal manipulation has been theorized as a potential mechanism of its efficacy...
July 1, 2015: Spine
Dhinu J Jayaseelan, Carol A Courtney, Michael Kecman, Daniel Alcorn
BACKGROUND AND PURPOSE: Quadriceps weakness is a common finding following knee injuries or surgery, and can be associated with significant functional limitations. This weakness or muscle inhibition may be due to central inhibitory mechanisms, rather than local peripheral dysfunction. Lumbopelvic manipulation has been shown to effect efferent muscle output by altering nociceptive processing. The purpose of this report is to describe the physical therapy management of anterior knee pain and chronic quadriceps weakness utilizing side-lying rotational lumbar thrust manipulation and therapeutic exercise for an individual eight months status-post ACL reconstruction...
December 2014: International Journal of Sports Physical Therapy
Geoffrey M Gelley, Steven R Passmore, Brian J MacNeil
This study used an observational design to examine the kinematics of spinal manipulative therapy (SMT) by determining the acceleration characteristics of the manipulative input at the cervical, thoracic, and lumbar spinal regions. Studies of SMT have been restricted to measuring the forces that result from the manipulative input. Several studies have indicated the rate of force development is a key parameter of clinically delivered SMT. Despite this, the movement strategies employed during SMT, including acceleration, have not been directly measured...
April 2015: Manual Therapy
Deepak Sebastian
A 36-year-old male experienced left sided back and radiating flank pain, following a fall on his buttock. A detailed medical evaluation ruled out the presence of red flags. Initial examination revealed positive findings of comparable local tenderness over the left T11, T12 and left paraspinal area, and a 2 cm shortening of the left leg. 8 treatment visits for a period of 4 weeks addressed mechanical dysfunction at the T11, T12, lumbar and pelvic region, comprising manual therapy, therapeutic exercise and pain relieving modalities...
October 2014: Journal of Bodywork and Movement Therapies
William R Reed, Randall Sozio, Joel G Pickar, Stephen M Onifer
OBJECTIVE: The objective of this preliminary study was to determine if high-velocity, low-amplitude spinal manipulation (HVLA-SM) thrust duration alters mechanical trunk activation thresholds of nociceptive-specific (NS) lateral thalamic neurons. METHODS: Extracellular recordings were obtained from 18 NS neurons located in 2 lateral thalamic nuclei (ventrolateral [n = 12] and posterior [n = 6]) in normal anesthetized Wistar rats. Response thresholds to electronic von Frey anesthesiometer (rigid tip) mechanical trunk stimuli applied in 3 lumbar directions (dorsal-ventral, 45° caudal, and 45° cranial) were determined before and immediately after the delivery of 3 HVLA-SM thrust durations (time control 0, 100, and 400 milliseconds)...
October 2014: Journal of Manipulative and Physiological Therapeutics
Dong-Yuan Cao, Joel G Pickar
We determined whether spinal manipulation could prevent and/or reverse the decrease and increase in paraspinal muscle spindle responsiveness caused respectively by lengthening and shortening histories of the lumbar muscles. Single unit spindle activity from multifidus and longissimus muscles was recorded in the L6 dorsal root in anesthetized cats. Muscle history was created and spinal manipulation delivered (thrust amplitude: 1.0mm, duration: 100ms) using a feedback-controlled motor attached to the L6 spinous process...
June 2014: Journal of the Canadian Chiropractic Association
Maruti Ram Gudavalli
OBJECTIVE: The objective of this study was to determine the instantaneous rate of loading during manual high-velocity, low-amplitude spinal manipulations (HVLA SMs) in the lumbar and thoracic regions and compare to the average rates of loading. METHODS: Force-time profiles were recorded using a hand force transducer placed between the hand of a doctor of chiropractic and the subject's back during 14 HVLA SM thrusts on asymptomatic volunteers while 3 doctors of chiropractic delivered the spinal manipulations...
June 2014: Journal of Manipulative and Physiological Therapeutics
William R Reed, Joel G Pickar, Randall S Sozio, Cynthia R Long
OBJECTIVES: High-velocity low-amplitude spinal manipulation (HVLA-SM), as performed by doctors who use manual therapy (eg, doctors of chiropractic and osteopathy), results in mechanical hypoalgesia in clinical settings. This hypoalgesic effect has previously been attributed to alterations in peripheral and/or central pain processing. The objective of this study was to determine whether thrust magnitude of a simulated HVLA-SM alters mechanical trunk response thresholds in wide dynamic range (WDR) and/or nociceptive specific (NS) lateral thalamic neurons...
June 2014: Journal of Manipulative and Physiological Therapeutics
Heidi Ojha, William Egan, Patricia Crane
OBJECTIVE AND IMPORTANCE: There is a paucity of research investigating the combined interventions of direction-specific lumbar exercise and manipulation for individuals with low back pain (LBP) who exhibit centralization or a directional preference. The purpose of this report was to describe the management and outcomes of a patient with chronic LBP who met two categories of the revised treatment based classification (TBC) approach initially described by Delitto and colleagues. CLINICAL PRESENTATION: A 55-year-old female with a 15-year history of right LBP/leg pain demonstrated centralization of symptoms with repeated extension and met four out of five criteria on the clinical prediction rule for thrust manipulation...
February 2013: Journal of Manual & Manipulative Therapy
William R Reed, Cynthia R Long, Gregory N Kawchuk, Joel G Pickar
OBJECTIVE: The purpose of this study was to determine how the preload that precedes a high-velocity, low-amplitude spinal manipulation (HVLA-SM) affects muscle spindle input from lumbar paraspinal muscles both during and after the HVLA-SM. METHODS: Primary afferent activity from muscle spindles in lumbar paraspinal muscles were recorded from the L6 dorsal root in anesthetized cats. High-velocity, low-amplitude spinal manipulation of the L6 vertebra was preceded either by no preload or systematic changes in the preload magnitude, duration, and the presence or absence of a downward incisural point...
February 2014: Journal of Manipulative and Physiological Therapeutics
William R Reed, Cynthia R Long, Joel G Pickar
OBJECTIVES: Manual therapy practitioners commonly assess lumbar intervertebral mobility before deciding treatment regimens. Changes in mechanoreceptor activity during the manipulative thrust are theorized to be an underlying mechanism of spinal manipulation (SM) efficacy. The objective of this study was to determine if facet fixation or facetectomy at a single lumbar level alters muscle spindle activity during 5 SM thrust durations in an animal model. METHODS: Spinal stiffness was determined using the slope of a force-displacement curve...
November 2013: Journal of Manipulative and Physiological Therapeutics
Maruti Ram Gudavalli, James DeVocht, Ali Tayh, Ting Xia
OBJECTIVE: Quantification of chiropractic high-velocity, low-amplitude spinal manipulation (HVLA-SM) may require biomechanical equipment capable of sampling data at high rates. However, there are few studies reported in the literature regarding the minimal sampling rate required to record the HVLA-SM force-time profile data accurately and precisely. The purpose of this study was to investigate the effect of different sampling rates on the quantification of forces, durations, and rates of loading of simulated side posture lumbar spine HVLA-SM delivered by doctors of chiropractic...
June 2013: Journal of Manipulative and Physiological Therapeutics
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