The Role of the Rate of Force Application in Responses to Spinal Manipulation Therapy

Neuromechanical Response to Spinal Manipulation Therapy: Effects of a Constant Rate of Force Application

The objective of the present study is to determine if spinal manipulations with a constant rate of force application but with different peak force and time to peak force lead to similar responses in healthy adults.

Study Overview

• Status: Completed
• Conditions: Spinal Manipulation
• Intervention / Treatment: Procedure: Spinal manipulation; Device: Apparatus used to deliver spinal manipulations

Detailed Description

Although there are indirect evidences that the rate of force application modulates neuromuscular responses to spinal manipulation therapy (SMT) through peak force or thrust duration modulations, such an assumption remains to be confirmed. Therefore, the objective of the present study was to determine if different SMT force-time profiles where a constant rate of force application would be maintained (through the modulation of the peak force and the time to peak force) lead to similar neuromechanical responses. Based on the available data relative to the effect of SMT biomechanical parameters modulation, it was hypothesized that neuromuscular responses would be similar across SMT force-time profiles, while vertebral displacements would increase as SMT peak force increases.

• Study Type: Interventional
• Enrollment (Actual): 25
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Healthy adult

Exclusion Criteria:

• Thoracic or lumbar pain
• History of back trauma or surgery
• Severe osteoarthritis
• Inflammatory arthritis
• Vascular conditions
• Contraindication to the use of SMT

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Participants; All volunteers will participate in an experimental session. Participants will be delivered four different spinal manipulations (SMT) at T7 with a rate of force application of about 2200 Newtons/seconds and a preload force of 25 Newtons (N). SMTs will differed in their time to peak force (ms) and peak force (N), respectively fixed as follow for each applied SMT: (1)57 ms / 150 N, (2)80 ms / 200 N, (3)102 ms / 250 N and (4)125 ms / 300 N.

Procedure: Spinal manipulation; Participants will lie down during the 45-minute experimental session. Vertebral displacements (cm) and muscle response amplitude (RMS value) will be recorded through kinematic markers (on T6, T7 and T8 spinous processes) and surface electromyography electrodes (on the left and right erector spinae at T6 and T8 vertebra level). Each SMT (4 per participant) will be delivered at T7 transverse processes by an apparatus. Responses during the thrust phase (duration equal to twice the time to peak force) and after the thrust (1,5s duration) will be compared between SMTs.; Other Names: Manual therapy; Device: Apparatus used to deliver spinal manipulations; An apparatus using a servo-controlled linear actuator motor (Linear Motor Series P01-48x360, LinMot Inc., Switzerland) will be used to deliver spinal manipulations.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Left T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Left T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T6 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Right T8 Normalized Root Mean Square (RMS) Value	Normalized amplitude (RMS) of surface electromyography response. The normalisation was achieved by dividing the obtained RMS by the RMS value before thrust application.	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Sixth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Seventh Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Eighth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 150N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Sixth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Seventh Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Eighth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 200N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Sixth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Seventh Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Eighth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 250N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Sixth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Seventh Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset
Vertebral Displacement of the Eighth Thoracic Vertebra	Absolute posterior to anterior vertebral displacement during the spinal manipulation in centimeter	During the 300N spinal manipulation procedure, assessed up to 2 seconds following thrust onset

Collaborators and Investigators

• Sponsor: Université du Québec à Trois-Rivières
• Collaborators: Fondation Chiropratique du Québec
• Investigators: Principal Investigator: Martin Descarreaux, DC, PhD, Université du Québec à Trois-Rivières

Publications and helpful links

General Publications

• Nougarou F, Page I, Loranger M, Dugas C, Descarreaux M. Neuromechanical response to spinal manipulation therapy: effects of a constant rate of force application. BMC Complement Altern Med. 2016 Jun 2;16:161. doi: 10.1186/s12906-016-1153-6.

Study record dates

Study Major Dates

• Study Start: June 1, 2013
• Primary Completion (Actual): June 1, 2014
• Study Completion (Actual): June 1, 2014

Study Registration Dates

• First Submitted: September 8, 2015
• First Submitted That Met QC Criteria: September 14, 2015
• First Posted (Estimate): September 15, 2015

Study Record Updates

• Last Update Posted (Estimate): February 5, 2016
• Last Update Submitted That Met QC Criteria: January 6, 2016
• Last Verified: January 1, 2016

More Information

Terms related to this study

• Keywords: spinal manipulation; electromyography; dose-response relationship; musculoskeletal manipulations; biomechanical phenomena
• Other Study ID Numbers: UQTR-2013-SMTrate