Effects of Lumbosacral Manipulation on Isokinetic Strength of the Knee Extensors and Flexors in Healthy Subjects: A Randomized, Controlled, Single-Blind Crossover Trial

Abstract

Objective: The purpose of this study was to investigate the effect of manual manipulations targeting the lumbar spine and/or sacroiliac joint on concentric knee extension and flexion forces. Torque production was measured during isometric and isokinetic contractions.

Methods: This was a randomized, controlled, single-blind crossover design with 21 asymptomatic, college-aged subjects who had never received spinal manipulation. During 2 separate sessions, subjects' peak torques were recorded while performing maximal voluntary contractions on an isokinetic dynamometer. Isometric knee extension and flexion were recorded at 60° of knee flexion, in addition to isokinetic measurements obtained at 60°/s and 180°/s. Baseline measurements were acquired before either treatment form of lumbosacral manipulation or sham manipulation, followed by identical peak torque measurements within 5 and 20 minutes posttreatment. Data were analyzed with a repeated measures analysis of variance.

Results: A statistically significant difference did not occur between the effects of lumbosacral manipulation or the sham manipulation in the percentage changes of knee extension and flexion peak torques at 5 and 20 minutes posttreatment. Similar, nonsignificant results were observed in the overall percentage changes of isometric contractions (spinal manipulation 4.0 ± 9.5 vs sham 1.2 ± 6.3, P = .067), isokinetic contractions at 60°/s (spinal manipulation - 4.0 ± 14.2 vs sham - 0.3 ± 8.2, P = .34), and isokinetic contractions at 180°/s (spinal manipulation - 1.4 ± 13.9 vs sham - 5.5 ± 20.0, P = .18).

Conclusion: The results of the current study suggest that spinal manipulation does not yield an immediate strength-enhancing effect about the knee in healthy, college-aged subjects when measured with isokinetic dynamometry.

Keywords: Knee; Muscle strength; Spinal manipulation.

Figures

Fig 1

Summary of experimental procedures. MVC, maximum voluntary contractions; MVIC, maximal voluntary isometric contraction; SM, spinal manipulation.

Fig 2

Percentage changes in peak torques at 5 minutes posttreatment compared with baseline. Mean ± SD. SM, spinal manipulation.

Fig 3

Percentage changes in peak torques at 20 minutes posttreatment compared with baseline. Mean ± SD. SM, spinal manipulation.

Fig 4

Percentage changes in peak torques averaged at both time points posttreatment compared with baseline. Mean ± SD. SM, spinal manipulation.