Terry L Grindstaff1, Brian G Pietrosimone2, Lindsay D Sauer3, D Casey Kerrigan4, James T Patrie3, Jay Hertel3, Christopher D Ingersoll5. 1. School of Pharmacy & Health Professions, Physical Therapy Department, 2500 California Plaza, Creighton University, Omaha, NE 68178, USA. Electronic address: GrindstaffTL@gmail.com. 2. University of North Carolina, Chapel Hill, NC, USA. 3. University of Virginia, Charlottesville, VA, USA. 4. JKM Technologies LLC, Charlottesville, VA, USA. 5. Central Michigan University, Mt. Pleasant, MI, USA.
Abstract
UNLABELLED: Manual therapies, directed to the knee and lumbopelvic region, have demonstrated the ability to improve neuromuscular quadriceps function in individuals with knee pathology. It remains unknown if manual therapies may alter impaired spinal reflex excitability, thus identifying a potential mechanism in which manual therapy may improve neuromuscular function following knee injury. AIM: To determine the effect of local and distant mobilisation/manipulation interventions on quadriceps spinal reflex excitability. METHODS:Seventy-five individuals with a history of knee joint injury and current quadriceps inhibition volunteered for this study. Participants were randomised to one of five intervention groups: lumbopelvic manipulation (grade V), lumbopelvic manipulation positioning (no thrust), grade IV patellar mobilisation, grade I patellar mobilisation, and control (no treatment). Changes in spinal reflex excitability were quantified by assessing the Hoffmann reflex (H-reflex), presynaptic, and postsynaptic excitability. A hierarchical linear-mixed model for repeated measures was performed to compare changes in outcome variables between groups over time (pre, post 0, 30, 60, 90 min). RESULTS: There were no significant differences in H-reflex, presynaptic, or postsynaptic excitability between groups across time. CONCLUSIONS: Manual therapies directed to the knee or lumbopelvic region did not acutely change quadriceps spinal reflex excitability. Although manual therapies may improve impairments and functional outcomes the underlying mechanism does not appear to be related to changes in spinal reflex excitability.
RCT Entities:
UNLABELLED: Manual therapies, directed to the knee and lumbopelvic region, have demonstrated the ability to improve neuromuscular quadriceps function in individuals with knee pathology. It remains unknown if manual therapies may alter impaired spinal reflex excitability, thus identifying a potential mechanism in which manual therapy may improve neuromuscular function following knee injury. AIM: To determine the effect of local and distant mobilisation/manipulation interventions on quadriceps spinal reflex excitability. METHODS: Seventy-five individuals with a history of knee joint injury and current quadriceps inhibition volunteered for this study. Participants were randomised to one of five intervention groups: lumbopelvic manipulation (grade V), lumbopelvic manipulation positioning (no thrust), grade IV patellar mobilisation, grade I patellar mobilisation, and control (no treatment). Changes in spinal reflex excitability were quantified by assessing the Hoffmann reflex (H-reflex), presynaptic, and postsynaptic excitability. A hierarchical linear-mixed model for repeated measures was performed to compare changes in outcome variables between groups over time (pre, post 0, 30, 60, 90 min). RESULTS: There were no significant differences in H-reflex, presynaptic, or postsynaptic excitability between groups across time. CONCLUSIONS: Manual therapies directed to the knee or lumbopelvic region did not acutely change quadriceps spinal reflex excitability. Although manual therapies may improve impairments and functional outcomes the underlying mechanism does not appear to be related to changes in spinal reflex excitability.
Authors: Neil A Segal; Natalie A Glass; David T Felson; Michael Hurley; Mei Yang; Michael Nevitt; Cora E Lewis; James C Torner Journal: Med Sci Sports Exerc Date: 2010-11 Impact factor: 5.411
Authors: Riann M Palmieri; Arthur Weltman; Jeffrey E Edwards; James A Tom; Ethan N Saliba; Danny J Mistry; Christopher D Ingersoll Journal: Knee Surg Sports Traumatol Arthrosc Date: 2005-02-01 Impact factor: 4.342
Authors: Terry L Grindstaff; Jay Hertel; James R Beazell; Eric M Magrum; D Casey Kerrigan; Xitao Fan; Christopher D Ingersoll Journal: J Athl Train Date: 2012 Jan-Feb Impact factor: 2.860