Treatment and Response Factors in Muscle Activation during Spinal Manipulation.
Treatment and Response Factors in Muscle Activation during Spinal Manipulation.
复制标题
脊柱推拿中肌肉激活的治疗和反应因素。
DOI：
10.3390/jcm12196377
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发表时间：
2023-10-06
影响因子：
3.9
通讯作者：
Davidson BS
中科院分区：
文献类型：
--
作者：
Currie SJ;Myers CA;Enebo BA;Davidson BS
在脊柱手法中施加的力会在脊柱旁肌肉中产生神经肌肉反应。对产生这种肌肉活动的因素进行系统的评估可以为临床提供洞察力。本研究的目的是量化治疗因素(手法顺序和手法部位)和反应因素(肌层、肌肉位置和肌肉侧)对脊柱手法神经肌肉反应的影响。记录了20名无症状受试者腰侧卧位手法时8个肌肉部位的表面肌电信号和内窥肌电信号。使用混合模型线性回归、效应大小和等价性检验比较了这些因素对肌肉反应次数和肌肉活动开始延迟的影响。治疗因素在肌肉反应次数(p=0.11，p=0.28)和肌肉活动开始延迟(p=0.35，p=0.35)方面，在手法顺序(第一或第二)和手法部位(L3或SI)之间没有统计学差异。与浅表肌肉相比，多裂肌的肌肉活动开始延迟时间明显缩短(p=0.02)。与右侧相比，左侧肌肉的反应次数显著增加(p=0.001)，肌肉活动开始延迟明显缩短(p<；0.001)。神经肌肉反应的位置、层次和侧面显示出随着距离手法部位的增加，肌肉反应率降低和肌肉活动开始延迟增加的趋势。这些结果建立在工作的基础上，表明手法部位的特异性可能不会在脊椎手法的神经肌肉反应中发挥作用--至少在腰椎内。此外，这些结果表明，在相似的区域(L3和S1)进行多次推拿并不会显著改变肌肉的反应，并有助于临床理解肌肉反应率越高，延迟越短，越接近操作。
The forces applied during a spinal manipulation produce a neuromuscular response in the paraspinal muscles. A systematic evaluation of the factors involved in producing this muscle activity provides a clinical insight. The purpose of this study is to quantify the effect of treatment factors (manipulation sequence and manipulation site) and response factors (muscle layer, muscle location, and muscle side) on the neuromuscular response to spinal manipulation. The surface and indwelling electromyographies of 8 muscle sites were recorded during lumbar side-lying manipulations in 20 asymptomatic participants. The effects of the factors on the number of muscle responses and the muscle activity onset delays were compared using mixed-model linear regressions, effect sizes, and equivalence testing. The treatment factors did not reveal statistical differences between the manipulation sequences (first or second) or manipulation sites (L3 or SI) in the number of muscle responses (p = 0.11, p = 0.28, respectively), or in muscle activity onset delays (p = 0.35 p = 0.35, respectively). There were significantly shorter muscle activity onset delays in the multifidi compared to the superficial muscles (p = 0.02). A small effect size of side (d = 0.44) was observed with significantly greater number of responses (p = 0.02) and shorter muscle activity onset delays (p < 0.001) in the muscles on the left side compared to the right. The location, layer, and side of the neuromuscular responses revealed trends of decreasing muscle response rates and increasing muscle activity onset delays as the distance from the manipulation site increased. These results build on the body of work suggesting that the specificity of manipulation site may not play a role in the neuromuscular response to spinal manipulation—at least within the lumbar spine. In addition, these results demonstrate that multiple manipulations performed in similar areas (L3 and S1) do not change the response significantly, as well as contribute to the clinical understanding that the muscle response rate is higher and with a shorter delay, the closer it is to the manipulation.
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DOI：
10.3389/fpain.2021.765921
发表时间：
2021
期刊：
Frontiers in pain research (Lausanne, Switzerland)
影响因子：
--
作者：
Gevers-Montoro C;Provencher B;Descarreaux M;Ortega de Mues A;Piché M
通讯作者：
Piché M
DOI：
10.1016/j.jmpt.2022.03.018
发表时间：
2022-01-01
影响因子：
1.3
作者：
Gorrell, Lindsay M.;Conway, Philip J.;Herzog, Walter
通讯作者：
Herzog, Walter
DOI：
10.1016/j.spinee.2004.11.006
发表时间：
2005-05-01
期刊：
The spine journal : official journal of the North American Spine Society
影响因子：
--
作者：
Ianuzzi, Allyson;Khalsa, Partap S
通讯作者：
Khalsa, Partap S
DOI：
10.1016/s0161-4754(99)70032-1
发表时间：
1999-09-01
影响因子：
1.3
作者：
Lehman, GJ;McGill, SM
通讯作者：
McGill, SM
影响因子：
6.1
作者：
Brenner, Alexander K.;Gill, Norman W.;Kiesel, Kyle
通讯作者：
Kiesel, Kyle