Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome.
Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome.
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DOI：
10.1016/j.clinbiomech.2021.105485
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Michener LA
中科院分区：
文献类型：
--
作者：
Hegarty AK;Hsu M;Roy JS;Kardouni JR;Kutch JJ;Michener LA
胸椎推拿可以改善肩痛患者的疼痛和功能;然而，这些益处背后的机制仍不清楚。在这里，我们评估了胸椎推拿对肌肉活动的影响，因为肌肉活动的改变是肩痛患者的关键障碍。我们还评估了肌肉活动变化与临床结果之间的关系，以描述神经肌肉驱动变化的有意义的背景。与肩峰下疼痛综合征相关的肩痛患者（n=28）接受了低振幅高速推胸手法，下，中，上胸椎。在手臂抬高过程中，在操作前后收集肌电图肌肉活动（上、中、下肌;前锯肌;三角肌;冈下肌）和肩部疼痛（11分量表），并将其标准化为参考收缩。在基线和干预后2-3天使用宾夕法尼亚肩关节评分（Penn）评估临床获益。在手臂上升过程中观察到肌肉活动显著增加（p=0.002）。使用向后逐步回归分析，手臂抬高过程中前锯肌活动的特定增加解释了操作后Penn评分的改善（p<0.05）。胸椎推拿立即增加神经肌肉驱动。此外，增加前锯肌活动，肩胛骨运动的关键肌肉，与肩关节临床结局的短期改善相关。
Thoracic spinal manipulation can improve pain and function in individuals with shoulder pain; however, the mechanisms underlying these benefits remain unclear. Here, we evaluated the effects of thoracic spinal manipulation on muscle activity, as alteration in muscle activity is a key impairment for those with shoulder pain. We also evaluated the relationship between changes in muscle activity and clinical outcomes, to characterize the meaningful context of a change in neuromuscular drive. Participants with shoulder pain related to subacromial pain syndrome (n=28) received thoracic manipulation of low amplitude high velocity thrusts to the lower, middle and upper thoracic spine. Electromyographic muscle activity (trapezius-upper, middle, lower; serratus anterior; deltoid; infraspinatus) and shoulder pain (11-point scale) was collected pre and post-manipulation during arm elevation, and normalized to a reference contraction. Clinical benefits were assessed using the Pennsylvania Shoulder Score (Penn) at baseline and 2–3 days post-intervention. A significant increase in muscle activity was observed during arm ascent (p=0.002). Using backward stepwise regression analysis, a specific increase in the serratus anterior muscle activity during arm elevation explained improved Penn scores following post-manipulation (p<0.05). Thoracic spinal manipulation immediately increases neuromuscular drive. In addition, increased serratus anterior muscle activity, a key muscle for scapular motion, is associated with short-term improvements in shoulder clinical outcomes.
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发表时间：
2014-11-01
影响因子：
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