Neural & Biomech. Responses to Mech. Feat. of Spinal Manipulation/Pickar, Joel

脊柱手法是一种以身体为基础的疗法，患者经常寻求肌肉骨骼的治疗 投诉。虽然临床上使用了许多技术，但每一种技术都有一个共同点 对脊椎施力。最常见的脊椎手法包括短杆、高速、低位 振幅(HVLA)推力。这项应用的重点是对HVLA脊柱手法的研究。通过ITS 从本质上讲，脊柱操作是一种持续不到一秒钟的机械干预(通常 200毫秒)，但产生的影响比干预本身更持久。多么?这个问题提供了以下基础 我们的研究和激励我们的长期目标：了解和提高脊柱的有效使用 操纵。我们将利用两位共同领导人开发的动物模型和方法 为了了解脊柱手法的空间和时间特征之间的关系 以及它们对脊柱旁组织的神经和生物力学反应的影响。我们将确定是否 椎旁肌梭初级传入信号的反应性和/或被动性 操作区域的生物力学特性比操作本身更持久。具体来说，我们将 确定肌梭反应性是否作为1)的函数而增加而脊柱僵硬减少 脊柱手法的持续时间；2)前负荷的存在、大小或形状 手法；3)用于脊柱手法的解剖接触点；4)与 其中应用了操纵。这些互补性研究的信息将有助于提供 有助于识别操作的剂量特征的信息 脊柱旁组织的生物力学特性可能是最敏感的，并在决定治疗策略方面 优化SM的投放。这项研究的创新之处在于它是第一次系统地研究 研究这种关系，并使用最常用的脊柱手法形式，即高速 低幅度脊椎手法。这项研究具有重要的意义，因为它有助于实现NCCAM 通过描述手法过程的生物力学特征来制定战略计划，以努力澄清 在操作实践中起作用的作用机制。

Spinal manipulation is a form of body-based therapy patients often seek for treatment of musculoskeletal complaints. While numerous techniques are used clinically, each shares the common denominator of applying force to the spine. The most form of spinal manipulation includes a short lever, High Velocity, Low Amplitude (HVLA) thrust. Investigation of HVLA spinal manipulation is the focus of this application. By its very nature spinal manipulation is a mechanical intervention that lasts a fraction of a second (typically <200ms) yet produces effects that outlast the intervention itself. How? This question provides the basis for our study and motivates our long term goal: to understand and improve the effective use of spinal manipulation. We will take advantage of an animal model and approaches developed by the two co-leaders in order to understand the relationship between spatial and temporal characteristics of a spinal manipulation and their effects on neural and biomechanical responses from paraspinal tissues. We will determine whether either the responsiveness of primary afferent signaling from paraspinal muscle spindle and/or the passive biomechanical properties of the manipulated region outlast the manipulation itself. Specifically, we will determine if muscle spindle responsiveness increases and spinal stiffness decreases as a function of 1) the spinal manipulation's duration; 2) the presence, magnitude or shape of a preload preceding the manipulation; 3) the anatomical contact point used for the spinal manipulation; and 4) the direction with which the manipulation is applied. The information from these complementary studies will help provide information useful for identifying dosing features of the manipulation to which the nervous system and biomechanical properties of paraspinal tissues may be most responsive and in determining strategies for optimizing the delivery of SM. The study is innovative in that it is represents the first systematic study to investigate this relationship and uses the most commonly applied form of spinal manipulation, a high velocity low amplitude spinal manipulation. The study is significant because it contributes to accomplishing NCCAM's strategic plan by characterizing the biomechanics of manipulative procedures in an effort to clarify the mechanisms of action operative in manipulation practices.