Duration of the effects of spinal manipulation on pain intensity and electromyographic activity of paravertebral parts of individuals with chronic mechanical low back pain

Authors

  • Walkyria Vilas Boas Fernandes Universidade Federal de Mato Grosso
  • Eduardo Silveira Bicalho Pontifícia Universidade Católica do Paraná (PUCPR) - Curitiba (PR), Brasil
  • Andrielle Elaine Capote Universidade Federal do Paraná. PR. Brasil
  • Elisangela Ferretti Manffra Pontifícia Universidade Católica do Paraná (PUCPR) - Curitiba (PR), Brasil

DOI:

https://doi.org/10.1590/1809-2950/14600023022016

Abstract

The objective of this research was to evaluate the effects of a manipulative intervention on the electromyographic activity of paraverterbral muscles and low back pain intensity, both immediately and 30 minutes after their application in individuals with chronic low back pain. Thirty-eight individuals were evaluated, being randomly divided into two groups: the one who received global vertebral manipulation technique (n=20), and control (n=18), which remained in lateral decubitus for 10 seconds on each side of the body. The electromyographic signal of paravertebral parts at L4-L5 level both right and left was collected during three cycles of flexion-relaxation-extension of the torso. In the intervals between cycles, participants reported the intensity of pain through the Visual Analog Scale (VAS, 100 mm). A significant reduction in pain intensity in the group that received the manipulation was observed, opposed to the control group, in which the score increased in VAS. The dimension of the effect on pain intensity was 1.0 and 0.9 right after the manipulation and 30 minutes later. The flexion/relaxation ratio (FRR) increased in the group that was subjected to manipulation, but remained unchanged in the control group. The FRR displayed effects between the groups that were 0.6 and 0.5 in both assessments. We were able to see effects of the manipulation in these two variables, and its continuation in the range observed, concluding that they linger at least during that time.

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References

Schneider MJ, Brach J, Irrgang JJ, Abbott KV, Wisniewski SR,

Delitto A. Mechanical vs manual manipulation for low back

pain: an observational cohort study. J Manipulative Physiol

Ther. 2010;33(3):193-200. doi: 10.1016/j.jmpt.2010.01.010.

Maigne J, Vautravers P. Mode dáction dês manipulations

vertébrales. Rev Rhum. 2003;70:713-9. doi:10.1016/

S1169-8330(03)00158-3

Ernest E. A systematic review of systematic reviews of spinal

manipulation. J R Soc Med. 2006;99(4):192-6. doi: 10.1258/

jrsm.99.4.192

Pickar JG. Neurophysiological effects of spinal manipulation.

Spine J. 2002;2:357-71. doi: http://dx.doi.org/10.1016/

S1529-9430(02)00400-X

Bicalho E, Setti JAP, Macagnan J, Cano JLR, Manffra EF.

Immediate effects of a high-velocity spine manipulation in

paraspinal muscles activity of nonspecific chronic low-back

pain subjects. Manual Ther. 2010;15(5):469-75. doi: 10.1016/j.

math.2010.03.012.

Ferreira ML, Ferreira PH, Hodges PW. Changes in postural

activity of the trunk muscles following spinal manipulative

therapy. Manual Ther. 2007;12:240-8. doi:10.1016/j.

math.2006.06.015.

Lalanne K, Lafond D, Descarreaux M. Modulation of

the flexion-relaxation response by spinal manipulative

therapy: a control group study. J Manipulative Physiol Ther.

;32(3):203-9. doi: 10.1016/j.jmpt.2009.02.010.

Neblett R, Mayer TG, Gatchel RJ, Keeley J, Proctor T, Anagnostis

C. Quantifying the lumbar flexionrelaxation phenomenon:

theory, normative data and clinical applications. Spine. 2003;

(13):1435-46. doi: 10.1016/j.jmpt.2014.07.003.

Colloca CJ, Hinrichs RN. The biomechanical and clinical

significance of the lumbar erector spinae flexion_relaxation

phenomenon: a review of literature. J Manipulative Physiol

Ther. 2005;28(8):623-31. doi:10.1016/j.jmpt.2005.08.005

Demoulin C, Crielaard J, Vanderthommen M. Spinal muscle

evaluation in healthy individuals and low-back-pain

patients: a literature review. Joint Bone Spine. 2007;74:9-13.

doi:10.1016/j.jbspin.2006.02.013

Fisioter Pesqui 2016;23(2):155-62

Walker BF, Williamson OD. Mechanical or inflammatory low

back pain. What are the potential signs and symptoms. Manual

Ther. 2009;14(3)314-20. doi: 10.1016/j.math.2008.04.003.

Koes BW, Tulder MWV, Thomas S. Diagnosis and treatment

of low back pain. BMJ. 2006;332:1430-4. doi:10.1136/

bmj.332.7555.1430.

Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation,

adaptation and validation of the Roland-Morris questionnaire −

Brazil Roland-Morris. Braz J Med Biol Res. 2001;34(2):203-10.

doi: http://dx.doi.org/10.1590/S0100-879X2001000200007.

Lehman GJ, McGill SM. Spinal manipulation causes variable

spine kinematic and trunk muscles electromyographic

responses. Clin Biomech. 2001;16(4):293-9. doi: http://dx.doi.

org/10.1016/S0268-0033(00)00085-1

Ritvanen T, Zaproudina N, Nissen M, Leinoven V, Hannine O.

Dynamic surface electromyographic responses in chronic

low back pain treated by traditional bone setting and

conventional physical therapy. J Manipulative Physiol Ther.

;30(1):31-7. doi:10.1016/j.jmpt.2006.11.010.

Ricard F. Tratamiento osteopatico de las lumbalgias y

ciaticas. Madrid: Panamericana, 1998.

Marshal P, Murphy B. Changes in the flexion relaxation response

following an exercise intervention. Spine. 2006a;31(23):877-

doi: 10.1097/01.brs.0000244557.56735.05

Biering-Sorenson. Physical measurements as risk indicators

for low back trouble over a one-year period. Spine.

;9(2):106-119, 1984.

Watson PJ, Phil CKBM, Main CJ, Chen ACN. Surface

electromyography in the identification of chronic low back

pain patients: the development of the flexion relaxation ratio.

Clin Biomech. 1997;12(3):165-71. doi: http://dx.doi.org/10.1016/

S0268-0033(97)00065-X

Ambroz C, Scott A, Ambroz A, Talbott EO. Chronic low back

pain assessment using surface electromyography. J Occup

Env Med. 2000;42(6):660-9.

Cohen J. Statistical power analysis for the behavioral sciences.

ed. New Jersey: Lawrence Erlbaum Associates, 1988.

Devotch JW, Pickar JG, Wilder DG. Spinal manipulation

alters electromyographic activity of paraspinal muscles:

a descriptive study. J Manipulative Physiol Ther.

;28(7):465-571. doi:10.1016/j.jmpt.2005.07.002.

Published

2016-06-06

Issue

Section

Original Research

How to Cite

Duration of the effects of spinal manipulation on pain intensity and electromyographic activity of paravertebral parts of individuals with chronic mechanical low back pain . (2016). Fisioterapia E Pesquisa, 23(2), 155-162. https://doi.org/10.1590/1809-2950/14600023022016