Year of Publication

2015

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Education

Department

Kinesiology and Health Promotion

First Advisor

Dr. J. W. Yates

Abstract

Spinal manipulative therapy (SMT) is a therapeutic procedure employed by various healthcare practitioners for alleviating acute and chronic musculoskeletal complaints. This form of treatment is also delivered to enhance the performance and augment the rehabilitation of athletes. However, despite research findings alleging the strength-modulating effects of SMT alongside numerous professional athletes’ positive anecdotal claims concerning its results, the physiological processes to explain its effects remain largely unexplained. Therefore, the purpose of this work was to investigate the effects of SMT in a college-aged sample population with two experiments.

The first study examined the effect of SMT targeting the lumbosacral region on concentric force production of the knee extensors and flexors. A randomized, controlled, single-blind crossover design was utilized with 21 subjects. Isometric and isokinetic peak torques (Nm) were recorded during maximal voluntary isometric contractions (MVIC) or maximal voluntary contractions (MVC) post-treatment of either SMT or a sham manipulation. The second study incorporated the same experimental design with 20 subjects to examine the effects of SMT on central nervous system (CNS) excitability. This was accomplished by assessing postactivation potentiation (PAP), measured with the Hoffmann Reflex (H-reflex). PAP is an enhanced neuromuscular response to prior contractile activity, and the H-reflex is the electromyographic (EMG) recording of submaximal electrical stimulation of the Ia monosynaptic reflex pathway. Subsequent to SMT and/or a plantar flexion MVIC, EMG amplitudes and isometric twitch torque generation of the gastrocnemius and soleus muscles were recorded during tibial nerve stimulations.

The results of the first study indicate that SMT did not produce a significant strength-modulating effect during isometric and isokinetic contractions of neither knee extension nor flexion. Similarly, the second study revealed that SMT immediately preceding the MVIC to induce PAP did not significantly increase H-reflex EMG amplitudes of either muscle or the simultaneous isometric twitch torque generation compared to the MVIC only. These data from both investigations suggest that SMT does not enhance strength or PAP. The positive anecdotal claims of athletes who utilize SMT may be due to other factors, such as the clinical efficacy of the treatment in addressing musculoskeletal injuries or a placebo effect.

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