Grayson Jane E, Barton Tom, Cabot Peter J, Souvlis Tina
School of Physiotherapy and Exercise Science, Griffith University, Gold Coast, Queensland 4222, Australia.
Man Ther. 2012 Aug;17(4):292-7. doi: 10.1016/j.math.2012.02.004. Epub 2012 Mar 14.
A rapid hypoalgesic effect following spinal manual therapy (SMT) has been demonstrated in humans. Although the characteristics of the pain relief are well described, the mechanisms have remained speculative. The purpose of this suite of studies was to investigate the effects of SMT on pain measures using animal models. This study employed a randomized, controlled design. Study 1: Rats without inflammation were allocated to either a treatment group (n = 6) that received three applications of joint mobilization centrally over L5 or a sham-treated group (n = 6) who received non-specific handling. Pressure pain threshold (PPT) and thermal pain threshold (TPT) were measured before and immediately after each intervention. Results demonstrated significantly increased mechanical nociceptive thresholds in the SMT group (p = 0.01) compared to that of the sham-treated group but no difference for thermal nociceptive thresholds. Study 2: The time course effect of an inflammatory and mechanical response following i.pl injection of inflammatory mediators was investigated to determine the appropriate time period for a treatment intervention. Study 3: The effects of SMT on mechanical nociception were investigated following interplanar injection of inflammatory mediators into the right hind paw of rats as a pain model (n = 6 for both SMT and sham-treated groups). Injection of endogenous metabolites produced significant swelling and flaring as well as increased PPT values following SMT (p < 0.02) compared with controls. These results demonstrate a rapid analgesic response following application of SMT, which has similar characteristics as that seen in both symptomatic and asymptomatic human populations.
脊柱手法治疗(SMT)后在人体中已证实具有快速的痛觉减退效果。尽管对疼痛缓解的特征已有详细描述,但其机制仍具有推测性。这一系列研究的目的是使用动物模型研究SMT对疼痛指标的影响。本研究采用随机对照设计。研究1:将无炎症的大鼠分为治疗组(n = 6),该组接受在L5水平进行三次中枢关节松动术,以及假治疗组(n = 6),该组接受非特异性处理。在每次干预前和干预后立即测量压力痛阈(PPT)和热痛阈(TPT)。结果表明,与假治疗组相比,SMT组的机械性伤害感受阈值显著提高(p = 0.01),但热伤害感受阈值无差异。研究2:研究腹腔注射炎性介质后炎症和机械反应的时间进程效应,以确定治疗干预的合适时间段。研究3:在大鼠右后爪平面间注射炎性介质作为疼痛模型(SMT组和假治疗组均为n = 6)后,研究SMT对机械性伤害感受的影响。与对照组相比,注射内源性代谢产物后出现明显肿胀和发红,且SMT后PPT值升高(p < 0.02)。这些结果表明,应用SMT后有快速的镇痛反应,其特征与有症状和无症状人群中观察到的相似。