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对高速低幅脊柱手法治疗力学参数的神经反应:预负荷参数的影响

Neural responses to the mechanical parameters of a high-velocity, low-amplitude spinal manipulation: effect of preload parameters.

作者信息

Reed William R, Long Cynthia R, Kawchuk Gregory N, Pickar Joel G

机构信息

Associate Professor, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa.

Professor, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa.

出版信息

J Manipulative Physiol Ther. 2014 Feb;37(2):68-78. doi: 10.1016/j.jmpt.2013.12.004. Epub 2014 Jan 3.

Abstract

OBJECTIVE

The purpose of this study was to determine how the preload that precedes a high-velocity, low-amplitude spinal manipulation (HVLA-SM) affects muscle spindle input from lumbar paraspinal muscles both during and after the HVLA-SM.

METHODS

Primary afferent activity from muscle spindles in lumbar paraspinal muscles were recorded from the L6 dorsal root in anesthetized cats. High-velocity, low-amplitude spinal manipulation of the L6 vertebra was preceded either by no preload or systematic changes in the preload magnitude, duration, and the presence or absence of a downward incisural point. Immediate effects of preload on muscle spindle responses to the HVLA-SM were determined by comparing mean instantaneous discharge frequencies (MIF) during the HVLA-SM's thrust phase with baseline. Longer lasting effects of preload on spindle responses to the HVLA-SM were determined by comparing MIF during slow ramp and hold movement of the L6 vertebra before and after the HVLA-SM.

RESULTS

The smaller compared with the larger preload magnitude and the longer compared with the shorter preload duration significantly increased (P = .02 and P = .04, respectively) muscle spindle responses during the HVLA-SM thrust. The absence of preload had the greatest effect on the change in MIF. Interactions between preload magnitude, duration, and downward incisural point often produced statistically significant but arguably physiologically modest changes in the passive signaling properties of the muscle spindle after the manipulation.

CONCLUSION

Because preload parameters in this animal model were shown to affect neural responses to an HVLA-SM, preload characteristics should be taken into consideration when judging this intervention's therapeutic benefit in both clinical efficacy studies and in clinical practice.

摘要

目的

本研究旨在确定在高速低幅脊柱整复术(HVLA-SM)之前的预负荷如何影响HVLA-SM期间及之后腰段椎旁肌的肌梭输入。

方法

在麻醉猫的L6背根记录腰段椎旁肌肌梭的初级传入活动。L6椎体的高速低幅脊柱整复术之前,要么不进行预负荷,要么对预负荷大小、持续时间以及是否存在向下切迹点进行系统性改变。通过比较HVLA-SM推力阶段的平均瞬时放电频率(MIF)与基线,确定预负荷对肌梭对HVLA-SM反应的即时影响。通过比较HVLA-SM前后L6椎体缓慢斜坡和保持运动期间的MIF,确定预负荷对肌梭对HVLA-SM反应的更持久影响。

结果

与较大预负荷大小相比,较小预负荷大小以及与较短预负荷持续时间相比,较长预负荷持续时间在HVLA-SM推力期间显著增加(分别为P = .02和P = .04)肌梭反应。无预负荷对MIF变化的影响最大。预负荷大小、持续时间和向下切迹点之间的相互作用在操作后肌梭的被动信号特性方面通常产生统计学上显著但可能生理上适度的变化。

结论

由于该动物模型中的预负荷参数显示会影响对HVLA-SM的神经反应,因此在临床疗效研究和临床实践中判断该干预措施的治疗益处时,应考虑预负荷特征。

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