Muscle testing response to provocative vertebral challenge and spinal manipulation: a randomized controlled trial of construct validity.

OBJECTIVE

To evaluate the relationship of muscle strength response to a provocative vertebral challenge and to spinal manipulation.

DESIGN

Prospective double-blind randomized controlled trial: crossover and between subjects designs.

SETTING

Laboratory: Center for Technique Research.

PARTICIPANTS

Sixty-eight naive volunteers from the student body, staff and faculty of the college.

INTERVENTIONS

Provocative vertebral challenge: standardized 4-5 kg force applied with a pressure algometer to the lateral aspects of the T3-12 spinous processes.

INTERVENTION

manual high velocity low amplitude adjustment or switched-off activator sham.

MAIN OUTCOME MEASURES

Piriformis muscle response was defined in two ways: reactivity (a decrease in muscle resistance, yes or nor, following a vertebral challenge); responsiveness (the cessation of reactivity following spinal manipulation). Relative response attributable to the maneuver (RRAM): the percent of an outcome attributable to the challenge or adjustment itself.

RESULTS

Average RRAM = 16% reactivity to vertebral challenge; average RRAM = 0% responsiveness to spinal manipulation. Six to 10% of muscle tests were positive regardless of examiner, previous finding or intervention.

CONCLUSIONS

For the population under investigation, muscle response appeared to be a random phenomenon unrelated to manipulable subluxation. In and of itself, muscle testing appears to be of questionable use for spinal screening and post-adjustive evaluation. Further research is indicated in more symptomatic populations, different regions of the spine, and using different indicator muscles.