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There is growing evidence showing that spinal manipulation increases muscle strength in healthy individuals as well as in people with some musculoskeletal and neurological disorders. However, the underlying mechanism by which spinal manipulation changes muscle strength is less clear. This study aimed to assess the effects of a single spinal manipulation session on the electrophysiological and metabolic properties of the tibialis anterior (TA) muscle. Maximum voluntary contractions (MVC) of the ankle dorsiflexors, high-density electromyography (HDsEMG), intramuscular EMG, and near-infrared spectroscopy (NIRS) were recorded from the TA muscle in 25 participants with low level recurring spinal dysfunction using a randomized controlled crossover design. The following outcomes: motor unit discharge rate (MUDR), strength (force at MVC), muscle conduction velocity (CV), relative changes in oxy- and deoxyhemoglobin were assessed pre and post a spinal manipulation intervention and passive movement control. Repeated measures ANOVA was used to assess within and between-group differences. Following the spinal manipulation intervention, there was a significant increase in MVC ( = 0.02; avg 18.87 ± 28.35%) and a significant increase in CV in both the isometric steady-state (10% of MVC) contractions ( < 0.01; avg 22.11 ± 11.69%) and during the isometric ramp (10% of MVC) contractions ( < 0.01; avg 4.52 ± 4.58%) compared to the control intervention. There were no other significant findings. The observed TA strength and CV increase, without changes in MUDR, suggests that the strength changes observed following spinal manipulation are, in part, due to increased recruitment of larger, higher threshold motor units. Further research needs to investigate the longer term and potential functional effects of spinal manipulation in various patients who may benefit from improved muscle function and greater motor unit recruitment.
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http://dx.doi.org/10.3390/healthcare8040548 | DOI Listing |
J Manipulative Physiol Ther
September 2025
Clinical & Health Services Research, Southern California University of Health Sciences, Whittier, California.
Objective: The purpose of this study was to evaluate the risk of selected adverse outcomes for older adults with a new episode of neck pain (NP) receiving chiropractic care compared to those receiving primary medical care with Prescription Drug Therapy (PDT) or primary care without medication.
Methods: Through analysis of Medicare claims data, we designed a retrospective cohort study including 291 604 patients with a new office visit for NP in 2019. We developed 3 mutually exclusive exposure groups: the Chiropractic Manipulative Therapy (CMT) group received spinal manipulative therapy from a chiropractor with no primary care visits; the PDT group visited primary care and filled an analgesic prescription within 7 days without chiropractic care, and the Primary Care Only (PCO) group visited primary care without chiropractic care or analgesic prescriptions.
N Am Spine Soc J
September 2025
Spine Institute of Connecticut at St. Francis Hospital, Hartford, CT, United States.
Background: The lateral transpsoas lumbar interbody fusion is associated with transient postoperative anterior thigh and inguinal dysesthesias and hip flexor weakness from manipulation of the psoas and interposed lumbar plexus. However, it remains unclear whether this translates to higher pain scores and opioid requirements.
Methods: Patients who had undergone one- or two-level extreme/direct (XLIF/DLIF), anterior (ALIF), or transforaminal lumbar interbody fusion (TLIF) between January 2018 and December 2023 for degenerative spinal pathology were included.
Somatotopy is a recurring organisational feature of the somatosensory system where adjacent neurons and their connections represent adjacent regions of the body. The molecular mechanisms governing the formation of such "body maps" remain largely unknown. Here we demonstrate that the cell surface proteins teneurin-3 and latrophilin-2 are expressed in opposing gradients in multiple somatotopic maps in the mouse, including within the dorsal horn of the spinal cord.
View Article and Find Full Text PDFZhongguo Gu Shang
August 2025
Department of TCM Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215000, Jiangsu, China.
Objective: To study the efficacy of lumbar oblique manipulation in the treatment of lumbar disc herniation with different herniation locations based on MSU classification.
Methods: A total of 272 patients with lumbar disc herniation who were treated from June 2023 to December 2023 were divided into central type group, paracentral type group, and far lateral type group. Among them, there were 73 cases in the central type group, including 41 males and 32 females, with an age of (46.
Am J Obstet Gynecol
July 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA.
Optimal neuraxial anesthesia for cesarean delivery requires a thorough understanding of patient, obstetrical, surgical, and anesthesia-related factors which can impact pain during and after cesarean delivery. While not all cesarean deliveries are the same from an obstetrical standpoint, not all anesthetics provide the same degree of anesthetic blockade and postcesarean analgesia; therefore, context is crucial to provide patients with a safe and pain-free experience. Communication between obstetrical and anesthesia teams is key to ensure that the anesthetic approach is tailored to the clinical scenario, particularly if emergency cesarean delivery is needed, and follows best practices for cesarean delivery anesthesia.
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