The temporal effects of a single session of high-velocity, low-amplitude thrust manipulation on subjects with spinal pain

Background: A high velocity, low amplitude thrust manipulation (HVLAT) is an intervention commonly used in the treatment of patients with spinal pain. Recent studies have reported on the possible neurophysiological effects of this technique which may be pertinent to the therapeutic value of these procedures. However, few studies have examined the temporal neurophysiological nature of a HVLAT beyond the immediate effects. Objectives: The purpose of this review is to summarize the literature on the temporal neurophysiological effects of a single HVLAT in patients with spinal pain. Methods: A systematic search of English articles was conducted using MEDLINE, CINAHL, and PEDro. Additional studies were identified with a hand search of the references of relevant articles. Search terms included spinal manipulation, chiropractic manipulation, osteopathic manipulation, spinal adjustment, cervical manipulation, lumbar manipulation, sacroiliac manipulation, neck pain, back pain, and sacroiliac pain. Quality scoring of the included articles was based on the Newcastle–Ottawa criteria. Results: Of the 478 articles identified, five articles ultimately met inclusion criteria into this review. These studies were of moderate to high quality. In all, follow-up measures after a single HVLAT were taken within a 30-minute to 5-hour period. Conclusion: In the absence of concurrent intervention, the neurophysiological effects seen after administration of a HVLAT were observed to be immediate in nature, with a return to baseline or reduction in effect noted at follow-up. Future studies examining the mechanisms of HVLAT should include dedicated follow-up periods to establish the temporal changes related to these techniques.

Duke Scholars

Author Rogelio Adrian Coronado Orthopaedic Surgery

Author Chad E. Cook Orthopaedic Surgery, Physical Therapy