Hypoalgesic Effect of Cervical Manipulation

Study Overview
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Brief Summary
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This study evaluates the hypoalgesic effect of global and specific cervical joint manipulation in healthy individuals. At first the participants received one of the interventions and after 48 hours, the other.

Detailed Description
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Cervical Joint Manipulation (CJM) are often used for pain treatment. Joint manipulation generates a series of stimuli within the central nervous system through the activation of proprioceptors located in the joint capsule or muscles, stimulates the PAG, causing pain inhibition by activation of non-opioid descending inhibitory pathways.

Official Title
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Hypoalgesic Effects of Specific vs Non-specific Cervical Manipulation in Healthy Subjects

Conditions
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Pain

Intervention / Treatment
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* Device: Global manipulation
* Device: Especific manipulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: healthy subjects of both sexes without pain complaints in the last 90 days Exclusion Criteria: previous spinal surgeries spinal canal stenosis vertebral fracture spondylolisthesis cancer acute infections hemorrhagic disorders active tuberculosis deep vein thrombosis osteoporosis rheumatic diseases metabolic diseases cardiorespiratory diseases smoking injury musculoskeletal injury use of pacemaker women in menstrual period pregnant women use of pain-killers in the last 48 hours use of anti-inflammatory drugs in the last 48 hours previous joint manipulation treatments aversion to cervical joint manipulation positivity in the vertebral artery test headache in the last seven days

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Participants received two interventions randomly at two times: global manipulation (GM) and specific manipulation (MS)
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Global manipulation<br>Manual therapy performed in the cervical region in a non-specific way. | Device: Global manipulation<br>* The therapist positioned himself at the head of the stretcher and with one hand supported the side of the participant's face. With the other hand supported the opposite face of the same and then performed contralateral rotation of the cervical and a slight traction to the tissue barrier to perform the manipulation impulse of high speed and short amplitude in rotation. The procedure was carried out bilaterally.<br>|
| Experimental: Especific manipulation<br>manual therapy performed specifically on the C6-7 segment | Device: Especific manipulation<br>* The therapist positioned himself at the head of the stretcher and with one hand kept the middle phalange of the second finger laterally on the articular processes of the C6-7 vertebrae. With the contralateral hand he supported the opposing face of the participant by performing a tilt up to the C6-7 segment and contralateral rotation up to the tissue barrier to carry out the impulse quickly and short. The procedure was carried out bilaterally.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure Pain Threshold at the posterior region of the forearm | The subjects were placed supine on a stretcher with their elbows fully extended and the anterior portion of the forearm resting on the stretcher. Subjects were instructed to keep their eyes closed during attempts. The examiner used a Somedic Type II digital pressure algometer (Somedic Inc, Hörby, Sweden) on the posterior region of the forearm 10cm below the lateral epicondyle of the elbow towards the third finger, keeping the forearm in pronation. The pressure was then applied perpendicular to the skin at a rate of 40kPa / s using a 1cm2 flat circular probe covered with 1mm of rubber to prevent any skin pain caused by sharp metal edges. | 1 minute after the end of the intervention. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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joint manipulation, cervical, pressure pain, manual therapy