Clinical trial NCT03736148: Effects of Manual vs Instrument-assisted Manipulation on Electromyographic Activity and Sympathetic Nervous System
Official title: Acute Effects of Manual vs Instrument-assisted Single Cervical Manipulation on Electromyographic Activity and Sympathetic Nervous System
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Healthy
Keywords: manipulation
electromyography
sympathetic nervous system
Lead sponsor: Escola Superior de Tecnologia da Saúde do Porto
Sponsor class: OTHER
First posted: 2018-11-08
Enrollment: 75
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Double blind randomized control placebo trial
Primary purpose: TREATMENT

Brief summary: This study evaluates the effects of manual and instrument-assisted cervical manipulation on electromyographic activity and sympathetic nervous system. Subjects were divided in four groups, one group was submitted to a manual cervical manipulation, other group was submitted to an instrument-assisted cervical manipulation, other group was submitted to a sham manipulation and another group served as control.

Detailed description: The manual manipulation was applied over C3/C4, as the participants were positioned in supine with the cervical spine in a neutral position. Slight ipsilateral side flexion and contralateral rotation were introduced until tension was perceived in the tissues at the contact point. A high-velocity, low-amplitude thrust manipulation was directed upward and medially in the direction of the subject's contralateral eye.

The instrument-assisted manipulation was applied using a handheld Activator IV Adjusting Instrument. Contacts were made firm enough to prevent slipping of the rubber tip but not so firm as to load the spring, in consistence with customary clinical use of the instrument. The spring was then loaded by means of the instrument's trigger mechanism, and the impulse was delivered in an anterosuperior direction, over the posterolateral aspect of the vertebra on the right lamina-pedicle junction of C3.

The sham manipulation to the right C3/C4 segment was administered using the same 'set-up' as for the manual manipulation; however, once the barrier was engaged, the head was re-positioned to neutral with no thrust applied. The control group individuals were positioned supine for the same twenty minutes as the other groups and they received no manual contact.

Eligibility criteria: Inclusion Criteria:

* Asymptomatic individuals
* Age above 18 years.

Exclusion Criteria:

* Presence of cervical pain
* History of surgery and/neck trauma
* Osteoporosis
* Current use of anticoagulant therapy
* Presence of dizziness and/or vertigo
* Pregnancy
* Cancer
* Any other contra-indication to spinal manipulation.

Primary outcomes:
measure: Sympathetic Nervous System activity through change in skin conductance values
timeFrame: 10 minutes post intervention
measure: Change of electromyographic activity of upper trapezius after spinal manipulation
timeFrame: 10 minutes post intervention
measure: Change of electromyographic activity of biceps brachii after spinal manipulation
timeFrame: 10 minutes post intervention
Secondary outcomes:
Other outcomes:
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