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Brain Sci. 2019 Jun 12;9(6). pii: E136. doi: 10.3390/brainsci9060136.

Increased Voluntary Activation of the Elbow Flexors Following a Single Session of Spinal Manipulation in a Subclinical Neck Pain Population.

Author information

1
Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand. Mat.Kingett@nzchiro.co.nz.
2
Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand. kelly.holt@nzchiro.co.nz.
3
Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand. imran.niazi@nzchiro.co.nz.
4
Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 0627, New Zealand. imran.niazi@nzchiro.co.nz.
5
Centre for Sensory-Motor Interactions (SMI), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark. imran.niazi@nzchiro.co.nz.
6
Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand. r.nedergaard@rn.dk.
7
Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark. r.nedergaard@rn.dk.
8
Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, NSW 2007, Australia. Michael.Lee-2@uts.edu.au.
9
Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand. heidi.haavik@nzchiro.co.nz.

Abstract

To investigate the effects of a single session of spinal manipulation (SM) on voluntary activation of the elbow flexors in participants with subclinical neck pain using an interpolated twitch technique with transcranial magnetic stimulation (TMS), eighteen volunteers with subclinical neck pain participated in this randomized crossover trial. TMS was delivered during elbow flexion contractions at 50%, 75% and 100% of maximum voluntary contraction (MVC) before and after SM or control intervention. The amplitude of the superimposed twitches evoked during voluntary contractions was recorded and voluntary activation was calculated using a regression analysis. Dependent variables were analyzed with two-way (intervention × time) repeated measures ANOVAs. Significant intervention effects for SM compared to passive movement control were observed for elbow flexion MVC (p = 0.04), the amplitude of superimposed twitch (p = 0.04), and voluntary activation of elbow flexors (p =0.03). Significant within-group post-intervention changes were observed for the superimposed twitch (mean group decrease of 20.9%, p < 0.01) and voluntary activation (mean group increase of 3.0%, p < 0.01) following SM. No other significant within-group changes were observed. Voluntary activation of the elbow flexors increased immediately after one session of spinal manipulation in participants with subclinical neck pain. A decrease in the amplitude of superimposed twitch during elbow flexion MVC following spinal manipulation suggests a facilitation of motor cortical output.

KEYWORDS:

elbow flexors; interpolated twitch technique (ITT); maximum contraction force; spinal manipulation; voluntary activation

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