title: Physiological responses to spinal manipulation therapy: investigation of the relationship between electromyographic responses and peak force.
abstract: OBJECTIVE
  It is believed that systematic modulation of spinal manipulative therapy (SMT) parameters should yield varying levels of physiological responses and eventually a range of clinical responses. However, investigation of SMT dose-physiological response relationship is recent and has mostly been conducted using animal or cadaveric models. The main objective of the present study is to investigate SMT dose-physiological response relation in humans by determining how different levels of force can modify electromyographic (EMG) responses to spinal manipulation.
  
  
  METHODS
  Twenty-six participants were subjected to 2 trials of 4 different SMT force-time profiles using a servo-controlled linear actuator motor. Normalized EMG activity of paraspinal muscles (left and right muscles at level T6 and T8) was recorded during and after SMT, and EMG values were compared across the varying levels of force.
  
  
  RESULTS
  Increasing the level of force yielded an increase in paraspinal muscle EMG activity during the thrust phase of SMT but also in the two 250-millisecond time windows after the spinal manipulation impulse. These muscle activations quickly attenuated (500 milliseconds after spinal manipulation impulse).
  
  
  CONCLUSIONS
  The study confirmed the presence of a local paraspinal EMG response after SMT and highlighted the linear relationship between the SMT peak force and paraspinal muscle activation.
authors.affiliation: Postdoctoral Fellowship, Département de Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Nougarou
authors.forename: Claude
authors.initials: C
authors.lastname: Dugas
authors.forename: Constance
authors.initials: C
authors.lastname: Deslauriers
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pagé
authors.forename: Martin
authors.initials: M
authors.lastname: Descarreaux
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D015331:Cohort Studies; D019245:Compressive Strength / Q000502:physiology*; D004576:Electromyography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D009119:Muscle Contraction / Q000502:physiology; D010147:Pain Measurement; D064170:Paraspinal Muscles / Q000502:physiology*; D011312:Pressure; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D016896:Treatment Outcome; D055815:Young Adult
keywords: Biomechanics; Dose Response Relationship; Electromyography; Force; Manipulation; Spinal