title: Peripheral oxidative stress blood markers in patients with chronic back or neck pain treated with high-velocity, low-amplitude manipulation.
abstract: OBJECTIVE
  The purpose of this study was to investigate oxidative-stress parameters in individuals with chronic neck or back pain after 5 weeks of treatment with high-velocity, low-amplitude (HVLA) spinal manipulation.
  
  
  METHODS
  Twenty-three individuals aged 38.2 ± 11.7 years with nonspecific chronic neck or back pain verified by the Brazilian Portuguese version of the Chronic Pain Grade, with a sedentary lifestyle, no comorbidities, and not in adjuvant therapy, underwent treatment with HVLA chiropractic manipulation twice weekly for 5 weeks. Therapeutic procedures were carried out by an experienced chiropractor. Blood samples were assessed before and after treatment to determine the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx), and the levels of nitric oxide metabolites and lipid hydroperoxides. These blood markers were analyzed by paired Student t test. Differences were considered statistically significant, when P was <.05.
  
  
  RESULTS
  There was no change in catalase but an increase in SOD (0.35 ± 0.03 U SOD per milligram of protein vs 0.44 ± 0.04 U SOD per milligram of protein; P < .05) and GPx (7.91 ± 0.61 nmol/min per milligram of protein vs 14.07 ± 1.07 nmol/min per milligram of protein; P < .001) activities after the treatment. The nitric oxide metabolites and the lipid hydroperoxides did not change after treatment.
  
  
  CONCLUSIONS
  High-velocity, low-amplitude spinal manipulation twice weekly for 5 weeks increases the SOD and GPx activities. Previous studies have shown a relationship between pain and oxidative and nitrosative parameters; thus, it is possible that changes in these enzymes might be related to the analgesic effect of HVLA spinal manipulation.
authors.affiliation: Academic Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: carolina.dc@clinicakolberg.com.br.
authors.forename: Carolina
authors.initials: C
authors.lastname: Kolberg
authors.affiliation: Academic Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Andréa
authors.initials: A
authors.lastname: Horst
authors.affiliation: Undergraduate Scholarship Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Maira S
authors.initials: MS
authors.lastname: Moraes
authors.affiliation: Academic Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Felipe Coutinho Kullmann
authors.initials: FC
authors.lastname: Duarte
authors.affiliation: Academic Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Ana Paula Konzen
authors.initials: AP
authors.lastname: Riffel
authors.affiliation: Academic Researcher, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Taína
authors.initials: T
authors.lastname: Scheid
authors.affiliation: Professor and Coordinator of Teaching, Chiropractic Orthopaedics and Traumatology Program, Faculdade América Latina, Caxias do Sul, Brazil.
authors.forename: Angela
authors.initials: A
authors.lastname: Kolberg
authors.affiliation: Associate Professor and Research Advisor, Department of Physiology, Institute of Basic Health Science, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil.
authors.forename: Wania A
authors.initials: WA
authors.lastname: Partata
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002374:Catalase / Q000378:metabolism; D059350:Chronic Pain / Q000534:rehabilitation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation*; D009569:Nitric Oxide / Q000097:blood; D018384:Oxidative Stress / Q000502:physiology*; D012720:Severity of Illness Index; D013482:Superoxide Dismutase / Q000097:blood; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; D002374:Catalase; D013482:Superoxide Dismutase
keywords: Antioxidant Enzymes; Chiropractic; Manipulation; Manual Therapy; Oxidative Stress; Spinal