title: Tissue damage markers after a spinal manipulation in healthy subjects: a preliminary report of a randomized controlled trial.
abstract: Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a 3 × 3 mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.
authors.affiliation: Centro de Fisioterapia y Psicología Soluciona, 18002 Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Achalandabaso
authors.affiliation: Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Plaza-Manzano
authors.affiliation: Department of Health Sciences, Universidad de Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Lomas-Vega
authors.affiliation: Department of Health Sciences, Universidad de Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Amat
authors.affiliation: Servicio de Análisis Clínicos, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain.
authors.forename: M V
authors.initials: MV
authors.lastname: Camacho
authors.affiliation: Servicio de Análisis Clínicos, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gassó
authors.affiliation: Department of Health Sciences, Universidad de Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Hita-Contreras
authors.affiliation: Department of Health Sciences, Universidad de Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Molina
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D002097:C-Reactive Protein / Q000378:metabolism; D002574:Cervical Vertebrae / Q000473:pathology*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005914:Globins; D064368:Healthy Volunteers; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D020393:Manipulation, Spinal; D009419:Nerve Tissue Proteins / Q000097:blood; D000078787:Neuroglobin; D013904:Thoracic Vertebrae / Q000473:pathology*; D019210:Troponin I / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009419:Nerve Tissue Proteins; D000078787:Neuroglobin; D019210:Troponin I; D005914:Globins; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase