An investigation into the effects of applying a lumbar Maitland mobilisation at different frequencies on sympathetic nervous system activity levels in the lower limb. (June 2016)

• Record Type: Journal Article
• Authors: Piekarz, Victoria; Perry, Jo
• Is Part Of: Manual therapy. Volume 23(2016:Jun.)
• Page Start: 83
• Page End: 89
• Publication Date: 2016-06
• Subjects: Sympathetic nervous system -- Lumbar spine -- Joint mobilisations; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy; Manipulation (Thérapeutique) -- Périodiques; Physiothérapie -- Périodiques; Maladies neuromusculaires -- Traitement -- Périodiques; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Electronic journals; Periodicals; Electronic journals; 615.82
• DOI: 10.1016/j.math.2016.01.001
• Languages: English
• ISSNs: 1356-689X

Abstract

Abstract: Background: Oscillatory Maitland mobilisations are commonly used in the management of lower back pain with research suggesting that mobilisations at 2 Hz may excite the sympathetic nervous system (SNS) more than sustained pressure glides or 0.5 Hz oscillatory mobilisations. Objectives: Investigate the effects of increasing the oscillation frequency greater than 2 Hz. Design: A double-blind, placebo-controlled, independent group experimental design. Method: Sixty healthy male volunteers were randomly allocated to one of four groups; a control group (no contact), placebo group (sustained static pressure to L4 vertebra), and two intervention groups receiving a centrally applied postero-anterior mobilisation applied at either 2 Hz or 3 Hz for three 1-min periods. SNS activity was recorded by a blinded data collector by continuous skin conductance (SC) activity levels in the feet using a Biopac MP35 electrodermal amplifier. Participants were blinded to their group allocation which was further validated by a post-experiment questionnaire ( p > 0.05). Results: The magnitude of sympathoexcitatory response was greatest for the 3 Hz mobilisation (20%) compared with the 2 Hz mobilisation (12%), placebo (−1%) and control conditions (3%). Only the 3 Hz group demonstrated statistical significance when compared to placebo intervention ( p = 0.002), and the control group ( p = 0.02). Conclusion: SC changes reflect those of previous studies using lumbar mobilisations at 2 Hz, however the 3 Hz group was found to have a greater magnitude of effect worthy of consideration within research and clinical settings. These findings provide preliminary evidence to support the use of 3 Hz oscillatory mobilisations to affect a greater magnitude of SNS activity than those previously reported (0.5, 1.5 and 2 Hz). Highlights: Maitland lumbar PA mobilisation at 2 Hz creates sympathoexcitatory responses of 12%. An atypical frequency mobilisation at 3 Hz results in responses in the order of 20%. Effects at 3 Hz are at least comparable to effects of a standard 2 Hz intervention. Further research into high frequency manual therapy interventions is recommended.