Effects of pressure applied during standardized spinal mobilizations on peripheral skin blood flow: A randomised cross-over study. (February 2016)

• Record Type: Journal Article
• Authors: Zegarra-Parodi, Rafael; Pazdernik, Vanessa K.; Roustit, Matthieu; Park, Peter Yong Soo; Degenhardt, Brian F.
• Is Part Of: Manual therapy. Volume 21(2016:Feb.)
• Page Start: 220
• Page End: 226
• Publication Date: 2016-02
• Subjects: Dose-response effect -- Peripheral skin blood flow -- Randomized cross-over study -- Spinal mobilization; 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.2015.08.008
• Languages: English
• ISSNs: 1356-689X

Abstract

Abstract: Background: Peripheral skin blood flow (SBF) changes during and after spinal mobilization (SM), evaluated with laser Doppler flowmetry, may document physiological responses associated with SM. Objectives: To document variations in SBF during and after application of an SM and evaluate influence of pressure on SBF by applying the same standardized SM with 3 different nonnoxious pressures. Design: Cross-over design with 4 interventions on 4 different days: control (no touch) and 3 SMs applied rhythmically at 5%, 40%, or 80% of pain pressure threshold (sham SM, low-pressure SM, or high-pressure SM, respectively). Method: Thirty-two individuals participated. The inspiratory gasp (IG) test was our positive control of vasoconstriction through excitation of the skin sympathetic nervous activity (SSNA). Each session comprised 5 phases: (1) baseline at the end of a 20-min acclimatization, (2) IG test, (3) post-IG phase, (4) SM phase or no manual contact for control, and (5) post-SM phase. A Biopac MP36 system collected SBF data, and a Novel Pliance-X system recorded pressure data. Results/findings: Equal and significant bilateral vasodilation occurred during application of unilateral sham SM, low-pressure SM, and high-pressure SM. Post-SM significant vasodilation persisted after high-pressure SM. Conclusions: The current study is the first to describe bilateral peripheral SBF changes occurring during and 5 min after application of standardized SMs. Our post-SM vasodilation suggests involvement of mechanisms other than the putative SSNA-excitatory mechanism proposed with skin conductance measurements. Persistence of post-SM vasodilation following only high-pressure SM suggests possible pressure-dependent mechanisms. However, further research is warranted to clarify our findings. Highlights: Unilateral spinal mobilizations induce equal, significant bilateral vasodilation. Post-mobilization vasodilation persisted after high-pressure spinal mobilizations. Pressure-dependent mechanisms may explain high-pressure mobilization results.