Electromyographic responses of back and limb muscles associated with spinal manipulative therapy.

STUDY DESIGN Ten young, asymptomatic male subjects underwent 11 clinically relevant spinal manipulative treatments along the length of the spine to test the magnitude and extent of reflex responses associated with the treatments. OBJECTIVES To determine the magnitude and extent of reflex responses elicited by spinal manipulative treatments. SUMMARY OF BACKGROUND DATA Spinal manipulative treatments have been associated with a reflexogenic relief of pain and a loss of hypertonicity in muscles within the treatment area. However, there is no study in which results show the probability of occurrence or the extent of reflex responses during spinal manipulative treatments. METHODS Asymptomatic subjects received spinal manipulative treatments on the cervical, thoracic, and lumbar levels and on the sacroiliac joint. Reflex activities were measured using 16 pairs of bipolar surface electrodes placed on the back and proximal limb musculature. The percentage of occurrence and the extent of reflex responses in the back and proximal limb musculature were determined. RESULTS Each treatment produced consistent reflex responses in a target-specific area. The reflex responses occurred within 50-200 msec after the onset of the treatment thrust and lasted for approximately 100-400 msec. The responses were probably of multireceptor origin and were elicited asynchronously. CONCLUSIONS This is the first study in which results show a consistent reflex response associated with spinal manipulative treatments. Because reflex pathways are evoked systematically during spinal manipulative treatment, there is a distinct possibility that these responses may cause some of the clinically observed beneficial effects, such as a reduction in pain and a decrease in hypertonicity of muscles.