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A structured review of spinal stiffness as a kinesiological outcome of manipulation: its measurement and utility in diagnosis, prognosis and treatment decision-making.

Authors :
Snodgrass SJ
Haskins R
Rivett DA
Source :
Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology [J Electromyogr Kinesiol] 2012 Oct; Vol. 22 (5), pp. 708-23. Date of Electronic Publication: 2012 Jun 08.
Publication Year :
2012

Abstract

Purpose: To review and discuss the methods used for measuring spinal stiffness and factors associated with stiffness, how stiffness is used in diagnosis, prognosis, and treatment decision-making and the effects of manipulative techniques on stiffness.<br />Methods: A systematic search of MEDLINE, EMBASE, CINAHL, AMED and ICL databases was conducted. Included studies addressed one of four constructs related to stiffness: measurement, diagnosis, prognosis and/or treatment decision-making, and the effects of manipulation on stiffness. Spinal stiffness was defined as the relationship between force and displacement.<br />Results: One hundred and four studies are discussed in this review, with the majority of studies focused on the measurement of stiffness, most often in asymptomatic persons. Eight studies investigated spinal stiffness in diagnosis, providing limited evidence that practitioner-judged stiffness is associated with radiographic findings of sagittal rotational mobility. Fifteen studies investigated spinal stiffness in prognosis or treatment decision-making, providing limited evidence that spinal stiffness is unlikely to independently predict patient outcomes, though stiffness may influence a practitioner's application of non-thrust manipulative techniques. Nine studies investigating the effects of manipulative techniques on spinal stiffness provide very limited evidence that there is no change in spinal stiffness following thrust or non-thrust manipulation in asymptomatic individuals and non-thrust techniques in symptomatic persons, with only one study supporting an immediate, but not sustained, stiffness decrease following thrust manipulation in symptomatic individuals.<br />Conclusions: The existing limited evidence does not support an association between spinal stiffness and manipulative treatment outcomes. There is a need for additional research investigating the effects of manipulation on spinal stiffness in persons with spinal pain.<br /> (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1873-5711
Volume :
22
Issue :
5
Database :
MEDLINE
Journal :
Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology
Publication Type :
Academic Journal
Accession number :
22683056
Full Text :
https://doi.org/10.1016/j.jelekin.2012.04.015