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Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia.

OBJECTIVE: The purpose of this study is to investigate the immediate effects of a single cervical spine manipulation and a manual contact intervention (MCI) on pressure pain thresholds (PPTs) and thermal pain thresholds over the elbow region and pain-free grip (PFG) force in patients with lateral ep...

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Published in:Journal of Manipulative & Physiological Therapeutics Vol. 31; no. 9; pp. 675 - 682
Main Authors: Fernández-Carnero J, Fernández-de-las-Peñas C, Cleland JA
Format: clinical trial pictorial research tables/charts Journal Article
Published: Elsevier B.V. Nov/Dec2008
Online Access:View this record in EBSCOhost
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      dt: Nov/Dec2008
      vid: 31
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      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        atl: Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia.
      aug:
        au:
          Fernández-Carnero J
          Fernández-de-las-Peñas C
          Cleland JA
        affil: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. josue.fernandez@urjc.es
      sug:
        subj:
          Manipulation, Chiropractic Evaluation
          Tennis Elbow Therapy
          Adult
          Analysis of Variance
          Clinical Trials
          Confidence Intervals
          Crossover Design
          Data Analysis Software
          Data Analysis, Statistical
          Descriptive Statistics
          Dynamometry
          Female
          Grip Strength
          Intraclass Correlation Coefficient
          Male
          Middle Age
          P-Value
          Pilot Studies
          Post Hoc Analysis
          Repeated Measures
          Spain
          Structural Equation Modeling
          Unpaired T-Tests
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: OBJECTIVE: The purpose of this study is to investigate the immediate effects of a single cervical spine manipulation and a manual contact intervention (MCI) on pressure pain thresholds (PPTs) and thermal pain thresholds over the elbow region and pain-free grip (PFG) force in patients with lateral epicondylalgia (LE). METHODS: A repeated measures, crossover, single-blinded randomized study was done. Ten patients with LE (5 female) aged from 30 to 49 years (mean, 42; SD, 6 years) participated in this study. Subjects attended 2 experimental sessions on 2 separate days at least 48 hours apart. At each session, participants received either a manipulative intervention or MCI assigned in a random fashion. Pressure pain threshold and hot and cold pain thresholds (HPT and CPT, respectively) over the lateral epicondyle of both elbows was assessed preintervention and 5 minutes postintervention by an examiner blinded to the treatment allocation of the patients. In addition, PFG on the affected arm and maximum grip force on the unaffected side were also assessed. A 3-way analysis of variance (ANOVA) with time (pre-post) and side (ipsilateral, contralateral to the intervention) as within-subjects variable and intervention (manipulation or MCI) as between-subjects variable was used to evaluate changes in PPT, HPT, CPT, or PFG. RESULTS: The ANOVA detected a significant effect for time (F = 37.2, P < .001) and a significant interaction between intervention and time (F = 25.1, P < .001) for PPT levels. Post hoc revealed that the manipulative intervention produced a greater increase of PPT in both sides when compared with MCI (P < .001). The ANOVA did not detect significant effects for time (F = 2.7, P > .2), intervention (F = 2.8, P > .2), or side (F = 0.9, P > .4) for HPT. Again, no significant effects for time (F = 0.8, P > .4), side (F = 0.6, P > .4), or intervention (F = 0.8, P > .5) was found for CPT. Finally, a significant interaction between intervention and time (F = 9.4, P = .004) and between time * side * intervention (F = 18.2, P < .001) was found for grip force. Post hoc analysis revealed that the cervical manipulation produced an increase of PFG on the affected side as compared with the MCI (P < .001). CONCLUSIONS: The application of a manipulation at the cervical spine produced an immediate bilateral increase in PPT in patients with LE. No significant changes for HPT and CPT were found. Finally, cervical manipulation increased PFG on the affected side, but not the maximum grip force on the unaffected arm. Future studies with larger sample sizes are required to examine the effects of thrust manipulation on PPT, HPT, CPT, or PFG.
      pubtype: Academic Journal
      doctype:
        clinical trial
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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