Manual therapy directed at the knee or lumbopelvic region does not influence quadriceps spinal reflex excitability

Terry L. Grindstaff, Brian G. Pietrosimone, Lindsay D. Sauer, D. Casey Kerrigan, James T. Patrie, Jay Hertel, Christopher D. Ingersoll

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Abstract

Manual therapies, directed to the knee and lumbopelvic region, have demonstrated the ability to improve neuromuscular quadriceps function in individuals with knee pathology. It remains unknown if manual therapies may alter impaired spinal reflex excitability, thus identifying a potential mechanism in which manual therapy may improve neuromuscular function following knee injury. Aim: To determine the effect of local and distant mobilisation/manipulation interventions on quadriceps spinal reflex excitability. Methods: Seventy-five individuals with a history of knee joint injury and current quadriceps inhibition volunteered for this study. Participants were randomised to one of five intervention groups: lumbopelvic manipulation (grade V), lumbopelvic manipulation positioning (no thrust), grade IV patellar mobilisation, grade I patellar mobilisation, and control (no treatment). Changes in spinal reflex excitability were quantified by assessing the Hoffmann reflex (H-reflex), presynaptic, and postsynaptic excitability. A hierarchical linear-mixed model for repeated measures was performed to compare changes in outcome variables between groups over time (pre, post 0, 30, 60, 90min). Results: There were no significant differences in H-reflex, presynaptic, or postsynaptic excitability between groups across time. Conclusions: Manual therapies directed to the knee or lumbopelvic region did not acutely change quadriceps spinal reflex excitability. Although manual therapies may improve impairments and functional outcomes the underlying mechanism does not appear to be related to changes in spinal reflex excitability.

Original languageEnglish (US)
Pages (from-to)299-305
Number of pages7
JournalManual Therapy
Volume19
Issue number4
DOIs
StatePublished - Aug 2014

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All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Grindstaff, T. L., Pietrosimone, B. G., Sauer, L. D., Kerrigan, D. C., Patrie, J. T., Hertel, J., & Ingersoll, C. D. (2014). Manual therapy directed at the knee or lumbopelvic region does not influence quadriceps spinal reflex excitability. Manual Therapy, 19(4), 299-305. https://doi.org/10.1016/j.math.2014.03.010