ArticleThe spine journal : official journal of the North American Spine Society2015
The effect of application site of spinal manipulative therapy (SMT) on spinal stiffness.
Article in The spine journal : official journal of the North American Spine Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2023Pooled it
- The importance of selecting the correct site to apply spinal manipulation when treating spinal pain: Myth or reality? A systematic review.Scientific reports · 2021Pooled it
- Changes in pain sensitivity and spinal stiffness in relation to responder status following spinal manipulative therapy in chronic low Back pain: a secondary explorative analysis of a randomized trial.BMC musculoskeletal disorders · 2021Trial
- The effect on clinical outcomes when targeting spinal manipulation at stiffness or pain sensitivity: a randomized trial.Scientific reports · 2020Trial
- The relation between bulk (external) and internal measures of spinal stiffness.Chiropractic & manual therapies · 2025Article
- Effects of combined hip exercise and passive stretching on muscle stiffness, pain perception and painrelated disability, and physical function in older adults with low back pain.Physical activity and nutrition · 2022Article
- A Systematic Review of Musculoskeletal Mobilization and Manipulation Techniques Used in Veterinary Medicine.Animals : an open access journal from MDPI · 2021Review
- Force Distribution Within Spinal Tissues During Posterior to Anterior Spinal Manipulative Therapy: A Secondary Analysis.Frontiers in integrative neuroscience · 2021Article
- Potential mechanisms for lumbar spinal stiffness change following spinal manipulative therapy: a scoping review.Chiropractic & manual therapies · 2020Article
- Aberrant intervertebral motion in patients with treatment-resistant nonspecific low back pain: a retrospective cohort study and control comparison.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Article
- Article
- Spinal Tissue Loading Created by Different Methods of Spinal Manipulative Therapy Application.Spine · 2017Article
- The comfort and safety of a novel rolling mechanical indentation device for the measurement of lumbar trunk stiffness in young adults.Chiropractic & manual therapies · 2017Article
- Chiropractic Identity in the United States: Wisdom, Courage, and Strength.Journal of chiropractic humanities · 2016Review
- Neural responses to the mechanical characteristics of high velocity, low amplitude spinal manipulation: Effect of specific contact site.Manual therapy · 2015Article
- What effect can manual therapy have on a patient's pain experience?Pain management · 2015Article
- Neural responses to the mechanical parameters of a high-velocity, low-amplitude spinal manipulation: effect of preload parameters.Journal of manipulative and physiological therapeutics · 2014Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
background contextLike other factors that can influence treatment efficacy (eg, dosage, frequency, time of day), the site of treatment application is known to affect various physical interventions such as topical anesthetics and cardiopulmonary resuscitation. Like these examples, spinal manipulative therapy (SMT) is a physical intervention that may exhibit maximal benefit when directed to a specific site. Whereas numerous studies of SMT efficacy have produced mixed results, few studies have taken into account the site of SMT application. PURPOSE: To determine if the site of SMT application modulates the effect of SMT in an anesthetized feline model. STUDY
designSpinal manipulative therapy applied to specific anatomic locations randomized in a Latin square design with a no-SMT control. OUTCOME MEASURES: Physiologic measures (spinal stiffness).
methodsSimulated SMT was delivered by a validated mechanical apparatus to the intact lumbar spine of eight anesthetized felines at four unique sites: L6 spinous process, left L6 lamina, left L6 mammillary process, and L7 spinous process. To measure spinal stiffness, a separate indentation load was applied mechanically to the L6 spinous process before and after each SMT application. Spinal stiffness was calculated from the resulting force-displacement curve as the average stiffness (k) and terminal instantaneous stiffness (TIS).
resultsRelative to the no-SMT control, significant decreases in spinal stiffness followed the SMT when L6 spinous and L6 lamina were used as the contact site. Terminal instantaneous stiffness significantly decreased -0.48 N/mm (upper, lower 95% confidence interval [-0.86, -0.09]) with L6 spinous as the contact site and decreased -0.44 N/mm (-0.82, -0.05), with the L6 lamina as the contact site. k increased 0.44 N/mm (-0.01, 088), using L6 spinous as the contact site.
conclusionsDecreases in terminal spinal stiffness were observed after SMT delivered at some application sites but not the others. The results suggest that SMT contact site modulates SMT's effect on spinal stiffness in a feline model. Changes in spinal terminal instantaneous spinal stiffness were similar in magnitude and direction to those observed in symptomatic human subjects who report benefits after SMT.
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Registered trials
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