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The effect of instrument-assisted spinal manipulation upon mechanical pain sensitivity in a healthy population compared to control: A feasibility randomised trial
Thesis   Open access

The effect of instrument-assisted spinal manipulation upon mechanical pain sensitivity in a healthy population compared to control: A feasibility randomised trial

Ali Zaher
Honours, Murdoch University
2021
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Abstract

Introduction: The efficacy and pain relief mechanism associated with instrument-assisted spinal manipulation is not well understood. Changes in pressure pain thresholds have been observed in manual spinal manipulation for up to 30 minutes; however, no studies have effectively examined these changes following instrument-assisted spinal manipulation. Objectives: To perform a feasibility randomised control trial to assess the changes in pressure pain thresholds in asymptomatic participants following instrument-assisted spinal manipulation compared to sham and control. Methods: 30 asymptomatic participants (mean age: 25.90 (SD 4.56)) were recruited and randomly assigned to either control, sham, or intervention group. The control group received no treatment, while the sham and intervention group received the procedure to their lumbar spine. The sham and intervention groups were further randomised to receive either left or right treatment. Pressure pain thresholds were measured bilaterally at four different locations, the infraspinatus, erector spinae muscle in the lumbar spine, medial calf, and tibialis anterior. Measurements were performed at immediately following the intervention at baseline, at 10, 20, and 30 minutes after the intervention. Results: A significant difference was observed in pressure pain thresholds over time as well as the side of manipulation irrespective of their treatment group. Repeated measures ANOVA tests found no significant difference between groups (control, sham, and intervention) at all the sites tested and treatment group by the side of manipulation over time. Conclusion: This study showed the feasibility of conducting a large, randomised control trial. Our results failed to demonstrate a significant difference in short-term changes to pressure pain thresholds following instrument-assisted spinal manipulation compared to sham and control. Due to wide confidence intervals and small sample size, a larger trial is required to investigate trends observed following this intervention.

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