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Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review

INTRODUCTION: The burden of musculoskeletal disorders increases every year, with low back and neck pain being the most frequently reported conditions for seeking manual therapy treatment. In recent years, manual therapy research has begun exploring the dose-response relationship between spinal manip...

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Autores principales: Pasquier, Mégane, Daneau, Catherine, Marchand, Andrée-Anne, Lardon, Arnaud, Descarreaux, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530068/
https://www.ncbi.nlm.nih.gov/pubmed/31139346
http://dx.doi.org/10.1186/s12998-019-0244-0
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author Pasquier, Mégane
Daneau, Catherine
Marchand, Andrée-Anne
Lardon, Arnaud
Descarreaux, Martin
author_facet Pasquier, Mégane
Daneau, Catherine
Marchand, Andrée-Anne
Lardon, Arnaud
Descarreaux, Martin
author_sort Pasquier, Mégane
collection PubMed
description INTRODUCTION: The burden of musculoskeletal disorders increases every year, with low back and neck pain being the most frequently reported conditions for seeking manual therapy treatment. In recent years, manual therapy research has begun exploring the dose-response relationship between spinal manipulation treatment characteristics and both clinical and physiological response to treatment. OBJECTIVE: The purpose of this scoping review was to identify and appraise the current state of scientific knowledge regarding the effects of spinal manipulation frequency and dosage on both clinical and physiological responses. METHODS: A scoping review was conducted to identify all available studies pertaining to our research question. Retrieved papers were screened using a 2-phase method, a selective sorting with titles and abstracts. Potentially relevant studies were read, and data was extracted for all included studies. Randomized control trials were assessed using the Cochrane Risk of Bias Tool for quality assessment. RESULTS: The search yielded 4854 publications from which 32 were included for analysis. Results were sorted by dosage or frequency outcomes, and divided into human or animal studies. Animal studies mainly focused on dosage and evaluated physiological outcomes only. Studies investigating spinal manipulation dosage effects involved both human and animal research, and showed that varying thrust forces, or thrust durations can impact vertebral displacement, muscular response amplitude or muscle spindle activity. Risk of bias analysis indicated only two clinical trials assessing frequency effects presented a low risk of bias. Although trends in improvement were observed and indicated that increasing the number of SM visits in a short period of time (few weeks) decreased pain and improve disability, the differences between the studied treatment frequencies, were often not statistically significant and therefore not clinically meaningful. CONCLUSION: The results of this study showed that SM dosage and frequency effects have been mostly studied over the past two decades. Definitions for these two concepts however differ across studies. Overall, the results showed that treatment frequency does not significantly affect clinical outcomes during and following a SM treatment period. Dosage effects clearly influence short-term physiological responses to SM treatment, but relationships between these responses and clinical outcomes remains to be investigated.
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spelling pubmed-65300682019-05-28 Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review Pasquier, Mégane Daneau, Catherine Marchand, Andrée-Anne Lardon, Arnaud Descarreaux, Martin Chiropr Man Therap Research INTRODUCTION: The burden of musculoskeletal disorders increases every year, with low back and neck pain being the most frequently reported conditions for seeking manual therapy treatment. In recent years, manual therapy research has begun exploring the dose-response relationship between spinal manipulation treatment characteristics and both clinical and physiological response to treatment. OBJECTIVE: The purpose of this scoping review was to identify and appraise the current state of scientific knowledge regarding the effects of spinal manipulation frequency and dosage on both clinical and physiological responses. METHODS: A scoping review was conducted to identify all available studies pertaining to our research question. Retrieved papers were screened using a 2-phase method, a selective sorting with titles and abstracts. Potentially relevant studies were read, and data was extracted for all included studies. Randomized control trials were assessed using the Cochrane Risk of Bias Tool for quality assessment. RESULTS: The search yielded 4854 publications from which 32 were included for analysis. Results were sorted by dosage or frequency outcomes, and divided into human or animal studies. Animal studies mainly focused on dosage and evaluated physiological outcomes only. Studies investigating spinal manipulation dosage effects involved both human and animal research, and showed that varying thrust forces, or thrust durations can impact vertebral displacement, muscular response amplitude or muscle spindle activity. Risk of bias analysis indicated only two clinical trials assessing frequency effects presented a low risk of bias. Although trends in improvement were observed and indicated that increasing the number of SM visits in a short period of time (few weeks) decreased pain and improve disability, the differences between the studied treatment frequencies, were often not statistically significant and therefore not clinically meaningful. CONCLUSION: The results of this study showed that SM dosage and frequency effects have been mostly studied over the past two decades. Definitions for these two concepts however differ across studies. Overall, the results showed that treatment frequency does not significantly affect clinical outcomes during and following a SM treatment period. Dosage effects clearly influence short-term physiological responses to SM treatment, but relationships between these responses and clinical outcomes remains to be investigated. BioMed Central 2019-05-22 /pmc/articles/PMC6530068/ /pubmed/31139346 http://dx.doi.org/10.1186/s12998-019-0244-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pasquier, Mégane
Daneau, Catherine
Marchand, Andrée-Anne
Lardon, Arnaud
Descarreaux, Martin
Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title_full Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title_fullStr Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title_full_unstemmed Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title_short Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
title_sort spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530068/
https://www.ncbi.nlm.nih.gov/pubmed/31139346
http://dx.doi.org/10.1186/s12998-019-0244-0
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