Manual therapy practitioners frequently include assessment of spinal joint mobility in their clinical examination and treatment of patients with low back pain. There is increasing evidence that clinical identification of spinal joint hypo- and hypermobility subgroups along with correspondingly tailored manual therapy treatment approaches can lead to more successful therapeutic outcomes. For example, individuals with low back pain and spinal hypomobility have been shown to respond better to spinal manipulation than those with spinal joint hypermobility. What underlying biological/neural mechanisms could be responsible for the different clinical responses from these subgroups when treated with spinal manipulation? This question motivates this career development plan which allows the candidate to accomplish his immediate goals of: a) working with an animal model that combines simulated spinal manipulation with peripheral neural recordings from lumbar paraspinal muscles and b) attaining knowledge of musculoskeletal biomechanics pertinent to the applied spinal loading that occurs during spinal manipulation through didactic coursework. In this study, an established cat lumbar spine model will be used to determine the effects of proximal, distal, and bi-segmental spinal joint hypo- and hypermobility on paraspinal muscle spindle discharge during simulated high velocity low amplitude spinal manipulation of different durations (25-400ms). Spinal joint hypomobility will be created by placing unilateral bone screws through the facet joint;hypermobility will be created via unilateral facetectomies. This study will reveal relationships between spinal joint dysfunction and sensory feedback related to a specific manual therapy intervention (spinal manipulation) with demonstrated effectiveness in the treatment of low back pain. By adding spinal joint hypo- and hypermobility conditions to an established animal model used to investigate spinal manipulation, this career development award provides the candidate with tools and experience to accomplish his long-term career goal of determining how spinal manipulation in the presence of spinal joint dysfunction affects the central nervous system. The candidate is a second generation chiropractor and this career development plan will be completed at the largest chiropractic research center in the world (Palmer Center for Chiropractic Research) which recently received a NIH/NCCAM grant to establish a four year multi-disciplinary Developmental Center for Clinical and Translational Science.

Public Health Relevance

Back pain is the second most frequent reason for physician visits and the third for surgery. This animal study is directed toward understanding the consequences of restricted or excessive spinal joint mobility on neural responses to a commonly used manual therapy treatment (spinal manipulation) for back pain. The results of this study may provide a rationale for clinically tailoring manual therapy treatment approaches for specifically identified spinal joint dysfunctions.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AT005935-03
Application #
8322706
Study Section
Special Emphasis Panel (ZAT1-PK (09))
Program Officer
Khalsa, Partap Singh
Project Start
2010-09-01
Project End
2015-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
3
Fiscal Year
2012
Total Cost
$128,339
Indirect Cost
$7,817
Name
Palmer College of Chiropractic
Department
Type
Other Domestic Higher Education
DUNS #
075845834
City
Davenport
State
IA
Country
United States
Zip Code
52803
Reed, William R; Long, Cynthia R; Kawchuk, Gregory N et al. (2018) Neural Responses to Physical Characteristics of a High-velocity, Low-amplitude Spinal Manipulation: Effect of Thrust Direction. Spine (Phila Pa 1976) 43:1-9
Reed, William R; Cranston, Jamie T; Onifer, Stephen M et al. (2017) Decreased spontaneous activity and altered evoked nociceptive response of rat thalamic submedius neurons to lumbar vertebra thrust. Exp Brain Res 235:2883-2892
Reed, William R; Pickar, Joel G; Sozio, Randall S et al. (2017) Characteristics of Paraspinal Muscle Spindle Response to Mechanically Assisted Spinal Manipulation: A Preliminary Report. J Manipulative Physiol Ther 40:371-380
Reed, William R; Pickar, Joel G (2015) Paraspinal Muscle Spindle Response to Intervertebral Fixation and Segmental Thrust Level During Spinal Manipulation in an Animal Model. Spine (Phila Pa 1976) 40:E752-9
Reed, William R; Long, Cynthia R; Kawchuk, Gregory N et al. (2015) Neural responses to the mechanical characteristics of high velocity, low amplitude spinal manipulation: Effect of specific contact site. Man Ther 20:797-804
Reed, William R; Liebschner, Michael A K; Sozio, Randall S et al. (2015) Neural Response During a Mechanically Assisted Spinal Manipulation in an Animal Model: A Pilot Study. J Nov Physiother Phys Rehabil 2:20-27
Reed, William R; Long, Cynthia R; Kawchuk, Gregory N et al. (2014) Neural responses to the mechanical parameters of a high-velocity, low-amplitude spinal manipulation: effect of preload parameters. J Manipulative Physiol Ther 37:68-78
Reed, William R; Sozio, Randall; Pickar, Joel G et al. (2014) Effect of spinal manipulation thrust duration on trunk mechanical activation thresholds of nociceptive-specific lateral thalamic neurons. J Manipulative Physiol Ther 37:552-60
Reed, William R; Pickar, Joel G; Long, Cynthia R (2014) Effect of changing lumbar stiffness by single facet joint dysfunction on the responsiveness of lumbar muscle spindles to vertebral movement. J Can Chiropr Assoc 58:160-9
Reed, William R; Pickar, Joel G; Sozio, Randall S et al. (2014) Effect of spinal manipulation thrust magnitude on trunk mechanical activation thresholds of lateral thalamic neurons. J Manipulative Physiol Ther 37:277-86

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