Spinal manipulation is a form of body-based therapy patients often seek for treatment of musculoskeletalcomplaints. While numerous techniques are used clinically, each shares the common denominator ofapplying force to the spine. The most form of spinal manipulation includes a short lever, High Velocity, LowAmplitude (HVLA) thrust. Investigation of HVLA spinal manipulation is the focus of this application. By itsvery nature spinal manipulation is a mechanical intervention that lasts a fraction of a second (typically<200ms) yet produces effects that outlast the intervention itself. How? This question provides the basis forour study and motivates our long term goal: to understand and improve the effective use of spinalmanipulation. We will take advantage of an animal model and approaches developed by the two co-leadersin order to understand the relationship between spatial and temporal characteristics of a spinal manipulationand their effects on neural and biomechanical responses from paraspinal tissues. We will determine whethereither the responsiveness of primary afferent signaling from paraspinal muscle spindle and/or the passivebiomechanical properties of the manipulated region outlast the manipulation itself. Specifically, we willdetermine if muscle spindle responsiveness increases and spinal stiffness decreases as a function of 1) thespinal manipulation's duration; 2) the presence, magnitude or shape of a preload preceding themanipulation; 3) the anatomical contact point used for the spinal manipulation; and 4) the direction withwhich the manipulation is applied. The information from these complementary studies will help provideinformation useful for identifying dosing features of the manipulation to which the nervous system andbiomechanical properties of paraspinal tissues may be most responsive and in determining strategies foroptimizing the delivery of SM. The study is innovative in that it is represents the first systematic study toinvestigate this relationship and uses the most commonly applied form of spinal manipulation, a high velocitylow amplitude spinal manipulation. The study is significant because it contributes to accomplishing NCCAM'sstrategic plan by characterizing the biomechanics of manipulative procedures in an effort to clarify themechanisms of action operative in manipulation practices.
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