Motor-evoked potentials recorded from lumbar erector spinae muscles: a study of corticospinal excitability changes associated with spinal manipulation.

摘要

OBJECTIVE: The purpose of this study was to determine if high-velocity, low-amplitude spinal manipulation (SM) altered the effects of corticospinal excitability on motoneuron activity innervating the paraspinal muscles. In a previous study using transcranial magnetic stimulation (TMS), augmentation of motor-evoked potentials (MEPs) from the gastrocnemius muscle after lumbar SM was reported. To date, there is no known report of the effect of SM on paraspinal muscle excitability. METHODS: The experimental design was a prospective physiologic evaluation of the effects of SM on corticospinal excitability in asymptomatic subjects. The TMS-induced MEPs were recorded from relaxed lumbar erector spinae muscles of 72 asymptomatic subjects. The MEP amplitudes were evaluated pre-SM and post-SM or conditions involving prethrust positioning and joint loading or control. RESULTS: There was a transient increase in MEP amplitudes from the paraspinal muscles as a consequence of lumbar SM (F([6,414]) = 8.49; P .05)without concomitant changes after prethrust positioning and joint loading or in control subjects (P .05). These data findings were substantiated by a significant condition x time interaction term (F([12,414]) = 2.28; P .05). CONCLUSIONS: These data suggest that there is a postsynaptic facilitation of alpha motoneurons and/or corticomotoneurons innervating paraspinal muscles as a consequence of SM. It appears that SM may offer unique sensory input to the excitability of the motor system as compared to prethrust positioning and joint loading and control conditions.