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. 2016 Dec 23;7(1):2.
doi: 10.3390/brainsci7010002.

Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles

Free PMC article

Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles

Heidi Haavik et al. Brain Sci. .
Free PMC article


This study investigates whether spinal manipulation leads to changes in motor control by measuring the recruitment pattern of motor units in both an upper and lower limb muscle and to see whether such changes may at least in part occur at the cortical level by recording movement related cortical potential (MRCP) amplitudes. In experiment one, transcranial magnetic stimulation input-output (TMS I/O) curves for an upper limb muscle (abductor pollicus brevis; APB) were recorded, along with F waves before and after either spinal manipulation or a control intervention for the same subjects on two different days. During two separate days, lower limb TMS I/O curves and MRCPs were recorded from tibialis anterior muscle (TA) pre and post spinal manipulation. Dependent measures were compared with repeated measures analysis of variance, with p set at 0.05. Spinal manipulation resulted in a 54.5% ± 93.1% increase in maximum motor evoked potential (MEPmax) for APB and a 44.6% ± 69.6% increase in MEPmax for TA. For the MRCP data following spinal manipulation there were significant difference for amplitude of early bereitschafts-potential (EBP), late bereitschafts potential (LBP) and also for peak negativity (PN). The results of this study show that spinal manipulation leads to changes in cortical excitability, as measured by significantly larger MEPmax for TMS induced input-output curves for both an upper and lower limb muscle, and with larger amplitudes of MRCP component post manipulation. No changes in spinal measures (i.e., F wave amplitudes or persistence) were observed, and no changes were shown following the control condition. These results are consistent with previous findings that have suggested increases in strength following spinal manipulation were due to descending cortical drive and could not be explained by changes at the level of the spinal cord. Spinal manipulation may therefore be indicated for the patients who have lost tonus of their muscle and/or are recovering from muscle degrading dysfunctions such as stroke or orthopaedic operations and/or may also be of interest to sports performers. These findings should be followed up in the relevant populations.

Keywords: movement related cortical potential; neural adaptations; transcranial magnetic stimulation.

Conflict of interest statement

The authors declare no conflict of interest.


Figure 1
Figure 1
Motor evoked potential (MEP) recruitment curve for the upper limb muscle (APB) across all subjects, (A) prior to (pre), and following (post0) the cervical manipulation intervention. (B) Control Passive head movement group. Raw and fitted MEP recruitment curve for APB: (C) prior to, and following the cervical manipulation intervention for n = 1; and (D) prior to, and following the PHM for n = 1.
Figure 2
Figure 2
Motor evoked potential (MEP) recruitment curve prior to, and following the full spinal manipulation intervention for lower limb muscle (TA): (A) input–output properties of the TA MEP; and (B) raw and fitted TA MEP recruitment curve for n = 1.
Figure 3
Figure 3
Group mean (±SE) of the early bereitschafts-potential (EBP), late bereitschafts potential (LBP) and Peak negativity (PN) amplitudes in the pre (black bars) versus post-spinal manipulation session (grey bars).

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