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Spinal reflex excitability changes after lumbar spine passive flexion mobilization
Ronald Bulbulian1, Jeanmarie Burke, J Donald Dishman
1New York Chiropractic College, Seneca Falls, NY 13148, USA. Rbulbulian@nycc.edu
Journal of Manipulative and Physiological Therapeutics
|October 17, 2002
Summary
Flexion distraction therapy for low back pain shows reduced H-reflex amplitude during trunk flexion, indicating motor neuron pool inhibition. Further studies are needed to understand these neurophysiologic responses.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Orthopedics
Background:
- Flexion distraction therapy is increasingly recognized for low back pain management.
- Previous research focused on intradiskal pressure, but neural responses remain underexplored.
Purpose of the Study:
- To investigate neural reflex responses to lumbar spine motion with three degrees of freedom.
- To evaluate soleus H-reflex changes during various trunk movements.
Main Methods:
- Assessed H-maximum reflexes in 12 subjects using stimulus response recruitment curves.
- Measured H-reflexes in neutral, flexion, lateral flexion, and axial rotation positions.
- Quantified spinal range of motion and expressed H-reflexes as a percentage of maximal M-wave.
Main Results:
- Trunk flexion led to a significant decrease in mean H-reflex amplitude and H/M ratio compared to the neutral position (P <.05).
- Observed variations in movement ranges despite consistent table positioning.
Conclusions:
- Trunk flexion is associated with motor neuron pool inhibition.
- The lack of significant changes in lateral flexion and rotation suggests involvement of various afferent receptors.
- Further dynamic motion studies are recommended to explore flexion distraction's neurophysiologic effects.