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Updated: May 25, 2025
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Utilizing Transcranial Magnetic Stimulation to Study the Human Neuromuscular System
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Neuromuscular Response to High-Velocity, Low-Amplitude Spinal Manipulation-An Overview.
Murdi S Alanazi1,2, Brian Degenhardt3,4, Gwyn Kelley-Franklin3
1Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Medicina (Kaunas, Lithuania)
|February 26, 2025
Summary
High-velocity, low-amplitude spinal manipulation (HVLA-SM) shows mixed neuromuscular responses. More rigorous research is needed to understand its mechanisms, despite its common use for musculoskeletal pain.
Area of Science:
- Neuromuscular physiology
- Manual therapy research
- Musculoskeletal rehabilitation
Background:
- Clinical use of spinal manipulation for musculoskeletal pain has significantly increased.
- HVLA-SM is recommended by global guidelines for conservative pain management.
- Mechanisms of action for HVLA-SM remain poorly understood.
Purpose of the Study:
- To review evidence on direct neuromuscular responses to HVLA-SM.
- To identify gaps in mechanistic knowledge of neuromuscular responses to HVLA-SM.
- To foster interprofessional dialogue and collaborative research.
Main Methods:
- Literature overview of studies published between 2000 and December 2024.
- Searched PubMed, CINAHL Ultimate, and EMBASE databases.
- Included studies focused on neuromuscular responses (EMG, muscle thickness, strength, reflexes, EEG, evoked potential) to thrust HVLA-SM, excluding non-HVLA-SM techniques and patient-centered outcomes.
Main Results:
- Neuromuscular findings related to HVLA-SM were often mixed.
- Evidence is accumulating for specific neuromuscular responses as study rigor increases.
- Limitations include small sample sizes and non-standardized HVLA-SM delivery.
Conclusions:
- Current evidence on neuromuscular responses to HVLA-SM is inconclusive due to study limitations.
- Further research is needed to clarify the direct neuromuscular effects of HVLA-SM.
- Standardization of HVLA-SM delivery and larger sample sizes are crucial for future studies.
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