OBJECTIVE: The purpose of this study was to determine the effects of lumbar spinal manipulation on the excitability of the motor neuron pool as assessed by means of transcranial magnetic stimulation.
METHODS: Motor-evoked potentials were recorded subsequent to transcranial magnetic stimulation. The motor-evoked potential peak-to-peak amplitudes in the right gastrocnemius muscle of healthy volunteers (n = 24) were measured before and after homolateral L5-S1 spinal manipulation (experimental group) or side-posture positioning with no manipulative thrust applied (control group). Immediately after the group-specific procedure, and again at 5 and 10 minutes after the procedure, 10 motor-evoked potential responses were measured at a rate of 0.05 Hz. An optical tracking system (OptoTRAK, Northern Digital Inc, Waterloo, Canada [<0.10 mm root-mean-square]) was used to monitor the 3-dimensional (3-D) position and orientation of the transcranial magnetic stimulation coil, in real time, for each trial.
RESULTS: The amplitudes of the motor-evoked potentials were significantly facilitated from 20 to 60 seconds relative to the prebaseline value after L5-S1 spinal manipulation, without a concomitant change after the positioning (control) procedure.
CONCLUSIONS: When motor neuron pool excitability is measured directly by central corticospinal activation with transcranial magnetic stimulation techniques, a transient but significant facilitation occurs as a consequence of spinal manipulation. Thus, a basic neurophysiologic response to spinal manipulation is central motor facilitation.
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