Study Design Randomized controlled trial. Background Spinal manipulation (SM) can trigger a cascade of responses involving multiple systems including the sympathetic nervous system (SNS) and the endocrine system, specifically the hypothalamic-pituitary (HP) axis. However, no manual therapy study has investigated the neuroendocrine response to SM (i.e., SNS-HP axis) in the same trial. Objective To determine short-term changes in SNS activity; heart rate variability (HRV) and endocrine activity (cortisol, testosterone and testosterone/cortisol (T/C) ratio) following a thoracic SM. Methods Twenty four healthy males aged between 18 and 45 years were randomized into two groups: thoracic spinal manipulation (n=12) and sham (n=12). Outcome measures were salivary cortisol (μg/dL), salivary testosterone (pg/mL), T/C ratio, HRV and changes in oxy-haemoglobin (O2Hb) concentration of the right calf muscle (μmol/L). Measurements were done before and at 5 minutes, 30 minutes and approximately 6 hours after intervention. Results A statistically significant group by time interaction was noted for T/C ratio (p<0.05) and salivary cortisol (p<0.01) concentrations. Significant between group differences were noted for salivary cortisol concentration at 5 min (mean difference (MD), 0.35; 95% CI: 0.12to0.6; interaction: p<.001) and T/C ratio at 6 hours post-intervention (MD), -0.91; 95% CI: -1.69to-0.04, p<0.05). However, SM did not differentially alter O2Hb, testosterone or HRV relative to responses in the sham group. Conclusion Thoracic SM resulted in an immediate decrease in salivary cortisol concentration and reduced T/C ratio 6 hours after intervention. A pattern of immediate sympathetic excitation was also observed in the SM group. J Orthop Sports Phys Ther, Epub 13 Jul 2017. doi:10.2519/jospt.2017.7348.
This research output has an Altmetric Attention Score of 41. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 October 2019.
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