Rehabilitacja Medyczna (Oct 2019)
Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
Abstract
Abstract Spine joint manipulation is a form of osteopathic treatment for spinal pain with various aetiologies. The most common form of these manoeuvres is HVLA (High Velocity Low Amplitude); (ICD-9 No. 93.62), which is widely used in everyday clinical practice by qualified physiotherapists and osteopaths. HVLA utilises a mechanical manipulative stimulus characterised by high speed, short duration and low amplitude of displacement of joint surfaces with respect to each other. Despite the long history of its usage, the mechanisms of their biological impact are still insufficiently explained. In this review, hypotheses concerning the therapeutic mechanism of HVLA impact were verified based on the analysis of scientific reports available in the PubMed and Medline databases. Reports have been discussed presenting theoretical mechanisms of the influence of HVLA techniques and experimental work taking up the issues of manipulation carried out on animal materials. Particular attention was focused on research examining basic biological mechanisms being the basis for explaining the observed clinical effects. The analysis of scientific reports in recent years has shown that there is no direct evidence pointing to the need for obtaining the phenomenon of cavitation during HVLA procedures. Moreover, research on animal models proves that HVLA are safe and non-invasive procedures from the point of view of biomechanics. They inhibit the development of hyperalgesia and allodynia as confirmed by immunohistochemical studies. Previous experimental studies have clearly shown that more than one biological mechanism is responsible for the obtained effects of HVLA therapy, and the patients' reactions to therapy are complex and individually variable. Please cite as: Szajkowski S., Dwornik M., Pasek J., Cieślar G. Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies. Med Rehabil 2019; 23(4): 47-53. DOI: 10.5604/01.3001.0013.5453 License This article is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License CC BY-SA (http://creativecommons.org/licenses/by-sa/4.0/)
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