Impact of Spinal Manipulation on Lower Extremity Motor Control in Lumbar Spinal Stenosis Patients: A Small-Scale Assessor-Blind Randomized Clinical Trial |
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Authors: | Steven R. Passmore Michael G. Johnson Saleh M. Aloraini Stephan Cooper Mina Aziz Cheryl M. Glazebrook |
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Affiliation: | 1. Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada;2. College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada;3. Research Department, New York Chiropractic College, Seneca Falls, New York;4. Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada;5. College of Applied Medical Sciences, Qassim University, Saudi Arabia;6. Applied Health Sciences Doctoral Program, University of Manitoba, Winnipeg, Manitoba, Canada;7. Research Department, Cleveland University, Kansas City, Missouri |
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Abstract: | ObjectiveThe purpose of this study was to quantify the impact of a single lumbar spinal manipulation (SM) intervention on the leg movement performance of degenerative lumbar spinal stenosis (LSS) patients in a small-scale registered randomized clinical trial.MethodsParticipants with LSS (n = 14) were tested at baseline for pain, lumbar range of motion, and behavioral or kinematic motor performance (using an established Fitts’ Law foot-pointing task), then underwent covariate adaptive randomization to receive SM or no intervention. Postintervention all dependent measures were repeated. Experimenters were blinded to patient group allocation. University ethics board approval was attained.ResultsFor the primary outcome movement time, there was no significant difference between groups. As predicted by Fitts’ Law, all participants had longer movement times as task difficulty increased. Secondary kinematic outcomes yielded no significant between-group differences. Consistent with Fitts’ Law, kinematic measures changed significantly with task difficulty. Pairwise comparisons revealed the kinematic variables were more adversely affected by greater movement amplitudes than target size changes. No exploratory differences in pain or lumbar range of motion were observed.ConclusionChanges in motor performance were not observed in this chronic pain population after a single SM intervention compared with a control group. Given the sample size, the study may have been underpowered to detect meaningful differences. Fitts’ Law was observed for the lower extremity–pointing task for an LSS population and may provide an objective measure of motor performance. |
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Keywords: | Corresponding author: Steven R. Passmore, DC, PhD, Faculty of Kinesiology and Recreation Management, 102 Frank Kennedy Centre, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada. Tel.: +1 204 474 6552. Manipulation, Spinal Spinal Stenosis Outcome Assessment (Health Care) Chiropractic |
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