Original Article
The Effect of Sacroiliac Joint Manipulation on Feed-Forward Activation Times of the Deep Abdominal Musculature

https://doi.org/10.1016/j.jmpt.2006.01.010Get rights and content

Abstract

Objectives

To determine the incidence of delayed feed-forward activation (FFA) times in a group of healthy young males; to retest those subjects who showed delayed FFA after 6 months to determine the reliability of the measure in the absence of treatment or injury in the intervening period; and to determine the effect of sacroiliac joint manipulation on delayed FFA times.

Methods

Ninety young males were assessed for the FFA of their deep abdominal muscles in relation to rapid upper limb movements. Those who met the criteria for delayed FFA (failure of deep abdominal activation within 50 milliseconds of deltoid activation) were then reassessed 6 months later. These subjects then underwent sacroiliac joint manipulation on the side demonstrating decreased joint movement during hip flexion and lateral flexion. Feed-forward activation times were then reassessed after joint manipulation.

Results

Seventeen (18.9%) of 90 subjects met the criteria of impaired FFA. Thirteen of 17 were available to be remeasured at 6-month follow-up. The intraclass correlation coefficient for FFA at this time was greater than 0.70 for all movement directions. There was a significant improvement (38.4%) in FFA times for this group when remeasured immediately after the sacroiliac joint manipulation.

Conclusions

Delayed FFA is a highly reproducible measure at long-term follow-up. This technique appears to be a sensitive marker of the neural effects of sacroiliac joint manipulation. Future prospective studies are needed to determine if delayed FFA times are a marker for those at risk for developing back pain.

Section snippets

Subjects

Ninety young male subjects (age, 20.1 ± 2.1 years; height, 1.79 ± .07 m; weight, 72.8 ± 8.5 kg) volunteered to participate in this study after responding to advertisements within the local university and sports clubs. From these results, 13 subjects (age, 19 ± 2 years; height, 1.77 ± 0.08 m; weight, 70.2 ± 8.9 kg) were further identified and volunteered to participate in the 6-month follow-up study. There were no significant differences in the descriptive statistics for the subjects after the

Assessment of Sacroiliac Joint Function

The 13 subjects who were retested after 6 months were screened before treatment to ensure they had clinical evidence of decreased sacroiliac joint movement. Although it is recognized that clinical tests of sacroiliac joint function have questionable reliability,17, 18, 19 these tests are still widely used clinically, and Flynn et al20 have adopted them as one of the criteria for a clinical prediction rule of whether a patient is likely to benefit from sacroiliac manipulation. To assess the

Latency Results

There were significant differences between all movement directions for the mean latency results (F267.2 = 58.35, P < .001, Table 1). The latency of the shoulder flexion task was significantly greater than shoulder abduction, and shoulder abduction was significantly greater than shoulder extension. The results in Table 2 indicate that the latency results for TrA/IO are highly reliable after a 6-month period. This is shown by an ICC of greater than 0.70 for all movement directions.

Assessment of Sacroiliac Joint Function

In all 13

Discussion

The results of this study provided support for the experimental hypotheses presented. It was found that 19% of asymptomatic subjects were identified with the sEMG technique as lacking feed-forward abdominal muscle activation, which was reproducible 6 months later. It was also demonstrated that there was a significant change in this delayed response after sacroiliac joint manipulation.

Conclusion

This study demonstrated an sEMG technique to reliably measure delayed activation of the TrA/IO signal during rapid upper limb movements, when measured 6 months apart. It also demonstrated that a sacroiliac joint manipulation can decrease the latency of TrA/IO during the shoulder flexion movement. This study has provided support for the theory that the TrA and IO are associated with the stability of the sacroiliac joint. Future studies will need to investigate whether the acute neuromuscular

Acknowledgement

The authors thank the Hamblin Chiropractic Research Fund Trust that provided preliminary funding for this project.

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