Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies

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 os...

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Main Authors: Sebastian Szajkowski, Michał Dwornik, Jarosław Pasek, Grzegorz Cieslar
Format: Article
Language:English
Published: Univeristy of Physical Education in Krakow 2019-10-01
Series:Rehabilitacja Medyczna
Subjects:
Online Access:https://rehmed.pl/resources/html/article/details?id=194435
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author Sebastian Szajkowski
Michał Dwornik
Jarosław Pasek
Grzegorz Cieslar
author_facet Sebastian Szajkowski
Michał Dwornik
Jarosław Pasek
Grzegorz Cieslar
author_sort Sebastian Szajkowski
collection DOAJ
description 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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spelling doaj.art-d09d48f5ae884bd28c73ee7f9e7ce7ce2022-12-22T01:33:59ZengUniveristy of Physical Education in KrakowRehabilitacja Medyczna1427-96221896-32502019-10-01234475310.5604/01.3001.0013.5453Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studiesSebastian Szajkowski0Michał Dwornik 1https://orcid.org/0000-0001-9029-1646Jarosław Pasek2https://orcid.org/0000-0002-4259-181X Grzegorz Cieslar 3https://orcid.org/0000-0003-2210-8744Masovian Medical College, Osteopathic Medicine Department, Physiotherapy Department, Warsaw, Poland Masovian Medical College, Osteopathic Medicine Department, Physiotherapy Department, Warsaw, Poland Jan Dlugosz Uniwersity, Faculty of Health Science, Częstochowa, Poland Medical University of Silesia in Katowice, School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Medicine, Institute of Angiology and Physical Medicine, Bytom, PolandAbstract 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/)https://rehmed.pl/resources/html/article/details?id=194435osteopathy treatmentmanipulationsspinehvlahvtexperimental studiesanimal model
spellingShingle Sebastian Szajkowski
Michał Dwornik
Jarosław Pasek
Grzegorz Cieslar
Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
Rehabilitacja Medyczna
osteopathy treatment
manipulations
spine
hvla
hvt
experimental studies
animal model
title Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
title_full Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
title_fullStr Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
title_full_unstemmed Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
title_short Evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
title_sort evaluation of mechanisms of therapeutic impact of joint manipulation based on the results of experimental studies
topic osteopathy treatment
manipulations
spine
hvla
hvt
experimental studies
animal model
url https://rehmed.pl/resources/html/article/details?id=194435
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AT jarosławpasek evaluationofmechanismsoftherapeuticimpactofjointmanipulationbasedontheresultsofexperimentalstudies
AT grzegorzcieslar evaluationofmechanismsoftherapeuticimpactofjointmanipulationbasedontheresultsofexperimentalstudies