International Journal of Osteopathic Medicine
Volume 10, Issue 2 , Pages 42-49, June 2007

The effects of high-velocity, low-amplitude manipulation and muscle energy technique on suboccipital tenderness

  • Luke Hamilton

      Affiliations

    • School of Health Sciences, Victoria University, Melbourne, Australia
    • Corresponding Author InformationCorresponding author. 182 Fulham Road, Gulliver QLD 4812, Australia. Tel.: +61 402 908 631.
    • ,
  • Caitlin Boswell

      Affiliations

    • School of Health Sciences, Victoria University, Melbourne, Australia
    • ,
  • Gary Fryer

      Affiliations

    • School of Health Sciences, Victoria University, Melbourne, Australia
    • Centre for Ageing, Rehabilitation and Exercise Science, Victoria University, Melbourne, Australia
    • A.T. Still Research Institute, Kirksville, MO, USA

Received 25 March 2007; received in revised form 15 August 2007; accepted 21 August 2007.

Abstract 

Background and objectives

High-velocity, low-amplitude (HVLA) manipulation and muscle energy technique (MET) are commonly advocated by manual therapists to resolve pain and dysfunction. The aim of this controlled, single blinded study was to investigate whether HVLA manipulation of the occipito–atlantal (OA) joint and/or an MET stretch had an effect on pressure pain thresholds (PPT) in the suboccipital musculature in an asymptomatic population.

Methods

Participants (N=90; mean age=23±5; 29 males and 61 females) were screened for suitability and PPT measurements were made using a hand-held electronic algometer which was positioned centrally in the suboccipital region. Participants were randomly allocated into three intervention groups and then received an HVLA thrust to cavitate the right and left OA joints, an MET stretch applied to the suboccipital muscles bilaterally, or a sham ‘functional’ technique. Post-intervention PPT measurements were recorded at 5 and 30min.

Analysis

Analysis of the PPT data using a SPANOVA revealed a significant difference over time (F2,174=8.80, P<0.01), but no significant difference between the groups (F2,87=0.08, P=0.93). Within-group changes were further analysed using paired t-tests and repeated measures ANOVA which revealed significant changes at 5min post treatment in the HVLA (P<0.01) and MET groups (P<0.01), but not in the control (P=0.35). At the 30min interval a significant change was calculated for the MET group (P<0.03), but not in the HVLA (P=0.29) or control group (P=0.21).

Conclusion

Neither HVLA manipulation nor MET significantly changed the PPT of the suboccipital muscles in asymptomatic participants. Both techniques produced greater mean increases in PPT and effect sizes compared to the control group, and investigation of the effect of these techniques in a symptomatic population is recommended.

Keywords: Manipulation, Stretching, Suboccipital, Muscles, Occipito–atlantal joint, Algometry, Osteopathic medicine

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PII: S1746-0689(07)00047-8

doi:10.1016/j.ijosm.2007.08.002

International Journal of Osteopathic Medicine
Volume 10, Issue 2 , Pages 42-49, June 2007

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