TY - JOUR
T1 - Immediate systemic neuroimmune responses following spinal mobilisation and manipulation in people with non-specific neck pain
T2 - a randomised placebo-controlled trial
AU - Lutke Schipholt, Ivo J.
AU - Coppieters, Michel W.
AU - Reijm, Martine
AU - Bontkes, Hetty J.
AU - Scholten-Peeters, Gwendolyne G. M.
N1 - Funding Information: We would like to thank Saida Tonouch-Aajoud, Petra Bonnet and Kim de Buck for laboratory assistance, Prof Jos Twisk for his statistical advice, and the MSG Science Network funded by the Dutch Association for Manual Therapy, Sports, Orofacial and Psychosomatic therapy ( https://www.msg-sciencenetwerk.nl/ ) (grant ID. N/A) for their support in participant recruitment. This study was funded by the Dutch Association for Manual Therapy (NVMT, grant ID. Bottom-up 2017 and Top-down_2018), and by the Faculty of Behavioural and Movement Sciences (grant ID. Lab Fund_2019) of Vrije Universiteit Amsterdam. The funding sources did not have a role in the study design, data collection, analyses and interpretation of the data, nor in the reporting of the results. Publisher Copyright: © 2023, Springer Nature Limited.
PY - 2023/12
Y1 - 2023/12
N2 - Spinal mobilisation/manipulation is a common intervention for spinal pain, yet the working mechanisms are largely unknown. A randomised placebo-controlled trial was conducted to (1) compare the immediate neuroimmune responses following spinal mobilisation/manipulation and placebo spinal mobilisation/manipulation; (2) compare the immediate neuroimmune responses of those with a good outcome with those of a poor outcome following spinal mobilisation/manipulation; and (3) explore the association between neuroimmune responses and pain reduction. One hundred patients were randomly allocated to spinal mobilisation/manipulation or a placebo mobilisation/manipulation. Primary outcomes were whole blood in-vitro evoked released concentrations of IL-1β and TNF-α measured 10 min and 2 h after the intervention. Immediate effects were studied because successful mobilisation/manipulation is often associated with immediate pain reduction, and immediate neuroimmune responses are less affected by potential confounders than long-term responses. Secondary outcomes included multiple systemic inflammatory marker concentrations, phenotypic analysis of white blood cells and clinical outcomes. Outcomes were compared between the experimental and placebo group, and between people with a good and poor outcome in the experimental group. Estimates of intervention effects were based on intention-to-treat analyses, by using linear mixed-effect models. Although there was a substantial difference in pain reduction between groups (mean (SD) difference visual analogue scale: 30 (21) mm at 10 min and 32 (21) mm at 2 h (p < 0.001) in favour of mobilisation/manipulation, there were no differences in primary outcomes between groups or between people with a good and poor outcome (p ≥ 0.10). In conclusion, possible neuroimmune responses following spinal mobilisations/manipulation cannot be identified at a systemic level. Future research may focus on longer treatment duration and more localised neuroimmune responses.
AB - Spinal mobilisation/manipulation is a common intervention for spinal pain, yet the working mechanisms are largely unknown. A randomised placebo-controlled trial was conducted to (1) compare the immediate neuroimmune responses following spinal mobilisation/manipulation and placebo spinal mobilisation/manipulation; (2) compare the immediate neuroimmune responses of those with a good outcome with those of a poor outcome following spinal mobilisation/manipulation; and (3) explore the association between neuroimmune responses and pain reduction. One hundred patients were randomly allocated to spinal mobilisation/manipulation or a placebo mobilisation/manipulation. Primary outcomes were whole blood in-vitro evoked released concentrations of IL-1β and TNF-α measured 10 min and 2 h after the intervention. Immediate effects were studied because successful mobilisation/manipulation is often associated with immediate pain reduction, and immediate neuroimmune responses are less affected by potential confounders than long-term responses. Secondary outcomes included multiple systemic inflammatory marker concentrations, phenotypic analysis of white blood cells and clinical outcomes. Outcomes were compared between the experimental and placebo group, and between people with a good and poor outcome in the experimental group. Estimates of intervention effects were based on intention-to-treat analyses, by using linear mixed-effect models. Although there was a substantial difference in pain reduction between groups (mean (SD) difference visual analogue scale: 30 (21) mm at 10 min and 32 (21) mm at 2 h (p < 0.001) in favour of mobilisation/manipulation, there were no differences in primary outcomes between groups or between people with a good and poor outcome (p ≥ 0.10). In conclusion, possible neuroimmune responses following spinal mobilisations/manipulation cannot be identified at a systemic level. Future research may focus on longer treatment duration and more localised neuroimmune responses.
KW - Duration of Therapy
KW - Humans
KW - Manipulation, Spinal
KW - Neck
KW - Neck Pain/therapy
UR - http://www.scopus.com/inward/record.url?scp=85166784908&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41598-023-39839-3
DO - https://doi.org/10.1038/s41598-023-39839-3
M3 - Article
C2 - 37550491
SN - 2045-2322
VL - 13
SP - 12804
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 12804
ER -