The temporal effects of a single session of high-velocity, low-amplitude thrust manipulation on subjects with spinal pain
Bibliographic record
Abstract
Background: A high velocity, low amplitude thrust manipulation (HVLAT) is an intervention commonly used in the treatment of patients with spinal pain. Recent studies have reported on the possible neurophysiological effects of this technique which may be pertinent to the therapeutic value of these procedures. However, few studies have examined the temporal neurophysiological nature of a HVLAT beyond the immediate effects. Objectives: The purpose of this review is to summarize the literature on the temporal neurophysiological effects of a single HVLAT in patients with spinal pain. Methods: A systematic search of English articles was conducted using MEDLINE, CINAHL, and PEDro. Additional studies were identified with a hand search of the references of relevant articles. Search terms included spinal manipulation, chiropractic manipulation, osteopathic manipulation, spinal adjustment, cervical manipulation, lumbar manipulation, sacroiliac manipulation, neck pain, back pain, and sacroiliac pain. Quality scoring of the included articles was based on the Newcastle–Ottawa criteria. Results: Of the 478 articles identified, five articles ultimately met inclusion criteria into this review. These studies were of moderate to high quality. In all, follow-up measures after a single HVLAT were taken within a 30-minute to 5-hour period. Conclusion: In the absence of concurrent intervention, the neurophysiological effects seen after administration of a HVLAT were observed to be immediate in nature, with a return to baseline or reduction in effect noted at follow-up. Future studies examining the mechanisms of HVLAT should include dedicated follow-up periods to establish the temporal changes related to these techniques.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".