SMT-1 Manual, pgs 45-56 Flashcards
- How is C-Fiber comparable to wind up?
Wind up results from tonic C-Fiber input and is an example of central sensitization that occurs in the dorsal horn cells.
- Can wind up be measured?
No, but thermal stimulus is an indirect measure.
- Biolosky et al 2008 divided 60 non-LBP subjects into what 3 groups?
- What was each group told?
- Pos expectation group told SMT was very effective, expect heat pain perception to be reduced.
- Neg expectation group told SMT was ineffective and expect heat pain perception to increase.
- Neutral expectation group told SMT effects are unknown for treating LBP and heat pain perception.
- According to Biolosky et al 2008, how is C-Fiber pain assessed?
- What were the results?
- What does this suggest?
It is assessed at the plantar foot, 10 heat pulses, at a rate of 0-100.
- Pos group had significant dec in LBP, 7.7/100
- Neg group had significant inc in LBP, 6.98/100
Hypoalgesia associated c SMT may be influenced by expectation.
- How did Bishop et al 2011 measure regional pain modulation p HVLAT?
Subjects rated 1st pain Abeta fibers and 2nd pain c-fiber, 0-100 from thermal stimuli on volar forearm and upper calf, then thenar eminence and medial longitudinal arch.
- What were the interventions for Bishop et al 2011?
- Results?
- Changes in thermal stimuli ratings?
- Upper Tx HVLAT supine
- Cx ext DNF c CCFT
- Control group rested supine for 5min
- resulted in no significant changes for any group
- no significant changes in thermal stimuli ratings
- Bishop et al 2011: What group experienced dec in TSS (secondary) pain?
- What does this prove?
- Tx HVLAT experienced significant reduction in pain greater than Cx ext or control group
- Immediate inhibition dec TSS p SMT, but only proven in healthy adults
- Have the mechanisms behind SMT really been proven?
Bialosky et al 2009 says they have not been established.
- Bialosky et al 2009: are biomechanical effects assessment reliable?
No
- What do joint techniques lack?
Precision, because forces are dissipated over a large area.
- Are nerve biased techniques specific to a single nerve?
No
- Does the choice of technique affect the outcome?
No
- Have lasting structural changes been identified?
No
- Have existing studies directly observed the central or peripheral nervous system?
No
- Stimulation of dPAG following SMT was suggested by whom?
Wright 1995
- Who suggested the lessening of TSS dorsal horn cells following SMT?
George et al 2006
- What 3 categories does Bialosky et al 2009 use for neurophysiological mechanisms of SMT?
Peripheral Mechanisms, Spinal Mechanisms, Supraspinal Mechanisms
- What are peripheral mechanisms of SMT?
MSK injuries produce an inflammatory response in the periphery which influence both healing and pain processing. SMT changes blood levels of inflammatory products such as SubP, serotonin, B-endorphins (descending pain inhibitory systems)
- For spinal mechanisms
- Who suggested SMT may exert an effect on the spinal cord by a counter irritant to modulate pain?
Boal & Gillette 2004
- Who speculated SMT bombards the CNS c sensory input from the muscle and joint proprioceptors?
Pickar & King 2006
- How does SMT indirectly implicate a spinal cord mediated effect?
Hypoalgesia, afferent discharge, dec motorneuron, pool activity, changes in muscle activity.