Is the cavitation associated with spinal manipulative therapy necessary for a therapeutic effect? A structured literature review
Item
- Title
- Is the cavitation associated with spinal manipulative therapy necessary for a therapeutic effect? A structured literature review
- Author(s)
- Fitzem, P
- Abstract
- Background: Practitioners and patients often see spinal manipulative therapy as successful when the technique releases an audible pop. The origin of this cavitation is thought to be caused by the sudden separation of the joint surfaces and consequently causing release of synovial gases, however the phenomenology is still poorly understood. Objective: This study was conducted to evaluate the necessity of cavitation in spinal manipulative therapy in order to determine whether the occurrence of an audible pop influences the therapeutic outcomes. Design: A structured literature review. Methods: Six databases were searched applying the Boolean logic. The search returns were screened according to the inclusion/exclusion criteria using Rayyan. The information of the included studies was documented in a review matrix to help answer the research question. A methodological quality assessment was performed using the Delphi list and the Cochrane Risk of Bias Tool. To be able to analyse the effect of the spinal manipulation compared to the of a sham procedure, effect sizes and p-values were also recorded. Results: Sixteen studies, that met the inclusion/exclusion criteria, were included in this review. Of the seven studies reporting effect size, five were identified as small, one as medium and one as large, in the sham group the overall effect was small. Statistical significance with p<0.05 was found in eight studies. The studies scored 5.375 on average on the Delphi list and only five studies scored low bias in the Cochrane Risk of Bias tool. Discussion: The overall effect reported in this review has shown favourable results for SM when compared to a sham procedure across a variety of outcome measures, however the effect size was still considered small in all studies. Unfortunately, interpretation of the results was challenging due to a variety of factors influencing the credibility of the included studies. Conclusion: This review has identified limitations in literature surrounding SM including a poor understanding of SM mechanisms. Due to heterogeneity of outcome measures, interventions and sham techniques, a justified conclusion to whether the cavitation associated with SM is necessary to provide positive therapeutic effect, could not been drawn.
- presented at
- European School of Osteopathy
- Date Accepted
- 2020
- Date Submitted
- 28.10.2020 18:08:19
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16660
- Inst-Identifier
- 1229
- Keywords
- Cavitation, Effectiveness, High-velocity thrust, Spinal manipulation
- Recommended
- 0
- Item sets
- Thesis
Fitzem, P, “Is the cavitation associated with spinal manipulative therapy necessary for a therapeutic effect? A structured literature review”, Osteopathic Research Web, accessed May 3, 2025, https://www.osteopathic-research.com/s/orw/item/195