Chiropractic Research

Auckland, New Zealand

Resolution of Nocturnal Enuresis

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Resolution of Nocturnal Enuresis in a 10-year-old Child Following Chiropractic Care to Reduce Vertebral Subluxation: A Case Report

Sara Luscombe, Joel Alcantara DC, Steven Holmes BChiro, Kelly Holt, BSc (Chiro), PhD

Objective: To describe the chiropractic care of a 10-year-old boy experiencing frequent nocturnal enuresis (NE), otherwise known as “bedwetting”.

Clinical Features: The child suffered from long-term regular bedwetting. Intervention and Outcome: The child received instrument assisted and drop table technique adjustments over a two month period. After four weeks of chiropractic care the child’s bedwetting ceased.

Conclusion: This case study adds to the growing body of literature that supports a possible link between chiropractic care and improvements in NE. Further research in this field is required to investigate this potential link.

Selective changes in cerebellar-cortical processing

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Selective changes in cerebellar-cortical processing following motor training

Heidi Haavik · Bernadette Murphy

Abstract: The aim of this study was to investigate the effect of varying stimulation rate and the effects of a repetitive typing task on the amplitude of somatosensory evoked potential (SEP) peaks thought to relate to cerebellar processing. SEPs (2,000 sweep averages) were recorded following median nerve stimulation at the wrist at frequencies of 2.47, 4.98, and 9.90 Hz from 12 subjects before and after a 20-min repetitive typing task.

Typing and error rate were recorded 2-min pre- and post-typing task. Effect of stimulation rate was analysed with ANOVA followed by pairwise comparisons (paired t tests). Typing effects were analysed by performing two-tailed paired t tests. Increasing stimulation frequency significantly decreased the N30 SEP peak amplitude (p < 0.02). Both the 4.98 and 9.90 Hz rates lead to significantly smaller N30 peak amplitudes compared to the 2.47 Hz (p ≤ 0.01). The N24 amplitude significantly increased following the typing task for both 4.98 and 2.47 Hz (p ≤ 0.025). In contrast, there was a highly significant decrease (p < 0.001) in the N18 peak amplitude post-typing at all frequencies. Typing rate increased (p < 0.001) and error rate decreased (p < 0.05) following the typing task. The results suggest that the N24 SEP peak amplitude is best recorded at 4.98 Hz since the N30 amplitude decreases and no longer contaminates the N24 peak, making the N24 visible and easier to measure, while still enabling changes due to repetitive activity to be measured.The decrease in N18 amplitude along with an increase in N24 amplitude with no change in N20 amplitude may be explained by the intervention reducing inhibition at the level of the cuneate nucleus and/or interior olives

Alterations in cortical and cerebellar motor processing

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Alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation

Julian Daligadu, MHSc, Heidi Haavik, PhD, Paul Yielder, PhD, Julianne Baarbe, BSC (Hons), and Bernadette Murphy, DC, PhD

Objective: The purpose of this study was investigate whether there are alterations in cerebellar output in a subclinical neck pain (SCNP) group and whether spinal manipulation before motor sequence learning might restore the baseline functional relationship between the cerebellum and motor cortex.

Methods: Ten volunteers were tested with SCNP using transcranial magnetic stimulation before and after a combined intervention of spinal manipulation and motor sequence learning. In a separate experiment, we tested 10 healthy controls using the same measures before and after motor sequence learning. Our transcranial magnetic stimulation measurements included short-interval intracortical inhibition, long-interval intracortical inhibition, and cerebellar inhibition (CBI).

Results: The SCNP group showed a significant improvement in task performance as indicated by a 19% decrease in mean reaction time (P b .0001), which occurred concurrently with a decrease in CBI following the combined spinal manipulation and motor sequence learning intervention (F1,6 = 7.92, P b .05). The control group also showed an improvement in task performance as indicated by a 25% increase in reaction time (P b .001) with no changes to CBI.

Conclusions: Subclinical neck pain patients have altered CBI when compared with healthy controls, and spinal manipulation before a motor sequence learning task changes the CBI pattern to one similar to healthy controls. (J Manipulative Physiol Ther 2013;36:527-537)

The role of spinal manipulation

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The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control

Heidi Haavik, Bernadette Murphy

Abstract: This review provides an overview of some of the growing body of research on the effects of spinal manipulation on sensory processing, motor output, functional performance and sensorimotor integration. It describes a body of work using somatosensory evoked potentials (SEPs), transcranial magnetic nerve stimulation, and electromyographic techniques to demonstrate neurophysiological changes following spinal manipulation. This work contributes to the understanding of how an initial episode(s) of back or neck pain may lead to ongoing changes in input from the spine which over time lead to altered sensorimotor integration of input from the spine and limbs.

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