High-velocity low amplitude spinal manipulation (HVLA-SMT) has been recommended as a preferred care option for an array of neuromusculoskeletal issues. This study analyzed the current literature regarding neurophysiological responses to HVLA-SMT without combining it with spinal mobilization.
It currently appears as though the neurophysiological response may vary between symptomatic and asymptotic people. There is also evidence that HVLA-SMT affects the autonomic nervous system. More than one study showed a significant effect on heart rate variability and skin conductance post-SMT.
We don’t yet know the clinical implications of these changes. Still, emerging research that links neurophysiological changes, perceived pain, and action mechanisms may identify additional subgroups of patients who may benefit from HVLA-SMT.
“…studies have indicated that spinal manipulation-like forces to the spine increased the discharge frequency of proprioceptive afferents…and force applications to lower thoracic and lumbar spinous processes inhibited the sympathetic outflow…”
“(in healthy subjects HVLA-SMT)…shifts towards sympathetic activity when applied to the lower cervical/upper thoracic spine and lumbar spine, and toward parasympathetic activity when applied to the upper cervical spine.”
“The systematic review points at effects of HVLA-SMT on the autonomic nervous system, reflected in“
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