Do Audible Sounds during a Lumbar Spine Thrust Manipulation Have an Impact on Brainwave Activity?

Background: To manage pain and stiffness of the lumbar spine, thrust manipulation is commonly used. High-velocity, small-amplitude thrust manipulation often elicits audible sounds. What causes this audible sound remains unclear, and its clinical significance has not been shown. This study aimed to identify how audible sound affects brainwave activity following a side-lying right rotatory thrust manipulation in a group of healthy individuals.

Methods: This was a quasi-experimental repeated measures study design in which 44 subjects completed the study protocol. A portable Bluetooth EEG device was used to capture brainwave activity. The environment was controlled during testing to minimize any factors influencing the acquisition of real-time EEG data. After a short accommodation period, initial brainwaves were measured. Following this, each subject underwent a lumbar 4-5 side-lying right rotatory thrust manipulation, immediately followed by a second brainwave measurement. A third measurement took place one minute later, followed by a fourth one at the three-minute mark.

Results: 21 subjects did not experience audible sounds, while 23 subjects experienced audible sounds. Both groups had significant changes measured by the 14 electrodes ( < 0.05). The audible group had more significant changes, which lasted only two minutes.

Conclusion: The lack of brainwave response differences between the audible and non-audible groups implies no direct, measurable placebo or beneficial effect from the audible sound. This study could not identify a benefit from the audible sound during an HVLA manipulation of the subjects.