Effects of thoracic manipulation with trigger point therapy on inflammatory cytokine levels in individuals with multiple sclerosis: a pilot study
Abstract
Background: Spinal manipulation (SM) may modulate immune and inflammatory responses in healthy and/or musculoskeletal pain populations, yet SM responses in neurodegenerative populations such as multiple sclerosis are essentially unknown. This pilot study estimated the potential effects of chiropractic thoracic SM combined with trigger point therapy on serum inflammatory cytokine/chemokine levels, neurodegeneration biomarkers, and clinical/performance-based outcomes in people with relapsing-remitting multiple sclerosis (RRMS). The goal was to inform the design of future research.
Methods: This pilot randomized, sham-controlled trial included 21 RRMS participants assigned to either SM (n = 11) or sham-SM (n = 10) groups. Interventions were delivered twice weekly for four weeks. Blood samples were collected at five timepoints: baseline (T0), 20 min and 2 h after first intervention (T1 and T2 respectively), and 20 min and 2 h after the final intervention (T3 and T4 respectively). Overall 21 inflammatory biomarkers, 3 neurodegenerative biomarkers and 12 clinical/performance outcomes were assessed. Between-group differences were evaluated by comparing change scores from baseline per group, and effect sizes were reported using Cohen's d.
Results: Eight cytokines/chemokines in the SM group demonstrated moderate to large effect sizes (d ≥ 0.5) at a single timepoint post-intervention compared with the sham-SM group, whereas six (IL-8, IL-17A, GM-CSF, MIP-1β, IFNγ, Fractalkine)…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 21 participants or records.
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