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Do Audible Sounds During a Metacarpophalangeal and Metatarsophalangeal Thrust Manipulation Have an Impact on Intra-Articular Joint Space and Brainwave Activity?

Year: 2025

Type: article

Abstract: BACKGROUND: Joint manipulation is commonly used to manage musculoskeletal dysfunctions. Joint manipulation can result in audible sounds. The clinical significance and cause of manipulation sound remain unclear. This study aimed to identify intra-articular distance following a metacarpophalangeal (MCP) II and metatarsophalangeal (MTP) II joint manipulation in healthy subjects. Additionally, the cortical response pattern was measured. METHODS: Twenty-five subjects completed this quasi-experimental repeated-measures study protocol. Musculoskeletal ultrasound was used to measure intra-articular joint distance, and a portable EEG device captured brainwave activity. The environment was controlled during testing. Initially, the joint distance of the MCP II and MTP II was measured followed by the recording of initial brainwaves. Following a pre-manipulation hold, a second brainwave measure was taken. After this, each subject underwent a thrust manipulation of either MCP II or MTP II, immediately followed by the next brainwave measurement. One minute later, the final and fourth measurement took place. RESULTS: < 0.05) following the MCP manipulation but less following the MTP manipulation. CONCLUSIONS: This study supports the tribonucleation theory explaining audible joint manipulation sounds. The manipulation of the MCP II joint resulted in increased Theta wave activity, indicating a state of relaxation, which was larger in the audible group. The MTP II manipulation had decreased cortical effects regardless of the presence of a sound. Despite these findings, the clinical usefulness of audible sounds remains questionable.

Source: Healthcare

DOI: 10.3390/healthcare13050554

Authors: Rob Sillevis, Fransisco Selva-Sarzo, Valerie Weiss, Eleuterio A. Sanchez Romero

Institutions: Florida Gulf Coast University, Universitat de València

Language: English

Topic: Musculoskeletal pain and rehabilitation

Subfield: Pharmacology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,258