ONO YUMIE    Department   Undergraduate School  , School of Science and Technology    Position   Professor
Language	Japanese
Publication Date	2017/02
Type	Academic Journal
Peer Review	Peer reviewed
Title	Functional brain imaging to assess the efficacy of manipulative therapy on pain relief
Contribution Type	Co-authored (other than first author)
Journal	Transactions of Japanese Society for Medical and Biological Engineering
Journal Type	Japan
Publisher	Japanese Society for Medical and Biological Engineering
Volume, Issue, Page	55(1),pp.1-8
Total page number	null
Author and coauthor	Yasuhiro Matsuda, Tatsuya Suzuki, Minoru Onozuka
Details	Manipulative therapy refers to a manual physical therapy approach by a Judo therapist to treat muscle or joint injuries. An evaluation of manipulative therapy outcome in patients typically involves an assessment of the range of motion of the target joint and subjective pain relief, as determined through an interview or using the visual analog scale (VAS). However, this approach for pain relief assessment has the limitation of being less objective and is problematic if the patient has difficulty communicating with the therapist. To address this concern, here we used functional near-infrared spectroscopy (fNIRS) analysis of prefrontal activity to evaluate changes in pain intensity before and after manipulative therapy. Participants were placed on a treatment table in a supine position with their knees kept straight, and fNIRS probes were attached to their bilateral prefrontal area, which is where the pain-induced cognitive response occurs. The participant's right leg was kept straight and inflected to the trunk to the extent that participants experienced a maximum pain level. At this time, the maximum hip joint flexion angle and a VAS score were determined as a pre-therapy baseline response. Participants received manipulative therapy for 5 minutes and then their right leg was inflected again to the same hip joint angle that was assessed at baseline to obtain a VAS score (post-therapy 1). The participant's right leg was then further inflected to the extent that participants experienced a maximum pain level, and then their maximum hip joint angle and VAS score were determined again (post-therapy 2). Both the VAS score and the prefrontal hemodynamic activity showed a significant decrease after the manipulative therapy (baseline vs. post-therapy 1), suggesting that the therapy increased the range of joint motion, and that the participants experienced less pain at the same joint angle. The maximum flection of the right leg significantly increased the maximum hip joint flexion angle (baseline vs. post-therapy 2). These results suggest that prefrontal hemodynamic activity can be used to objectively measure pain intensity, which may be applicable to quantitatively evaluate the effect of manipulative therapy.