EMG

Salma Bouqartacha et al. (2026) · Chiropractic & manual therapies

This randomized mechanistic cross-over trial with 89 adults explored how two hands-on neck treatments differ right after they are delivered. Chronic neck pain, defined here as pain lasting at least 12 weeks, is one of the leading causes of disability worldwide. Spinal manipulation (SM) is a single quick, shallow thrust applied to a joint, and spinal mobilization (Smob) is a slower, repeated rocking pressure on the same area. Both are recommended in clinical guidelines, but they are often lumped together, so little was known about how their effects on pain, movement and muscle activity compare. Participants were aged 18 to 65, with an average of 35 years, and 65% were women. They were recruited in Zurich, Switzerland, and Trois-Rivieres, Canada. Each person attended two sessions three days apart, receiving SM in one and Smob in the other in random order. SM was one thrust to the most painful neck joint while lying face up, and Smob was 30 seconds of repeated pressure on the same level while lying face down. Pain was rated from 0 to 10, and neck movement, tenderness to pressure, grip strength and muscle electrical activity were measured before and after. Pain dropped by 0.79 points after SM and 0.37 points after Smob, a gap of 0.41 points (p = 0.002), which stayed below the 1.3 points considered clinically meaningful. Neck movement improved after both treatments, by about 4.6 degrees after SM and 3.7 degrees after Smob in bending forward and back, with no difference between them. Neck muscles responded more strongly during SM, with activity in the sternocleidomastoid about six times higher (0.144 versus 0.023). Tenderness and grip strength changed inconsistently, and the grip decrease of 1.13 kg was far under the 6 kg detectable change. Participants' own global impression of change favored SM (p < 0.001) but also stayed below the clinical threshold. Upper trapezius activity was likewise higher during SM (0.083 versus 0.024). No serious adverse events were reported. The authors state that statistically significant differences did not reach clinical significance, so the trial cannot support conclusions about which treatment works better in practice. Only immediate effects after one session were measured, many outcomes were tested, participants could tell the treatments apart, and baseline disability was mostly mild to moderate. Clinician training also differed between sites. The authors propose that future trials examine several sessions of each treatment, since a multi-session or combined approach may reach clinical relevance.

Peerapat Lertwiram et al. (2025) · PloS one

This cross-over randomized trial with 32 children and teenagers explored whether Traditional Thai Massage could help improve walking in kids with spastic cerebral palsy (CP), a lifelong condition affecting muscle control and movement. Physical therapy is the usual treatment, but it takes significant time and trained staff — resources that are often scarce, especially in rural areas — so researchers tested whether a hands-on Thai bodywork technique, based on centuries-old pressure-and-stretch methods along the body's energy lines, could work as well. Each participant tried both treatments in turn: 30-minute Thai massage sessions twice a week for 6 weeks, and standard physical therapy sessions (stretching, strengthening, and walking practice) three times a week for 6 weeks, with a 6-week break in between so the effects of one treatment wouldn't carry over into the next. To measure results precisely, researchers used a 3D motion-capture system (the same kind of technology used in movie special effects) to score each child's walking pattern, plus muscle sensors, a treadmill breathing test, and a pressure-sensing walkway. The Thai massage group ended up with noticeably better walking scores than the physical therapy group — a meaningful improvement close to the threshold doctors consider clinically important — and their thigh muscles showed more activity during walking. Neither treatment beat the other on muscle stiffness, foot pressure, or how much oxygen the children used while walking. No one had any injuries or complications from either treatment, and families stuck with the program well, completing over 80% of sessions. This is an encouraging early sign that a low-cost, low-tech massage approach rooted in traditional Thai medicine might help children with cerebral palsy walk better — potentially as well as, or even slightly better than, standard physical therapy over the same timeframe. However, this was a small study, more than 1 in 5 participants didn't complete every follow-up visit, and the physical therapy given may have been too brief to show its best possible results. Bigger studies are needed before Thai massage could be recommended as a routine treatment.