Award Date


Degree Type


Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy

Advisor 1

Louie Puentadura

First Committee Member

Merrill Landers

Second Committee Member

Robbin Hickman

Third Committee Member

Merrill Landers

Number of Pages



Background: Balance issues are prevalent in all ages of the population and can lead to many debilitating secondary impairments. There are various methods for treating balance problems, one of which is cervical spine manipulation (CSM). It seems to be biologically plausible that CSM would be an effective intervention, as it elicits effects in the same systems that are impaired in people with balance issues: vestibular, visual, and somatosensory.

Objective: The aim of this study is to investigate the immediate differences in balance and proprioception following a CSM in asymptomatic subjects.

Design: An experimental, cross-over study design was used

Methods: Thirty-four eligible asymptomatic volunteers (mean age 25.0 years old) with no current neck pain, neck pain within the past 6 months, balance disorders, or vertebral artery insufficiency participated. Participants came for testing 2 times; once for the sham procedure and once for the CSM procedure. The order in which the participant received their interventions was randomly assigned. Balance was assessed prior to and immediately following the CSM intervention and sham procedure using the SMART NeuroCom Balance Master™ Sensory Organization Test (SOT) and Laser Cervical Proprioceptive test (LCPT). Investigators conducting the tests were blinded to which intervention the participant had received.

Results: There was a statistically significant main effect of time for the LCPT scores in the overall sample (F(1,33)=4.780, p=0.036, Power=.565). There was also a statistically significant main effect of time for the vestibular component of the SOT (F(1,33)=5.333, p=0.027, Power=.611) and the main effect of intervention for the somatosensory component of SOT (F(1,33)=5.554, p=0.025, Power=.628). There was no significant difference between gross pre and post scores between test groups for the LCPT total error, (F(1,33)=1.221, p=.277, Power 0.189. No significant difference was found between composite SOT scores pre and post intervention (F(1,33)=0.205, p=0.654, Power 0.072 . For the individual components of balance no significant interaction was found: somatosensory, (F(1,33)=0.370, p=0.547 Power 0.091; vestibular, F(1,33)=0.126, p=0.725, Power 0.064; visual, F(1,33)=0.054, p=0.818, Power 0.056).


The main limitations in this study were the small sample size, ceiling effect with SOT testing, and unestablished reliability and validity of the LCPT.

Conclusions: It has been shown that it is biologically plausible for CSM to evoke changes in people with balance disorders based off of proposed mechanisms and established research. Although this research was unable to capture changes in balance and proprioception following CSM, it would benefit this body of literature to repeat the design with more sensitive and valid outcome measures.


Equilibrium (Physiology); Manipulation (Therapeutics); Spinal adjustment


Body Regions | Physical Therapy | Rehabilitation and Therapy

File Format


File Size

1.273 Kb

Degree Grantor

University of Nevada, Las Vegas




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