CCA Young Investigator Award
nisms are foundational to the effects of spinal manipula-
tion, I also have a keen interest to concurrently explore
the neurophysiological (somato- somatic, somato-viscer-
al) effects of spinal manipulation and its role in the man-
agement of myofascial pain syndromes”.
Dr. Srbely is currently finishing data collection for his
first study which he presented at the CCCRC Chiroprac-
tic Research Symposium in Montreal in September 2004.
In addition, he and Dr. Dickey are in the midst of collabo-
rating with other labs on the next phase of these studies,
which will investigate these neurophysiological effects in
greater detail via direct nerve fiber recordings.
The Canadian Chiropractic Association Research
Committee met in Vancouver recently and reviewed all of
the abstracts submitted to the Research Symposium that
were eligible for the Young Investigator Award and unan-
imously decided on Dr. John Srbely.
This particular award is given to exceptional chiroprac-
tors to recognize the increasing role that young research-
ers play in the Canadian chiropractic researcher culture.
Dr. John Z Srbely, BSc, DC, DAc, PhD(student) The Goals of this Award are:
1. to recognize outstanding research on chiropractic topics
2. to attract chiropractors and other scientists to study
chiropractic research topics
3. to advance the discipline of chiropractic
Dr. John Srbely is in his 13th year of chiropractic practice
in Toronto following graduation from CMCC in 1992. In The award is given for original non-published research
September of 2003, he began post-graduate studies in and provides a plaque and $1000 prize. The Award is
Neurophysiology and Biophysics under the guidance of generally presented at the annual meeting of The CCA.
Dr. Jim Dickey PhD at the University of Guelph and is
currently enrolled in a PhD programme. Congratulations to Dr. Srbely!
His broad interest lies in pain mechanisms with a spe-
cific interest in the neurophysiology of myofascial pain
and trigger points. In addition, “as these neural mecha-
74 J Can Chiropr Assoc 2005; 49(2)
CCA Young Investigator Award
Stimulation of myofascial trigger points causes systematic physiological effects
John Srbely, James P. Dickey Pressure sensitivity changes at infraspinatus
trigger point site after stimulation of ispsilateral
Address supraspinatus trigger point
University of Guelph, Guelph, Ontario, Canada. 2
PPT Ratio to Baseline
Myofascial trigger points (TrP) are discrete palpable hy- 1.6
perirritable loci within taut bands of skeletal muscle; pres-
sure application elicits a referral sensation/paresthesiae.1 1.4
There is growing body of evidence suggesting that a sub-
stantial proportion of common adult musculoskeletal pain
syndromes are manifestations of myofascial trigger point 1
activity.2 The possible role of neuroadaptive processes
such as long-term potentiation/central sensitization, and 0.8
potential management via modalities such as spinal ma- 0 5 10 15
nipulative therapy,3 is of special interest to the authors. Figure 1: representative data of the PPT ratio versus time
This study will explore the neurophysiological interac- for one pilot subject.
tions of the trigger point complex by evaluating whether
stimulation of one TrP site can influence the pain sensitiv-
ity at another trigger point site innervated by the same neu- Conclusion
rological segment(s). Preliminary results suggest that systematic physiological
effects on a trigger point complex may be induced by
Methods stimulation of other trigger point sites specifically inner-
The study involves stimulation of a trigger point locus vated by the same neurological level(s). This data may
within the supraspinatus muscle (via intramuscular dry suggest two distinct processes at play in the neuromodu-
needling). The supraspinatus TrP will be confirmed by lation effect: an early segmental effect which gives way
the presence of a visible local twitch response within the to subsequent supraspinal/non-segmental effects.
muscle, evoked during needle penetration. Raw pain-
pressure threshold values (PPT) will be recorded from a Funding
trigger point site within the ipsilateral infraspinatus mus- This project was funded by NSERC.
cle at selected time intervals of 1, 2, 5 and 15 minutes. A
baseline (pre-needling) reading will be recorded and the References
absolute PPT readings at each time interval (1–15 min) 1 Simons DG. Postgrad Med 1983; 73(2):66, 68–70, 73.
represented as a ratio of this baseline value. 2 Simons DG. J Electromyography and Kinesiology 2004;
3 Boal RW. J Manipulative and Physiol Ther 2004;
Figure 1 illustrates representative data for one of the pilot
subjects in our study. PPT readings in the infraspinatus
sharply increase (i.e. decreased trigger point sensitivity)
for the first two minutes post-needling. At the 2 minute
mark, the PPT values tend to stabilize. Interestingly, the
PPT values once again demonstrate a gradual, distinct
rise between the 5 to 15 minute period, suggestive of a
further decline in sensitivity at the infraspinatus site.
J Can Chiropr Assoc 2005; 49(2) 75