SPINAL MANIPULATION INCREASES MAXIMUM VOLUNTARY CONTRACTION AND CORTICAL DRIVE: A NARRATIVE REVIEW

Abstract

Purpose – This paper reviews the evidence on the effects of spinal manipulation on neuromuscular performance, focusing on maximum voluntary contraction (MVC) and cortical drive. The study aims to reframe spinal manipulation not only as a clinical intervention but also as a health innovation with implications for ergonomics, rehabilitation, and workforce health.

Design/Methodology/Approach – A narrative review methodology was applied. Peer-reviewed studies published between 2000 and 2024 were identified across biomedical, ergonomics, and innovation management databases. Clinical trials and experimental neurophysiology studies employing electromyography (EMG) and transcranial magnetic stimulation (TMS) were synthesized. Findings were further interpreted through innovation frameworks, including the Technology Acceptance Model and the Diffusion of Innovations, to assess adoption potential.

Findings – Evidence indicates that spinal manipulation enhances cortical drive, improves MVC, and facilitates neuroplastic adaptations in both healthy individuals and clinical populations. Ergonomic applications show reductions in musculoskeletal discomfort and improvements in concentration and productivity. Technology-enabled validation using EMG and TMS strengthens observability and credibility, while barriers include skepticism within conventional biomedical paradigms and regulatory fragmentation.

Originality/Value – This review uniquely integrates clinical neurophysiology with innovation management, positioning spinal manipulation as a technology-enabled healthcare innovation. It advances theoretical understanding of sensorimotor integration while highlighting managerial and policy implications. The study supports broader interdisciplinary collaboration in developing evidence-based, innovation-driven healthcare strategies.