April 2024

Quantitative Evaluation of Manipulative Therapy Effects by Tissue Blood Flow and Muscle Stiffness Measurements

Authors: Rin Hirasawa 1, Mikie Nakabayashi 1, Yasuhiro Matsuda 2, Yumie Ono 3


  1. Electrical Engineering Program, Graduate School of Science and Technology, Meiji University
  2. Faculty of Medical Science, Nippon Sport Science University
  3. Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University

Journal: Advanced Biomedical Engineering - March 2024, Volume 13, Pages 66-72 (DOI: 10.14326/abe.13.66)

Manipulative therapy (MT) is a therapy in which a judo therapist manually rubs, presses, or taps the musculoskeletal system. MT is considered a cost-effective physical therapy that noninvasively promotes blood flow, relieves pain, and improves muscle flexibility. However, very few studies have evaluated the effectiveness of MT using objective measures in comparison with other medical fields; moreover, consistent results have not been obtained.

In this study, we evaluated the upper trapezius muscles of 36 young adults using diffuse correlation spectroscopy (DCS) and a digital palpation system (MyotonPRO) to examine the effects of MT on local blood flow and stiffness. DCS is a new tissue blood flow measurement technique that can measure dynamic local blood flow in deeper tissue noninvasively using near-infrared light. MyotonPRO is a commercially available digital palpation system that can quantitatively evaluate muscle stiffness.

A 5-min MT session significantly increased the blood flow by approximately 2-fold on the treated side, and the effects lasted 20 min. Additionally, muscle stiffness decreased on the treated side, while no change was observed on the untreated side, indicating the clinical benefits of MT in enhancing blood flow and promoting mobility. The results also demonstrated that the greater the initial stiffness of the patient’s muscle, the more effective MT was in reducing muscle stiffness. Although not statistically significant, a correlation trend was observed between the relative increase in blood flow and the decrease in stiffness of the treated muscle, suggesting a relationship between the effects of MT on blood flow and the relaxation of muscle tone.


Keywords: manipulative therapy, diffuse correlation spectroscopy, blood flow, muscle stiffness

In this study, MT was administered for 5 min on the right upper trapezius muscle. Blood flow and muscle stiffness were compared before MT and 20 min after the end of MT. The results showed that local tissue blood flow remained significantly increased for at least 20 minutes after MT, regardless of muscle stiffness. The results also suggest that MT has the potential to alleviate muscle tension, particularly for muscles with higher stiffness levels.