***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Speed performance during gait initiation is known to be dependent on the capacity of the central nervous system to generate efficient anticipatory postural adjustments ( APA ) . According to the posturo-kinetic capacity ( PKC ) concept , any factor enhancing postural chain mobility and especially spine mobility , may facilitate the development of APA and thus speed performance . “ Spinal Manipulative Therapy High-Velocity , Low-Amplitude ” ( SMT-HVLA ) is a healing technique applied to the spine which is routinely used by healthcare practitioners to improve spine mobility . As such , it may have a positive effect on the PKC and therefore facilitate gait initiation . The present study aim ed to investigate the short-term effect of thoracic SMT-HVLA on spine mobility , APA and speed performance during gait initiation . Healthy young adults ( n = 22 ) performed a series of gait initiation trials on a force plate before ( “ pre-manipulation ” condition ) and after ( “ post-manipulation ” condition ) a sham manipulation or an HVLA manipulation applied to the ninth thoracic vertebrae ( T9 ) . Participants were r and omly assigned to the sham ( n = 11 ) or the HVLA group ( n = 11).The  spine range of motion ( ROM ) was assessed in each participant immediately after the sham or HVLA manipulations using inclinometers . The results showed that the maximal thoracic flexion increased in the HVLA group after the manipulation , which was not the case in the sham group . In the HVLA group , results further showed that each of the following gait initiation variables reached a significantly lower mean value in the post-manipulation condition as compared to the pre-manipulation condition : APA duration , peak of anticipatory backward center of pressure displacement , center of gravity velocity at foot-off , mechanical efficiency of APA , peak of center of gravity velocity and step length . In contrast , for the sham group , results showed that none of the gait initiation variables significantly differed between the pre- and post-manipulation conditions . It is concluded that HVLA manipulation applied to T9 has an immediate beneficial effect on spine mobility but a detrimental effect on APA development and speed performance during gait initiation . We suggest that a neural effect induced by SMT-HVLA , possibly mediated by a transient alteration in the early sensory-motor integration , might have masked the potential mechanical benefits associated with increased spine mobility STUDY DESIGN R and omized , blinded , controlled crossover trial . OBJECTIVE To determine if thrust joint manipulation ( TJM ) to the lumbar spine would result in changes to the resting and contraction thickness of transversus abdominis ( TrA ) in healthy individuals . BACKGROUND Recent studies have demonstrated an immediate decrease in resting thickness and an increase in contraction thickness in TrA following lumbar TJM in patients with low back pain ( LBP ) who met a clinical prediction rule ( CPR ) for spinal manipulation . This observed phenomenon has not been investigated in healthy individuals . METHODS Thirty-five healthy participants were r and omly assigned to receive a TJM or sham manipulation treatment . All participants received instruction on how to produce an isolated concentric contraction of the TrA that involved visual ultrasound imaging biofeedback . Data were analyzed using ultrasound imaging to measure changes in thickness of the TrA at rest and during contraction , following the administration of each treatment . RESULTS There were no interactions observed between treatment and time for TrA muscle thickness at rest ( P = .351 ) and during the contracted state ( P = .761 ) . CONCLUSION Our results indicate that TJM to the lumbar spine does not appear to affect the resting or contraction thickness of TrA in healthy individuals . These findings are in contrast to previous research in which patients with LBP who met a CPR demonstrated an immediate decrease in resting thickness and an increase in contraction thickness in TrA following lumbar TJM Purpose The primary purpose of this study was to investigate whether a single session of spinal manipulation ( SM ) increases strength and cortical drive in the lower limb ( soleus muscle ) of elite Taekwondo athletes . Methods Soleus-evoked V-waves , H-reflex and maximum voluntary contraction ( MVC ) of the plantar flexors were recorded from 11 elite Taekwondo athletes using a r and omized controlled crossover design . Interventions were either SM or passive movement control . Outcomes were assessed at pre-intervention and at three post-intervention time periods ( immediate post , post 30 min and post 60 min ) . A multifactorial repeated measures ANOVA was conducted to assess within and between group differences . Time and session were used as factors . A post hoc analysis was carried out , when an interactive effect was present . Significance was set at p ≤ 0.05 . Results SM increased MVC force [ F(3,30 ) = 5.95 , p < 0.01 ] , and V-waves [ F(3,30 ) = 4.25 , p = 0.01 ] over time compared to the control intervention . Between group differences were significant for all time periods ( p < 0.05 ) except for the post60 force measurements ( p = 0.07 ) . Conclusion A single session of SM  increased muscle strength and corticospinal excitability to ankle plantar flexor muscles in elite Taekwondo athletes . The increased MVC force lasted for 30 min and the corticospinal excitability increase persisted for at least 60 min We describe a framework for defining  pilot and feasibility studies  focusing on studies conducted in preparation for a r and omised controlled trial . To develop the framework , we undertook a Delphi survey ; ran an open meeting at a trial methodology conference ; conducted a review of definitions outside the health research context ; consulted experts at an international consensus meeting ; and review ed 27 empirical pilot or feasibility studies . We initially adopted mutually exclusive definitions of pilot and feasibility studies . However , some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions . Their viewpoint was supported by definitions outside the health research context , the use of the terms ‘ pilot ’ and ‘ feasibility ’ in the literature , and participants at the international consensus meeting . In our framework , pilot studies are a subset of feasibility studies , rather than the two being mutually exclusive . A feasibility study asks whether something can be done , should we proceed with it , and if so , how . A pilot study asks the same questions but also has a specific design feature : in a pilot study a future study , or part of a future study , is conducted on a smaller scale . We suggest that to facilitate their identification , these studies should be clearly identified using the terms ‘ feasibility ’ or ‘ pilot ’ as appropriate . This should include feasibility studies that are largely qualitative ; we found these difficult to identify in electronic search es because research ers rarely used the term ‘ feasibility ’ in the title or abstract of such studies . Investigators should also report appropriate objectives and methods related to feasibility ; and give clear confirmation that their study is in preparation for a future r and omised controlled trial design ed to assess the effect of an intervention OBJECTIVE The purpose of this study was to measure the impact of midlumbar spinal manipulation on asymptomatic cyclist sprint performance and hip flexibility . METHODS Twelve cyclists were equally r and omized into an AB : BA crossover study design after baseline testing . Six participants were in the AB group , and 6 were in the BA group . The study involved 1 week of rest in between each of the 3 tested conditions : baseline testing ( no intervention prior to testing ) , condition A ( bilateral midlumbar spine manipulation prior to testing ) , and condition B ( sham acupuncture prior to testing , as a control ) . Testing was blinded and involved a sit- and -reach test followed by a 0.5-km cycle ergometer sprint test against 4-kp resistance . Outcome measures were sit- and -reach distance , time to complete 0.5 km , maximum heart rate , and rating of perceived exertion . An additional 8 cyclists were recruited and used as a second set of controls that engaged in 3 testing sessions without any intervention to track test acclimation . An analysis of variance was used to compare dependent variables under each of the 3 conditions for the experimental group and control group # 1 , and a repeated- measures analysis of variance was used to analyze test acclimation in control group # 2 . RESULTS Lumbar spine manipulation did not demonstrate statistically significant between-group changes in sit- and -reach ( P = .765 ) , 0.5-km sprint performance time ( P = .877 ) , maximum exercise heart rate ( P = .944 ) , or rating of perceived exertion ( P = .875 ) . CONCLUSIONS The findings of this preliminary study showed that midlumbar spinal manipulation did not improve hip flexibility or cyclist power output of asymptomatic participants compared with an acupuncture sham and no-treatment control groups OBJECTIVE The objective of this study was to perform an investigation evaluating if cervical spinal manipulative therapy ( SMT ) can increase grip strength on judo athletes in a top 10 national-ranked team . METHODS A single-blinded , prospect i ve , comparative , pilot , r and omized , clinical trial was performed with 18 athletes of both sexes from a judo team currently competing on a national level . The athletes were r and omly assigned to 2 groups : chiropractic SMT and sham . Three interventions were performed on each of the athletes at different time points . Force measurements were obtained by a hydraulic dynamometer immediately before and after each intervention at the same period before training up to 3 weeks with at least 36 hours between interventions . RESULTS Analysis of grip strength data revealed a statistically significant increase in strength within the treatment group after the first intervention ( 6.95 % right , 12.61 % left ) as compared with the second ( 11.53 % right , 17.02 % left ) and the third interventions ( 10.53 % right , 16.81 % left ) . No statistically significant differences were found in grip strength comparison within the sham group . Overall differences in strength were consistently significant between the study groups ( P = .0025 ) . CONCLUSION The present study suggests that the grip strength of national level judo athletes receiving chiropractic SMT improved compared to those receiving sham Background The most utilized soccer kicking method is the instep kicking technique . Decreased motion in spinal joint segments results in adverse biomechanical changes within in the kinematic chain . These changes may be linked to a negative impact on soccer performance . This study tested the immediate effect of lumbar spine and sacroiliac manipulation alone and in combination on the kicking speed of uninjured soccer players . Methods This 2010 prospect i ve , pre-post experimental , single-blinded ( subject ) required forty asymptomatic soccer players , from regional premier league teams , who were purposively allocated to one of four groups ( based on the evaluation of the players by two blinded motion palpators ) . Segment dysfunction was either localized to the lumbar spine ( Group 1 ) , sacroiliac joint ( Group 2 ) , the lumbar spine and sacroiliac joint ( Group 3 ) or not present in the sham laser group ( Group 4 ) . All players underwent a st and ardized warm-up before the pre- measurements . Manipulative intervention followed after which post- measurements were completed . Measurement outcomes included range of motion changes ( digital inclinometer ) ; kicking speed ( Speed Trac ™ Speed Sport Radar ) and the subjects ’ perception of a change in kicking speed . SPSS version 15.0 was used to analyse the data , with repeated measures ANOVA and a p-value < 0.05 ( CI 95 % ) . Results Lumbar spine manipulation result ed in significant range of motion increases in left and right rotation . Sacroiliac manipulation result ed in no significant changes in the lumbar range of motion . Combination manipulative interventions result ed in significant range of motion increases in lumbar extension , right rotation and right SI joint flexion . There was a significant increase in kicking speed post intervention for all three manipulative intervention groups ( when compared to sham ) . A significant correlation was seen between Likert based-scale subjects ’ perception of change in kicking speed post intervention and the objective results obtained . Conclusions This pilot study showed that lumbar spine manipulation combined with SI joint manipulation , result ed in an effective intervention for short-term increases in kicking speed/performance . However , the lack of an a priori analysis , a larger sample size and an unblinded outcome measures assessor requires that this study be repeated , addressing these concerns and for these outcomes to be vali date OBJECTIVE The purpose of this study was to examine the immediate effects of spinal manipulative therapy ( SMT ) on trunk proprioception in subjects with asymptomatic chronic low back pain ( CLBP ) and determine if those effects lasted 1 week . METHODS This unbalanced r and omized controlled crossover design examined 33 subjects with CLBP .  Proprioception was tested via joint position sense , threshold to detect passive motion ( TTDPM ) , direction of motion ( DM ) , and force reproduction . Each subject received lumbar manipulation or a sham procedure followed by proprioception retest . This procedure was repeated 1 week later using the opposing treatment . Subjects receiving SMT in the second session returned a third time receiving the sham procedure again . RESULTS Spinal manipulative therapy produced an effect for TTDPM in the manipulation first group ( P = .008 ) , the sham procedure produced an effect for joint position sense in the sham first group ( P = .005 ) . Spinal manipulative therapy had a 1-week effect for the manipulation first group ( P = .006 ) . No effect was noted for either DM or force reproduction . CONCLUSIONS Results suggest SMT had minimal immediate effect on trunk proprioception . The effects noted occurred in session 1 , implicating learning as a potential source . Learning , from repetitive proprioception training , may enhance neuromuscular control in subjects with CLBP before the use of therapeutic exercise . Subjects showed smaller deficits than previously reported for TTDPM or DM , suggesting proprioception deficits may correlate with pain level OBJECTIVE This study investigates the effect of chiropractic treatment on  hip joint extension ability 
    Output:
    
Sport-specific studies show no effect of SMT except for a small increase in basketball free-throw accuracy .
Conclusion The preponderance of evidence suggests that SMT in comparison to sham or other interventions does not enhance performance-based outcomes in asymptomatic adult population .
In the few studies suggesting a positive immediate effect , the importance of such change is uncertain .