John Z Srbely

• DC PhD
• Associate Professor at University of Guelph

Ultrasonographic characteristics of skeletal muscles are related to their health status and functional capacity, but they still provide limited information on muscle composition during the inflammatory process. It has been demonstrated that an alteration in muscle composition or structure can have disparate effects on different ranges of ultrasonog...

Low back pain (LBP) is the leading cause of disability worldwide. Most LBP is non-specific or idiopathic, which is defined as symptoms of unknown origin without a clear specific cause or pathology. Current guidelines for clinical evaluation are based on ruling out underlying serious medical conditions, but not on addressing underlying potential con...

Introduction/Purpose Kinesiologists are well suited to work collaboratively or independently within the health system to improve patient/client care and well-being. This cross-sectional survey explored perceptions of the integration of registered kinesiologists (RKins) into the health system in Ontario. Methods RKins ( n = 202) and other health pr...

Background and Objective Low-back and neck pain affect a great number of individuals worldwide. The pressure pain threshold has the potential to be a useful quantitative measure of mechanical pain in a clinical setting, if it proves to be reliable in this population. The objectives of this systematic review are to: (1) analyze the literature evalua...

Background Myofascial Pain Syndrome (MPS) is a common pain disorder. Diagnostic criteria include physical findings which are often unreliable or not universally accepted. A precise biosignature may improve diagnosis and treatment effectiveness. The purpose of this study was to assess whether microanalytic assays significantly correlate with charact...

In the context of the electroacupuncture (EA) neurobiological mechanisms, we have previously demonstrated the involvement of formyl peptide receptor 2 (FPR2/ALX) in the antihyperalgesic effect of EA. The present study investigated the involvement of peripheral FPR2/ALX in the antihyperalgesic effect of EA on inflammatory cytokines levels, oxidative...

This study set out to examine ultrasonographic attributes of non-neurosegmentally (pectoral-forelimb) and neurosegmentally linked (hindlimb) myotomes in an experimental model that leads to neurogenic inflammation in segmentally linked myotomes, and to evaluate quantitative correlations among ultrasonographic attributes of the muscles, relative cont...

An amendment to this paper has been published and can be accessed via the original article.

The nociceptive withdrawal reflex (NWR) threshold is commonly employed in the lower limb to assess clinical and experimentally induced pain. However, no studies to date have investigated changes in spinal nociception in the upper limb, via the NWR threshold, following experimentally induced central sensitization (CS). We tested the hypothesis that...

A normal functioning lymphatic pump mechanism and unimpaired venous drainage are required for the body to remove inflammatory mediators from the extracellular compartment. Impaired vascular perfusion and/or lymphatic drainage may result in the accumulation of inflammatory substances in the interstitium, creating continuous nociceptor activation and...

BACKGROUND The pathophysiology of chronic musculoskeletal pain is linked to the neurophysiologic condition known as central sensitization. Developing reliable, sensitive and clinically feasible techniques for quantifying central sensitization is a timely priority for advancing the field of chronic pain diagnosis and management. OBJECTIVE To compar...

Naturally occurring spine osteoarthritis is clinically associated with the manifestation of chronic inflammatory muscle (myofascial) disease. The purpose of this study was to investigate the causal association between experimentally induced spine osteoarthritis and neurogenic inflammatory responses within neurosegmentally linked myotomes. Wistar Ky...

Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit...

Corso, M, Liang, L, Tran, S, Howitt, S, Srbely, J, and Mior, SA. The immediate effect of spinal manipulation on ball velocity and neuromuscular function during an instep kick in former Varsity soccer players: a feasibility study. J Strength Cond Res XX(X): 000-000, 2020-Spinal manipulation (SM) has been shown to increase ball velocity (BV) in socce...

Augmented expression of substance P (SP) in the cartilaginous tissue has been shown to promote degenerative changes in the cartilaginous matrix of distal contralateral articular joints via neurogenic inflammation post-monoarthritis-induction contributing to the symmetrical spread of osteoarthritis (OA). However, no studies have explored whether sim...

Substance P (SP) is enhanced in myotomes in a clinical population with myofascial pain syndrome. However, measurements of SP are invasive presenting difficulties when studying human populations. In comparison, quantitative b-mode ultrasound imaging is a noninvasive imaging technique that has been used to detect differences in muscle texture between...

There is currently confusion surrounding the phenotype of and diagnostic criteria for myofascial pain syndrome (MPS) in the published literature. This narrative literature review investigated whether there is consensus regarding the descriptive terminology used for MPS and the trend of MPS publications over time. The phrase “myofascial pain syndrom...

Introduction: Topical capsaicin is commonly employed to experimentally induce central sensitization (CS) in humans. While previous studies have investigated the effect of skin pre-heating on the sensitizing effect of capsaicin, no studies have compared the synergistic effect of skin pre-heating on the magnitude of sensitization via topical capsaic...

Introduction: The effectiveness of spinal manipulative therapy (SMT) for improving athletic performance in healthy athletes is unclear. Assessing the effect of SMT on other performance outcomes in asymptomatic populations may provide insight into the management of athletes where direct evidence may not be available. Our objective was to systematic...

Objective: This study aimed to investigate the association between naturally occurring spinal osteoarthritis (OA) (L3-L5), the expression of substance P (SP) centrally (L4-L5) and the presence of neurogenic inflammation within the neurosegmentally linked quadriceps (L2-L5) in elderly rats versus young controls. Design: Eight aged (27 ± 3.2 months)...

Chronic myofascial pain (MPS) is the most common form of chronic musculoskeletal pain, however, the pathophysiology is poorly understood 1. The Neurogenic Hypothesis proposes that MPS may be the clinical expression of intramuscular neurogenic inflammation arising from central sensitization induced by a primary pathology residing within the common n...

Objective Consistent terminology to describe the diagnostic criteria for fibromyalgia (FM) and myofascial pain syndrome (MPS) is required to address the reported inadequacies in diagnosis. The present review investigated intervention studies in FM and MPS populations to determine the lexicon of the current diagnostic criteria used to identify chron...

Introduction/Background Myofascial trigger points (MTrPs) are common in soft tissue musculoskeletal pain conditions. It is believed that MTrPs are local contractures within the extrafusal fibers of skeletal muscles. Further characterizing muscle pathophysiology is desirable to design effective treatments. This study was designed to measure muscle f...

Two prominent forms of chronic musculoskeletal pain disorders are fibromyalgia (FM) and myofascial pain syndrome (MPS). Inconsistent diagnosis of chronic musculoskeletal pain is an important clinical issue, as MPS is often mistaken for FM. Distinction between the two diagnoses depends largely on identification of either tender points or myofascial...

Patients with lumbar facet joint injury have been shown to develop maladaptive responses within the central nervous system, including neuropathic and central sensitization. Central sensitization is characterized as an amplification of neural signaling within the central nervous system that elicits sensory changes such as mechanical allodynia as we...

Bone pain is a leading cause of disability and reduced quality of life in the elderly. While previous research has identified peripheral neuroadaptations associated with osteoporosis, no study has investigated how these peripheral modifications may impact central neural processing. The purpose of this study is to investigate the relationship betwee...

Objective: The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therap...

Background Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. Methods We conduc...

Our research group recently published a Delphi study that identified Canadian chiropractic profession research priority areas. At the same time, the Canadian Chiropractic Research Foundation (CCRF) was developing their own research priority areas. In this commentary, we discuss the results of the Delphi study, compare and contrast these results to...

Objective: In 2010, Wolfe et al. demonstrated poor physician use of the 1990 fibromyalgia diagnostic criteria and proposed the 2010 criteria to address physician shortcomings. No follow-up studies have investigated whether physicians are using these criteria. The purpose of this study was to provide seminal data on physician knowledge and use of t...

Objectives: The goal of this study was to assess agreement on signs and symptoms of myofascial pain for chiropractors, physicians, and registered massage therapists. Methods: 337 healthcare practitioners participated in the survey. The questionnaire probed clinician agreement with the chosen signs and symptoms using a seven-point agreement scale...

Introduction: The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population. Methods: 1013 first year Canadian university students completed the Modified Zung Depression Index, the Modified Somatic Perception Questionnaire, and a survey about low back pain frequency and in...

Context: Females suffer 4-6 times more non-contact anterior cruciate ligament (ACL) injuries than males due to neuromuscular control deficits of the hip musculature leading to increases in hip adduction angle, knee abduction angle, and knee abduction moment during dynamic tasks such as single-leg squats. Lateral trunk displacement has been further...

Objective: Central sensitization has been associated with the pathophysiology of somatoautonomic responses however, the causal role of central sensitization in the clinical manifestation of somatoautonomic responses has not previously been demonstrated in humans. The purpose of this study was to test the hypothesis that a temporal relationship exis...

Optimal delivery of health care service requires evidence-based practice by the professionals within their respective fields. Kinesiology recently became a regulated health profession in the Province of Ontario, drawing on principles of movement science in related areas of human clinical and performance disciplines to appropriately guide practice....

Background: Pressure algometry is a commonly employed technique in the assessment of both regional and widespread musculoskeletal pain. Despite its acceptance amongst clinicians and scientists, the relationship between rate of pressure application (RoA) and pain pressure threshold (PPT) remains poorly understood. We set out to test the hypothesis...

Objective: To investigate the expression of the major player in neurogenic inflammation, Substance P, in neurosegmentally linked knee joints in rats exposed to experimentally induced spinal facet joint compression injury at L5-L6.

Objective: The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders (NADs) and whiplash-associated disorders (WADs). This guideline replaces 2 prior chiropractic guidelines on NADs and WADs. Methods: Pertinent systematic reviews on 6 topic areas (education, multimodal care, exercise, work dis...

Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain encountered by primary healthcare practitioners on a daily basis. It is generally accepted amongst the broad profile of healthcare practitioners treating MPS that the presence of discrete, palpable and tender nodules within the muscle, known as myofa...

Objective: To investigate the summative effect of two consecutive spinal manipulative therapy (SMT) interventions within the same session on the pain pressure sensitivity of neurosegmentally linked myofascial tissues. Methods: 26 participants were recruited and assessed for the presence of a clinically identifiable myofascial trigger point in th...

Background: Two of the most common Quantitative Sensory Techniques (QST) employed to detect allodynia include mechanical brush allodynia and Semmes-Weinstein monofilaments. However, their relative sensitivity at detecting allodynia is poorly understood. The purpose of this study was to compare the sensitivity of brush allodynia against Semmes-Wein...

Evidence has shown that that upper limb muscles peripheral to the cervical spine, such as the biceps brachii, can demonstrate functional deficits in the presence of chronic neck pain. However, few studies have examined how neck pain can affect the fatigability of upper limb muscles; therefore we were motivated to investigate the effects of acutely...

Experimental pain is known to affect neuroplasticity of the motor cortex as well as motor performance, but less is known about neuroplasticity of somatosensory processing in the presence of pain. Early somatosensory evoked potentials (SEPs) provide a mechanism for investigating alterations in sensory processing and sensorimotor integration (SMI)....

The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults. A total of 36 participants (19 men, 17 women; age, 28.0 [5.3] years; body mass index, 26.5...

Myofascial pain syndrome presents a significant physical and financial burden to society. In view of the aging demographics, myofascial pain promises to be an even greater challenge to health care in the future. Myofascial trigger points have been identified as important anatomic and physiologic phenomena in the pathophysiology of myofascial pain....

To test the hypothesis that dry needle stimulation of a myofascial trigger point (sensitive locus) evokes segmental anti-nociceptive effects. Double-blind randomized controlled trial. Forty subjects (21 males, 19 females). Test subjects received intramuscular dry needle puncture to a right supraspinatus trigger point (C4,5); controls received sham...

Objective: To test the hypothesis that dry needle stimulation of a myofascial trigger point (sensitive locus) evokes segmen-tal anti-nociceptive effects. Design: Double-blind randomized controlled trial. Subjects: Forty subjects (21 males, 19 females). Methods: Test subjects received intramuscular dry needle puncture to a right supraspinatus trigge...

Unlabelled: This study investigated whether inducing central sensitization evokes segmental increases in trigger point pressure sensitivity. We evoked central sensitization at the C(5) segment and validated its presence via mechanical cutaneous sensitivity (brush allodynia) testing. Trigger point pressure sensitivity was quantified using the pain...

Musculoskeletal pain affects a significant proportion of the general population. The myofascial trigger point is recognized as a key factor in the pathophysiology of musculoskeletal pain. Ultrasound is commonly employed in the treatment and management of soft tissue pain and, in this study, we set out to investigate the segmental antinociceptive ef...

Ultrasound has been widely used in clinical settings for the management of various ailments but many authors still question its efficacy. An accumulating body of literature demonstrates that ultrasound evokes a broad spectrum of bioeffects which may be therapeutically beneficial in the management of a variety of clinical conditions. A critical revi...

Objective : To investigate whether therapeutic ultrasound modulates the pain sensitivity of myofascial trigger points. Design : Repeated measures, single-blinded randomized controlled trial of ultrasound treatment of trigger points. Setting : Outpatient injury rehabilitation clinic. Subjects : Forty-four patients (22 males, 22 females) with trigger...