Forces Exerted During Spinal Manipulative Therapy

Conway, Philip J.; Kawchuk, Greg; Zhang, Yuan-Ting; Hasler, E.M.

doi:10.1097/00007632-199307000-00014

Cited by 148 publications

(129 citation statements)

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14] More recently, those same tools are being used to augment the learning in chiropractic colleges in the United States and abroad, 11,[15][16][17][18][19][20][21][22][23][24] and in physical therapy programs as well. 25 Preload, peak loads, and speed have all been suggested as important performance factors.…”

Section: Introductionmentioning

confidence: 99%

Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Owens¹,

Russell²,

Hosek³

et al. 2017

Journal of Chiropractic Education

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Objective: To assess the force profiles of high-velocity low-amplitude thrusts delivered to a mannequin on a force platform by novice students given only verbal instructions. Methods: Student volunteers untrained in adjusting delivered a series of adjustments to a mannequin on a force platform. Participants performed 3 light, 3 normal, and 3 heavy thrusts on 5 listings specifying contact point, hand, and direction. Force profiles were analyzed for speed and amplitude, consistency, and force discrimination. Two recording sessions occurred 10 weeks apart. Results: Sixteen participants (11 females, 5 male) completed the study. Peak forces ranged from 880 to 202 N for heavy thrusts and 322-to 66 N for light thrusts. Thrust rate was from 8.1 to 1.8 Newtons per millisecond. Average coefficients of variability (CV ¼ STD/mean) at each load level (initial/final) were heavy: 17%/15%; normal: 16%/15%; and light: 20%/20%, with 0 as ideal. A force ratio measured students' abilities to distinguish thrust magnitude. The heavy/normal ratio (initial/final) was 1.35/1.39, and the light/normal ratio was 0.70/0.67. Conclusions: At this point, without force feedback being used in the classroom, novice students can produce thrusts that look like those of their teachers and of experienced practitioners, but they may not produce similar speed and force values. They are consistent within and between sessions and can discriminate between light and heavy loads. A natural next step in our educational research will be to measure adjustment factors on more experienced cohorts of students with and without the presence of force-feedback training apparatus.

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Section: Introductionmentioning

confidence: 99%

Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Owens¹,

Russell²,

Hosek³

et al. 2017

Journal of Chiropractic Education

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“…Although research directed towards understanding the mechanisms of SMT has increased dramatically, the most fundamental biomechanical aspects of this intervention are still poorly understood (Maigne & Guillon, 2000;Keller et al, 2003;Maigne & Guillon, 2000;Cramer et al, 2006;Herzog et al, 1993a). …”

Section: Introductionmentioning

confidence: 99%

“…During the manipulative procedure there is often a "cracking" sound signifying successful cavitation of the joint (Herzog et al, 1993a;Herzog et al, 1997;Ross et al, 2004;Pickar & Kang, 2006). Cavitation is theorized to be the result of the formation of vapor and gas bubbles within the synovial fluid upon quick separation of the joint.…”

Section: Introductionmentioning

confidence: 99%

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Acceleration of clinician hand movements during spinal manipulative therapy

Gelley¹,

Passmore

MacNeil

2015

Manual Therapy

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The primary objective of this study was to determine the acceleration characteristics of spinal manipulative therapy (SMT) and whether patient anthropometric parameters correlated with the SMT kinematic parameters. For this, a wireless tri-axial accelerometer was taped to the dorsum of a clinician's hand to record the accelerations generated during clinical treatment of 95 symptomatic patients. Peak acceleration magnitudes differed significantly between spinal levels (p<0.0001; lumbar > cervical > thoracic = sacroiliac). The latencies of these peaks were also significantly different (p<0.0001; lumbar < cervical = thoracic < sacroiliac). Within a given spinal level, acceleration amplitudes varied over a wide range with temporal parameters remaining relatively constant. Overall, anthropometric parameters were poorly correlated with SMT parameters. In summary, distinct acceleration amplitudes were observed across spinal levels with relatively constant temporal factors. Thus, clinicians appear to vary the magnitude rather than the duration of the SMT thrust.ii Acknowledgements

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“…2 However, most orthopedic tests that are used for spine related presentations [3][4][5] do not adequately assess functional, coupled end-range limitations that reflect the specific forces commonly associated with those that are delivered when a manual adjustment is performed. [6][7][8][9][10][11][12][13][14][15][16] Orthopedic and functional examination procedures are used widely yet there is little research that adequately investigates the reliability, sensitivity, and specificity of the majority of them. Doctors who use manual therapies as one of their primary interventions may additionally use a variety of specific technique protocols.…”

Section: Introductionmentioning

confidence: 99%