Efficacy of different biomechanical strategies for modulating force-time parameters of high-velocity low-amplitude manipulation of the thoracic spine: a randomized crossover experimental study.

IF 2 4区医学 Q2 REHABILITATION

Chiropractic & Manual Therapies Pub Date : 2025-06-11 DOI:10.1186/s12998-025-00585-0

Grand Choi, Averie McGuinty, Nicole Meaghan Smith, Erinn McCreath Frangakis, David Starmer, Samuel J Howarth, Simon Wang

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引用次数: 0

Abstract

Background: Manual therapy, including high-velocity low-amplitude spinal manipulation (HVLA-SM), is a complex motor task performed by trained individuals. The ability to modulate the magnitude of applied forces is an attribute of proficiency that is challenging for providers and students. Adopting different biomechanical strategies may facilitate force modulation by practitioners performing HVLA-SM. This study evaluated the efficacy of different biomechanical strategies on force-time characteristics of prone thoracic HVLA-SM.

Methods: A randomized crossover experimental design was used. Data were collected between October 2022 and May 2023 from chiropractic students at the Canadian Memorial Chiropractic College who performed HVLA-SM targeted to the thoracic spine of a prone-lying manikin using as much force as possible in each of six different strategies. Strategies (S1 to S6) were specifically developed to successively increase a person's ability to produce force while performing HVLA-SM. Force-time parameters for the HVLA-SM trials were recorded. Peak force was the primary outcome of interest while preload force, load rate, and time to peak force were analyzed as secondary measures.

Results: Data were collected from 97 participants (51 female). Peak force increased successively from S1 to S5 with moderate effects (- 0.45 ≤ effect size ≤ -0.72). There was no statistical difference in either peak force or load rate between S5 and S6. Load rate also did not statistically increase between S3 and S4 where different muscle groups were targeted to produce force. The strategy with the highest peak force (S6) also demonstrated the lowest preload force.

Conclusions: Strategies used in this study effectively facilitated modulation of force-time characteristics of prone thoracic HVLA-SM. Thus, training approaches may consider introducing people to different biomechanical strategies to enhance HVLA-SM force modulation.

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不同生物力学策略调节胸椎高速低振幅操作力-时间参数的有效性：一项随机交叉实验研究。

背景：手工治疗，包括高速低幅度脊柱推拿（HVLA-SM），是一项复杂的运动任务，由训练有素的个体完成。调节施加力大小的能力是熟练程度的一个属性，这对提供者和学生来说是一个挑战。采用不同的生物力学策略可能有助于从业者进行hvlasm的力调节。本研究评估了不同生物力学策略对俯卧胸椎HVLA-SM的力-时间特征的影响。方法：采用随机交叉试验设计。数据收集于2022年10月至2023年5月期间，来自加拿大纪念脊医学院（Canadian Memorial chiropractic College）的脊医学生，他们在六种不同的策略中使用尽可能大的力量对俯卧假人的胸椎进行HVLA-SM。策略（S1至S6）是专门开发的，用于在执行hvlam - sm时依次提高一个人产生力量的能力。记录HVLA-SM试验的力-时间参数。峰值力是我们关注的主要结果，而预载荷力、负荷率和达到峰值力的时间作为次要指标进行分析。结果：收集了97名参与者（女性51名）的数据。峰值力从S1到S5依次增大，效果适中（- 0.45≤效应量≤-0.72）。S5和S6的峰值力和负荷率均无统计学差异。负荷率在S3和S4之间也没有统计学上的增加，其中不同的肌肉群被瞄准产生力。峰值力最高的策略（S6）也显示出最低的预紧力。结论：本研究中使用的策略有效地促进了俯卧胸椎HVLA-SM的力-时间特征的调节。因此，训练方法可以考虑引入不同的生物力学策略来增强hvlam - sm力调节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chiropractic & Manual Therapies Medicine-Complementary and Alternative Medicine

CiteScore

3.20

自引率

15.80%

发文量

审稿时长

20 weeks

期刊介绍： Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals. Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches. Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.