Michele J Maiers, Alexander R Sundin, Ryan J Oster, Steven Kreul, Quinn Malone, Steven R Passmore
{"title":"与年龄相关的背景因素决定了基于力的操作剂量：一项前瞻性横断面研究。","authors":"Michele J Maiers, Alexander R Sundin, Ryan J Oster, Steven Kreul, Quinn Malone, Steven R Passmore","doi":"10.1186/s12998-025-00584-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Contextual factors influence clinicians' delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT.</p><p><strong>Methods: </strong>Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological (\"healthy\" vs degenerative spine), and felt (perceived as \"young\" vs. \"old\") age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between \"young\" and \"old\" contextual factors of age, using a 3-way repeated measures ANOVA model.</p><p><strong>Results: </strong>Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34-64) years and 18.3 (SD = 10.8, range 5-39) years of experience. A main effect in peak force was found for both chronological (F(<sub>2,30</sub>) = 26.18; p <.001, η<sub>p</sub><sup>2</sup> = 0.636) and pathological age (F(<sub>1,15</sub>) = 11.58; p =.004, η<sub>p</sub><sup>2</sup> = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(<sub>2,20</sub>) = 9.50; p <.001, η<sub>p</sub><sup>2</sup> = 0.487) and peak velocity (F(<sub>2,20</sub>) = 7.20; p =.004, η<sub>p</sub><sup>2</sup> = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(<sub>1,10</sub>) = 12.23; p =.006, η<sub>p</sub><sup>2</sup> = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age.</p><p><strong>Conclusion: </strong>Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"20"},"PeriodicalIF":2.0000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093877/pdf/","citationCount":"0","resultStr":"{\"title\":\"Contextual factors related to aging determine force-based manipulation dosage: a prospective cross-sectional study.\",\"authors\":\"Michele J Maiers, Alexander R Sundin, Ryan J Oster, Steven Kreul, Quinn Malone, Steven R Passmore\",\"doi\":\"10.1186/s12998-025-00584-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Contextual factors influence clinicians' delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT.</p><p><strong>Methods: </strong>Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological (\\\"healthy\\\" vs degenerative spine), and felt (perceived as \\\"young\\\" vs. \\\"old\\\") age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between \\\"young\\\" and \\\"old\\\" contextual factors of age, using a 3-way repeated measures ANOVA model.</p><p><strong>Results: </strong>Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34-64) years and 18.3 (SD = 10.8, range 5-39) years of experience. A main effect in peak force was found for both chronological (F(<sub>2,30</sub>) = 26.18; p <.001, η<sub>p</sub><sup>2</sup> = 0.636) and pathological age (F(<sub>1,15</sub>) = 11.58; p =.004, η<sub>p</sub><sup>2</sup> = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(<sub>2,20</sub>) = 9.50; p <.001, η<sub>p</sub><sup>2</sup> = 0.487) and peak velocity (F(<sub>2,20</sub>) = 7.20; p =.004, η<sub>p</sub><sup>2</sup> = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(<sub>1,10</sub>) = 12.23; p =.006, η<sub>p</sub><sup>2</sup> = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age.</p><p><strong>Conclusion: </strong>Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.</p>\",\"PeriodicalId\":48572,\"journal\":{\"name\":\"Chiropractic & Manual Therapies\",\"volume\":\"33 1\",\"pages\":\"20\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093877/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chiropractic & Manual Therapies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12998-025-00584-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chiropractic & Manual Therapies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12998-025-00584-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
Contextual factors related to aging determine force-based manipulation dosage: a prospective cross-sectional study.
Background: Contextual factors influence clinicians' delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT.
Methods: Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological ("healthy" vs degenerative spine), and felt (perceived as "young" vs. "old") age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between "young" and "old" contextual factors of age, using a 3-way repeated measures ANOVA model.
Results: Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34-64) years and 18.3 (SD = 10.8, range 5-39) years of experience. A main effect in peak force was found for both chronological (F(2,30) = 26.18; p <.001, ηp2 = 0.636) and pathological age (F(1,15) = 11.58; p =.004, ηp2 = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(2,20) = 9.50; p <.001, ηp2 = 0.487) and peak velocity (F(2,20) = 7.20; p =.004, ηp2 = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(1,10) = 12.23; p =.006, ηp2 = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age.
Conclusion: Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.
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.
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