Methods: A search of the literature was conducted to identify the sources that reported quantification of the HVLA spinal thrust. MEDLINE-OVID (1966-present), MANTIS-OVID (1950-present), and CINAHL-EBSCO host (1981-present) were searched. Eligibility criteria included that thrust subjects were human, animal, or manikin and that the thrust type was a hand-delivered HVLA spinal thrust. Data recorded were single force, force-time, or displacement-time histories. Publications were in English language and after 1980. The relatively small number of studies, combined with the diversity of method and data interpretation, did not enable meta-analysis.
Results: Twenty-seven studies met eligibility criteria: 17 studies measured thrust as a primary outcome (13 human, 2 cadaver, and 2 porcine). Ten studies demonstrated changes in psychomotor learning related to quantified thrust data on human, manikin, or other device.
Conclusions: Quantifiable parameters of the HVLA spinal thrust exist and have been described. There remain a number of variables in recording that prevent a standardized kinematic description of HVLA spinal manipulative therapy. Despite differences in data between studies, a relationship between preload, peak force, and thrust duration was evident. Psychomotor learning outcomes were enhanced by the application of thrust data as an augmented feedback tool.
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