Index to Chiropractic Literature
Index to Chiropractic Literature
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Sunday, September 26, 2021
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ID 24823
  Title Procedure selection and patient positioning influence spine kinematics during high-velocity, low-amplitude spinal manipulation applied to the low back
URL https://www.ncbi.nlm.nih.gov/pubmed/28196632
Journal J Manipulative Physiol Ther. 2017 Mar-Apr;40(3):147-155
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes

Objectives: This investigation compared indirect 3-dimensional angular kinematics (position, velocity, and acceleration) of the lumbar spine for 2 different high-velocity, low-amplitude (HVLA) spinal manipulation procedures (lumbar spinous pull or push), and altered initial patient lower limb posture.

Methods: Twenty-four participants underwent 6 HVLA procedures directed toward the presumed L4 vertebra, reflecting each combination of 2 variants of a spinal manipulation application technique (spinous pull and push) and 3 initial hip flexion angles (0°, 45°, and 90°) applied using a right lateral recumbent patient position. All contact forces and moments between the patient and the external environment, as well as 3-dimensional kinematics of the patient’s pelvis and thorax, were recorded. Lumbar spine angular positions, velocities, and accelerations were analyzed within the preload and impulse stages of each HVLA trial.

Results: Lumbar spine left axial rotation was greater for the pull HVLA. The pull HVLA also generated a greater maximum (leftward) and lower minimum (rightward) axial rotation velocity and deceleration and greater leftward and rightward lateral bend velocities, acceleration, and deceleration components. Not flexing the hip produced the greatest amount of extension, as well as the lowest axial rotation and maximum axial rotation acceleration during the impulse.

Conclusions: This investigation provides basic kinematic information for clinicians to understand the similarities and differences between 2 HVLA side-lying manipulations in the lumbar spine. Use of these findings and novel technology can drive future research initiatives that can both affect clinical decision making and influence teaching environments surrounding spinal manipulative therapy skill acquisition.

Author keywords: Musculoskeletal Manipulations, Lumbar Region, Biomechanical Phenomena, Low Back Pain, Chiropractic

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link and select a publisher from PubMed's LinkOut feature.


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