Martha Funabashi1, François Nougarou2, Martin Descarreaux3, Narasimha Prasad4, Greg Kawchuk5. 1. Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada. 2. Département de Génie Électrique et Informatique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada. 3. Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada. 4. Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada. 5. Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada. Electronic address: Greg.kawchuk@ualberta.ca.
Abstract
OBJECTIVE: In order to define the relation between spinal manipulative therapy (SMT) input parameters and the distribution of load within spinal tissues, the aim of this study was to determine the influence of force magnitude and application site when SMT is applied to cadaveric spines. METHODS: In 10 porcine cadavers, a servo-controlled linear actuator motor provided a standardized SMT simulation using 3 different force magnitudes (100N, 300N, and 500N) to 2 different cutaneous locations: L3/L4 facet joint (FJ), and L4 transverse processes (TVP). Vertebral kinematics were tracked optically using indwelling bone pins, the motion segment removed and mounted in a parallel robot equipped with a 6-axis load cell. The kinematics of each SMT application were replicated robotically. Serial dissection of spinal structures was conducted to quantify loading characteristics of discrete spinal tissues. Forces experienced by the L3/L4 segment and spinal structures during SMT replication were recorded and analyzed. RESULTS: Spinal manipulative therapy force magnitude and application site parameters influenced spinal tissues loading. A significant main effect (P < .05) of force magnitude was observed on the loads experienced by the intact specimen and supra- and interspinous ligaments. The main effect of application site was also significant (P < .05), influencing the loading of the intact specimen and facet joints, capsules, and ligamentum flavum (P < .05). CONCLUSION: Spinal manipulative therapy input parameters of force magnitude and application site significantly influence the distribution of forces within spinal tissues. By controlling these SMT parameters, clinical outcomes may potentially be manipulated.
OBJECTIVE: In order to define the relation between spinal manipulative therapy (SMT) input parameters and the distribution of load within spinal tissues, the aim of this study was to determine the influence of force magnitude and application site when SMT is applied to cadaveric spines. METHODS: In 10 porcine cadavers, a servo-controlled linear actuator motor provided a standardized SMT simulation using 3 different force magnitudes (100N, 300N, and 500N) to 2 different cutaneous locations: L3/L4 facet joint (FJ), and L4 transverse processes (TVP). Vertebral kinematics were tracked optically using indwelling bone pins, the motion segment removed and mounted in a parallel robot equipped with a 6-axis load cell. The kinematics of each SMT application were replicated robotically. Serial dissection of spinal structures was conducted to quantify loading characteristics of discrete spinal tissues. Forces experienced by the L3/L4 segment and spinal structures during SMT replication were recorded and analyzed. RESULTS: Spinal manipulative therapy force magnitude and application site parameters influenced spinal tissues loading. A significant main effect (P < .05) of force magnitude was observed on the loads experienced by the intact specimen and supra- and interspinous ligaments. The main effect of application site was also significant (P < .05), influencing the loading of the intact specimen and facet joints, capsules, and ligamentum flavum (P < .05). CONCLUSION: Spinal manipulative therapy input parameters of force magnitude and application site significantly influence the distribution of forces within spinal tissues. By controlling these SMT parameters, clinical outcomes may potentially be manipulated.
Authors: Martha Funabashi; Alexander Cleveland Breen; Diana De Carvalho; Isabelle Pagé; François Nougarou; Martin Descarreaux; Gregory N Kawchuk Journal: Front Integr Neurosci Date: 2022-02-04
Authors: William R Reed; Michael A K Liebschner; Carla R Lima; Harshvardhan Singh; Christopher P Hurt; Daniel F Martins; James M Cox; Maruti R Gudavalli Journal: Chiropr Man Therap Date: 2022-09-06