Three-Dimensional Vertebral Motions Produced by Mechanical Force Spinal Manipulation
Received 30 August 2005
Abstract
Objective
The aim of this study was to quantify and compare the 3-dimensional intersegmental motion responses produced by 3 commonly used chiropractic adjusting instruments.
Methods
Six adolescent Merino sheep were examined at the Institute for Medical and Veterinary Science, Adelaide, Australia. In all animals, triaxial accelerometers were attached to intraosseous pins rigidly fixed to the L1 and L2 spinous processes under fluoroscopic guidance. Three handheld mechanical force chiropractic adjusting instruments (Chiropractic Adjusting Tool [CAT], Activator Adjusting Instrument IV [Activator IV], and the Impulse Adjusting Instrument [Impulse]) were used to randomly apply posteroanterior (PA) spinal manipulative thrusts to the spinous process of T12. Three force settings (low, medium, and high) and a fourth setting (Activator IV only) were applied in a randomized repeated measures design. Acceleration responses in adjacent segments (L1 and L2) were recorded at 5 kHz. The multiaxial intersegmental (L1-L2) acceleration and displacement response at each force setting was computed and compared among the 3 devices using a repeated measures analysis of variance (α = .05).
Results
For all devices, intersegmental motion responses were greatest for axial, followed by PA and medial-lateral (ML) measurement axes for the data examined. Displacements ranged from 0.11 mm (ML axis, Activator IV low setting) to 1.76 mm (PA axis, Impulse high setting). Compared with the mechanical (spring) adjusting instruments (CAT, Activator IV), the electromechanical Impulse produced the most linear increase in both force and intersegmental motion response and resulted in the greatest acceleration and displacement responses (high setting). Significantly larger magnitude intersegmental motion responses were observed for Activator IV vs CAT at the medium and high settings (P < .05). Significantly larger-magnitude PA intersegmental acceleration and displacement responses were consistently observed for Impulse compared with Activator IV and CAT for the high force setting (P < .05).
Conclusions
Larger-magnitude, 3D intersegmental displacement and acceleration responses were observed for spinal manipulative thrusts delivered with Impulse at most force settings and always at the high force setting. Our results indicate that the force-time characteristics of impulsive-type adjusting instruments significantly affects spinal motion and suggests that instruments can and should be tuned to provide optimal force delivery.
aDirector of Research, Musculoskeletal Research Foundation, Florida Orthopaedic Institute, Temple Terrace, Fla
bPresident, Neuro Mechanical Innovations, Master's Candidate, Department of Kinesiology, Biomechanics Laboratory, Exercise and Sport Science Research Institute, Arizona State University, Tempe, Ariz; Clinic Director, State of the Art Chiropractic Center, Phoenix, Ariz
cHead, The Adelaide Centre For Spinal Research, Institute of Medical and Veterinary Science, Adelaide, South Australia
dSenior Consultant, Department of Orthopaedic Surgery, Eeuwfeestkliniek Hospital, Antwerpen, Belgium
Submit requests for reprints to: Tony Keller, Professor and Chair, Department of Mechanical Engineering University of Vermont 19 Votey Building Burlington, VT 05405-0156.
Dr Tony Keller and Dr Chris Colloca developed the Impulse Adjusting Instrument. This work was funded in part by NeuroMechanical Innovations, Inc.
ABSTRACT