FORCES EXERTED DURING SPINAL MANIPULATIVE THERAPY

Spinal manipulative therapy has been widely recognized in the medical fields as a conservative treatment modality for spinal dysfunction and pain. Spinal manipulative therapy consists of an application of a thr usting force on a specific part of the spine in a well-defined directi on. The magnitude of this force has been associated with positive trea tment effects, such as realigning vertebral bodies, mobilizing spinal joints, relaxing back musculature through reflex pathways, and produci ng a respiratory burst. However, direct force measurements during spin al manipulative therapy in a clinically relevant situation have not be en performed to date. The purpose of this study was to measure the for ces exerted onto patients during spinal manipulative therapy on variou s locations of the spinal column. Force measurements were obtained usi ng a thin, flexible pressure mat. The results indicate that peak and p reload forces are considerably smaller for spinal manipulative therapy performed on the cervical spine compared to corresponding values obta ined on the thoracic spine and sacroiliac joint. Furthermore, for trea tments on the thoracic spine and sacroiliac joint, a significant relat ion was found to exist between preload and peak forces.