Quantifying the high-velocity, low-amplitude spinal manipulative thrust: a systematic review

J Manipulative Physiol Ther. 2010 Sep;33(7):542-53. doi: 10.1016/j.jmpt.2010.08.001.

Abstract

Objectives: The purpose of this study was to systematically review studies that quantify the high-velocity, low-amplitude (HVLA) spinal thrust, to qualitatively compare the apparatus used and the force-time profiles generated, and to critically appraise studies involving the quantification of thrust as an augmented feedback tool in psychomotor learning.

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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Biomechanical Phenomena
  • Electric Stimulation
  • Electromyography
  • Humans
  • Manipulation, Chiropractic / methods*
  • Manipulation, Spinal / methods
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiology*
  • Musculoskeletal Diseases / therapy*
  • Range of Motion, Articular
  • Sensory Thresholds / physiology*
  • Weight-Bearing / physiology*