Acceleration of clinician hand movements during spinal manipulative therapy
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The primary objective of this study was to determine the acceleration characteristics of spinal manipulative therapy (SMT) and whether patient anthropometric parameters correlated with the SMT kinematic parameters. For this, a wireless tri-axial accelerometer was taped to the dorsum of a clinician’s hand to record the accelerations generated during clinical treatment of 95 symptomatic patients. Peak acceleration magnitudes differed significantly between spinal levels (p<0.0001; lumbar > cervical > thoracic = sacroiliac). The latencies of these peaks were also significantly different (p<0.0001; lumbar < cervical = thoracic < sacroiliac). Within a given spinal level, acceleration amplitudes varied over a wide range with temporal parameters remaining relatively constant. Overall, anthropometric parameters were poorly correlated with SMT parameters. In summary, distinct acceleration amplitudes were observed across spinal levels with relatively constant temporal factors. Thus, clinicians appear to vary the magnitude rather than the duration of the SMT thrust.