Establishing force and speed training targets for lumbar spine high-velocity, low-amplitude chiropractic adjustments*

Owens, Edward F.; Hosek, Ronald S.; Sullivan, Stephanie; Russell, Brent S.; Mullin, Linda; Dever, Lydia L.

doi:10.7899/jce-15-5

Cited by 14 publications

(9 citation statements)

References 21 publications

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“…The values we found ranging between 15% and 20% are higher than we found in a secondary analysis of faculty thrusts from our previous study, 29 in which faculty members' heavy thrusts had CVs of only 12%, 13% for normal thrusts, and 16% for light thrusts. The student values are inflated by a few individuals having CVs in the range of 30%-60%, while no faculty members had values above 25%.…”

Section: Discussioncontrasting

confidence: 89%

“…Faculty can clearly control their force application when asked to provide light or heavy thrusts. 29 They can control direction of thrust, demonstrating clear medial-to-lateral vectors for single-hand prone lumbar thrusts. 30 For this current study, we used the same equipment as the 2 previous studies to assess the abilities of students at baseline, that is, under the current educational scheme.…”

Section: Introductionmentioning

confidence: 97%

“…We carried out 2 previous studies assessing faculty performance of HVLA adjustments on a mannequin as a way to develop training targets for student achievement. 29,30 The conclusions from 2 previous studies were that faculty provide a wide range of adjustment loads, but there is a generally consistent thrust rate of over 3 Newtons per millisecond (N/ms). Faculty can clearly control their force application when asked to provide light or heavy thrusts.…”

Section: Introductionmentioning

confidence: 99%

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Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Owens¹,

Russell²,

Hosek³

et al. 2017

Journal of Chiropractic Education

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Objective: To assess the force profiles of high-velocity low-amplitude thrusts delivered to a mannequin on a force platform by novice students given only verbal instructions. Methods: Student volunteers untrained in adjusting delivered a series of adjustments to a mannequin on a force platform. Participants performed 3 light, 3 normal, and 3 heavy thrusts on 5 listings specifying contact point, hand, and direction. Force profiles were analyzed for speed and amplitude, consistency, and force discrimination. Two recording sessions occurred 10 weeks apart. Results: Sixteen participants (11 females, 5 male) completed the study. Peak forces ranged from 880 to 202 N for heavy thrusts and 322-to 66 N for light thrusts. Thrust rate was from 8.1 to 1.8 Newtons per millisecond. Average coefficients of variability (CV ¼ STD/mean) at each load level (initial/final) were heavy: 17%/15%; normal: 16%/15%; and light: 20%/20%, with 0 as ideal. A force ratio measured students' abilities to distinguish thrust magnitude. The heavy/normal ratio (initial/final) was 1.35/1.39, and the light/normal ratio was 0.70/0.67. Conclusions: At this point, without force feedback being used in the classroom, novice students can produce thrusts that look like those of their teachers and of experienced practitioners, but they may not produce similar speed and force values. They are consistent within and between sessions and can discriminate between light and heavy loads. A natural next step in our educational research will be to measure adjustment factors on more experienced cohorts of students with and without the presence of force-feedback training apparatus.

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Section: Discussioncontrasting

confidence: 89%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Owens¹,

Russell²,

Hosek³

et al. 2017

Journal of Chiropractic Education

Self Cite

View full text Add to dashboard Cite

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“…It has been hypothesized that doctors of chiropractic vary the level of peak force delivered during an HVLA-SM thrust depending on patient presentation. 2 However, due to the large peak force variability among clinicians, [13][14][15][16] it is unlikely that those forces are consistent across clinicians for similar patient presentations without specific training. Previous HVLA-SM training programs have largely focused on intra-clinician consistency (consistency in the ability to deliver force levels unique to themselves rather than for a specific patient presentation).…”

Section: Discussionmentioning

confidence: 99%

“…12 Moreover, peak thrust forces vary substantially among experienced clinicians. [13][14][15][16] Focused training methods may be necessary to develop the ability to deliver manipulation with specific biomechanical parameters. The ability to deliver prescribed manipulative forces consistently also is necessary to address some questions related to treatment dosing, which can be answered only by applying standardized manipulative forces and loading rates.…”

Section: Introductionmentioning

confidence: 99%

High-velocity, low-amplitude spinal manipulation training of prescribed forces and thrust duration: A pilot study

Shannon¹,

Vining²,

Gudavalli³

et al. 2019

Journal of Chiropractic Education

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Objective: High-velocity, low-amplitude spinal manipulation (HVLA-SM) may generate different therapeutic effects depending on force and duration characteristics. Variability among clinicians suggests training to target specific thrust duration and force levels is necessary to standardize dosing. This pilot study assessed an HVLA-SM training program using prescribed force and thrust characteristics. Methods: Over 4 weeks, chiropractors and students at a chiropractic college delivered thoracic region HVLA-SM to a prone mannequin in six training sessions, each 30 minutes in duration. Force plates embedded in a treatment table were used to measure force over time. Training goals were 350 and 550 Newtons (N) for peak force and 150 ms for thrust duration. Verbal and visual feedback was provided after each training thrust. Assessments included 10 consecutive thrusts for each force target without feedback. Mixed-model regression was used to analyze assessments measured before, immediately following, and 1, 4, and 8 weeks after training. Results: Error from peak force target, expressed as adjusted mean constant error (standard deviation), went from 107 N (127) at baseline, to 0.2 N (41) immediately after training, and 32 N (53) 8 weeks after training for the 350 N target, and 63 N (148), À6 N (58), and 9 N (87) for the 550 N target. Student median values met thrust duration target, but doctors' were .150 ms immediately after training. Conclusion: After participation in an HVLA-SM training program, participants more accurately delivered two prescribed peak forces, but accuracy decreased 1 week afterwards. Future HVLA-SM training research should include follow-up of 1 week or more to assess skill retention.

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Chiropractic: An Integrative Approach to the Evaluation and Treatment of Elite Athletes Utilizing Spinal Manipulation

Miller

2022

Neurosurgical Care of Athletes

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Establishing force and speed training targets for lumbar spine high-velocity, low-amplitude chiropractic adjustments*

Cited by 14 publications

References 21 publications

Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

High-velocity, low-amplitude spinal manipulation training of prescribed forces and thrust duration: A pilot study

Chiropractic: An Integrative Approach to the Evaluation and Treatment of Elite Athletes Utilizing Spinal Manipulation

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