A descriptive study of the force and displacement profiles of the toggle-recoil spinal manipulative procedure (adjustment) as performed by chiropractors

Graham, B.A.; Clausen, P.; Bolton, P.S.

doi:10.1016/j.math.2009.07.003

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Volume 15, Issue 1 , Pages 74-79, February 2010

A descriptive study of the force and displacement profiles of the toggle-recoil spinal manipulative procedure (adjustment) as performed by chiropractors

B.A. Graham
- School of Biomedical Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton, NSW, Australia
P. Clausen
- School of Engineering, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan, NSW, Australia
P.S. Bolton
- School of Biomedical Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton, NSW, Australia
- Corresponding author at: School of Biomedical Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia. Tel.: +64 2 49217020; fax: +64 2 49217406.

Received 20 October 2008; received in revised form 24 June 2009; accepted 10 July 2009. published online 13 August 2009.

Abstract

The aim of this study was to determine the variability of the thrust parameters produced by practitioners performing a high velocity spinal manipulative therapy technique (toggle-recoil) normally applied to the neck.

Fourteen participants performed three thrust trials, separated by >30minutes, on a patient simulation device. Force and displacement generated during the thrusts were simultaneously recorded and analysed off line. Peak thrust force ranged from 18.2 to 246N with a mean of 111.2N (SD 48.8). Time to peak thrust force ranged from 20 to 100ms, mean 67.5 ms (SD 13.1). Peak thrust displacement ranged from 6.1 to 28.9mm, mean 24.1mm (SD 4.9) and time to peak thrust displacement ranged from 22.5 to 105ms, mean 59.4ms (SD 13.8).

This study demonstrates that the force and displacement induced by any individual practitioner on a simulator can vary by up to 50% during a toggle-recoil thrust. Furthermore, different practitioners may vary in their force by as much 100% and in displacement by 50% when the toggle-recoil spinal manipulative procedure is performed.

Keywords: Manipulation, Chiropractic, Neck