Dataset Information

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

ABSTRACT:

Objective

We developed an adjusting bench with a force plate supporting the lumbar portion to measure loads transmitted during lumbar manual adjustment. It will be used to provide force-feedback to enhance student learning in technique labs. The study goal is to define the learning target loads and speeds, with instructors as expert models.

Methods

A total of 11 faculty members experienced in teaching Gonstead technique methods performed 81 simulated adjustments on a mannequin on the force plate. Adjustments were along 9 lumbopelvic "listings" at 3 load levels: light, normal, and heavy. We analyzed the thrusts to find preload, peak load, duration, and thrust rate.

Results

Analysis of 891 thrusts showed wide variations between doctors. Peak loads ranged from 100 to 1400 N. All doctors showed clear distinctions between peak load levels, but there was overlap between high and low loads. Thrust rates were more uniform across doctors, averaging 3 N/ms.

Conclusion

These faculty members delivered a range of thrusts, not unlike those seen in the literature for high velocity, low amplitude manipulation. We have established at least minimum force and speed targets for student performance, but more work must be done to create a normative adjustment to guide refinement of student learning.

SUBMITTER: Owens EF

PROVIDER: S-EPMC4771001 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Publications

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

Owens Edward F EF Hosek Ronald S RS Sullivan Stephanie G B SG Russell Brent S BS Mullin Linda E LE Dever Lydia L LL

The Journal of chiropractic education 20151124 1

<h4>Objective</h4>We developed an adjusting bench with a force plate supporting the lumbar portion to measure loads transmitted during lumbar manual adjustment. It will be used to provide force-feedback to enhance student learning in technique labs. The study goal is to define the learning target loads and speeds, with instructors as expert models.<h4>Methods</h4>A total of 11 faculty members experienced in teaching Gonstead technique methods performed 81 simulated adjustments on a mannequin on ...[more]

PMID: 26600272

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Project description:AIMS:We analysed the changes in force-velocity-power variables and jump performance in response to an individualized training program based on the force-velocity imbalance (FVimb). In particular, we investigated (i) the individual adaptation kinetics to reach the optimal profile and (ii) de-training kinetics over the three weeks following the end of the training program. METHODS:Sixty subjects were assigned to four sub-groups according to their initial FVimb: high or low force-deficit (FD) and high or low velocity-deficit (VD). The duration of training intervention was set so that each individual reached their "Optimal force-velocity (F-v) profile". Mechanical and performance variables were measured every 3 weeks during the program, and every week after the end of the individualized program. RESULTS:All subjects in the FD sub-groups showed extremely large increases in maximal theoretical force output (+30±16.6% Mean±SD; ES = 2.23±0.28), FVimb reduction (-74.3±54.7%; ES = 2.17±0.27) and large increases in jump height (+12.4±7.6%; ES = 1.45±0.23). For the VD sub-groups, we observed moderate to extremely large increases in maximal theoretical velocity (+15.8±5.1%; ES = 2.72±0.29), FVimb reduction (-19.2±6.9%; ES = 2.36±0.35) and increases in jump height (+10.1±2.7%; ES = 0.93±0.09). The number of weeks needed to reach the optimal F-v profile (12.6 ± 4.6) was correlated to the magnitude of initial FVimb (r = 0.82, p<0.01) for all participants regardless of their initial subgroup. No significant change in mechanical variables or jump performance was observed over the 3-week de-training period. CONCLUSIONS:Collectively, these results provide useful insights into a more specific, individualized (i.e. based on the type and magnitude of FVimb) and accurate training prescription for jumping performance. Considering both training content and training duration together with FVimb may enable more individualized, specific and effective training monitoring and periodization.

Project description:PurposeTo characterize the inter- and intraobserver variability of qualitative, non-disk contour degenerative findings of the lumbar spine at magnetic resonance (MR) imaging.Materials and methodsThe case accrual method used to perform this institutional review board-approved, HIPAA-compliant retrospective study was the random selection of 111 interpretable MR examination cases of subjects from the Spine Patient Outcomes Research Trial. The subjects were aged 18-87 years (mean, 53 years +/- 16 [standard deviation]). Four independent readers rated the cases according to defined criteria. A subsample of 40 MR examination cases was selected for reevaluation at least 1 month later. The following findings were assessed: spondylolisthesis, disk degeneration, marrow endplate abnormality (Modic changes), posterior anular hyperintense zone (HIZ), and facet arthropathy. Inter- and intraobserver agreement in rating the data was summarized by using weighted kappa statistics.ResultsInterobserver agreement was good (kappa = 0.66) in rating disk degeneration and moderate in rating spondylolisthesis (kappa = 0.55), Modic changes (kappa = 0.59), facet arthropathy (kappa = 0.54), and posterior HIZ (kappa = 0.44). Interobserver agreement in rating the extent of Modic changes was moderate: kappa Values were 0.43 for determining superior anteroposterior extent, 0.47 for determining superior craniocaudal extent, 0.57 for determining inferior anteroposterior extent, and 0.48 for determining inferior craniocaudal extent. Intraobserver agreement was good in rating spondylolisthesis (kappa = 0.66), disk degeneration (kappa = 0.74), Modic changes (kappa = 0.64), facet arthropathy (kappa = 0.69), and posterior HIZ (kappa = 0.67). Intraobserver agreement in rating the extent of Modic changes was moderate, with kappa values of 0.54 for superior anteroposterior, 0.60 for inferior anteroposterior, 0.50 for superior craniocaudal, and 0.60 for inferior craniocaudal extent determinations.ConclusionThe interpretation of general lumbar spine MR characteristics has sufficient reliability to warrant the further evaluation of these features as potential prognostic indicators.

Dataset Information

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

Objective

Methods

Results

Conclusion

Publications

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

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