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Optimized prediction of contact force application during side-lying lumbar manipulation

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Structural and chiropractic

J Manipulative Physiol Ther.2012 Nov-Dec;35(9):669-77.

Authors:

C A Myers, B A Enebo, B S Davidson

Abstract.

Objectives: The purposes of this study included the following: (1) to predict L3 contact force during side-lying lumbar manipulation by combining direct and indirect measurements into a single mathematical framework and (2) to assess the accuracy and confidence of predicting L3 contact force using common least squares (CLS) and weighted least squares (WLS) methods. Methods: Five participants with no history of lumbar pain underwent 10 high-velocity, low-amplitude lumbar spinal manipulations at L3 in a side-lying position. Data from 5 low-force criterion standard trials where the L3 contact force was directly measured were used to generate participant-specific force prediction algorithms. These algorithms were used to predict L3 contact force in 5 experimental trials performed at therapeutic levels. The accuracy and effectiveness of CLS and WLS methods were compared. Results: Differences between the CLS-predicted forces and the criterion standard-measured forces were 621.0 ± 193.5 N. Differences between the WLS-predicted forces and the criterion standard-measured forces were -3.6 ± 9.1 N. The 95% limits of agreement ranged from 234.0 to 1008.0 N for the CLS and -21.9 to 14.7 N for the WLS. During both the criterion standard and experimental trials, the CLS overestimated contact forces with larger variance than the WLS. Conclusion: This novel method to predict spinal contact force combines direct and indirect measurements into a single framework and preserves clinically relevant practitioner-participant contacts. As advanced instrumentation becomes available, this framework will enable advancements in training and high-quality research on mechanisms of spinal manipulative therapy.

Publication Date: 

2012 Nov-Dec

OEID: 

5382

Myers, AC., Enebo, AB., Davidson, SB. (2012) 'Optimized prediction of contact force application during side-lying lumbar manipulation', J Manipulative Physiol Ther.2012 Nov-Dec;35(9):669-77.

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