The kinematics and intra- and inter-therapist consistencies of lower cervical rotational manipulation

The aim of this study was to determine the in vivo kinematics of cervical rotational manipulation in normal subjects and examine the consistency of this technique within and between therapists. A four camera motion analysis system operating at 120 Hz was used to measure the head on trunk angular displacements during manipulation performed by three therapists on eight subjects. One of the therapists performed the manipulation twice for each subject over separate sessions. A consistent pattern of de-rotation prior to thrust was found with little motion other than axial rotation during de-rotation and thrust. The pooled mean de-rotation displacement was 4.8 degrees and the pooled mean thrust angle was 11.3 degrees , but these varied widely, and none of the kinematic parameters recorded proved to be consistent within or between therapists. Most of the kinematic parameters were correlated with the exception of thrust duration. Qualitative analysis shows a consistent technique in cervical rotational manipulation. Pre-manipulation positioning of the head relative to the trunk was fairly consistent for a single therapist over separate sessions, but other than this, the kinematic parameters in cervical rotational manipulation are generally inconsistent within and between therapists.