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CAVITATION SOUNDS DURING CERVICOTHORACIC SPINAL MANIPULATION.

James Dunning, Firas Mourad, Andrea Zingoni1

  • 1Università di Pisa, Information Engineering Department, Pisa, Italy.

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High-velocity low-amplitude (HVLA) thrust manipulation to the cervicothoracic spine most often produces unilateral cavitation sounds on the side opposite the clinician

Keywords:
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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Musculoskeletal Research

Background:

  • Limited research exists on audible cavitation during cervicothoracic spine manipulation.
  • Understanding cavitation characteristics is crucial for refining HVLA techniques.

Purpose of the Study:

  • To determine the side of cavitation during cervicothoracic junction (CTJ) HVLA thrust manipulation.
  • To quantify the number and duration of cavitations and manipulation duration.

Main Methods:

  • A quasi-experimental study involving 32 patients with upper trapezius myalgia.
  • Bilateral accelerometers recorded audio signals during HVLA thrusts to the T1-2 articulation.
  • Short-Time Fourier Transformation (STFT) analyzed frequency content and energy bursts.

Main Results:

  • Unilateral cavitation occurred in 91.4% of manipulations, predominantly on the contralateral side.
  • The mean number of cavitations per manipulation was 4.35.
  • Mean manipulation duration was 60.77 ms, and single cavitation duration was 4.13 ms.

Conclusions:

  • Cavitation during CTJ HVLA manipulation is typically unilateral and contralateral to the applicator.
  • Multiple cavitation sounds are common, suggesting complex acoustic phenomena.
  • The simple gas bubble collapse theory may not fully explain all observed sounds.