Comparison of force-time characteristics of prone cervicothoracic spinal manipulative therapy between chiropractic...

Although the force-time characteristics of spinal manipulative therapy (SMT) have been extensively studied, evidence on the maturation of SMT delivered to the cervicothoracic junction is scarce. The aim of this study is to compare the force-time characteristics of a cervicothoracic SMT technique between experienced chiropractors and chiropractic interns. .

Participants performed a total of 18 posterior-to-anterior cervicothoracic SMT on a human-shaped manikin, fixed to an instrumented treatment table. Participants were instructed to execute the technique, contacting either the right or the left side of the manikin, at 3 different levels of force: low, typical, and high. Three-level analysis of variance was used to assess the effect of group (experienced chiropractors or interns), force level, and contact side on force-time characteristics. Variability of these characteristics among participants was also evaluated.

No statistically significant differences were observed in any of the force-time characteristics between chiropractic interns (n = 15) and experienced chiropractors (n = 10), nor on the contact side used to perform the SMT (p > .05). Significant effects on force level were noted for all force-time characteristics (p < .05), except for impulse duration (p > .05). The interns displayed more variability than experienced chiropractors for the force at thrust initiation only (p = .02). .

This study shows that both chiropractic interns and experienced clinicians deliver SMT to the cervicothoracic junction with similar force-time characteristics. However, final-year students exhibited greater variability in controlling their force just before initiating the thrust, indicating that some aspects of their motor skill may still be developing.