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Impact of hand position on force-time characteristics during spinal manipulation and mobilization: An observational
Philippe Rousseau1, Mégane Lévesque1, Christophe Désy1
1Department of Chiropractic, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, Québec, G8Z 4M3, Canada; Research Group on Neuromusculoskeletal Disorders (GRAN), Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, Québec, G8Z 4M3, Canada.
Background:
Spinal manipulation and mobilization are widely used manual therapies for spine pain management. Although their force-time characteristics vary considerably across studies, the influence of hand position on these parameters remains poorly understood. This study aimed to compare the effects of three hand positions on the force-time characteristics of thoracic posterior-to-anterior spinal manipulations and mobilizations performed by chiropractic interns, and to assess the between-session reliability of these characteristics.
Methods:
Ten interns completed two identical sessions one week apart. Participants performed 10 manipulation and 10 mobilization trials for each of three hand positions on a manikin placed on an instrumented treatment table. Force-time characteristics were extracted using MT-Analyzer™ software. Between-session reliability was assessed using ICC₃,₁, and position effects were evaluated with Friedman tests.
Findings:
Hand position significantly influenced several force-time parameters, with the reinforced unilateral position generally producing lower forces than the two bilateral positions. For mobilization, the thenar bilateral position produced greater peak force than the reinforced unilateral position in both sessions. For manipulation, position effects varied between sessions, mainly involving preload force in session 1 and peak force and force amplitude in session 2. Between-session reliability was poor to moderate for most parameters. Mobilization peak force was significantly lower than manipulation peak force but comparable to manipulation force amplitude.
Interpretation:
Hand position influences the force-time characteristics of both manipulation and mobilization and may help modulate the force delivered, although this effect varied between sessions. The poor-to-moderate between-session reliability highlights the instability of force-time profiles among interns.
