Hessell B W, Herzog W, Conway P J, McEwen M C
Faculty of Physical Education, University of Calgary, Alberta, Canada.
J Manipulative Physiol Ther. 1990 Oct;13(8):448-53.
The purpose for conducting this study was to quantify the forces exerted by a chiropractor on a patient during spinal manipulative therapy. Six patients received three treatments each from two chiropractors for a sacroiliac joint fixation. The Thompson technique was used to treat the patients. The force characteristics of the spinal manipulation were analyzed with respect to the following five points: preloading force, peak force, duration of manipulation, impulse of manipulation and point of application of the peak force. The results obtained indicated that all treatments have certain common characteristics; for example, a preload force is always followed by a large thrusting force. The values for the preload force, peak force, duration and impulse were found to have large standard deviations for a given adjuster and between patients. The location of the point of application of the peak force relative to a low back reference system appeared to be very consistent. However, it was not on the posterior superior iliac spines (PSIS) as expected, but always slightly medial to this point. This is the first study to report force results which were measured directly during spinal manipulative therapy in a clinical situation. In further studies, the results of this investigation will be compared to results obtained from a large population of patients and chiropractic adjusters. Differences in the force characteristics between chiropractors will be compared to clinical and objective measures of the rehabilitation process of the patients in order to find an "optimal" way of performing spinal manipulative therapies.
开展这项研究的目的是量化脊椎按摩师在脊柱手法治疗过程中施加于患者的力量。六名患者因骶髂关节固定分别接受了两位脊椎按摩师的三次治疗。采用汤普森技术对患者进行治疗。针对以下五点分析了脊柱手法的力量特征：预加载力、峰值力、手法持续时间、手法冲量以及峰值力的施加点。所得结果表明，所有治疗都具有某些共同特征；例如，预加载力之后总是紧接着一个较大的推力。对于给定的调整师以及不同患者而言，预加载力、峰值力、持续时间和冲量的值均具有较大的标准差。相对于下背部参考系统，峰值力施加点的位置似乎非常一致。然而，它并非如预期那样位于髂后上棘（PSIS）上，而是总是略偏向该点的内侧。这是第一项报告在临床情况下脊柱手法治疗期间直接测量的力量结果的研究。在进一步的研究中，将把本研究的结果与从大量患者和脊椎按摩调整师那里获得的结果进行比较。还将比较不同脊椎按摩师之间力量特征的差异与患者康复过程的临床及客观指标，以便找到进行脊柱手法治疗的“最佳”方式。
