Svoboda Katie, Howarth Samuel J, Funabashi Martha, Gorrell Lindsay M
Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
Chiropr Man Therap. 2025 Jan 6;33(1):1. doi: 10.1186/s12998-024-00564-x.
Spinal manipulation (MAN) and mobilization (MOB) are biomechanically different yet both elicit pain reduction and increased range of motion. Previous investigations have focused on quantifying kinetics (e.g., applied forces) or, recipient kinematics (i.e., movements) during MAN and MOB. While these studies provide valuable information, they do not report on the strategies adopted by providers when performing the complex motor tasks of MAN and MOB. This review sought to synthesise the literature reporting on provider kinematics during the delivery of MAN and MOB.
This scoping literature review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. MEDLINE (Ovid), PsychINFO, Cochrane Library, Web of Science, Embase, Scopus, PEDro, ICL and CINAHL databases were searched from inception to September 2023 for terms relating to provider kinematics during the delivery of MAN and MOB. Data were extracted and reported descriptively, including: general study characteristics, number and characteristics of individuals who delivered/received MAN and/or MOB, region treated, equipment used and kinematic parameters of the individual delivering the procedure.
Of 4,844 records identified, five (0.1%) fulfilled the eligibility criteria and were included in the analysis. Of these, provider kinematics were reported for the delivery of MAN in four (80%) and for the delivery of MOB in one (20%) article. Practitioners applied the procedure in all (100%) and students in one (20%) study. Spinal regions treated were: lumbar (n = 4), thoracic (n = 2) and cervical (n = 1). Data were reported heterogeneously but were most commonly captured using either video or motion capture equipment (n = 4, 80%). The direction of applied force was fully reported in one (20%) and only partially reported (one spinal region) in another study.
There are a small number of studies reporting heterogeneously on provider kinematics during the delivery of MAN and MOB. Clear reporting of the procedure from a biomechanical perspective and of the measurement equipment used could enable future meta-analysis of provider kinematic data, the use of provider kinematic data in the development of technique skills curricula and could feasibly be used to mitigate risk of injury for providers.
脊柱整复术（MAN）和松动术（MOB）在生物力学上有所不同，但两者都能减轻疼痛并增加活动范围。以往的研究主要集中在量化整复术和松动术中的动力学（如施加的力）或接受者的运动学（即运动）。虽然这些研究提供了有价值的信息，但它们没有报告提供者在执行整复术和松动术等复杂运动任务时所采用的策略。本综述旨在综合报告整复术和松动术实施过程中提供者运动学的文献。
本范围综述遵循《范围综述报告的首选项目》（PRISMA-ScR）声明进行报告。检索了MEDLINE（Ovid）、PsychINFO、Cochrane图书馆、科学网、Embase、Scopus、PEDro、ICL和CINAHL数据库，从建库至2023年9月，查找与整复术和松动术实施过程中提供者运动学相关的术语。对数据进行提取并进行描述性报告，包括：一般研究特征、实施/接受整复术和/或松动术的个体数量及特征、治疗部位、使用的设备以及实施该操作的个体的运动学参数。
在识别出的4844条记录中，有5条（0.1%）符合纳入标准并被纳入分析。其中，4篇（80%）文章报告了整复术实施过程中的提供者运动学，1篇（20%）文章报告了松动术实施过程中的提供者运动学。在所有研究（100%）中从业者应用了该操作，在1项研究（20%）中有学生参与。治疗的脊柱区域包括：腰椎（n = 4）、胸椎（n = 2）和颈椎（n = 1）。数据报告方式各异，但最常用视频或动作捕捉设备进行采集（n = 4，80%）。在1项研究（20%）中完整报告了施加力的方向，在另一项研究中仅部分报告了（一个脊柱区域）施加力的方向。
少数研究对整复术和松动术实施过程中提供者的运动学进行了不同方式的报告。从生物力学角度清晰报告操作过程以及所使用的测量设备，有助于未来对提供者运动学数据进行荟萃分析，在技术技能课程开发中使用提供者运动学数据，并有可能用于降低提供者的受伤风险。
