• Gudavalli MR
• Rowell RM

• Biomechanical Phenomena
• Low Back Pain / therapy
• Manipulation, Chiropractic

Background: Patients with low back pain often seek chiropractic care and more than ninety percent of chiropractors use lumbar side posture manipulation for the treatment of low back pain. During this procedure chiropractors deliver forces by means of hand contact on the patient in a side lying position. The objective of this pilot study was to report on the three-dimensional forces at the hand contact between the chiropractorand the simulated patient (asymptomatic volunteers) during side posture lumbar high velocity low amplitude adjustments.

Methods: In 2005, two licensed chiropractors delivered spinal manipulations to the lumbar spines of theparticipants. A three-dimensional force transducer (Model # Mini-45, ATI-Industrial Automation, Apex, North Carolina) was used to measure the three-dimensional loads. The force-time histories were analyzed for preloads, peak loads, duration of thrusts to peak load, duration of thrust for completion, rate of loading, and magnitudes of the three forces and the resultant total force delivered by the chiropractor.

Results: The two chiropractors delivered a total of 14 thrusts to the five symptomatic volunteers. Normal force (Fz) is the dominating force, followed by inferior-superior force (Fx). The lateral force (Fy) occurred in both directions.

Conclusions: This study reports on the three dimensional load (three forces and the total resultant force) characteristics of chiropractor-patient hand contact while delivering a chiropractic high velocity low amplitude (HVLA) manipulation in a side lying position.

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