• Thurnherr N
• Schweinhardt P
• Gorrell LM

• Adult
• Affiliation / Balgrist University Hospital. Department of Chiropractic Medicine. Integrative Spinal Research
• Affiliation / Zurich University of Applied Sciences. Institute for Health Sciences
• Aged
• Female
• Healthy Volunteers
• Male
• Manikins
• Middle Aged
• Open Access Document
• Thoracic Vertebrae / physiology

Background: Many health care professionals use spinal mobilization (MOB) and manipulation (MAN) to treat musculoskeletal disorders. Research shows advantages of learning these techniques using a manikin. However, the force-time characteristics of MOB and MAN applied to manikins may differ from those delivered clinically to humans. This study reports on differences between the force-time characteristics of MOB and MAN delivered by experienced physiotherapists to the thoracic spine of both humans and a manikin.

Methods: Data were collected September-October 2023. Experienced physiotherapists applied prone MOB (Grade 3 central posterior-to-anterior, 30 s) and a single prone MAN to the T6 vertebra of three healthy human volunteers and a manikin with each volunteer-manikin pair representing one of three different patient scenarios (vignettes): vignette 1: 30-year-old male, 185 cm; vignette 2: 50-year-old male, 175 cm, and vignette 3: 65-year-old female, 165 cm. The applied forces were measured using a flexible pressure pad (100 Hz) and were compared descriptively between humans and the manikin.

Results: Data were analyzed from 13 physiotherapists (seven females, age (median, IQR): 40 (36-45) years, experience as physiotherapist: 14 (12-21) years). Peak forces on the manikin were higher than on the humans. Specifically, for MOB, average mean peak force differences (95% confidence interval) were: vignette 1: 58N (36, 80); vignette 2: 99N (74, 124); and vignette 3: 50N (31, 68). Similarly, for MAN, average peak force differences were: vignette 1: 128N (79, 177); vignette 2: 147N (94, 199); and vignette 3: 137N (101, 172). For MAN, greater mean peak forces were applied on vignette 1 than vignette 3 on the human 355N vs 284N and on the manikin 483N vs 421N.

Conclusion: In this study force-time characteristics of MOB and MAN performed by experienced physiotherapists on the thoracic spine of a manikin were different from those delivered to healthy humans: the forces applied to the manikin were higher for all vignettes for both techniques. However, forces were modulated to the vignette, both on the human and manikin.

Author keywords: Biomechanics; Manikin; Manipulation; Mobilization; Thoracic spine.

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