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Russell BS, Keller M, Wynd SE, Hosek RS, Owens EF, Hoiriis KT. Angular Kinematics of Chiropractic Supine Cervical Spine Manipulation: Rotational Measures and Comparisons to Doctor and Recipient Perceptions. J Manipulative Physiol Ther 2022; 45:497-507. [PMID: 36922054 DOI: 10.1016/j.jmpt.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/20/2022] [Accepted: 12/01/2022] [Indexed: 03/17/2023]
Abstract
OBJECTIVES The primary purposes of this study were to measure axial rotation during supine cervical spinal manipulative therapy (cSMT) and to record recipients' and doctors' perceptions of rotational magnitudes. METHODS Experienced doctors of chiropractic (DCs) provided supine cSMT and acted as recipients of cSMT. Participants who received SMT wore inertial measurement units attached to the forehead and sternum for motion capture. Afterward, recipients and DCs completed questionnaires asking about their perceptions of motion. Data were analyzed for magnitudes of axial rotation at peak thrust and correlations with patient and doctor perceptions. Secondary analyses included angular velocity, angular acceleration, and other kinematic variables. RESULTS We recorded 23 SMT events with 14 DCs. Rotation at thrust peaks averaged 32.4° (17.4°). Doctors' and recipients' perceptions of rotation were higher than measured values 45% and 50% of the time, respectively. Maximum angular velocity and acceleration averaged 221.9°/s (124.9) and 4786.5°/s2 (2456.6), respectively. We found no correlation between perceptions and velocity or acceleration; doctors' perceptions had an inverse correlation with measurements. CONCLUSION On average, we found rotation during supine cSMT to be 32°. Both DCs and SMT recipients overestimated rotation compared with actual measurements. These factors should be considered in discussions of rotation and SMT.
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Affiliation(s)
- Brent S Russell
- Life University Center for Chiropractic Research, Atlanta, Georgia.
| | - Mackenzie Keller
- Life University Center for Chiropractic Research, Atlanta, Georgia
| | - Shari E Wynd
- Department of Foundational Sciences, Texas Chiropractic College, Pasadena, Texas
| | - Ronald S Hosek
- Life University Center for Chiropractic Research, Atlanta, Georgia
| | - Edward F Owens
- Life University Center for Chiropractic Research, Atlanta, Georgia
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Weiner MT, Russell BS, Elkins LM, Hosek RS, Owens EF, Kelly G. Spinal Kinematic Assessment of Chiropractic Side-Posture Adjustments: Development of a Motion Capture System. J Manipulative Physiol Ther 2022; 45:298-314. [DOI: 10.1016/j.jmpt.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/06/2021] [Accepted: 07/13/2022] [Indexed: 10/14/2022]
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Lee R, James C, Edwards S, Skinner G, Young JL, Snodgrass SJ. Evidence for the Effectiveness of Feedback from Wearable Inertial Sensors during Work-Related Activities: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:6377. [PMID: 34640695 PMCID: PMC8512480 DOI: 10.3390/s21196377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/03/2023]
Abstract
Background: Wearable inertial sensor technology (WIST) systems provide feedback, aiming to modify aberrant postures and movements. The literature on the effects of feedback from WIST during work or work-related activities has not been previously summarised. This review examines the effectiveness of feedback on upper body kinematics during work or work-related activities, along with the wearability and a quantification of the kinematics of the related device. Methods: The Cinahl, Cochrane, Embase, Medline, Scopus, Sportdiscus and Google Scholar databases were searched, including reports from January 2005 to July 2021. The included studies were summarised descriptively and the evidence was assessed. Results: Fourteen included studies demonstrated a 'limited' level of evidence supporting posture and/or movement behaviour improvements using WIST feedback, with no improvements in pain. One study assessed wearability and another two investigated comfort. Studies used tri-axial accelerometers or IMU integration (n = 5 studies). Visual and/or vibrotactile feedback was mostly used. Most studies had a risk of bias, lacked detail for methodological reproducibility and displayed inconsistent reporting of sensor technology, with validation provided only in one study. Thus, we have proposed a minimum 'Technology and Design Checklist' for reporting. Conclusions: Our findings suggest that WIST may improve posture, though not pain; however, the quality of the studies limits the strength of this conclusion. Wearability evaluations are needed for the translation of WIST outcomes. Minimum reporting standards for WIST should be followed to ensure methodological reproducibility.
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Affiliation(s)
- Roger Lee
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle 2308, Australia
| | - Carole James
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Resources Health and Safety, The University of Newcastle, Newcastle 2308, Australia
| | - Suzi Edwards
- School of Health Sciences, The University of Sydney, Sydney 2006, Australia;
| | - Geoff Skinner
- School of Information and Physical Sciences, The University of Newcastle, Newcastle 2308, Australia;
| | - Jodi L. Young
- Department of Physical Therapy, Bellin College, Green Bay, WI 54311, USA;
| | - Suzanne J. Snodgrass
- School of Health Sciences, The University of Newcastle, Newcastle 2308, Australia; (C.J.); (S.J.S.)
- Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle 2308, Australia
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Kinematic consistency in the knee manipulation learning: A comparison between expert and beginner therapists. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Duquette SA, Starmer DJ, Plener JB, BSc DAG. A pilot study to determine the consistency of peak forces during cervical spine manipulation utilizing mannequins. THE JOURNAL OF CHIROPRACTIC EDUCATION 2021; 35:8-13. [PMID: 32930333 PMCID: PMC7958664 DOI: 10.7899/jce-18-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 04/04/2019] [Accepted: 10/15/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Cervical spine manipulation is a complex motor skill used to treat musculoskeletal ailments such as neck pain. There is evidence demonstrating the effectiveness of objective feedback and mannequins for the teaching of spinal manipulation (SM) in the thoracic and lumbar spine. This paper examines the effectiveness of an educational intervention combining both mannequins and force-sensing technology for teaching cervical SM. METHODS Fourth-year chiropractic interns were separated into 2 groups: an intervention group and a group trained with the standard curriculum. The intervention included a 60-minute educational session focused on targeting 100 N total peak force cervical manipulations on mannequins, with objective feedback through force-sensing table technology. Pre- and post-CMs were recorded on both a mannequin and a paired student partner, with an attempt to have a target total peak force of 100 N. RESULTS Ninety students were recruited. The invention group (n = 46) scored significantly better at the outcome compared to the control group (n = 44) when manipulating the mannequin (p = .003). These improvements did not carry over when manipulating a paired human partner (p = .067). CONCLUSION Following a 1-hour cervical SM educational intervention utilizing thrusting on mannequins and force-sensing table technology, students demonstrated improved peak force control for SM delivered on the mannequin. However, this improvement was not carried over to SM delivered on human subjects.
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Effects of Cervical Rotatory Manipulation (CRM) on Carotid Atherosclerosis Plaque in Vulnerability: A Histological and Immunohistochemical Study Using Animal Model. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3793840. [PMID: 30863777 PMCID: PMC6378770 DOI: 10.1155/2019/3793840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/22/2018] [Accepted: 01/10/2019] [Indexed: 11/17/2022]
Abstract
Background The safety of cervical rotatory manipulation (CRM) is still controversial, especially in patients with carotid artery atherosclerosis (CAS). The study aimed to investigate the effects of CRM on carotid plaques in vulnerability. Methods 50 rabbits were randomly divided into four groups: model rabbits with CRM [CAS-CRM (n=15)]; model rabbits without CRM [CAS (n=15)]; normal rabbits with CRM [Normal-CRM (n=10)]; and Blank-control group (n=10). CAS disease models were induced by carotid artery balloon injury combined with a high-fat diet for 12 weeks. Then, CRM technique was performed in CAS-CRM and Normal-CRM groups for 3 weeks. In the end, determination of serum level of hs-CRP and Lp-PLA2, histological analysis under HE and Masson trichromic staining, and immunohistochemical analysis with CD34 and CD68 antibody were completed in order. Results Carotid stenosis rates on successful model rabbits ranged from 70% to 98%. The CAS-CRM group had an increased level of hs-CRP (P<0.05), in comparison with the CAS group, whereas effects were not significant between the Normal-CRM group and Blank-control group. In comparison with the CAS group, the positive expression of CD34 and CD68 in the CAS-CRM group increased significantly (P<0.05). Conclusion CRM therapy may increase the vulnerability of carotid plaque in rabbits with severe CAS.
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Belón-Perez P, Cuesta-Vargas AI. Immediate Effects of Thoracic Spine Manipulation Upon Shoulder Functionality in Patients With Sutured Rotator Cuff Repair: A Prospective Study. J Manipulative Physiol Ther 2018; 41:589-595. [PMID: 30442357 DOI: 10.1016/j.jmpt.2018.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 11/24/2017] [Accepted: 02/28/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the immediate effect of thoracic spine manipulation upon active flexion and abduction mobility of the shoulder, spine temperature, and the size of the subacromial space as measured by ultrasound in 3 positions (internal, neutral, and external rotation) of the glenohumeral joint in patients who have undergone surgery because of subacromial impingement. METHODS Quasi-experimental, prospective, short-term effect study with consecutively sampled participants. Thirty-two patients had undergone subacromial decompression together with supraspinatus tendon suture. The following variables were studied: age, sex, dominant shoulder, presurgery evolution time, working status, surface temperature of dorsal segment with limited mobility, premanipulation functional assessment using the Spanish version of the Upper Limb Functional Index Scale, goniometric range of motion measurement at glenohumeral joint before and after manipulation, and ultrasound measurement of subacromial space before and after manipulation. RESULTS Significant differences and small effect size were found in measurements for flexion and abduction movements after thoracic spine manipulation (P > .001; ES > 0.2) and subacromial space measurements in neutral rotation and external rotation (P > .001), but without clinical relevance effect size (<0.2). CONCLUSIONS Active shoulder flexion and abduction mobility increase after manipulation of thoracic spine in patients who have undergone surgery for rotator cuff suture. Subacromial space increases significantly with shoulder in neutral and external rotation position after manipulation. No differences were found regarding surface temperature of manipulated area.
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Affiliation(s)
| | - Antonio Ignacio Cuesta-Vargas
- Grupo de Clinimetria (AE-14), Facultad de Ciencias de la Salud, Departamento de Fisioterapia, Instituto de Investigación en Biomedicina de Málaga (IBIMA), Universidad de Málaga, Andalucia Tech, Málaga, Spain; School of Clinical Science, Faculty of Health at Queensland Universtity Technology, Brisbane, Australia.
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Kope R, O'Brien J, Sadi J, Walton DM, Ferreira LM. Quantifying performance metrics of cervical spine mobilization for improved education and clinical outcomes: Early experience with a novel wearable device. J Rehabil Assist Technol Eng 2018; 5:2055668318765396. [PMID: 31191931 PMCID: PMC6453047 DOI: 10.1177/2055668318765396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/19/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Evaluation of manual skills training for spinal rehabilitation has been
stagnant for 40 years. Observation and mimicry are coupled with feedback
from “expert” observers to train and evaluate learners, relying on rater
experience to discern speed and force. Spinal manipulation is a controlled
act under the Regulated Health Professions Act (1991) as it is not without
risk. The discordance between current methods for evaluating proficiency and
the potential risks of inadequate application is a critical gap. Methods This work reports a novel wearable device that measures finger forces via
microstrain bending of the physiotherapist’s nail. The device leaves the
tactile finger pad unobstructed and does not interfere with treatment
application. Five expert-level physiotherapists performed a standard
postero-anteriorly directed spinal segmental mobilization treatment for
1 min at 1–1.5 Hz rhythm. Results The device successfully measured all treatment forces (0.2–27.3 N).
Physiotherapists applied a maximum force rate of 0.03 ± 0.01 N/s with a
rhythm of 1.76 ± 0.38 Hz. In 15 trials, there were no device failures. The
device was easily applied and removed, and physiotherapists were able to
walk about and interact normally with patients. Conclusions These results indicate that this technology can be integrated into a skills
training program to provide quantitative feedback for objective
assessments.
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Affiliation(s)
- Ryan Kope
- 1Western University Faculty of Engineering, London, Canada
| | - Jordan O'Brien
- 1Western University Faculty of Engineering, London, Canada
| | - Jackie Sadi
- 1Western University Faculty of Engineering, London, Canada
| | - David M Walton
- 1Western University Faculty of Engineering, London, Canada
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Marchand AA, Mendoza L, Dugas C, Descarreaux M, Pagé I. Effects of practice variability on spinal manipulation learning. THE JOURNAL OF CHIROPRACTIC EDUCATION 2017; 31:90-95. [PMID: 28121458 PMCID: PMC5656152 DOI: 10.7899/jce-16-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the effects of practice variability on chiropractic students' capacity to deliver spinal manipulations (SMs) of a targeted peak force. METHODS Forty students participated in an experimental session including either a variable or a constant practice protocol of 45 SMs. SMs were delivered on a computer-connected device that recorded force-time profiles. Ten SMs with a target peak force of 350-N were performed before practice, immediately following practice, and 2 days later. Mixed-design analyses of variance were used to assess the effect of practice type on SM biomechanical parameters and on the constant, the absolute error (AE), and the variable error (VE). RESULTS The practice period led to significantly more accurate (FAE[2,76] = 6.17, p < .01) and consistent (FVE[2,76] = 3.90, p = .02) performances at the postintervention assessment regardless of practice type. Among biomechanical parameters, preload force was higher at the retention assessment than at baseline (F[2,76] = 6.53, p < .01), while rate of force application significantly decreased between the baseline and the retention assessment (F[2,76] = 4.10, p = .02). CONCLUSION This experimental study showed that 1 session of SM practice including feedback leads to an increase in SM peak force accuracy and consistency, whether or not the practice period included variable practice. The current results confirmed that short practice periods with feedback should be included in the chiropractic curriculum.
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González-Sánchez M, Ruiz-Muñoz M, Ávila-Bolívar AB, Cuesta-Vargas AI. Kinematic real-time feedback is more effective than traditional teaching method in learning ankle joint mobilisation: a randomised controlled trial. BMC MEDICAL EDUCATION 2016; 16:261. [PMID: 27716215 PMCID: PMC5054622 DOI: 10.1186/s12909-016-0789-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/30/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND To analyse the effect of real-time kinematic feedback (KRTF) when learning two ankle joint mobilisation techniques comparing the results with the traditional teaching method. METHODS Double-blind randomized trial. SETTINGS Faculty of Health Sciences. PARTICIPANTS undergraduate students with no experience in manual therapy. Each student practised intensely for 90 min (45 min for each mobilisation) according to the random methodology assigned (G1: traditional method group and G2: KRTF group). G1: an expert professor supervising the student's practice, the professorstudent ratio was 1:8. G2: placed in front of a station where, while they performed the manoeuvre, they received a KRTF on a laptop. OUTCOME MEASURES total time of mobilisation, time to reach maximum amplitude, maximum angular displacement in the three axes, maximum and average velocity to reach the maximum angular displacement, average velocity during the mobilisation. RESULTS Among the pre-post intervention measurements, there were significant differences within the two groups for all outcome variables, however, G2 (KRTF) achieved significantly greater improvements in kinematic parameters for the two mobilisations (significant increase in displacement, velocity and significant reduction in the mobilisations runtime) than G1. Ankle plantar flexion: G1's measurement stability (post-intervention) ranged between 0.491 and 0.687, while G2's measurement stability ranged between 0.899 and 0.984. Ankle dorsal flexion mobilisation: G1 the measurement stability (post-intervention) ranged from 0.543 and 0.684 while G2 ranged between 0.899 and 0.974. CONCLUSION KRTF was proven to be more effective tool than traditional teaching method in the teaching - learning process of two joint mobilisation techniques. TRIAL REGISTRATION NCT02504710.
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Affiliation(s)
- Manuel González-Sánchez
- Departamento de Fisioterapia, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Arquitecto Francisco Peñalosa s/n. (ampliación Campus Teatinos), 29071 Málaga, Spain
| | - Maria Ruiz-Muñoz
- Departamento de Enfermería y Podología, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Antonio I. Cuesta-Vargas
- Departamento de Fisioterapia, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Arquitecto Francisco Peñalosa s/n. (ampliación Campus Teatinos), 29071 Málaga, Spain
- School of Clinical Sciences at Queensland University, Brisbane, Australia
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Ke JQ, Yin B, Fu FW, Shao SM, Lin Y, Dong QQ, Wang XT, Zheng GQ. A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy. Medicine (Baltimore) 2016; 95:e2693. [PMID: 26844510 PMCID: PMC4748927 DOI: 10.1097/md.0000000000002693] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy.A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, although the patient remained conscious, he could not speak but could communicate with the surrounding by blinking or moving his eyes, and turned to complete quadriplegia, complete facial and bulbar palsy, dyspnea at 4 hours after admission. He was diagnosed with LIS. Then, the patient was received cervical and brain computed tomography angiography that showed bilateral VAD. Aortocranial digital subtraction angiography showed vertebrobasilar thrombosis, blocking left vertebral artery, and stenosis of right vertebral artery. The patient was treated by using emergency arterial embolectomy and followed by antiplatelet therapy and supportive therapy in the intensive care unit and a general ward. Twenty-seven days later, the patient's physical function gradually improved and discharged but still left neurological deficit with muscle strength grade 3/5 and hyperreflexia of limbs.Our findings suggested that CSM might have potential severe side-effect like LIS due to bilaterial VAD, and arterial embolectomy is an important treatment choice. The practitioner must be aware of this complication and should give the patients informed consent to CSM, although not all stroke cases temporally related to SCM have pre-existing craniocervical artery dissection.
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Affiliation(s)
- Jiang-Qiong Ke
- From the Department of Neurology (JQK, FWF, SMS, YL, QQD, XTW, GQZ); and Department of Neurosurgery (BY), the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Cuesta-Vargas AI, González-Sánchez M, Lenfant Y. Inertial Sensors as Real-Time Feedback Improve Learning Posterior-Anterior Thoracic Manipulation: A Randomized Controlled Trial. J Manipulative Physiol Ther 2015. [DOI: 10.1016/j.jmpt.2015.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Xu X, Chen KB, Lin JH, Radwin RG. The accuracy of the Oculus Rift virtual reality head-mounted display during cervical spine mobility measurement. J Biomech 2015; 48:721-724. [DOI: 10.1016/j.jbiomech.2015.01.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/19/2014] [Accepted: 01/11/2015] [Indexed: 10/24/2022]
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