Biomechanics in Spinal Manipulation
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Use of High Velocity-Low Amplitude Thrusts in Spinal Manipulation
Biomechanics is an instrumental science in managing spinal musculoskeletal disorders. This science requires the application of physical impulses on the treatment points on the spine that occurs only for a short duration, typically ranging between 100 to 200 milliseconds (Colombi & Testa, 2019; Gorrell et al., 2016; Harwich, 2017). These impulses help distribute the stress in the affected tissues and control the associated pain or discomfort. In most cases, a technique such as thrusts delivery with the high velocity, low amplitude (HVLA) through the spine joints is vital in restoring motions within the bones of the neck and back.
Primary, chiropractors, use high-velocity low amplitude thrusts in preventing and controlling the pain that affects the joints of the spine with the main aim of bringing back joint motion to normal. This method is only effective when conducted appropriately by the use of manual or machine techniques (Jordon et al., 2017). On most occasions, the required resources for performing this kind of biomechanical therapy involve the use of hands that are usually coupled by skilled personnel who can do the high velocity and low amplitude required for about150 milliseconds. Also, the use of devices is useful in delivering the impulses within a relatively shorter time of fewer than ten milliseconds. Even though running these machines must be accompanied by skillful personnel to avoid the risk that may arise due to the technical failure or lack of proper expertise. Typically, the mechanically-assisted manipulation of the spine is more effective than manual method since the thrust velocity and magnitude are standardizable.
However, the physical impulses providers must take note of the physical fitness of the patient, and be acquitted with the device setting if in case they are using the machine-assisted- technique to prevent further complications that may arise afterward (Sarker et al., 2020). Besides, the manipulative thrust delivery is largely dependent on the anatomy of the treatment location and mobility of the spinal tissues. Therefore, it is essential to have a proper understanding of the mentioned factors.
References
Colombi, A., & Testa, M. (2019). The effects induced by spinal manipulative therapy on the immune and endocrine systems. Medicina, 55(8), 448. https://doi.org/10.3390/medicina55080448
Gorrell, L. M., Engel, R. M., Brown, B., & Lystad, R. P. (2016). The reporting of adverse events following spinal manipulation in randomized clinical trials—a systematic review. The Spine Journal, 16(9), 1143-1151. https://doi.org/10.1016/j.spinee.2016.05.018
Harwich, A. S. (2017). Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques. Journal of chiropractic humanities, 24(1), 15-23. https://doi.org/10.1016/j.echu.2017.01.001
Jordon, M. K., Beattie, P. F., D’Urso, S., & Scriven, S. (2017). Spinal manipulation does not affect pressure pain thresholds in the absence of neuromodulators: a randomized controlled trial. Journal of Manual & Manipulative Therapy, 25(4), 172-181. https://doi.org/10.1080/10669817.2016.1230352
Sarker, K. K., Sethi, J., & Mohanty, U. (2020). Comparative clinical effects of spinal manipulation, core stability exercise, and supervised exercise on pain intensity, segmental instability, and health-related quality of life among patients with chronic nonspecific low back pain: A randomized control trial. Journal of Natural Science, Biology and Medicine, 11(1), 27. https://doi.org/10.4103/jnsbm.JNSBM_101_19