Evidence map›Paper›PMID 40500758›Full record

Trial reportChiropractic & manual therapies2025

Efficacy of different biomechanical strategies for modulating force-time parameters of high-velocity low-amplitude manipulation of the thoracic spine: a randomized crossover experimental study.

Grand Choi, Averie McGuinty, Nicole Meaghan Smith, Erinn McCreath Frangakis, David Starmer, Samuel J Howarth, Simon Wang

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Chiropractic & manual therapies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Grand ChoiDivision of Undergraduate and Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Averie McGuintyDivision of Undergraduate and Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Nicole Meaghan SmithDivision of Undergraduate and Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Erinn McCreath FrangakisDepartment of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue, Waterloo, ON, Canada.
David StarmerDivision of Undergraduate and Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Samuel J HowarthDivision of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, Canada.
Simon WangDivision of Undergraduate and Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. swang@cmcc.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManual therapy, including high-velocity low-amplitude spinal manipulation (HVLA-SM), is a complex motor task performed by trained individuals. The ability to modulate the magnitude of applied forces is an attribute of proficiency that is challenging for providers and students. Adopting different biomechanical strategies may facilitate force modulation by practitioners performing HVLA-SM. This study evaluated the efficacy of different biomechanical strategies on force-time characteristics of prone thoracic HVLA-SM.

methodsA randomized crossover experimental design was used. Data were collected between October 2022 and May 2023 from chiropractic students at the Canadian Memorial Chiropractic College who performed HVLA-SM targeted to the thoracic spine of a prone-lying manikin using as much force as possible in each of six different strategies. Strategies (S1 to S6) were specifically developed to successively increase a person's ability to produce force while performing HVLA-SM. Force-time parameters for the HVLA-SM trials were recorded. Peak force was the primary outcome of interest while preload force, load rate, and time to peak force were analyzed as secondary measures.

resultsData were collected from 97 participants (51 female). Peak force increased successively from S1 to S5 with moderate effects (- 0.45 ≤ effect size ≤ -0.72). There was no statistical difference in either peak force or load rate between S5 and S6. Load rate also did not statistically increase between S3 and S4 where different muscle groups were targeted to produce force. The strategy with the highest peak force (S6) also demonstrated the lowest preload force.

conclusionsStrategies used in this study effectively facilitated modulation of force-time characteristics of prone thoracic HVLA-SM. Thus, training approaches may consider introducing people to different biomechanical strategies to enhance HVLA-SM force modulation.

Indexed as

Manipulation, SpinalThoracic VertebraeAdultBiomechanical PhenomenaCross-Over StudiesFemaleHumansMaleManikinsYoung AdultForce-sensingManual therapyMotor learningSkill developmentSpinal manipulation

Identifiers

PMID40500758
PMCPMC12160424

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.