Lumbar Biomechanics
Essential Literature
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DO PARTICIPANTS WITH LOW BACK PAIN WHO RESPOND TO SPINAL MANIPULATIVE THERAPY DIFFER BIOMECHANICALLY FROM NONRESPONDERS, UNTREATED CONTROLS OR ASYMPTOMATIC CONTROLS?
Wong et.al 2015
Conclusion:
Those reporting post-SMT improvement in disability demonstrated simultaneous changes between self-reported and objective measures of spinal function. This coherence did not exist for asymptomatic controls or no-treatment controls. These data imply that SMT impacts biomechanical characteristics within SMT responders not present in all patients with LBP. This work provides a foundation to investigate the heterogeneous nature of LBP, mechanisms underlying differential therapeutic response, and the biomechanical and imaging characteristics defining responders at baseline.
Inter-rater agreement,of the prone hip extension test &SLR
Bruno et.al. 2014
Conclusion:
Classification schemes for the PHE test and ASLR test based on the presence or absence of specific “abnormal” lumbopelvic motion patterns demonstrated substantial inter-rater agreement. Although the specificity of these schemes also appears to be relatively high, their sensitivity was found to be relatively poor.
Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body
Shin et.al 2013
Conclusion:
This study demonstrated that a dynamic lumbar axial rotation coupling with lateral bendings is segment-dependent and can create a coordinated dynamic coupling to maintain the global dynamic balance of the body. The results could improve our understanding of the normal physiologic lumbar axial rotation and to establish guidelines for diagnosing pathological lumbar motion.
Validity of Palpation Techniques For L5 Spinous Identification
Merz et. al. 2013
Conclusion:
For localization palpation, bony landmarks should be marked and used as an orientation and motion palpation should be used in context of the marked landmarks. The use of several techniques and their agreement with each other improves the accuracy of localization palpation significantly. Further studies should assess standardized technique combinations, with the aim to achieve a reproducible accurate assignment of anatomical structures by palpation.
Basic Science Research Related Chiropractic Spinal Adjusting
Gregory Cramer et al. 2006
Determining Cavitation Location During Lumbar and Thoracic SMT
Ross et. al. 2004
Conclusion:
It appears that SMT is not as accurate as once assumed. Perhaps the clinical response is the result of the fact that, in most cases, many cavitations occur during a single manipulative procedure. By this “shotgun” approach, the offending joints are manipulated and the patient responds. On the other hand, a general mechanical effect on tissues near the symptomatic site may be sufficient to produce effects. Whatever the case, techniques used to “target” treatment to a joint may not be necessary, but if accuracy is required, other techniques may need to be used.
The Frictional Properties at the Skin-Fascia interface
Bereznick et. al. 2002
Conclusion:
The skin–fascia interface over the thoracic spine exhibits negligible friction. This suggests that efforts to apply an oblique force during thoracic manipulation may be wasted effort. These novel results then challenge the concept that directional specificity during spine manipulation is required to generate desirable therapeutic outcome.