Essential Literature
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.
Gregory Cramer et al. 2006
Conclusion:
The summaries of the literature for the 6 topic sections (anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system) indicated that a significant body of basic science research evaluating chiropractic spinal adjusting has been completed and published.
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.
Interexaminer Reliability of Thoracic Motion Palpation Using Confidence Levels
Cooperstein et. al 2009
Conclusion:
When each examiner was “very confident” as to the most fixated thoracic segment, the levels they identified were very close. This corresponds to “good” agreement, an uncommon result in most interexaminer motion palpation studies. Thus, the confidence level of examiners had an effect on the interexaminer reliability of thoracic spine.
Sizer et. al. 2007
Conclusion:
Findings suggest that the coupling of the thoracic spine is inconsistent and, if used in clinical reasoning and methodology, may merit specific segmental testing. More rigorous, in vivo investigations are needed to evaluate the coupling pattern of the thoracic spine in symptomatic subjects prepositioned in both thoracic flexion and extension. Present studies on coupling behavior may yield some useful information, but clinicians need to recognize that not all individuals will display the same mechanical behaviors.
Determining Cavitation Location During Lumbar and Thoracic SMT
Basic Science Research Related Chiropractic Spinal Adjusting
The Frictional Properties at the Skin-Fascia interface