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Aim <p>The ongoing debate surrounding spinal vertebral manipulation revolves around whether the observed effects result from an actual mechanical change in vertebral segmental position or if they are attributed to the placebo effect of manipulation and the audible “click” sound originating from the vertebral joint.</p> Methods <p>This single-blinded, randomized controlled trial included 28&#xa0;male athletes, divided into intervention and sham groups. The intervention group received thoracic spine thrust manipulation, while the sham group underwent identical positioning without thrust application. Vertebral alignment in the thoracic and lumbar regions was assessed pre- and post-treatment using stereophotogrammetric surface analysis in a&#xa0;standing position.</p> Results <p>Thoracic thrust manipulation led to a&#xa0;statistically significant acute decrease in the maximum kyphotic angle (from 52.2 ± 9.2° to 49.3 ± 8.5°, <i>p</i> = 0.05) and vertebral rotation in the horizontal plane (−1.7 ± 6° to −1.2 ± 5°, <i>p</i> = 0.03) compared to the sham group. No significant changes were found in the maximum value of the lordotic angle, sagittal shift, or coronal shift (<i>p</i> &gt; 0.05).</p> Conclusion <p>The true acute kinematic effects of thoracic high-velocity, low-amplitude thrust practices are observed within the targeted thoracal region and do not significantly instant impact in lumbar segments indirectly. While this finding may not provide precise information about the therapeutic efficacy of vertebral manipulation, it can still be valuable for clinicians and researchers in understanding the mechanism of action behind spinal manipulation and in comparing its biomechanical effects with placebo therapies.</p>

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Immediate biomechanical impact of segmental thrust manipulation versus sham manipulation on thoracic vertebral alignment

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Kemal Eren Guducu,
  • Bihter Akinoglu,
  • Tugba Kocahan,
  • Hilal Yazici Ilhan,
  • Hayri Baran Yosmaoglu

摘要

Aim

The ongoing debate surrounding spinal vertebral manipulation revolves around whether the observed effects result from an actual mechanical change in vertebral segmental position or if they are attributed to the placebo effect of manipulation and the audible “click” sound originating from the vertebral joint.

Methods

This single-blinded, randomized controlled trial included 28 male athletes, divided into intervention and sham groups. The intervention group received thoracic spine thrust manipulation, while the sham group underwent identical positioning without thrust application. Vertebral alignment in the thoracic and lumbar regions was assessed pre- and post-treatment using stereophotogrammetric surface analysis in a standing position.

Results

Thoracic thrust manipulation led to a statistically significant acute decrease in the maximum kyphotic angle (from 52.2 ± 9.2° to 49.3 ± 8.5°, p = 0.05) and vertebral rotation in the horizontal plane (−1.7 ± 6° to −1.2 ± 5°, p = 0.03) compared to the sham group. No significant changes were found in the maximum value of the lordotic angle, sagittal shift, or coronal shift (p > 0.05).

Conclusion

The true acute kinematic effects of thoracic high-velocity, low-amplitude thrust practices are observed within the targeted thoracal region and do not significantly instant impact in lumbar segments indirectly. While this finding may not provide precise information about the therapeutic efficacy of vertebral manipulation, it can still be valuable for clinicians and researchers in understanding the mechanism of action behind spinal manipulation and in comparing its biomechanical effects with placebo therapies.