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Background <p>Many health care professionals use spinal mobilization (MOB) and manipulation (MAN) to treat musculoskeletal disorders. Research shows advantages of learning these techniques using a manikin. However, the force–time characteristics of MOB and MAN applied to manikins may differ from those delivered clinically to humans. This study reports on differences between the force–time characteristics of MOB and MAN delivered by experienced physiotherapists to the thoracic spine of both humans and a manikin.</p> Methods <p>Data were collected September–October 2023. Experienced physiotherapists applied prone MOB (Grade 3 central posterior-to-anterior, 30&#xa0;s) and a single prone MAN to the T6 vertebra of three healthy human volunteers and a manikin with each volunteer-manikin pair representing one of three different patient scenarios (vignettes): vignette&#xa0;1: 30-year-old male, 185&#xa0;cm; vignette&#xa0;2: 50-year-old male, 175&#xa0;cm, and vignette 3: 65-year-old female, 165&#xa0;cm. The applied forces were measured using a flexible pressure pad (100&#xa0;Hz) and were compared descriptively between humans and the manikin.</p> Results <p>Data were analyzed from 13 physiotherapists (seven females, age (median, IQR): 40 (36–45) years, experience as physiotherapist: 14 (12–21) years). Peak forces on the manikin were higher than on the humans. Specifically, for MOB, average mean peak force differences (95% confidence interval) were: vignette 1: 58N (36, 80); vignette 2: 99N (74, 124); and vignette 3: 50N (31, 68). Similarly, for MAN, average peak force differences were: vignette 1: 128N (79, 177); vignette 2: 147N (94, 199); and vignette 3: 137N (101, 172). For MAN, greater mean peak forces were applied on vignette 1 than vignette 3 on the human 355N vs 284N and on the manikin 483N vs 421N.</p> Conclusion <p>In this study force–time characteristics of MOB and MAN performed by experienced physiotherapists on the thoracic spine of a manikin were different from those delivered to healthy humans: the forces applied to the manikin were higher for all vignettes for both techniques. However, forces were modulated to the vignette, both on the human and manikin.</p>

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Force variability of thoracic spine mobilization and manipulation delivered by experienced physiotherapists to healthy human volunteers and a manikin: an observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月9日

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  • Nathalie Thurnherr,
  • Petra Schweinhardt,
  • Lindsay M. Gorrell

摘要

Background

Many health care professionals use spinal mobilization (MOB) and manipulation (MAN) to treat musculoskeletal disorders. Research shows advantages of learning these techniques using a manikin. However, the force–time characteristics of MOB and MAN applied to manikins may differ from those delivered clinically to humans. This study reports on differences between the force–time characteristics of MOB and MAN delivered by experienced physiotherapists to the thoracic spine of both humans and a manikin.

Methods

Data were collected September–October 2023. Experienced physiotherapists applied prone MOB (Grade 3 central posterior-to-anterior, 30 s) and a single prone MAN to the T6 vertebra of three healthy human volunteers and a manikin with each volunteer-manikin pair representing one of three different patient scenarios (vignettes): vignette 1: 30-year-old male, 185 cm; vignette 2: 50-year-old male, 175 cm, and vignette 3: 65-year-old female, 165 cm. The applied forces were measured using a flexible pressure pad (100 Hz) and were compared descriptively between humans and the manikin.

Results

Data were analyzed from 13 physiotherapists (seven females, age (median, IQR): 40 (36–45) years, experience as physiotherapist: 14 (12–21) years). Peak forces on the manikin were higher than on the humans. Specifically, for MOB, average mean peak force differences (95% confidence interval) were: vignette 1: 58N (36, 80); vignette 2: 99N (74, 124); and vignette 3: 50N (31, 68). Similarly, for MAN, average peak force differences were: vignette 1: 128N (79, 177); vignette 2: 147N (94, 199); and vignette 3: 137N (101, 172). For MAN, greater mean peak forces were applied on vignette 1 than vignette 3 on the human 355N vs 284N and on the manikin 483N vs 421N.

Conclusion

In this study force–time characteristics of MOB and MAN performed by experienced physiotherapists on the thoracic spine of a manikin were different from those delivered to healthy humans: the forces applied to the manikin were higher for all vignettes for both techniques. However, forces were modulated to the vignette, both on the human and manikin.