Clinical Biomechanics
Volume 12, Issue 6 , Pages 393-399, September 1997

Variability of forces applied by experienced therapists during spinal mobilization

  • M.C. Harms

      Affiliations

    • Corresponding Author InformationCorrespondence and reprint requests to: Dr M. Harms, Camden and Islington Community Health Services NHS Trust, c/o Physiotherapy Department, The Middlesex Hospital, Mortimer Street, London W1N 8AA, UK.
    • Camden and Islington Community Health Services NHS Trust, Physiotherapy Department, The Middlesex Hospital, London, UK
    • Department of Materials and IRC in Biomedical Materials, Queen Mary and Westfield College, University of London, London, UK
    • ,
  • D.L. Bader

      Affiliations

    • Department of Materials and IRC in Biomedical Materials, Queen Mary and Westfield College, University of London, London, UK

Received 26 November 1996; accepted 19 March 1997.

Abstract 

Objective. To determine the variation in forces used by different therapists during mobilization of the lumbar spine and the repeatability and reproducibility of individual therapists.

Design. An instrumented mobilization couch was developed to measure the forces applied to the trunk during spinal mobilization.

Background. Due to limitations in equipment design and data analysis, previous related studies demonstrate equivocal results.

Methods. The system was used to collect data from a sample of 30 experienced therapists to evaluate variation, repeatability and reproducibility during the application of five mobilization procedures.

Results. The variation in forces used by different therapists when performing the same technique was substantial, ranging between 63 and 347 N for one technique. During this procedure, 30% of the therapists were found to be relatively consistent, repeating the magnitude of the force applied at the first session within 5%. Others demonstrated considerable variation, exhibiting a difference as great as 34%.

Conclusions. The inconsistency between experienced therapists has considerable implications for clinical practice. Changes in the magnitude and rate of loading are likely to have different effects due to the inherent viscoelastic behaviour of soft tissues.

Keywords:  Spinal mobilization, repeatability, reproducibility, low back pain, force measurement

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PII: S0268-0033(97)00023-5

Clinical Biomechanics
Volume 12, Issue 6 , Pages 393-399, September 1997

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