Spinal manipulation in the 11th century Middle East.
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OBJECTIVE: To explore the effect of manipulation on segmental motion of lumbar vertebra and the clinical significance before and after treatment, and evaluation with charge couple device (CCD) measurement system. METHODS: CCD and dynamic radiography were conducted in 30 patients before and after treated by manipulation or other conservative therapy, analysis and comparisons in segmental motion ranges of flexion-extension and lateral bending, correlation between data of CCD system and radiography as well as characteristics of lumbar vertebral function recovery after manipulation were performed. RESULTS: Certain correlation between data of CCD and radiography was shown by linear correlation test (r = 0.42-0.72, P < 0.05-0.01). Paired t test showed that the lower lumbar segmental flexion-extension function was significantly recovered (t = 2.26-2.61, P < 0.05-0.01) after manipulation, but the recovery on other segments was insignificant. CONCLUSION: The special designed CCD system is of important clinical significance in assessing segmental lumbar vertebral function. Lower lumbar vertebral flexion-extention functional state is a crucial criterium for evaluation of manipulative therapy in lumbar intervertebral disc protrusion.
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The product of the adjusting physician's mass and acceleration does not quantify the adjustive force as popularly believed, an error stemming from a misunderstanding of Newton's second law. In this paper, a gedanken experiment illustrates the misapplication of F = ma and suggests that the adjustive force depends on the impact velocity, mass of the doctor, and intrinsic physical properties of the doctor and patient.
The average adjustive force is shown to be an explicit function of the doctor's mass, the doctor's impact velocity, and the intrinsic stiffness and elasticity of the doctor and patient. A simple model is used to derive an adjustive force equation. The generalization of this equation to actual manipulative technique is also explored.
The role of quickness, adjustive amplitude, preadjustive tension, and countertension in facilitating joint distraction to cavitation is investigated. These characteristics are further shown to contribute to joint isolation, protection of joints from injury, and enhanced adjustive efficiency. Block and spring "slinky dog" models aid in illustrating the physics principles involved. The complete role of mass and acceleration in the adjustive process is discussed.
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