Spinal manipulation is a manual treatment technique that delivers a thrust,using specific biomechanical parameters to exert its therapeutic effects.These parameters have been shown to have a unique dose-response relationship with the physiological responses of the therapy.So far,however,there has not been a unified approach to standardize these biomechanical characteristics.In fact,it is still undeter-mined how they affect the observed clinical outcomes of spinal manipulation.This study,therefore,reviewed the current body of literature to explore these dosage parameters and evaluate their signifi-cance,with respect to physiological and clinical outcomes.From the experimental studies reviewed herein,it is evident that the modulation of manipulation's biomechanical parameters elicits transient physiological responses,including changes in neuronal activity,electromyographic responses,spinal stiffness,muscle spindle responses,paraspinal muscle activity,vertebral displacement,and segmental and intersegmental acceleration responses.However,to date,there have been few clinical trials that tested the therapeutic relevance of these changes.In addition,there were some inherent limitations in both human and animal models due to the use of mechanical devices to apply the thrust.Future studies evaluating the effects of varying biomechanical parameters of spinal manipulation should include clini-cians to deliver the therapy in order to explore the true clinical significance of the dose-response relationship.

Giles Gyer;Jimmy Michael;James Inklebarger;Imtiaz Ibne Alam

Department of Clinical Skills,the London College of Osteopathic Medicine,Boston Place,London NW1,United Kingdom;Department of Pharmacy,Stamford University Bangladesh,Dhaka 1217,Bangladesh

结合医学学报（英文版）

[1]Giles Gyer;Jimmy Michael;James Inklebarger;Imtiaz Ibne Alam-.Effects of biomechanical parameters of spinal manipulation:A critical literature review)[J].结合医学学报（英文版）,2022(01):4-12

undeter,paraspinal,intersegmental,cians

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