Search JIM Advanced Search

Journal of Integrative Medicine ›› 2022, Vol. 20 ›› Issue (1): 4-12.doi: 10.1016/j.joim.2021.10.002

• Review • Previous Articles     Next Articles

Effects of biomechanical parameters of spinal manipulation: A critical literature review

Giles Gyer a, Jimmy Michael a, James Inklebarger a, Imtiaz Ibne Alam b   

  1. a Department of Clinical Skills, the London College of Osteopathic Medicine, Boston Place, London NW1, United Kingdom of Great Britain and Northern Ireland
    b Department of Pharmacy, Stamford University Bangladesh, Dhaka 1217, Bangladesh
  • Received:2021-03-02 Accepted:2021-08-10 Online:2022-01-12 Published:2021-10-19
  • Contact: Giles Gyer

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 undetermined 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 significance, 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 clinicians to deliver the therapy in order to explore the true clinical significance of the dose-response relationship.

Key words: Spinal manipulation, Biomechanical characteristics, Biomechanical parameters, Dosage, Force-time profile

[1] Jie-yu Zuo, Chulhun Park, Michael Doschak, Raimar Löbenberg. Are the release characteristics of Erzhi pills in line with traditional Chinese medicine theory? A quantitative study. Journal of Integrative Medicine, 2021, 19(1): 50-55.
[2] Bao Yan-ju, Hua Bao-jin. Discussion on six errors of formulas corresponding to syndromes in using the classic formulas. Journal of Chinese Integrative Medicine, 2012, 10(12): 1363-1370.
[3] Shreeraj H. Shah, Jayvadan K. Patel, Nirav V. Patel. Gastroretentive floating drug delivery systems with potential herbal drugs for Helicobacter pylori eradication: A review. Journal of Chinese Integrative Medicine, 2009, 7(10): 976-982.
Full text



[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239