Suzanne J. Snodgrass, Darren A. Rivett and Val J. Robertson
The aim of this study was to quantify the manual forces applied to the cervical spine during joint mobilization. Ten physiotherapists performed posterior-to-anterior mobilizations to C2 and C7 (both centrally and unilaterally, 1 right and 1 left, grades I-IV) on a single asymptomatic male subject. Manual forces were measured in 3 planes using an instrumented treatment table. The instrumented table showed excellent reliability and accuracy. There were considerable differences between therapists for mean peak force, force amplitude, and oscillation frequency for each technique and grade. Intratherapist repeatability for all mobilization parameters was high. Force amplitude and oscillation frequency measures indicated that therapists generally adhered to the published definitions of the grades of mobilization when applying force, but when asked, provided quite different definitions of the grades. The authors conclude that this study provides preliminary evidence that cervical mobilization forces vary considerably between therapists, but intratherapist repeatability is high.
Journal of Manipulative and Physiological Therapeutics, Volume 30, Issue 1,