title: Quantification of prone thoracic manipulation using inertial sensor-derived accelerations.
abstract: OBJECTIVE
  The aim of this study was to determine the linear acceleration, time-to-peak acceleration, and effect of hand position comparing 2 clinicians completing a thoracic manipulation.
  
  
  METHODS
  Thirteen volunteers received a right- and left-"handed" prone thoracic manipulation while accelerations were recorded by an inertial sensor. Peak thrust acceleration and time-to-peak thrust were measured.
  
  
  RESULTS
  There were differences in thrust acceleration between right- and left-handed techniques for one therapist. The mean peak thrust acceleration was different between therapists, with the more practiced therapist demonstrating greater peak thrust accelerations. Time-to-peak acceleration also revealed between therapist differences, with the more practiced therapist demonstrating shorter time-to-peak acceleration. Cavitation data suggested that manipulations with greater accelerations were more likely to result in cavitation.
  
  
  CONCLUSIONS
  The results of this study suggest that with greater frequency of use, therapists are likely to achieve greater accelerations and shorter time-to-peak accelerations. Furthermore, this study showed that an inertial sensor can be used to quantify important variables during thoracic manipulation and are able to detect intertherapist differences in technique.
authors.affiliation: Lecturer in Physiotherapy, School of Health and Social Care, Bournemouth University, Bournemouth, UK. Electronic address: jwilliams@bournemouth.ac.uk.
authors.forename: Jonathan Mark
authors.initials: JM
authors.lastname: Williams
authors.affiliation: Professor, Faculty of Health Sciences, Department of Psychiatry and Physiotherapy, University of Malaga, Malaga, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cuesta-Vargas
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D016684:Prone Position; D013904:Thoracic Vertebrae
keywords: Biomechanics; Manual Therapy; Spine