Forces Applied

Researchers work for ways to measure everything. That's science!

The Cox® Technic community is so grateful for all their work. Here are the articles related to those forces measured.

CERVICAL SPINE

M. Ram Gudavalli, Stacie A. Salsbury, Robert D. Vining, Cynthia R. Long, Lance Corber, Avinash G. Patwardhan and Christine M. Goertz. Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials. 2015 Jun 5;16:259. doi: 10.1186/s13063-015-0770-6.
Gudavalli MR, Vining RD, Salsbury SA, Corber LG, Long CR, Patwardhan AG, Goertz CM. Clinician proficiency in delivering manual treatment for neck pain within specified force ranges. Spine J. 2015 Apr 1;15(4):570-6. doi: 10.1016/j.spinee.2014.10.016. Epub 2014 Oct 22.
Gudavalli MR, Vining RD, Salsbury SA, Goertz CM. Training and certification of doctors of chiropractic in delivering manual cervical traction forces: Results of a longitudinal observational study. J Chiropr Educ. 2014 Sep 19.
Gudavalli R, Potluri T, Carandang G et al. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study. Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 954134, 10 pages, 2013.

Cervical spine flexion distraction protocols lowerC4-C7 levels intradiscal pressures 96 - 1583 mmHG pressure depending on the level and protocol used.

LUMBAR SPINE

Gudavalli R, Cox J: Real-time force feedback during flexion-distraction procedure for low back pain: A pilot study. J Can Chiropr Assoc 2014; 58(2):193-197

documents the effective use of a pressure transducer to objectively measure and train physicians in the proper force application of flexion distraction procedures

ALEXANDER W, VINING R, GUDAVALLI. MR FORCES APPLIED TO PATIENTS WITH LOW BACK PAIN DURING FLEXION DISTRACTION TREATMENT: A CLINICAL CASE SERIES. ABSTRACTS OF ACC-RAC CONFERENCE PROCEEDINGS 2016 - (2016) Poster presentation abstracts. Journal of Chiropractic Education: March 2016, Vol. 30, No. 1, pp. 69-80.

The forces delivered by a chiropractor during manual and automated long y axis Cox® distraction, lateral flexion and circumduction) to 12 patients were studied from preload to maximum axial load delivered.
Peak axial load in manual distraction was 73.7N and with automated long y axis were 136.0N
Clinical note: training is necessary to discern and apply proper force during Cox® long y axis automated and manual flexion distraction and decompression spinal manipulation.
Note: Circumduction forces are higher. We teach circumduction is a strong force and elicited in good triple joint health.

Publications