The force sensing technology used in our FSTT® system has been around for a long time. Several research papers have been published using the hardware incorporated into our system, or our system directly.
Please see below for a reference list of studies related to force sensing technology in manual therapies to better understand the impact this technology has had on the profession, and opportunities for the future.
Cambridge ED, Triano JJ, Ross JK, Abbott MS. Comparison of force development strategies of spinal manipulation used for thoracic pain. Man Ther. (2012) 17:241–5. doi: 10.1016/j.math.2012.02.003
Chiradejnant A, Latimer J, Maher CG. Forces applied during manual therapy to patients with low back pain. J Manipul Physiol Ther. (2002) 25:362–9. doi: 10.1067/mmt.2002.126131
Chiradejnant A, Maher CG, Latimer J. Development of an instrumented couch to measure forces during manual physiotherapy treatment. Man Ther. (2001) 6:229–34. doi: 10.1054/math.2001.0418
Conradie M, Smit E, Louw M, Prinsloow M, Loubser L, Wilsdorf A. Do experienced physiotherapists apply equal magnitude of force during a grade I central pa on the cervical spine? South Afr J Physiother. (2004) 60:18. doi: 10.4102/sajp.v60i4.191
Conway P, Herzog W, Zhang Y, Hasler E, Ladly K. Forces required to cause cavitation during spinal manipulation of the thoracic spine. Clin Biomech. (1993) 8:210–4. doi: 10.1016/0268-0033(93)90016-B
Downie AS, Vemulpad S, Bull PW. Quantifying the high-velocity, low[1]amplitude spinal manipulative thrust: a systematic review. J Manipul Physiol Ther. (2010) 33:542–53. doi: 10.1016/j.jmpt.2010.08.001
Funabashi M, Nougarou F, Descarreaux M, Prasad N, Kawchuk GN. Does the application site of spinal manipulative therapy alter spinal tissues loading? Spine J. (2018) 18:1041–52. doi: 10.1016/j.spinee.2018.01.008
Funabashi M, Nougarou F, Descarreaux M, Prasad N, Kawchuk GN. Spinal tissue loading created by different methods of Spinal Manipulative Therapy (SMT) Application. Spine. (2017) 42:635–43. doi: 10.1097/BRS.0000000000002096
Goodsell M, Lee M, Latimer J. Short-term effects of lumbar posteroanterior mobilization in individuals with low-back pain. J Manipul Physiol Ther. (2000) 23:332–42. doi: 10.1016/S0161-4754(00)90208-2
Gorgos, Kara S., Nicole T. Wasylyk, Bonnie L. Van Lunen, and Matthew C. Hoch. Inter-clinician and intra-clinician reliability of force application during joint mobilization: a systematic review. Manual therapy 19, no. 2 (2014): 90-96. doi.org/10.1016/j.math.2013.12.003
Gudavalli M, Rowell R. Three-dimensional chiropractor-patient contact loads during side posture lumbar spinal manipulation: a pilot study. Chiropr Man Ther. (2014) 22:1–13. doi: 10.1186/s12998-014-0029-4
Gudavalli MR, Cox JM. Real-time force feedback during flexion-distraction procedure for low back pain: a pilot study. J Can Chiropr Assoc. (2014) 58:193–200.
Gudavalli MR, Devocht J, Tayh A, Xia T. Effect of sampling rates on the quantification of forces, durations, and rates of loading of simulated side posture high-velocity, low-amplitude lumbar spine manipulation. J Manipul Physiol Ther. (2013) 36:261–6. doi: 10.1016/j.jmpt.2013. 05.010
Gudavalli MR. Instantaneous rate of loading during manual high-velocity, low-amplitude spinal manipulations. J Manipul Physiol Ther. (2014) 37:294–9. doi: 10.1016/j.jmpt.2014.01.006
Harms MC, Bader DL. Variability of forces applied by experienced therapists during spinal mobilization. Clin Biomech. (1997) 12:393–9. doi: 10.1016/S0268-0033(97)00023-5
Harms MC, Innes SM, Bader DL. Forces measured during spinal manipulative procedures in two age groups. Rheumatology. (1999) 38:267–74. doi: 10.1093/rheumatology/38.3.267
Herzog W, Kats M, Symons B, Herzog W, Kats M, Symons B. The effective forces transmitted by high-speed, low-amplitude thoracic manipulation including commentary by Swenson RS. Spine. (2001) 26:2105– 11. doi: 10.1097/00007632-200110010-00012
Hessell BW, Herzog W, Conway PJ, Mcewen MC. Experimental measurement of the force exerted during spinal manipulation using the Thompson technique. J Manipul Physiol Ther. (1990) 13:448–53.
Howarth SJ, D’angelo K, Triano JJ. Development of a linked segment model to derive patient low back reaction forces and moments during high-velocity low-amplitude spinal manipulation. J Manipul Physiol Ther. (2016) 39:176–84. doi: 10.1016/j.jmpt.2016.02.009
Kawchuk GN, Herzog W. Biomechanical characterization (fingerprinting) of five novel methods of cervical spine manipulation. J Manipul Physiol Ther. (1993) 16:573–7.
Kirstukas SJ, Backman JA. Physician-applied contact pressure and table force response during unilateral thoracic manipulation. J Manipul Physiol Ther. (1999) 22:269–79. doi: 10.1016/S0161-4754(99)70059-X
Mercier, Marie-Andrée, Philippe Rousseau, Martha Funabashi, Martin Descarreaux, and Isabelle Pagé. Devices used to measure force-time characteristics of spinal manipulations and mobilizations: A mixed-methods scoping review on metrologic properties and factors influencing use. Frontiers in Pain Research 2 (2021). doi : 10.3389/fpain.2021.755877
Mikhail J, Funabashi M, Descarreaux M, Pagé I. Assessing forces during spinal manipulation and mobilization: factors influencing the difference between forces at the patient-table and clinician-patient interfaces. Chiropract Manual Ther. (2020) 28:1–10. doi: 10.1186/s12998-020-00346-1
Pasquier M, Daneau C, Marchand AA, Lardon A, Descarreaux M. Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review. Chiropr Man Therap. (2019) 27:23. doi: 10.1186/s12998-019-0244-0
Petersen EJ, Thurmond SM, Shaw CA, Miller KN, Lee TW, Koborsi JA. Reliability and accuracy of an expert physical therapist as a reference standard for a manual therapy joint mobilization trial. J Man Manip Ther. (2021) 29:189–95. doi: 10.1080/10669817.2020.1844853
Rogers CM, Triano JJ. Biomechanical measure validation for spinal manipulation in clinical settings. J Manipul Physiol Ther. (2003) 26:539–48. doi: 10.1016/j.jmpt.2003.08.008
Snodgrass SJ, Rivett DA, Robertson VJ, Stojanovski E. Forces applied to the cervical spine during posteroanterior mobilization. J Manipul Physiol Ther. (2009) 32:72–83. doi: 10.1016/j.jmpt.2008.09.012
Snodgrass SJ, Rivett DA, Robertson VJ. Calibration of an instrumented treatment table for measuring manual therapy forces applied to the cervical spine. Man Ther. (2008) 13:171–9. doi: 10.1016/j.math.2007.04.002
Snodgrass SJ, Rivett DA, Robertson VJ. Manual forces applied during cervical mobilization. J Manipul Physiol Ther. (2007) 30:17–25. doi: 10.1016/j.jmpt.2006.11.008
Snodgrass SJ, Rivett DA, Robertson VJ. Manual forces applied during posterior-to-anterior spinal mobilization: a review of the evidence. J Manipul Physiol Ther. (2006) 29:316–29. doi: 10.1016/j.jmpt.2006.03.006
Todd AJ, Carroll MT, Mitchell EK. Forces of commonly used chiropractic techniques for children: a review of the literature. J Manipul Physiol Ther. (2016) 39:401–10. doi: 10.1016/j.jmpt.2016.05.006
Triano J, Schultz AB. Loads transmitted during lumbosacral spinal manipulative therapy. Spine. (1997) 22:1955–64. doi: 10.1097/00007632-199709010-00003
Triano JJ, Lester S, Starmer D, Hewitt EG. Manipulation peak forces across spinal regions for children using mannequin simulators. J Manipul Physiol Ther. (2017) 40:139–46. doi: 10.1016/j.jmpt.2017.01.001
Triano JJ. Biomechanics of spinal manipulative therapy. Spine J. (2001) 1:121–30. doi: 10.1016/S1529-9430(01)00007-9
Tuttle N, Jacuinde G. Design and construction of a novel low-cost device to provide feedback on manually applied forces. J Orthopaedic Sports Phys Ther. (2011) 41:174–9. doi: 10.2519/jospt.2011.3461
Van Zoest G, Gosselin G. Three-dimensionality of direct contact forces in chiropractic spinal manipulative therapy. J Manipul Physiol Ther. (2003) 26:549–56. doi: 10.1016/j.jmpt.2003.08.001
Van Zoest GGJM, Van Den Berg HTCM, Holtkamp FC. Three[1]dimensionality of contact forces during clinical manual examination and treatment: a new measuring system. Clin Biomech. (2002) 17:719–22. doi: 10.1016/S0268-0033(02)00132-8
Waddington G, Diong J, Adams R. Development of a hand dynamometer for the control of manually applied forces. J Manipul Physiol Ther. (2006) 29:297–304. doi: 10.1016/j.jmpt.2006.03.007
Waddington GS, Adams RD. Initial development of a device for controlling manually applied forces. Man Ther. (2007) 12:133–8. doi: 10.1016/j.math.2006.06.009
Descarreaux M, Dugas C, Lalanne K, Vincelette M, Normand MC. Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters. Spine J. (2006) 6:138–45. doi: 10.1016/j.spinee.2005.07.001
Kope R, O’brien J, Sadi J, Walton DM, Ferreira LM. Quantifying performance metrics of cervical spine mobilization for improved education and clinical outcomes: early experience with a novel wearable device. J Rehabil Assistive Technol Eng. (2018) 5:2055668318765396. doi: 10.1177/2055668318765396
Lardon A, Pasquier M, Audo Y, Barbier-Cazorla F, Descarreaux M. Effects of an 8-week physical exercise program on spinal manipulation biomechanical parameters in a group of 1st-year chiropractic students. J Chiropract Educ. (2019) 33:118–24. doi: 10.7899/JCE-18-15
Pasquier, Mégane, Charlène Chéron, Gaëtan Barbier, Claude Dugas, Arnaud Lardon, and Martin Descarreaux. "Learning spinal manipulation: objective and subjective assessment of performance." Journal of Manipulative and Physiological Therapeutics 43, no. 3 (2020): 189-196. doi:10.1019/j.jmpt.2019.12.010
Petersen EJ, Thurmond SM, Buchanan SI, Chun DH, Richey AM, Nealon LP. The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial. J Man Manip Ther. (2019) 1–11. doi: 10.1080/10669817.2019.1673953
Petersen EJ, Thurmond SM, Shaw CA, Miller KN, Lee TW, Koborsi JA. Reliability and accuracy of an expert physical therapist as a reference standard for a manual therapy joint mobilization trial. J Man Manip Ther. (2021) 29:189–95. doi: 10.1080/10669817.2020.1844853
Sheaves EG, Snodgrass SJ, Rivett DA. Learning lumbar spine mobilization: the effects of frequency and self-control of feedback. J Orthopaedic Sports Phys Ther. (2012) 42:114–24. doi: 10.2519/jospt.2012. 3691
Snodgrass SJ, Rivett DA, Robertson VJ, Stojanovski E. A comparison of cervical spine mobilization forces applied by experienced and novice physiotherapists. J Orthopaedic Sports Phys Ther. (2010) 40:392–401. doi: 10.2519/jospt.2010.3274
Snodgrass SJ, Rivett DA, Robertson VJ, Stojanovski E. Real-time feedback improves accuracy of manually applied forces during cervical spine mobilisation. Man Ther. (2010) 15:19–25. doi: 10.1016/j.math.2009. 05.011
Stainsby BE, Clarke MCS, Egonia JR. Learning spinal manipulation: a best evidence synthesis of teaching methods. J Chiropract Educ. (2016) 30:138–51. doi: 10.7899/JCE-15-8
Starmer DJ, Guist BP, Tuff TR, Warren SC, Williams MGR. Changes in manipulative peak force modulation and time to peak thrust among first-year chiropractic students following a 12-week detraining period. J Manipul Physiol Ther. (2016) 39:311–7. doi: 10.1016/j.jmpt.2016.02.010
Triano J, Descarreaux M, Dugas C. Biomechanics–review of approaches for performance training in spinal manipulation. J Electromyogr Kinesiol. (2012) 22:732–9. doi: 10.1016/j.jelekin.2012.03.011
Triano JJ, Gissler T, Forgie M, Milwid D. Maturation in rate of high[1]velocity, low-amplitude force development. J Manipulative Physiol Ther. (2011) 34:173–80. doi: 10.1016/j.jmpt.2011.02.007
Triano JJ, Rogers CM, Combs S, Potts D, Sorrels K. Developing skilled performance of lumbar spine manipulation [randomized controlled Frontiers in Pain Research | www.frontiersin.org 12 October 2021| Volume 2 | Article 755877 Mercier et al. Manual Therapy Force-Time Characteristics Measurement trial]. J Manipul Physiol Ther. (2002) 25:353–61. doi: 10.1067/mmt.2002. 126132
Van Zoest GGJ, Staes FFG, Stappaerts KH. Three-dimensional manual contact force evaluation of graded perpendicular push force delivery by second-year physiotherapy students during simple feedback training. J Manipul Physiol Ther. (2007) 30:438–49. doi: 10.1016/j.jmpt.2007.06.001
Aguirrebena IL, Newham D, Critchley DJ. Mechanism of action of spinal mobilizations: a systematic review. Spine. (2016) 159–72. doi: 10.1097/BRS.0000000000001151
Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. (2009) 14:531–8. doi: 10.1016/j.math.2008.09.001
Conradie M, Smit E, Louw M, Prinsloow M, Loubser L, Wilsdorf A. Do experienced physiotherapists apply equal magnitude of force during a grade I central pa on the cervical spine? South Afr J Physiother. (2004) 60:18. doi: 10.4102/sajp.v60i4.191
Conway P, Herzog W, Zhang Y, Hasler E, Ladly K. Forces required to cause cavitation during spinal manipulation of the thoracic spine. Clin Biomech. (1993) 8:210–4. doi: 10.1016/0268-0033(93)90016-B
Goodsell M, Lee M, Latimer J. Short-term effects of lumbar posteroanterior mobilization in individuals with low-back pain. J Manipul Physiol Ther. (2000) 23:332–42. doi: 10.1016/S0161-4754(00)90208-2
Pasquier M, Daneau C, Marchand AA, Lardon A, Descarreaux M. Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review. Chiropr Man Therap. (2019) 27:23. doi: 10.1186/s12998-019-0244-0
Waddington G, Lau G, Adams R. Manual application of controlled forces to thoracic and lumbar spine with a device: rated comfort for the receiver’s back and the applier’s hands. J Manipul Physiol Ther. (2007) 30:365–73. doi: 10.1016/j.jmpt.2007.04.006
