measurINg forceS durInG cHiropractic Treatment

Low back pain (LBP) is a well-recognized health problem. One common manual therapy available
for the treatment of LBP is spinal manipulation (SM), which can be separated into 2
categories: High-Velocity Low-Amplitude (thrust) and Low-Velocity (non-thrust) SM according
to their force-delivery profiles. One commonly utilized non-thrust SM technique is the
Flexion-Distraction procedure. Several studies have reported manually applied forces during
thrust SM; however, the forces used during non-thrust SM, specifically those used with
Flexion-Distraction treatment are still unknown. The results of this pilot study will
provide preliminary information on treatment forces and sample size justification for future
full-scale trials, while also ascertaining the feasibility of the study protocol and patient
recruitment methods for such trials.

Inclusion Criteria:

- Able to demonstrate the necessary abilities (English language, literacy) needed to
provide informed consent without the assistance of another person (e.g., a proxy,
spouse, family member or other support person)

- Self-reported low back pain (acute, subacute or chronic) at the time of examination
and enrollment

Exclusion Criteria:

- Weight > 300lbs

- Spinal Pathology or conditions contraindicating study procedures or compromising
participant safety

- Inflammatory arthropathy involving the spine (e.g. Ankylosing spondylitis, Rheumatoid
arthritis)

- Spinal fracture in the past 6 months

- Other conditions requiring referral (e.g. self-reporting alcohol/substance dependence
or abuse, unstable spinal segments, and cauda equina syndrome)

- Pregnant or planning to become pregnant within the next 5 weeks

- Unable to tolerate study procedures safely

- Altered Mental Capacity

- Sensitivity to adhesives used in the study

- Uncontrolled hypertension

- Co-morbidity requiring simultaneous clinical management that compromises ability to
deliver study procedures or assess the participant's heath status or poses as a
scheduling burden

- Retention of legal advice or seeking a health-related insurance claim

- Compliance concerns (e.g. scheduling conflicts, moving from the quad city area,
unwilling to undergo required study procedures or receive treatment from study
doctor(s))

- Quebec Task Force Classification of 10 or 11: (chronic pain syndrome,
visceral/infectious source of LBP)