In vivo transient vibration assessment of the normal human thoracolumbar spine

Objective: The objective of this study was to quantify the mobility characteristics dynamic stiffness and mechanical impedance) of the normal human thoracolumbar spine with a transient vibration analysis technique. Design: This study is a prospective clinical investigation to obtain normative biomechanical data from the human male and female spine in vivo. Setting: Musculoskeletal research laboratory, university setting. Subjects: Twenty asymptomatic subjects (age range, 20-60 years) with no recent history of musculoskeletal complaints. Main Outcome Measures: Mechanical impedance, effective stiffness, and resonant frequency analyses were used to quantify the dynamic stiffness of the thoracolumbar spine in this subject population. Data were obtained from posteroanterior mechanical thrusts delivered with an activator adjusting instrument equipped with a load cell and accelerometer by means of a portable computer. Results: In response to the activator adjusting instrument thrusts, the thoracolumbar spine typically exhibited an impedance minimum at Frequencies ranging between 30 and 50 Hz. The maximum posteroanterior impedance and corresponding maximum effective stiffness of the thoracolumbar spine and sacrum was roughly 3 to 8 times greater than the magnitude of the impedance minimum. Statistically significant differences in mobility between male and female subjects were noted, particularly for frequencies corresponding to male and female subjects were noted, pars the maximum mobility (40 Hz) and minimum mobility (10-20 Hz, 70-80 Hz). For most subjects (both male and female), the lumbar region exhibited a higher impedance and stiffness (less mobility) when compared with the thoracic region. Conclusions: The posteroanterior mechanical behavior of the human thoracolumbar spine was Found to be sensitive to mechanical stimulus frequency and showed significant region-specific and gender differences. In the frequency range of 30 to 50 Hz, the lumbar spine of this subject population is the least stiff and therefore has the greatest mobility. From a biomechanical point-of-view, the results of this study indicate that dynamic spinal manipulative therapy procedures will produce more spinal motion for a given force, particularly when the posteroanterior manipulative thrust is delivered in frequency ranges at or near the resonant frequency. In this regard, spinal manipulative therapy procedures designed to target the resonant frequency of the spine require less force application. Both magnitude and Frequency content of manual and mechanical thrusting manipulations may be critical elements for therapeutic outcome.