Biomechanical Analysis of the Coordinated Movements of the Therapist’s Hands and Feet during Lumbopelvic Manipulation: A Preliminary Study

Spinal manipulation (SM) is a common manual therapy technique; however, there is limited knowledge regarding the coordination of hand and foot forces during SM. This study investigated the biomechanics of force transmission and generation in the hands and feet of a single therapist who performed pelvic SM on 45 healthy subjects. Two force plates were used to measure the ground reaction forces (GRF) from the feet, and one controller was used to measure the contact hand forces (CHF). The results showed that foot force preceded hand force and that the foot and hand exhibited opposing patterns of force variation. The CHF peak was positively correlated with the CH preload maximum and minimum forces and negatively correlated with the GRF run-down. These findings suggested that the therapist used a coordinated strategy of avoiding weight support with the feet and supporting the weight with the hands to amplify the thrust force. This study provides new insights into the biomechanics of SM and has implications for teaching, motor learning, and safety.