Logo of nihpaAbout Author manuscriptsSubmit a manuscriptHHS Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
PMC full text:
Spine (Phila Pa 1976). Author manuscript; available in PMC 2016 Jul 1.
Published in final edited form as:
Spine (Phila Pa 1976). 2015 Jul 1; 40(13): E752–E759.
doi: 10.1097/BRS.0000000000000915

Figure 5

Schematic of a proposed spinal manipulation neural mechanoreceptor activation gradient model in which maximum afferent activity occurs at the site of peak thrust force and decreasing, yet substantial levels of afferent activity is elicited from this point bi-directionally. While not reducing the emphasis on clinical HVLA-SM thrust accuracy, this gradient may account for clinical efficacy despite technique diversity and poor inter-examiner reliability for optimal thrust site determination.