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.