CCR Art of the Adjustment Team Projects

Our researchers are at the forefront of studying the biomechanics of the chiropractor’s most important tool, the adjustment. In addition to knowledge of anatomy and joint biomechanics, and the skill to correctly identify anatomical locations on patients, students need training in several physical components of performing adjustments. All of these motor skills need to be accomplished in a coordinated manner, with proper body mechanics, to produce an adjustment that is effective and safe for the patient and the doctor.

The Technique Lab of the Future (TLOF), a collaboration between the CCR’s Art of the Adjustment research team and the Chiropractic Sciences Division, is an initiative using state-of-the-art technology and methods for the technique faculty to utilize as a part of student learning. The technique lab features 13 Palpation and Adjusting Trainer mannequins (PATs) developed at Life University. PATs have the size and weight, and the realistic feel, of an average person, with full-spine articulations and skeleton covered with cinematic-quality silicone skin and soft tissue. PATs have pressure sensors at 64 key bony landmarks of the spine and pelvis, with proprietary software, for students to palpate for structures and to receive when the structure has been located.

Using an adjusting bench with a built-in force plate, students are taught to reproduce the magnitude, line of drive, and speed of thrusts similar to targets provided by their instructors. University researchers have been investigating forces applied during adjustments and the motion characteristics of chiropractors and the recipients of chiropractic adjustment. Future developments will include an “adjusting glove” to measure force and track hand orientation, and motion tracking equipment to provide students advanced performance feedback during early technique training.

None of these tools replace the human-to-human adjustment and palpation skills training in the technique program. They do, however, provide a repeatable and safe way for students to learn to control their thrusts through repeated practice on the mannequins, before they apply those skills to humans.

Beginning in 2017, Life University researchers have been investigating kinematic and kinetic characteristics of supine cervical adjustments: 3-D motion as would be experienced by a patient and the forces applied by a DC. Studies with human beings and PAT mannequins as recipients of adjustments have been published as 2 peer-reviewed papers, with a third in review with a journal, and have been presented at 4 conferences.

It is possible to measure the forces applied by a DC with flexible sensors placed between the DC’s hand and the patient or with a force plate under the patient, embedded in a chiropractic treatment table, and each method has advantages and disadvantages. The Art of the Adjustment team has recorded thoracic thrusts performed by DCs and students, with their study presented at the annual Association of Chiropractic Colleges Research Agenda Conference in 2025.

There have been few studies of the movements that patients’ and DCs’ bodies go through during an adjustment. This Art of the Adjustment team is tracking movements of a certified expert in Gonstead Technique and of healthy volunteers receiving cervical chair-style adjustments, and of the forces the DC applies during the adjustments.

This motion-capture study of a senior-year DC student performing a supine cervical thrust on a PAT mannequin represents part of the Art of the Adjustment team’s exploration of research-based content for technique education. From the data we identified angular positions for the spinal regions, shoulders, elbows, wrists, hips, knees, and ankles at set-up and peak of thrust. We also generated a 5-viewing-angle “skeletal avatar” video from the system software. Studies of this type will provide valuable information to chiropractic technique instructors and their students.