J Manipulative Physiol Ther. 1993 Jan; 16(1): 33-6.

Manual force, mechanically assisted articular chiropractic technique using long and/or short level contacts.

Bergmann TF.

OBJECTIVE: To identify what has been theorized and/or written about the manual techniques generically classified as manual force, mechanically assisted articular chiropractic technique that utilize either short-lever contacts or a combination of short- and long-lever contacts. DATA SOURCES: A search of the Medline bibliographic database using MeSH key words (chiropractic/methods; osteopathic manipulation) was performed. The Index to Chiropractic Literature and Chiropractic Research Abstracts Collection (CRAC) were searched for the past 10 yr using the key terms of chiropractic-methods; chiropractic techniques; manipulation, chiropractic, manipulation, osteopathic, manipulation, spinal; and manipulation, joint. A hand search of textbooks was undertaken as well as review of the references included in books, monographs and collected papers. STUDY SELECTION: Studies in English were included, but it must be noted that these include publications that are not peer reviewed or refereed in any way. DATA EXTRACTION: Descriptions that discussed aspects of manipulative procedures with the characteristics were extracted by a single author. DATA SYNTHESIS: Very little was found or accessible with traditional methods of literature retrieval. Descriptions of characteristics for the attributes of techniques which use mechanical assistance to impart a force applied to specific contacts in combination with short and long levers are provided. The technique procedures which fall into this category use the mechanical assistance of specialized table parts, including drop sections and distracting sections, to achieve functional changes in the vertebral three-joint complex. Conjecture and speculation as to the advantages of mechanical assistance are presented. CONCLUSIONS: This type of review is considered the first step in the evaluative process for a chiropractic technique procedure. It demonstrates that very little has been written in an accessible fashion relative to techniques which are classified as manual force, mechanically assisted articular chiropractic techniques that utilize either short-lever contacts or a combination of short- and long-lever contacts. Controlled prospective clinical trials to evaluate efficacy in using these technique procedures are nonexistent. Furthermore, there are no comparison studies to determine whether the techniques which fit into this category are any more effective or efficient in producing a positive clinical outcome than techniques in other categories. The proponents of these technique procedures should be performing the studies and publishing the results that either support or deny the usefulness of these procedures.