Accelerometer Assessment of Spinal Joint Crepitus Before and After Spinal Manipulation
Bibliographic record
Abstract
The objective of this IRB‐approved project was to assess spinal joint [facet joint, zygapophyseal (Z) joint] vibrations/sounds (crepitus) during lumbar motion before and after side‐posture spinal manipulation (SM). Methods Using methods previously developed to assess joint cavitation, 9 accelerometers were applied to the lumbar region of 5 healthy and 5 low back pain (LBP) subjects, allowing assessment of crepitus. Subjects underwent full lumbar ranges of motion, SM, and repeated ranges of motion, while accelerometer recordings were made. Subjects were also divided into 3 age groups for comparisons (18–25, 26–45, and 46–65 years). Primary outcomes included: incidence of crepitus, crepitus prevalence (average number of crepitus events/subject), crepitus amplitude, and motion(s) producing the most crepitus. Results The accelerometry methods were successfully implemented on all subjects. Crepitus was identified as simultaneous deviations from baseline of multiple accelerometers. As in previous work, artifacts had a distinct appearance and were easily distinguished from crepitus. Overall, 23 instances of crepitus were recorded from 15 different Z joints. Crepitus prevalence decreased pre‐ to post‐SM (average pre= 1.4 crepitus/subject, range 0–7 crepitus/subject vs. post= 0.9, range 0–2). Crepitus prevalence progressively increased from the youngest to oldest age groups (pre‐SM= 0.0, 1.67, and 2.0, respectively, range 0–10; and post‐SM= 0.5, 0.83, and 1.5, range 1–5). Prevalence was higher in LBP subjects compared to healthy (pre‐SM‐LBP= 2.0, range 0–7, vs. pre‐SM‐healthy= 0.8, range 0–4; post‐SM‐LBP= 1.0, range 0–2 vs. post‐SM‐healthy= 0.8, range 0–2), even though healthy subjects were older than LBP (40.8 years vs. 27.8 years). Crepitus amplitude was <0.16 mV. Average pre‐SM crepitus amplitude was 0.08 mV, which was greater than post‐SM crepitus, which was 0.03 mV. The pre‐ vs. post‐SM crepitus difference was greater in LBP (pre‐SM 0.09 mV, post‐SM 0.04) than healthy subjects (pre‐SM 0.04 mV, post‐SM 0.03 mV). Flexion produced the most crepitus (pre‐SM eight, 57.1%, post‐SM six, 66.7%, and overall fourteen, 60.9%). For pre‐SM, flexion was followed by right lateral flexion (three, 21.4%) with extension, left lateral flexion and left rotation all producing the same amount of crepitus (one each, 7.1%). Post‐SM flexion was followed by extension (two, 22.2%) and right rotation (one, 11.1%), with no crepitus recorded in the other motions. Conclusions Crepitus was greatest in flexion; prevalence increased with age, was higher in LBP than healthy subjects, and overall decreased following SM; crepitus amplitude was lower post‐SM than pre‐SM. Support or Funding Information NIH/NCCIH Grant# – 3R01AT000123‐06S2
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".