Effects of Sports Expertise on Force Accuracy During Spinal Manipulation in Chiropractic Students

Introduction: The aim of this study was to investigate whether sports expertise and related characteristics are associated with spinal manipulation accuracy in chiropractic students. Methods: A cross-sectional experimental study was conducted with 111 chiropractic students. Participants performed standardized high-velocity, low-amplitude thoracic spinal manipulations on a force-sensing table targeting a peak force of 450 N. Force-time data were recorded to assess performance accuracy using absolute error and consistency using variable error. Sports expertise, sport type (endurance, strength, and precision), chiropractic program year, and weekly physical activity were collected via questionnaires. Linear mixed models were used to examine associations between these factors and spinal manipulation accuracy in both univariate and multivariable analyses. Results: The mean absolute error across trials was 41.97 ± 32.60 N, whereas the mean variable error was 50.21 ± 33.89 N. In univariate analyses, sport type ( p = 0.034), chiropractic training year ( p < 0.001), and total weekly physical activity ( p = 0.042) were significantly associated with spinal manipulation accuracy. Participants involved in endurance sports showed greater absolute error than those involved in strength and precision sports. No significant effects were observed for variable error. Sport expertise was not significantly associated with spinal manipulation accuracy ( p = 0.361). In the multivariable model, chiropractic training year ( p = 0.004) and total weekly physical activity ( p = 0.018) remained significant predictors of absolute error, whereas sport type ( p = 0.091) and sport expertise ( p = 0.087) did not reach statistical significance. Discussion: Spinal manipulation accuracy was primarily associated with chiropractic training year and overall physical activity level. Sport-related factors showed limited independent associations with performance, highlighting the importance of task-specific training in developing spinal manipulation skills.