{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:30:04Z","timestamp":1770989404620,"version":"3.50.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"The Science and Technology Research Project of the Education Department of Jiangxi Province","award":["No. GJJ2201411"],"award-info":[{"award-number":["No. GJJ2201411"]}]},{"name":"The Jiangxi Provincial Administration of Traditional Chinese Medicine Science and Technology Programme Project","award":["No. 2024A0101"],"award-info":[{"award-number":["No. 2024A0101"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Complement Med Ther"],"DOI":"10.1186\/s12906-026-05258-w","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T10:56:15Z","timestamp":1768992975000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical effects of the prone stretching and adjusting cervical manipulation : a three-dimensional finite element analysis study"],"prefix":"10.1186","volume":"26","author":[{"given":"Xiang-ming","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-nian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"5258_CR1","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/brain\/117.2.325","volume":"117","author":"K Radhakrishnan","year":"1994","unstructured":"Radhakrishnan K, Litchy WJ, O\u2019Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy: A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325\u201335.","journal-title":"Brain"},{"key":"5258_CR2","doi-asserted-by":"publisher","first-page":"728","DOI":"10.2519\/jospt.2000.30.12.728","volume":"30","author":"RS Wainner","year":"2000","unstructured":"Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther. 2000;30:728\u201344.","journal-title":"J Orthop Sports Phys Ther"},{"key":"5258_CR3","first-page":"7","volume":"28","author":"S-M Zhang","year":"2013","unstructured":"Zhang S-M, liu Y-Z, Zhang Z-J. Cervical discectomy and intervertebral foramen decompression in treatment of cervical spondylotic radiculopathy[J]. Chin J Bone Joint Injury. 2013;28:7\u20139.","journal-title":"Chin J Bone Joint Injury"},{"key":"5258_CR4","first-page":"2139","volume":"31","author":"H-T Ding","year":"2016","unstructured":"Ding H-T, Wang Q-F, Tang X-Z, Zhang S-D. Study on the clinical effects of back-lying and forward-bending traction micro-regulating method on treating cervical spondylotic radiculopathy. Chin J Traditional Chin Med. 2016;31:2139\u201342.","journal-title":"Chin J Traditional Chin Med"},{"key":"5258_CR5","doi-asserted-by":"publisher","first-page":"802","DOI":"10.2519\/jospt.2005.35.12.802","volume":"35","author":"JA Cleland","year":"2005","unstructured":"Cleland JA, Whitman JM, Fritz JM, Palmer JA. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. J Orthop Sports Phys Ther. 2005;35:802\u201311.","journal-title":"J Orthop Sports Phys Ther"},{"key":"5258_CR6","doi-asserted-by":"publisher","first-page":"152","DOI":"10.2519\/jospt.2006.36.3.152","volume":"36","author":"MA Waldrop","year":"2006","unstructured":"Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: a case series. J Orthop Sports Phys Ther. 2006;36:152\u20139.","journal-title":"J Orthop Sports Phys Ther"},{"key":"5258_CR7","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1097\/00007632-198612000-00003","volume":"11","author":"W Dillin","year":"1986","unstructured":"Dillin W, et al. Cervical radiculopathy. A review. Spine (Phila Pa 1976). 1986;11:988\u201391.","journal-title":"Spine (Phila Pa 1976)"},{"key":"5258_CR8","doi-asserted-by":"publisher","first-page":"723","DOI":"10.2519\/jospt.2011.3592","volume":"41","author":"SW Forbush","year":"2011","unstructured":"Forbush SW, Cox T, Wilson E. Treatment of patients with degenerative cervical radiculopathy using a multimodal Conservative approach in a geriatric population: A case series. J Orthop Sports Phys Therapy. 2011;41:723\u201333.","journal-title":"J Orthop Sports Phys Therapy"},{"key":"5258_CR9","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jmpt.2013.07.002","volume":"36","author":"CK Peterson","year":"2013","unstructured":"Peterson CK, Schmid C, Leemann S, Anklin B, Humphreys BK. Outcomes from magnetic resonance Imaging\u2013Confirmed symptomatic cervical disk herniation patients treated with High-Velocity, Low-Amplitude spinal manipulative therapy: A prospective cohort study with 3-Month Follow-Up. J Manip Physiol Ther. 2013;36:461\u20137.","journal-title":"J Manip Physiol Ther"},{"key":"5258_CR10","first-page":"33","volume":"81","author":"JD Eubanks","year":"2010","unstructured":"Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81:33\u201340.","journal-title":"Am Fam Physician"},{"issue":"3","key":"5258_CR11","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.jbmt.2010.03.004","volume":"14","author":"W Herzog","year":"2010","unstructured":"Herzog W. The biomechanics of spinal manipulation. J Bodyw Mov Ther. 2010;14(3):280\u20136.","journal-title":"J Bodyw Mov Ther"},{"issue":"5","key":"5258_CR12","first-page":"33","volume":"9","author":"A Roberts","year":"2022","unstructured":"Roberts A, Harris K, Outen B, Bukvic A, Smith B, Schultz A, Bergman S, Mondal D. Osteopathic manipulative medicine: A brief review of the Hands-On treatment approaches and their therapeutic uses. Med (Basel). 2022;9(5):33.","journal-title":"Med (Basel)"},{"key":"5258_CR13","first-page":"128","volume":"27","author":"D-F Yan","year":"2020","unstructured":"Yan D-F. Experience of Shao Mingxi in syndrome differentiation and treatment of cervical spondylosis. China J Traditional Chin Med Inform. 2020;27:128\u201330.","journal-title":"China J Traditional Chin Med Inform"},{"key":"5258_CR14","first-page":"1101","volume":"35","author":"Handbook of Practical Tuina","year":"2010","unstructured":"Handbook of Practical Tuina. PLA Med J. 2010;35:1101. 2nd ed.","journal-title":"PLA Med J"},{"key":"5258_CR15","unstructured":"Feng Y-Z, Qiao Z-k, Geng T. Research of Massage with Four Fingers in Treating Cervical Spondylosis. Clin J Tradit Chin Med.\u00a02018;30:941\u2013944."},{"key":"5258_CR16","first-page":"32","volume":"8","author":"Z-k Xiong","year":"2017","unstructured":"Xiong Z-k, Xue M-X, Zhao M-X. Giant puncture of Yanglingquan with four-finger pushing method for the treatment of fallen pillows in 30 cases. Massage Rehabilitation Med. 2017;8:32\u20134.","journal-title":"Massage Rehabilitation Med"},{"key":"5258_CR17","first-page":"17","volume":"48","author":"Y-Z Feng","year":"2016","unstructured":"Feng Y-Z. Zhang shinian\u2019s experience in the treatment of cervicogenic hypertension. Jiangsu Traditional Chin Med. 2016;48:17\u20138.","journal-title":"Jiangsu Traditional Chin Med"},{"key":"5258_CR18","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1080\/03014460903019879","volume":"36","author":"O Panagiotopoulou","year":"2009","unstructured":"Panagiotopoulou O. Finite element analysis (FEA): applying an engineering method to functional morphology in anthropology and human biology. Ann Hum Biol. 2009;36:609\u201323.","journal-title":"Ann Hum Biol"},{"key":"5258_CR19","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/j.jbiomech.2003.10.002","volume":"37","author":"BC Bourne","year":"2004","unstructured":"Bourne BC, Van Der Meulen MCH. Finite element models predict cancellous apparent modulus when tissue modulus is scaled from specimen CT-attenuation. J Biomech. 2004;37:613\u201321.","journal-title":"J Biomech"},{"key":"5258_CR20","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.jbiomech.2007.08.016","volume":"41","author":"A Boryor","year":"2008","unstructured":"Boryor A, et al. Stress distribution and displacement analysis during an intermaxillary disjunction\u2014A three-dimensional FEM study of a human skull. J Biomech. 2008;41:376\u201382.","journal-title":"J Biomech"},{"key":"5258_CR21","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.jbiomech.2008.11.036","volume":"42","author":"MB Panzer","year":"2009","unstructured":"Panzer MB, Cronin DS. C4\u2013C5 segment finite element model development, validation, and load-sharing investigation. J Biomech. 2009;42:480\u201390.","journal-title":"J Biomech"},{"key":"5258_CR22","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1016\/j.jbiomech.2008.03.028","volume":"41","author":"H-YK Cheng","year":"2008","unstructured":"Cheng H-YK, Lin C-L, Wang H-W, Chou S-W. Finite element analysis of plantar fascia under stretch\u2014The relative contribution of windlass mechanism and Achilles tendon force. J Biomech. 2008;41:1937\u201344.","journal-title":"J Biomech"},{"key":"5258_CR23","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1016\/j.jbiomech.2008.03.035","volume":"41","author":"S Portnoy","year":"2008","unstructured":"Portnoy S, et al. Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee. J Biomech. 2008;41:1897\u2013909.","journal-title":"J Biomech"},{"key":"5258_CR24","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.jmpt.2014.05.007","volume":"37","author":"L-P Wu","year":"2014","unstructured":"Wu L-P, et al. Real-Time monitoring of stresses and displacements in cervical nuclei Pulposi during cervical spine manipulation: A finite element model analysis. J Manip Physiol Ther. 2014;37:561\u20138.","journal-title":"J Manip Physiol Ther"},{"key":"5258_CR25","doi-asserted-by":"publisher","first-page":"2692","DOI":"10.1097\/00007632-200112150-00012","volume":"26","author":"MM Panjabi","year":"2001","unstructured":"Panjabi MM, et al. Mechanical properties of the human cervical spine as shown by Three-Dimensional Load\u2013Displacement curves. Spine. 2001;26:2692\u2013700.","journal-title":"Spine"},{"key":"5258_CR26","first-page":"4607","volume":"27","author":"L-Q Ye","year":"2023","unstructured":"Ye L-Q, Chen C, Liu Y-H. Finite element analysis of position effects on reduction of facet joint displacement by cervical rotatory manipulation for cervical spondylotic radiculopathy. Tissue Eng Res China. 2023;27:4607\u201311.","journal-title":"Tissue Eng Res China"},{"key":"5258_CR27","first-page":"433","volume":"26","author":"Y-M Li","year":"2009","unstructured":"Li Y-M, Wu L-P, Wen F-Q. .Effect of pulling and rotating manipulation in different postures on intradiscal pressure of the cervical spinal Cord[J]. J Guangzhou Univ Traditional Chin Med. 2009;26:433\u20137.","journal-title":"J Guangzhou Univ Traditional Chin Med"},{"key":"5258_CR28","first-page":"4385","volume":"27","author":"B-J Liu","year":"2023","unstructured":"Liu B-J, et al. Three-dimensional finite element method to analyze Biomechanical characteristics of spinal manipulation. Tissue Eng Res China. 2023;27:4385\u201392.","journal-title":"Tissue Eng Res China"},{"key":"5258_CR29","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1007\/s10439-022-03088-8","volume":"50","author":"S Lindenmann","year":"2022","unstructured":"Lindenmann S, Tsagkaris C, Farshad M, Widmer J. Kinematics of the cervical spine under healthy and degenerative conditions: A systematic review. Ann Biomed Eng. 2022;50:1705\u201333.","journal-title":"Ann Biomed Eng"},{"key":"5258_CR30","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1080\/10255842.2022.2089026","volume":"26","author":"WU Rahman","year":"2023","unstructured":"Rahman WU, et al. Biomechanical effect of C5-C6 intervertebral disc degeneration on the human lower cervical spine (C3-C7): a finite element study. Comput Methods Biomech Biomed Engin. 2023;26:820\u201334.","journal-title":"Comput Methods Biomech Biomed Engin"},{"issue":"2","key":"5258_CR31","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1097\/01.brs.0000195173.47334.1f","volume":"31","author":"T Ishii","year":"2006","unstructured":"Ishii T, Mukai Y, Hosono N, Sakaura H, Fujii R, Nakajima Y, Tamura S, Iwasaki M, Yoshikawa H, Sugamoto K. Kinematics of the cervical spine in lateral bending: in vivo three-dimensional analysis. Spine (Phila Pa 1976). 2006;31(2):155\u201360.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"5258_CR32","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/00007632-198801000-00003","volume":"13","author":"JP Nolan Jr","year":"1988","unstructured":"Nolan JP Jr, Sherk HH. Biomechanical evaluation of the extensor musculature of the cervical spine. Spine (Phila Pa 1976). 1988;13(1):9\u201311.","journal-title":"Spine (Phila Pa 1976)"},{"key":"5258_CR33","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1007\/s00264-020-04593-y","volume":"44","author":"S Liao","year":"2020","unstructured":"Liao S, Jung MK, H\u00f6rnig L, Gr\u00fctzner PA, Kreinest M. Injuries of the upper cervical spine-how can instability be identified? Int Orthop. 2020;44:1239\u201353.","journal-title":"Int Orthop"},{"key":"5258_CR34","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.math.2012.12.002","volume":"18","author":"W Salem","year":"2013","unstructured":"Salem W, Lenders C, Mathieu J, Hermanus N, Klein P. In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation. Man Ther. 2013;18:339\u201344.","journal-title":"Man Ther"},{"key":"5258_CR35","unstructured":"Zai,\u00a0X et al. In vivo measurement of three-dimensional motion of the upper cervical spine using CT three-dimensional reconstruction. China Orthop Inj. 2019;32:658\u2013665."},{"key":"5258_CR36","first-page":"897","volume":"32","author":"H-X Li","year":"2017","unstructured":"Li H-X, et al. Dynamic characteristics of vertical standing atlantoaxial vertical rotation in normal adults[. Chin J Bone Joint Inj. 2017;32:897\u2013900.","journal-title":"Chin J Bone Joint Inj"},{"key":"5258_CR37","first-page":"2526","volume":"20","author":"D Wei","year":"2016","unstructured":"Wei D, et al. Three-dimensional transient motion characteristics of atlanto-axial joint in healthy adults under physiological load. Chinese J Tissue Eng Res. 2016;20:2526\u201332.","journal-title":"Chinese J Tissue Eng Res"},{"key":"5258_CR38","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.nic.2022.07.027","volume":"32","author":"CD Norris","year":"2022","unstructured":"Norris CD, Anzai Y. Anatomy of neck Muscles, Spaces, and lymph nodes. Neuroimaging Clin N Am. 2022;32:831\u201349.","journal-title":"Neuroimaging Clin N Am"},{"key":"5258_CR39","doi-asserted-by":"publisher","first-page":"29","DOI":"10.4045\/tidsskr.09.0296","volume":"130","author":"P Holck","year":"2010","unstructured":"Holck P. Cervikalcolumnas anatomi. Tidsskriftet. 2010;130:29\u201332.","journal-title":"Tidsskriftet"}],"container-title":["BMC Complementary Medicine and Therapies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12906-026-05258-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12906-026-05258-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12906-026-05258-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:22:47Z","timestamp":1770985367000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12906-026-05258-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5258"],"URL":"https:\/\/doi.org\/10.1186\/s12906-026-05258-w","relation":{},"ISSN":["2662-7671"],"issn-type":[{"value":"2662-7671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"assertion":[{"value":"13 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Gannan Medical University, China (approval no. 2019806). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of the clinical photograph in Fig. 2\u2009A was obtained from the participant.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"57"}}