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Deficits in motor coordination, language, and learning difficulties were common problems that persisted in the minimal and global impairment groups.

Background: Thrust manipulation to the spine has been shown to be an effective treatment for pain reduction associated with musculoskeletal disorders. However, the mechanisms of action tied to this intervention have yet to be sufficiently explained.Objectives: This manuscript reviews the literature related to supraspinal mechanisms associated with pain inhibition, which may also be associated with hypoalgesia following spinal manipulation. Such information adds to the current body of evidence that has demonstrated centrally mediated hypoalgesic effects following manipulation to be influenced by both dorsal horn inhibition and patient expectation. Major findings: Areas believed to be responsible for processing pain include the amygdala, anterior cingulate, thalamus, insula, cerebellum, primary and secondary somatosensory cortices, periaqueductal grey, or dorsal horn. The periaqueductal grey receives information from spinoreticular and spinomesencephalic pathways in the spinal cord, as well as descending information from the amygdala and cortex. The inhibition of sensory stimuli in the dorsal horn may result in decreased projection of ascending information to the periaqueductal grey and modulation from higher-level cortical structures. Neuroimaging research in animals has demonstrated activation of such cortical structures in response to pain with subsequent decreased activation of these areas following joint mobilization. Researchers have yet to identify supraspinal structures associated with spinal manipulation in human subjects. Conclusions: Future investigation should strive to identify supraspinal structures activated in human subjects following thrust manipulation. The identification of cortical and subcortical structures associated with hypoalgesia following spinal manipulation may influence the acceptance and use of this intervention with patients when indicated.

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At the 1995 ASEE Annual Conference, we reported on a newly developed project combining 4 th semester Industrial Engineering students and 8 th semester Physical Therapy(PT) students.[3] This project required them to develop various reports and recommendations for implementing the Americans with Disabilities Act (ADA) on and around campus. At the 1996 Illinois/Indiana section conference we reported on a parallel project among the same IE students along with Teacher Education(ETE) 6 th semester students.[4] Since that time, the projects have evolved and the method of guiding the students has changed. Also, the outcomes required have been modified to provide less content on the actual project and more on the development of interdisciplinary teams and teams in general. It is only on the last lecture day of the semester that the IE students have explained the underlying concepts of team formation that they had been exposed to. The concepts that are, sometimes dramatically, placed before the students include the need to provide "investment" time when a group is heterogeneous, the presence of authority from outside the group activities (the nearly graduated PT majors often awe the sophomores with their professionalism), and the need for good, if sometimes brief, communication among the group members. Depending on the project chosen, other concepts and other pieces of their education are brought into use. The PT and TE students do not have the advantage of two projects being manipulated in different manners. However, the exposure of other professionals to IE has a number of benefits, not the least is that some engineers are directly involved in topics not normally thought of as engineering. This paper reports on the continuing evolution of the teaching mechanisms in both the IE and PT courses involved. Various successes and failures are noted as well as plans for the future.