Changes in adjustment force, speed, and direction factors in chiropractic students after 10 weeks undergoing standard technique training

Abstract

Objective: To assess the force profiles of high-velocity low-amplitude thrusts delivered to a mannequin on a force platform by novice students given only verbal instructions. Methods: Student volunteers untrained in adjusting delivered a series of adjustments to a mannequin on a force platform. Participants performed 3 light, 3 normal, and 3 heavy thrusts on 5 listings specifying contact point, hand, and direction. Force profiles were analyzed for speed and amplitude, consistency, and force discrimination. Two recording sessions occurred 10 weeks apart. Results: Sixteen participants (11 females, 5 male) completed the study. Peak forces ranged from 880 to 202 N for heavy thrusts and 322-to 66 N for light thrusts. Thrust rate was from 8.1 to 1.8 Newtons per millisecond. Average coefficients of variability (CV ¼ STD/mean) at each load level (initial/final) were heavy: 17%/15%; normal: 16%/15%; and light: 20%/20%, with 0 as ideal. A force ratio measured students' abilities to distinguish thrust magnitude. The heavy/normal ratio (initial/final) was 1.35/1.39, and the light/normal ratio was 0.70/0.67. Conclusions: At this point, without force feedback being used in the classroom, novice students can produce thrusts that look like those of their teachers and of experienced practitioners, but they may not produce similar speed and force values. They are consistent within and between sessions and can discriminate between light and heavy loads. A natural next step in our educational research will be to measure adjustment factors on more experienced cohorts of students with and without the presence of force-feedback training apparatus.

Development of a mannequin lab for clinical training in a chiropractic program

“…Most technological efforts have been aimed at providing force and rate feedback at the preload and peak load phases of the thrusts. [2][3][4][5][6] Owens et al 7 used a force plate to also study the precise vectors of manipulative thrusts. The Force-Sensing Table Technology (FSTT) produced at Canadian Memorial Chiropractic College (Toronto, Canada) has been used in several studies of the educational efficacy of using such tools.…”

Quantifying performance metrics of cervical spine mobilization for improved education and clinical outcomes: Early experience with a novel wearable device

“…Previous studies that have quantified the forces of such treatments transmitted to subjects have used measurement devices that are interposed between the subject and therapists hands 13 or have measured the load transmitted through the subject and table via floor-mounted load cells using live patients 14 or mannequins. 15 In the former case, interposed devices obstruct the therapist from the subject, which may confound application of the standard therapy protocols. In the latter cases, a floor-mounted load cell setup would require precise tracking of the therapist's point of load application.…”