Learning Spinal Manipulation

Harvey, Marie-Pierre; Wynd, Shari; Richardson, Lance; Dugas, Claude; Descarreaux, Martin

doi:10.7899/1042-5055-25.2.125

Cited by 21 publications

(7 citation statements)

References 18 publications

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“…The teaching of spinal manipulative techniques at Murdoch University is consistent with that described by Harvey et al [ 15 ]. Students are first introduced to the theoretical aspects of spinal manipulation by attending didactic lectures in areas such as anatomy, biomechanics and spinal manipulative technique, they then combine this knowledge with the subjective assessment of observing an instructor/expert perform spinal manipulative techniques.…”

Section: Introductionsupporting

confidence: 81%

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The simulated early learning of cervical spine manipulation technique utilising mannequins

Chapman¹,

Stomski

Losco

et al. 2015

Chiropr Man Therap

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BackgroundTrivial pain or minor soreness commonly follows neck manipulation and has been estimated at one in three treatments. In addition, rare catastrophic events can occur. Some of these incidents have been ascribed to poor technique where the neck is rotated too far. The aims of this study were to design an instrument to measure competency of neck manipulation in beginning students when using a simulation mannequin, and then examine the suitability of using a simulation mannequin to teach the early psychomotor skills for neck chiropractic manipulative therapy.MethodsWe developed an initial set of questionnaire items and then used an expert panel to assess an instrument for neck manipulation competency among chiropractic students. The study sample comprised all 41 fourth year 2014 chiropractic students at Murdoch University. Students were randomly allocated into either a usual learning or mannequin group. All participants crossed over to undertake the alternative learning method after four weeks. A chi-square test was used to examine differences between groups in the proportion of students achieving an overall pass mark at baseline, four weeks, and eight weeks.ResultsThis study was conducted between January and March 2014. We successfully developed an instrument of measurement to assess neck manipulation competency in chiropractic students. We then randomised 41 participants to first undertake either “usual learning” (n = 19) or “mannequin learning” (n = 22) for early neck manipulation training. There were no significant differences between groups in the overall pass rate at baseline (χ2 = 0.10, p = 0.75), four weeks (χ2 = 0.40, p = 0.53), and eight weeks (χ2 = 0.07, p = 0.79).ConclusionsThis study demonstrates that the use of a mannequin does not affect the manipulation competency grades of early learning students at short term follow up. Our findings have potentially important safety implications as the results indicate that students could initially gain competence in neck manipulation by using mannequins before proceeding to perform neck manipulation on each other.

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Section: Introductionsupporting

confidence: 81%

“…In a previous study, differences in learning outcomes were examined by comparing students who undertook either practitioner-positioning training or complete practice training [ 15 ]. The practitioner-positioning approach involved students learning the components of spinal manipulation without ever delivering the thrust component.…”

Section: Discussionmentioning

confidence: 99%

The simulated early learning of cervical spine manipulation technique utilising mannequins

Chapman¹,

Stomski

Losco

et al. 2015

Chiropr Man Therap

View full text Add to dashboard Cite

show abstract

“…Should other studies demonstrate that these (Cambridge et al 2012), or other SMT application parameters may influence clinical outcome (e.g. application site, application angle), there would be an interesting opportunity to train clinicians to reproduce these specific parameters and then evaluate their ability to do so (Harvey et al 2011). …”

Section: Discussionmentioning

confidence: 99%

“…), investigators often limit the parameters they study to decrease experimental complexity. In many cases, the chosen parameters are force magnitude and force duration as these parameters can be readily quantified with a range of technologies including pressure mats (Kawchuk, and Herzog 1993), instrumented tables (Triano, and Schultz 1997) and manikins (Harvey et al 2011). In addition, SMT force magnitude and force duration have significant clinical importance as their values are used to distinguish between types of manual therapy (e.g.…”

Section: Introductionmentioning

confidence: 99%

The effect of duration and amplitude of spinal manipulative therapy (SMT) on spinal stiffness

et al. 2012

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The aim of this study was to determine the effect of spinal manipulation therapy (SMT) force magnitude and force duration on the spinal stiffness of a feline preparation. A mechanical device performed simulated SMTs at the L6 spinous process in 22 anesthetised felines. Subjects were divided into four groups. Two groups (no preload, preload) received SMT having maximal displacements of 1.0mm, 2.0mm and 3.0mm of total displacement (displacement control). In two other groups (preload, no preload), SMTs were applied with maximal loads of 25%, 55% and 85% body weight (force control). Each of the SMTs were applied in order of increasing displacement or force amplitudes, at increasing durations ranging from 25 to 250 ms. Spinal stiffness was quantified by applying an indentation load to external surface of the back. Linear mixed effects models were fit for post-SMT stiffness variables. When SMT was applied under displacement control with and without a preceding preload, a significant interactive effect occurred between force magnitude and force duration (p≤0.05) for some of the stiffness variables. The findings from this experiment demonstrate that spinal stiffness in a feline model was affected by the interaction of the force amplitude and force duration parameters but the exact nature of this interaction remains unclear. This study provides guidance for further investigation given other SMT parameters not tested here may facilitate the ability of SMT to alter spinal stiffness.

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“…The mastery of complex psychomotor skills is a prerequisite for chiropractic treatments. Students typically acquire these skills through observation of their teachers demonstrating specific procedures and through practice on fellow students [2]. There is growing evidence that motor learning principles such as mental practice [3], augmented feedback [4] or different training schedules [5] can promote skills acquisition.…”

Section: Introductionmentioning

confidence: 99%

Peyton’s four-step approach for teaching complex spinal manipulation techniques – a prospective randomized trial

et al. 2016

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BackgroundThe objectives of this prospective randomized trial were to assess the impact of Peyton’s four-step approach on the acquisition of complex psychomotor skills and to examine the influence of gender on learning outcomes.MethodsWe randomly assigned 95 third to fifth year medical students to an intervention group which received instructions according to Peyton (PG) or a control group, which received conventional teaching (CG). Both groups attended four sessions on the principles of manual therapy and specific manipulative and diagnostic techniques for the spine. We assessed differences in theoretical knowledge (multiple choice (MC) exam) and practical skills (Objective Structured Practical Examination (OSPE)) with respect to type of intervention and gender. Participants took a second OSPE 6 months after completion of the course.ResultsThere were no differences between groups with respect to the MC exam. Students in the PG group scored significantly higher in the OSPE. Gender had no additional impact. Results of the second OSPE showed a significant decline in competency regardless of gender and type of intervention.ConclusionsPeyton’s approach is superior to standard instruction for teaching complex spinal manipulation skills regardless of gender. Skills retention was equally low for both techniques.

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Learning Spinal Manipulation

Cited by 21 publications

References 18 publications

The simulated early learning of cervical spine manipulation technique utilising mannequins

The simulated early learning of cervical spine manipulation technique utilising mannequins

The effect of duration and amplitude of spinal manipulative therapy (SMT) on spinal stiffness

Peyton’s four-step approach for teaching complex spinal manipulation techniques – a prospective randomized trial

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