Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters

Descarreaux, Martin; Dugas, Claude; Lalanne, Kim; Vincelette, Mireille; Normand, Martin

doi:10.1016/j.spinee.2005.07.001

Cited by 64 publications

(87 citation statements)

References 19 publications

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“…However, learning SM requires a basic set of fundamental skills that, when properly mastered, can be generalised to a larger span of therapeutic procedures [10]. It is possible that this could lead to a more thorough and regular application of complex motor skills in clinical routine, as well as provide the opportunity to implement alternate teaching means such as quantitative augmented feedback strategies [24,25] or special manikin or simulator training [24]. There is little data with regard to the minimum time necessary to become an experienced SM operator.…”

Section: Discussionmentioning

confidence: 99%

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

et al. 2012

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Purpose To assess the use of peer-assisted learning (PAL) of complex manipulative motor skills with respect to gender in medical students. Methods In 2007-2010, 292 students in their 3rd and 4th years of medical school were randomly assigned to two groups [Staff group (SG), PAL group (PG)] led by either staff tutors or student-teachers (ST). The students were taught bimanual practical and diagnostic skills (course education module of eight separate lessons) as well as a general introduction to the theory of spinal manipulative therapy. In addition to qualitative data collection (Likert scale), evaluation was performed using a multiple-choice questionnaire in addition to an objective structured clinical examination (OSCE). Results Complex motor skills as well as palpatory diagnostic competencies could in fact be better taught through professionals than through ST (manipulative OSCE grades/ diagnostic OSCE score; SG vs. PG; male: P = 0.017/ P \ 0.001, female: P \ 0.001/P \ 0.001). The registration of theoretical knowledge showed equal results in students taught by staff or ST. In both teaching groups (SG: n = 147, PG: n = 145), no significant differences were observed between male and female students in matters of manipulative skills or theoretical knowledge. Diagnostic competencies were better in females than in males in the staff group (P = 0.041) Overall, students were more satisfied with the environment provided by professional teachers than by ST, though male students regarded the PAL system more suspiciously than their female counterparts. Conclusions The peer-assisted learning system does not seem to be generally qualified to transfer such complex spatiotemporal demands as spinal manipulative procedures.

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Section: Discussionmentioning

confidence: 99%

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

et al. 2012

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“…[1][2][3][4] These studies also identified some specific conditions that enable a faster and more efficient learning process and systematically suggest that skilled spinal manipulation performance is promoted through guided rehearsal and experience and that measurable improvement in observed performance can be reached when qualitative or quantitative feedback related to force time parameters is provided. 2,3,5 Despite this growing body of evidence indicating that, from a motor learning perspective, HVLA spinal manipulation may be regarded as another psychomotor skill, motor learning principles are rarely fully integrated in chiropractic curricula. Learning HVLA spinal manipulation within the chiropractic educational realm involves complex issues related to tradition, safety, and effectiveness in the application of such treatment procedures.…”

Section: Introductionmentioning

confidence: 94%

“…[1][2][3][4] Recent studies clearly highlight the similarities between the learning processes involved in this particular psychomotor task and the skills encountered in sports and leisure activities. [1][2][3][4] These studies also identified some specific conditions that enable a faster and more efficient learning process and systematically suggest that skilled spinal manipulation performance is promoted through guided rehearsal and experience and that measurable improvement in observed performance can be reached when qualitative or quantitative feedback related to force time parameters is provided. 2,3,5 Despite this growing body of evidence indicating that, from a motor learning perspective, HVLA spinal manipulation may be regarded as another psychomotor skill, motor learning principles are rarely fully integrated in chiropractic curricula.…”

Section: Introductionmentioning

confidence: 98%

Learning Spinal Manipulation

Harvey

Wynd

Richardson

et al. 2011

Journal of Chiropractic Education

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Purpose:The goal of the present study was to quantify the high-velocity, low-amplitude spinal manipulation biomechanical parameters in two cohorts of students from different teaching institutions. The first cohort of students was taught chiropractic techniques in a patient-doctor positioning practice setting, while the second cohort of students was taught in a "complete practice" manipulation setting, thus performing spinal manipulation skills on fellow student colleagues. It was hypothesized that the students exposed to complete practice would perform the standardized spinal manipulation with better biomechanical parameters. Methods: Participants (n = 88) were students enrolled in two distinct chiropractic programs. Thoracic spine manipulation skills were assessed using an instrumented manikin, which allowed the measurement of applied force. Dependent variables included peak force, time to peak force, rate of force production, peak force variability, and global coordination. Results: The results revealed that students exposed to complete practice demonstrated lower time to peak force values, higher peak force, and a steeper rate of force production compared with students in the patient-doctor positioning scenario. A significant group by gender interaction was also noted for the time to peak force and rate of force production variables. Conclusion: The results of the present study confirm the importance of chiropractic technique curriculum and perhaps gender in spinal manipulation skill learning. It also stresses the importance of integrating spinal manipulation skills practice early in training to maximize the number and the quality of significant learner-instructor interactions. (J Chiropr Educ 2011;25(2):125-131)

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14] More recently, those same tools are being used to augment the learning in chiropractic colleges in the United States and abroad, 11,[15][16][17][18][19][20][21][22][23][24] and in physical therapy programs as well. 25 Preload, peak loads, and speed have all been suggested as important performance factors.…”

Section: Introductionmentioning

confidence: 99%

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

Owens¹,

Russell²,

Hosek³

et al. 2017

Journal of Chiropractic Education

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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.

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Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters

Cited by 64 publications

References 19 publications

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

Learning Spinal Manipulation

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

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