Objective: To determine the effects of a physical exercise program on spinal manipulation (SM) performance in 1st-year chiropractic students. Methods: One hundred and thirteen students from 2 chiropractic schools were assigned to 1 of 2 groups: exercise group (EG) for campus A students or control group (CG) (no training) for campus B students. All participated in 2 1-hour experimental training sessions that were added to the usual technique curriculum. At the beginning and at the end of each session, SM thrust duration and preload force release were recorded as dependent variables in 5 trials performed on a force-sensing table for a total of 10 recorded trials per session. The session consisted of several drills during which augmented feedback was provided to students to improve their skills. The EG performed physical exercises (push-ups, core stabilization, and speeder board exercises) 3 times per week for an 8-week period between the 2 training sessions. Results: The mean thrust duration increased between the 2 sessions [+0.8 ms (±15.6)]. No difference between groups was found using a t test for independent samples ( p = .94). The mean preload force release decreased between the 2 sessions (−6.1 N [±17.1]). Differences between groups were found using a t test for independent samples ( p = .03); the results showed a reduction of preload force release in the participants in the EG group compared to those in the CG group (−8.1 N [±16.9] vs −0.3 N [±16.5]). Conclusion: A physical exercise program seems to be beneficial in the SM learning process; chiropractic students should therefore be encouraged to do home physical exercises to develop their physical capabilities and improve SM delivery.

Objective: The purpose of this study was to investigate gender differences and expertise effects on biomechanical parameters as well as force accuracy and variability for students learning spinal manipulation. Methods: A total of 137 fourth- and fifth-year students were recruited for the study. Biomechanical parameters (preload, time to peak force, peak force, rate of force), as well as accuracy and variability of thoracic spine manipulation performance, were evaluated during 5 consecutive trials using a force-sensing table and a target force of 450 N. Gender, expertise differences on biomechanical parameters, as well as constant, variable, and absolute error were assessed using 2-way analysis of variance. Results: Analyses showed significant gender differences for several biomechanical parameters, as well as significant gender differences in accuracy and variability. Although women showed lower time to peak force and rate of force values, they were more precise and showed less variability than men when performing thoracic spine manipulations. Students with clinical expertise (fifth-year students) used less force and were more precise. Conclusion: Our results showed that gender differences in spinal manipulation performance exist and that these differences seem to be mainly explained by alternative motor strategies. To develop gender-specific teaching methods, future studies should explore why men and women approach spinal manipulation tasks differently.