Effects of practice variability on spinal manipulation learning*

Marchand, Andrée-Anne; Mendoza, Laura; Dugas, Claude; Descarreaux, Martin; Pagé, Isabelle

doi:10.7899/jce-16-8

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…27 Compared with posteriorto-anterior thoracic mobilization, our preload data are comparable to the force magnitude of grade IV mobilization that is considered the grade level before the thrust achievement defined as grade V. 9 Regular use of manipulative procedure is essential in developing manual skills, and several studies have attested to the significance of practice training to improve accuracy (targeted force level) and consistency in manipulation performances. 13,28 The results obtained herein confirmed that some preload difference exists between students and TPs but not for all. This small discrepancy may be explained by various individual learning processes and skills acquisition between the fifth-year students during their educational program as previously suggested by Loranger et al 29 Similarly, Enebo et al 30 demonstrated the benefit of practice training on spinal manipulation performance and competency.…”

Section: Reaction Force Orientationsupporting

confidence: 72%

Reaction Force Magnitude and Orientation During Supine Thoracic Spine Thrust Manipulation: An Exploratory Analysis and Reliability of Preload and Impulse Phase

Dugailly

Michaud

Feipel

et al. 2020

Journal of Manipulative and Physiological Therapeutics

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Objective: The main purpose of this study was to explore specific kinetic parameters during supine thoracic thrust manipulation and to analyze task reliability and differences between various practitioners Methods: Kinetic parameters were assessed by examining ground reaction force magnitude and orientation (on the basis of the zenithal angle) using force platforms. The manipulative procedure (consisting of the application of 3 preloads followed by 1 single thrust adjustment) was performed by different practitioners at 3 sessions. Application of thrust was allowed for trained practitioners only. Preload force, peak force, and vector force orientation were compared between sessions and practitioners. Results: Reliability analysis showed that practitioners achieved similar preload and peak force independent of the session, with comparable force orientation data. Differences between practitioners were observed for preload and peak force but not regarding the zenithal angle during the thrust phase. Conclusion:This study is the first that explores kinetic parameters for supine thoracic thrust manipulation. Task repeatability was confirmed and several differences were observed between practitioners. Certainly, there is a need for further investigation examining both dynamic parameters (ie, velocity and accelerations) and the potential neurologic effect of such manipulative technique.

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Section: Reaction Force Orientationsupporting

confidence: 72%

Reaction Force Magnitude and Orientation During Supine Thoracic Spine Thrust Manipulation: An Exploratory Analysis and Reliability of Preload and Impulse Phase

Dugailly

Michaud

Feipel

et al. 2020

Journal of Manipulative and Physiological Therapeutics

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“…Interestingly, the S-A group increased its peak force during the retention block (block 3), but increased the difference between the target force and the peak force applied, which can be considered a performance decrease. Although previous study have shown that small regimen of augmented feedback can improve SM learning [ 7 , 15 , 16 ], the limited number of practice trials with augmented feedback for each force target may have been insufficient to trigger learning effects. Moreover, according to the guidance hypothesis, augmented feedback can lead to error corrections and subsequent learning but providing inadequate feedback (e.g.…”

Section: Discussionmentioning

confidence: 99%

Can self-assessment and augmented feedback improve performance and learning retention in manual therapy: results from an experimental study

Pasquier,

Memari,

Lardon

et al. 2023

Chiropr Man Therap

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Background The purpose of this study was to investigate how feedback and self-assessment strategies affect performance and retention of manual skills in a group of chiropractic students. Methods Seventy-five students participated in two spinal manipulation (SM) learning sessions using a force-sensing table. They were recruited between May and November 2022 during HVLA technical courses. Students were randomly assigned into three different groups: participants in group 1 received visual feedback, those in group 2 received visual feedback after self-assessment, and participants in group 3 (C) received no feedback. During the first session, participants started with one block of 3 familiarization trials, followed by two blocks of 6 SM HVLA (high velocity low amplitude) posterior-to-anterior thoracic SM trials, with 3 trials performed with a target force of 450 N and 3 others at 800 N. They received feedback according to their group during the first block, but no feedback was provided during the second block. All participants were invited to participate in a second session for the retention test and to perform a new set SM without any form of feedback. Results Results showed that visual feedback and visual feedback in addition to self-assessment did not improve short-term SM performance, nor did it improve performance at the one-week retention test. The group that received visual feedback and submitted to self-assessment increased the difference between the target force and the peak force applied, which can be considered a decrease in performance. Conclusion No learning effects between the three groups of students exposed to different feedback and self-assessment learning strategies were highlighted in the present study. However, future research on innovative motor learning strategies could explore the role of external focus of attention, self-motivation and autonomy in SM performance training.

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“…The discrepancy between student and experienced clinician thrust duration suggests there may be a difference in how students, who are still learning subtle coordination aspects of HVLA-SM, adapt to and learn the ability to deliver prescribed forces compared to clinicians whose motor skills are perhaps more ingrained. Marchand et al 22 noted that the level of preload force applied was predictive of loading rate, suggesting that training prescribed preload force together with peak force may lead to an increased consistency of thrust duration. 22 Additional study is needed to better understand these phenomena.…”

Section: Discussionmentioning

confidence: 99%

“…Marchand et al 22 noted that the level of preload force applied was predictive of loading rate, suggesting that training prescribed preload force together with peak force may lead to an increased consistency of thrust duration. 22 Additional study is needed to better understand these phenomena.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High-velocity, low-amplitude spinal manipulation training of prescribed forces and thrust duration: A pilot study

Shannon¹,

Vining²,

Gudavalli³

et al. 2019

Journal of Chiropractic Education

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Objective: High-velocity, low-amplitude spinal manipulation (HVLA-SM) may generate different therapeutic effects depending on force and duration characteristics. Variability among clinicians suggests training to target specific thrust duration and force levels is necessary to standardize dosing. This pilot study assessed an HVLA-SM training program using prescribed force and thrust characteristics. Methods: Over 4 weeks, chiropractors and students at a chiropractic college delivered thoracic region HVLA-SM to a prone mannequin in six training sessions, each 30 minutes in duration. Force plates embedded in a treatment table were used to measure force over time. Training goals were 350 and 550 Newtons (N) for peak force and 150 ms for thrust duration. Verbal and visual feedback was provided after each training thrust. Assessments included 10 consecutive thrusts for each force target without feedback. Mixed-model regression was used to analyze assessments measured before, immediately following, and 1, 4, and 8 weeks after training. Results: Error from peak force target, expressed as adjusted mean constant error (standard deviation), went from 107 N (127) at baseline, to 0.2 N (41) immediately after training, and 32 N (53) 8 weeks after training for the 350 N target, and 63 N (148), À6 N (58), and 9 N (87) for the 550 N target. Student median values met thrust duration target, but doctors' were .150 ms immediately after training. Conclusion: After participation in an HVLA-SM training program, participants more accurately delivered two prescribed peak forces, but accuracy decreased 1 week afterwards. Future HVLA-SM training research should include follow-up of 1 week or more to assess skill retention.

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Effects of practice variability on spinal manipulation learning*

Cited by 6 publications

References 28 publications

Reaction Force Magnitude and Orientation During Supine Thoracic Spine Thrust Manipulation: An Exploratory Analysis and Reliability of Preload and Impulse Phase

Reaction Force Magnitude and Orientation During Supine Thoracic Spine Thrust Manipulation: An Exploratory Analysis and Reliability of Preload and Impulse Phase

Can self-assessment and augmented feedback improve performance and learning retention in manual therapy: results from an experimental study

High-velocity, low-amplitude spinal manipulation training of prescribed forces and thrust duration: A pilot study

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