Kinematic real-time feedback is more effective than traditional teaching method in learning ankle joint mobilisation: a randomised controlled trial

Abstract

BackgroundTo analyse the effect of real-time kinematic feedback (KRTF) when learning two ankle joint mobilisation techniques comparing the results with the traditional teaching method.MethodsDouble-blind randomized trial. Settings: Faculty of Health Sciences. Participants: undergraduate students with no experience in manual therapy. Each student practised intensely for 90 min (45 min for each mobilisation) according to the random methodology assigned (G1: traditional method group and G2: KRTF group). G1: an expert professor supervising the student’s practice, the professorstudent ratio was 1:8. G2: placed in front of a station where, while they performed the manoeuvre, they received a KRTF on a laptop. Outcome measures: total time of mobilisation, time to reach maximum amplitude, maximum angular displacement in the three axes, maximum and average velocity to reach the maximum angular displacement, average velocity during the mobilisation.ResultsAmong the pre-post intervention measurements, there were significant differences within the two groups for all outcome variables, however, G2 (KRTF) achieved significantly greater improvements in kinematic parameters for the two mobilisations (significant increase in displacement, velocity and significant reduction in the mobilisations runtime) than G1. Ankle plantar flexion: G1′s measurement stability (post-intervention) ranged between 0.491 and 0.687, while G2′s measurement stability ranged between 0.899 and 0.984. Ankle dorsal flexion mobilisation: G1 the measurement stability (post-intervention) ranged from 0.543 and 0.684 while G2 ranged between 0.899 and 0.974.ConclusionKRTF was proven to be more effective tool than traditional teaching method in the teaching - learning process of two joint mobilisation techniques.Trial registration NCT02504710.

The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial

“…Traditional teaching methods for learning joint mobilization skills have consisted of an expert instructor demonstrating techniques followed by student practice sessions [21,29,30,58,59]. During these sessions, students typically receive limited objective feedback about the forces applied due to large faculty-student ratios and may continue to practice erroneous motor patterns that adversely affect skill mastery.…”

“…During these sessions, students typically receive limited objective feedback about the forces applied due to large faculty-student ratios and may continue to practice erroneous motor patterns that adversely affect skill mastery. Previous studies have explored more non-traditional methods of teaching joint mobilization with promising results [29,31,58,59,71]. Gonzalez-Sanchez et al [29] and Triano et al [58,59] utilized quantitative feedback devices with subjects and found that those teaching methods were superior to the traditional approach.…”

“…Previous studies have explored more non-traditional methods of teaching joint mobilization with promising results [29,31,58,59,71]. Gonzalez-Sanchez et al [29] and Triano et al [58,59] utilized quantitative feedback devices with subjects and found that those teaching methods were superior to the traditional approach. However, an expert clinician is still needed in the learning process to provide a reference standard for joint mobilization forces [71,72].…”

“…Prior to graduation, physical therapy students must demonstrate an understanding of the indications and contraindications of manual therapy and demonstrate competence in these skills to ensure they can be effectively and safely applied [2,[23][24][25][26][27][28]. Traditionally, physical therapy students learn joint mobilization skills through observation of and interaction with an expert instructor followed by extensive practice of techniques on peers, faculty, and eventually patients [21,29]. This method may be less than ideal as there is little objective feedback about the forces applied.…”

“…This method may be less than ideal as there is little objective feedback about the forces applied. Perception of forces and subsequent verbal feedback about applied mobilization forces may be less accurate when compared to real-time quantified force measurements [29][30][31][32].…”