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

J Man Manip Ther. 2020 Sep;28(4):201-211. doi: 10.1080/10669817.2019.1673953. Epub 2019 Oct 8.

Abstract

Objective: To examine the effects of real-time, objective feedback on learning lumbar spine joint mobilization techniques by entry-level Doctor of Physical Therapy (DPT) students.

Methods: A randomized, controlled, crossover design was used. Twenty-four 1st Year DPT students were randomized into two groups. Group 1 (n = 12) practiced with the real-time feedback device first and then without it, while Group 2 (n = 12) practiced without the device first and then with it. Both practice periods with and without the device were 4 weeks long. Data were collected at Baseline, 5 weeks, 11 weeks, and 16 weeks. The crossover period was 5 weeks long, during which neither group practiced with or without the device. Eight force parameters were measured: R1 force; R2 force; Grade III and Grade IV mean peak force, frequency, and amplitude.

Results: When students practiced with the real-time feedback device, they more closely matched the reference standard for two outcomes: 1) the mean difference in R2 force between student and reference standard was better with device (38.0 ± 26.7 N) than without it (51.0 ± 38.5 N); P = .013; and 2) the mean difference in Grade III peak to peak amplitude force was also better with device (8.9 ± 9.3 N) than without it (11.8 ± 11.0); P = .026. All other force parameters improved when students practiced with the real-time feedback device, however, the differences between when they practiced without the device were not statistically significant.

Discussion: Real-time, objective feedback using a direct force measurement device improved learning for some aspects of lumbar spine joint mobilization by entry-level physical therapy students.

Level of evidence: 2b.

Keywords: Manual therapy; force; motor skills.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Cross-Over Studies
  • Female
  • Humans
  • Knowledge of Results, Psychological*
  • Lumbar Vertebrae
  • Male
  • Manipulation, Spinal / methods*
  • Physical Therapists / education*
  • Young Adult

Grants and funding

This study was funded in part by the University of the Incarnate Word (UIW), Office of Research and Graduate Studies. Additional donations in kind were provided by the UIW School of Physical Therapy to complete the study.This study was reviewed and accepted by the Institutional Review Board at the University of the Incarnate Word, San Antonio, TX. The IRB deemed this study as non-clinical as the purpose was to examine the effect only on the providers (for example, provider knowledge or attitudes). In this study the effect of real-time feedback on the learning of a manual therapy technique was studied. Therefore, it was not included in a public trials registry.