M. Phillis1, O. Rasmussen1, K. Learman1,2, W. Ge1,2
1Youngstown State University, Graduate Studies in Health and Rehabilitation Sciences, Youngstown, United States, 2Youngstown State University, Center of Excellence in Sports Medicine and Applied Biomechanics, Youngstown, United States
Background: Spinal mobilization is a manual therapy technique that is often used by physical therapists to decrease stiffness, improve range of motion, decrease pain, and improve function. The magnitude of spinal mobilization is categorized between grades I and V based on the applied force compared to the reaction of an individual patient. Traditionally, students learn spinal mobilization through classroom instructions with subjective feedback from their instructors and student peers. A force sensor that provides real-time objective visual feedback may improve student learning.
Purpose: The purpose of the study was to assess student learning of spinal mobilization with real-time objective visual feedback.
Methods: Twenty-eight subjects were recruited using convenience sampling in the second-year physical therapy class in a public university in Northeast Ohio. The research design was a randomized controlled trial. Subjects were randomly assigned to the experimental or control group. Both groups attended a 4-hour spinal manipulation class as usual in the curriculum. In the experimental group, subjects were able to practice spinal manipulation using the Activ5 device (Activbody, San Diego, CA, USA) for real-time objective visual feedback during in-class lecture and lab. Activ5 device has a built-in force sensor that can provide realtime objective visual feedback via a Bluetooth connected mobile device. In the control group, subjects were taught spinal mobilization using the traditional approach. At the end of the class, students completed an eight-question confidence questionnaire. Subjective confidence was documented as 0 being "not confident" and 10 "very confident". Student spinal mobilization skill was assessed by an experienced instructor using a 10-point scale.
Results: The experimental group (n=14) comprised of 7 females and 7 males with a mean age of 25.3 (SD 3.2 ) years, old did not differ from the control group (n=14) comprised of 9 females and 5 males with a mean age 26.4 (SD 7.8) years old. There was no statistically significant difference for the confidence questionnaire scores between the experimental (5.12 (SD 1.03)) and control groups (5.44 (SD 0.84)), with p= 0.37 and an SMD of 0.34. The experimental group had a slightly higher average score (8.21(SD 1.20)) in the skill performance compared to the control group 7.96 (SD 1.47). There was no statistically significant difference between the experimental and control groups (p= 0.63 with an SMD of 0.19).
Conclusion(s): The results did not demonstrate statistically significant benefits of using the Activ5 device in student learning compared to traditional approach. The sample size was small and there might have been some diffusion between groups in the lab during practice and training. Additionally, the time the class spent on learning mobilization with the device may not have been sufficient to produce increased confidence in spinal mobilization.
Implications: Physical therapy educators should continuously seek to improve their teaching methods for manual techniques. Real-time objective visual feedback can be used to improve consistency in teaching methods. Although our study did not show a statistically significant difference in the results, future refinement of the pedagogical technique may be necessary to prove that real-time objective visual feedback can assist students to transition into competent clinicians.
Funding, acknowledgements: Youngstown State University Office of Assessment.
Keywords: education, spinal mobilization, force sensor
Topic: Education: methods of teaching & learning
Did this work require ethics approval? Yes
Institution: Youngstown State University
Committee: IRB
Ethics number: 20-290
All authors, affiliations and abstracts have been published as submitted.
