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Cervical spine mobilisation forces applied by physiotherapy students.

Suzanne J Snodgrass1, Darren A Rivett, Val J Robertson

  • 1Discipline of Physiotherapy, University of Newcastle, Hunter Building, Callaghan, NSW 2308, Australia. Suzanne.Snodgrass@newcastle.edu.au

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|April 28, 2010
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Summary

Physiotherapy students" manual force application during cervical spine mobilization varies significantly. Factors like subject stiffness and student experience influence applied forces, highlighting the need for objective feedback in training.

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Area of Science:

  • Biomechanics
  • Physiotherapy Education
  • Spinal Mobilization Techniques

Background:

  • Postero-anterior (PA) mobilization is a core component of physiotherapy curricula for cervical spine treatment.
  • The manual forces exerted by students during training are currently unknown, impacting effective and safe learning strategies.

Purpose of the Study:

  • To quantify the mechanical forces applied by physiotherapy students during cervical PA mobilization.
  • To identify factors influencing force application in novice clinicians.

Main Methods:

  • 120 physiotherapy students performed Grades I-IV central and unilateral PA mobilizations on asymptomatic subjects.
  • Manual forces were measured using an instrumented table; spinal stiffness was assessed using a standardized oscillating force device.
  • Statistical analyses included ANOVA, ICC for reliability, and linear regression for factor association.

Main Results:

  • Mobilization forces increased with grade, peaking at 63.7N for Grade IV C7 central PA technique.
  • Inter-student reliability was poor (ICC=0.23), while intra-student repeatability was better (ICC=0.83).
  • Higher forces correlated with C7 stiffness, thumb pain, male gender, and earlier learning stage; lower forces correlated with C2 stiffness.

Conclusions:

  • This study provides the first quantitative description of cervical mobilization forces applied by students.
  • Findings reveal significant variability and identify key influencing factors, forming a basis for developing objective feedback mechanisms.
  • Objective feedback is crucial for enhancing the effectiveness and safety of physiotherapy student training in cervical mobilization.