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The Effectiveness of Instruction on Lumbar Spine Thrust Joint Manipulation Task Performance
Cory Manton1,2,3,4, Quincy Conley1,2,3,4, Joshua A Cleland1,2,3,4
1Cory Manton is the assistant professor in the Doctor of Physical Therapy Program, and director in the Orthopedic Physical Therapy Residency Program at the Arizona School of Health Sciences at the A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206 (cmanton@atsu.edu). Please address all correspondence to Cory Manton.
Peyton's 4-step (P4) approach improved student accuracy in lumbar spine thrust joint manipulation (TJM) more than the "see one, do one" (S1D1) method. No differences were found in performance time or outcome, but P4 enhanced procedural knowledge.
Area of Science:
- Physical Therapy Education
- Musculoskeletal Rehabilitation
- Manual Therapy Techniques
Background:
- Uncertainty exists regarding optimal teaching methods for thrust joint manipulation (TJM) in physical therapy programs.
- Traditional
- see one, do one
- (S1D1) is common, but its effectiveness for TJM compared to structured approaches is unclear.
Purpose of the Study:
- To compare the effectiveness of Peyton's 4-step (P4) approach versus the S1D1 approach for teaching lumbar spine TJM.
- To assess the impact of each method on students' attitudes, beliefs, and motivation regarding spinal TJM.
Main Methods:
- A factorial quasi-experimental design was employed with student physical therapists randomly assigned to P4 or S1D1 groups.
- Performance accuracy, time, and outcome of lumbar spine TJM were measured.
- Student attitudes, beliefs, and motivation were assessed via paper surveys.
Main Results:
- An interaction between instructional group and time significantly favored the P4 approach for task performance accuracy (P = .03).
- No significant differences were observed between groups for performance time, outcome, attitudes, beliefs, or motivation (P > .19).
Conclusions:
- The P4 approach demonstrated superior effectiveness in enhancing student accuracy for lumbar spine TJM in an academic setting compared to S1D1.
- While P4 improved procedural knowledge, no differences were noted in performance time or outcome.
- Preliminary findings suggest P4 may be a valuable tool for instructors to build TJM proficiency before practical application.
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