Changes in Manipulative Peak Force Modulation and Time to Peak Thrust among First-Year Chiropractic Students Following a 12-Week Detraining Period.

OBJECTIVE: The purpose of this study was to analyze differences in peak force modulation and time-to-peak thrust in posterior-to-anterior (PA) high-velocity-low-amplitude (HVLA) manipulations in first-year chiropractic students prior to and following a 12-week detraining period. METHODS: Chiropractic students (n=125) performed 2 thrusts prior to and following a 12-week detraining period: total peak force targets were 400 and 600 N, on a force-sensing table using a PA hand contact of the participant's choice (bilateral hypothenar, bilateral thenar, or cross bilateral). Force modulation was compared to defined target total peak force values of 600 and 400 N, and time-to-peak thrust was compared between data sets using 2-tailed paired t-tests. RESULTS: Total peak force for the 600 N intensity varied by 124.11 + 65.77 N during the pre-test and 123.29 + 61.43 N during the post-test compared to the defined target of 600 N (P = .90); total peak force for the 400 N intensity varied by 44.91 + 34.67 N during the pre-test and 44.60 + 32.63 N during the post-test compared to the defined target of 400 N (P = .57). Time-to-peak thrust for the 400 N total peak force was 137.094 + 42.47 milliseconds during the pre-test and 125.385 + 37.46 milliseconds during the post-test (P = .0004); time-to-peak thrust for the 600 N total peak force was 136.835 + 40.48 milliseconds during the pre-test and 125.385 + 33.78 milliseconds during the post-test (P = .03). CONCLUSIONS: The results indicate no drop-off in the ability to modulate force for either thrust intensity, but did indicate a statistically significant change in time-to-peak thrust for the 400 N total peak force thrust intensity in first-year chiropractic students following a 12-week detraining period.

A pilot study to determine the consistency of peak forces during cervical spine manipulation utilizing mannequins.

OBJECTIVE: Cervical spine manipulation is a complex motor skill used to treat musculoskeletal ailments such as neck pain. There is evidence demonstrating the effectiveness of objective feedback and mannequins for the teaching of spinal manipulation (SM) in the thoracic and lumbar spine. This paper examines the effectiveness of an educational intervention combining both mannequins and force-sensing technology for teaching cervical SM. METHODS: Fourth-year chiropractic interns were separated into 2 groups: an intervention group and a group trained with the standard curriculum. The intervention included a 60-minute educational session focused on targeting 100 N total peak force cervical manipulations on mannequins, with objective feedback through force-sensing table technology. Pre- and post-CMs were recorded on both a mannequin and a paired student partner, with an attempt to have a target total peak force of 100 N. RESULTS: Ninety students were recruited. The invention group (n = 46) scored significantly better at the outcome compared to the control group (n = 44) when manipulating the mannequin (p = .003). These improvements did not carry over when manipulating a paired human partner (p = .067). CONCLUSION: Following a 1-hour cervical SM educational intervention utilizing thrusting on mannequins and force-sensing table technology, students demonstrated improved peak force control for SM delivered on the mannequin. However, this improvement was not carried over to SM delivered on human subjects.

Participation strategies and student performance: An undergraduate health science retrospective study.

OBJECTIVE: This research explores participatory evidence-based teaching methods in a health science course to see if a relationship emerged between the level of student participation and course performance, the type of participation and course performance, or the amount of participation and course performance and level of demonstrated learning. METHODS: Level of student participation was dichotomous (100% or <100%), and differences between groups on a knowledge test were compared using an unpaired t test. Type of participation was also dichotomous (in class or out), and differences in course performance on the knowledge test were compared using the unpaired t test. Amount of participation and course performance and level of demonstrated learning were also tested after the knowledge test was measured using a matrix based upon Bloom's taxonomy. RESULTS: Students who participated 100% of the time scored 6% higher on average than students with less than 100% participation (t[183] = 3.55, p = .0005, d = 0.52). There was no difference between groups when assessing for differences in course performance by type of participation. Students with 100% participation scored higher on the short answer question section of the examination (t[183] = 4.58, p = .0001, d = 0.68), but there was no difference on the multiple choice question part of the examination. CONCLUSION: Full participation in the course was related to higher examination scores and higher scores on examination questions assessing higher levels in the cognitive domain.

Whole body vibration and cerebral palsy: a systematic review.

PURPOSE: The goal of this review is to evaluate the effects of whole body vibration on outcomes in patients with cerebral palsy. The findings in this review may help clinicians make evidence informed decisions on the use of whole body vibration for cerebral palsy. METHODS: A systematic search was conducted on April 29, 2014.The following search terms were used to search of several databases: (whole body vibration OR whole-body vibration OR whole body-vibration OR WBV) AND (cerebral palsy). Articles that met the inclusion criteria were assessed using the Scottish intercollegiate guidelines network (SIGN) rating system to assess the methodology and bias of the articles for randomized control trials. RESULTS: The search produced 25 articles, of which 12 duplicates were identified and removed. Another seven articles were not considered since they did not fit the inclusion criteria, leaving a total of five studies for review. Four of the articles analyzed the effects of WBV in children while the other study focused on adults with cerebral palsy. There was one low quality article, four acceptable quality articles and one high quality article when assessed using the SIGN criteria. CONCLUSIONS: It appears that whole body vibration has the potential to provide symptomatic relief for patients with cerebral palsy. Whole body vibration may improve spasticity, muscle strength and coordination. There is a lack of research to conclusively determine whether it does alter bone mineral density.

OBJECTIF: L'objectif de cette étude est d'évaluer les effets de la vibration du corps entier sur les résultats chez les patients atteints de paralysie cérébrale. Les conclusions de cette étude peuvent aider les cliniciens à prendre des décisions éclairées par des données probantes sur le recours à des vibrations du corps entier pour la paralysie cérébrale. MÉTHODOLOGIE: Une recherche systématique a été effectuée le 29 avril 2014. Les termes de recherche suivants ont été utilisés pour la recherche de plusieurs bases de données : (whole body vibration OR whole-body vibration OR whole body-vibration OR WBV) AND (cerebral palsy) [(vibration du corps entier) ET (paralysie cérébrale)]. Les articles qui répondaient aux critères d'inclusion ont été évalués à l'aide du système de notation SIGN (Scottish intercollegiate guidelines network) pour évaluer la méthodologie et la partialité des articles pour des essais cliniques randomisés. RÉSULTATS: La recherche a permis de recenser 25 articles, dont 12 qui étaient doubles ont été éliminés. Sept autres articles n'ont pas été retenus, car ils ne répondaient pas aux critères d'inclusion, laissant au total cinq articles pour l'étude. Quatre des articles analysaient les effets de la vibration du corps entier chez les enfants tandis que l'autre étude portait sur des adultes atteints de paralysie cérébrale. L'évaluation de la qualité des articles selon les critères SIGN a révélé un article de qualité médiocre, quatre articles de qualité acceptable et un article de bonne qualité. CONCLUSIONS: Il semble que le traitement par vibrations du corps entier a le potentiel de fournir un soulagement symptomatique chez les patients atteints de paralysie cérébrale. La vibration du corps entier peut améliorer la spasticité, la force musculaire et la coordination. Les recherches ne sont pas suffisantes pour permettre de déterminer de façon concluante si elle modifie la densité minérale osseuse.

The examination of soft tissue compliance in the thoracic region for the development of a spinal manipulation training mannequin.

PURPOSE: To determine if the soft tissue compliance of the thoracic paraspinal musculature differs based on gender and body type to help create a foam human analogue mannequin to assist in the training of spinal manipulative therapy. METHODS: 54 volunteers were grouped based on their gender and body types. In the prone position, thoracic paraspinal soft tissue compliance was measured at T1, T3 T6, T9 and T12 vertebrae levels bilaterally using a tissue compliance meter. RESULTS: There was no significant difference in tissue compliance when comparing the genders except at T1 (p=0.026). When comparing body types, significantly higher tissue compliance was found between endomorphs and the other groups. No significant difference was found between ectomorphs and mesomorphs. The compliance for the participants in this study ranged from 0.122 mm/N to 0.420 mm/N. CONCLUSION: There are significant differences in thoracic spine soft tissue compliance in healthy asymptomatic patients between genders in the upper thoracic spine, and between different body types throughout the thoracic spine. It may be beneficial to create multiple versions of practice mannequins to simulate variations amongst different patients.

OBJECTIF: Déterminer si la compliance des tissus mous de la masse musculaire thoracique paradorsale diffère selon le sexe et le type corporel afin de créer un mannequin en mousse de forme humaine pour aider à la formation en traitement par manipulation dorsale. MÉTHODOLOGIE: On a regroupé 54 volontaires en fonction de leur sexe et de leur type corporel. En position allongée, on a mesuré la compliance des tissus mous thoraciques paradorsaux au niveau des vertèbres T1, T3, T6, T9 et T12 bilatéralement à l'aide d'un dispositif de mesure de compliance. RÉSULTATS: Il n'y a pas de grande différence sur le plan de la compliance des tissus lorsqu'on compare les sexes, sauf à la vertèbre T1 (p = 0,026). En comparant les types corporels, une compliance des tissus bien plus élevée a été remarquée chez les endomorphes par rapport aux autres groupes. Il n'y a pas de différence importante entre les ectomorphes et les endomorphes. La compliance pour les participants à cette étude allait de 0,122 mm/N à 0,420 mm/N. CONCLUSION: Il existe de grandes différences entre la compliance des tissus mous thoraciques dorsaux chez les patients en santé asymptomatiques entre les sexes dans la colonne thoracique supérieure et entre les différents types corporels dans toute la colonne thoracique. Il peut être bénéfique de créer plusieurs versions de mannequins de pratique pour simuler les variations chez les différents patients.

Observed improvements in an intern's ability to initiate critical emergency skills in different cardiac arrest scenarios using high-fidelity simulation.

Objective : The objective of this study was to report observed changes in an intern's ability to initiate critical emergency skills in different cardiac arrest scenarios with high-fidelity simulation over a 10-month period. Methods : One intern's performance was retrospectively analyzed using video recordings of 4 simulations at different stages in the training program. The key outcome was the duration of time expired for 4 critical skills, including activating the emergency response system, initiating cardiopulmonary resuscitation (CPR), using an automated external defibrillator (AED), and passively administrating oxygen. Results : The intern became more efficient in each subsequent simulation for activating the emergency response system and initiating CPR. The time to use the AED stayed relatively constant. The administration of oxygen was inconsistent. Conclusion : An improvement in the speed of applying emergency critical skills was observed with this intern. These improvements in skill may improve patient outcomes and survival rates. We propose further educational research with high-fidelity simulation in the area of assessing emergency skills.