The association between students' confidence and ability to modulate spinal manipulation force-time characteristics of specific target forces: a cross-sectional study.

Autor: Nim C; Medical Research Unit, Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Oestre Hougvej 55, 5500, Middelfart, Denmark. casper.nim@rsyd.dk.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. casper.nim@rsyd.dk.; Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. casper.nim@rsyd.dk., Smith N; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Starmer D; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Wang S; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Choi G; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Alayed A; Canadian Memorial Chiropractic College, Toronto, ON, Canada., AlShareef J; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Gnjatic A; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Sloan K; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Wong K; Canadian Memorial Chiropractic College, Toronto, ON, Canada., Funabashi M; Canadian Memorial Chiropractic College, Toronto, ON, Canada.; Department of Chiropractic, Université du Québec À Trois-Rivières, Trois-Rivières, Canada.
Jazyk: angličtina
Zdroj: Chiropractic & manual therapies [Chiropr Man Therap] 2024 Nov 11; Vol. 32 (1), pp. 34. Date of Electronic Publication: 2024 Nov 11.
DOI: 10.1186/s12998-024-00557-w
Abstrakt: Background: Spinal manipulative therapy (SMT) is a guideline-recommended care for musculoskeletal pain taught in various undergraduate programs. Visual feedback through force-sensing tables can improve modulation of SMT force-time characteristics and, potentially, students' confidence, both factors important for clinical competence and patient outcomes. However, it is unclear if a link exists between students' confidence and ability in SMT force-time modulation. We aim to investigate this relationship and whether it was moderated by experience.
Methods: This cross-sectional study recruited first- to third-year Canadian Memorial Chiropractic College students. Participants provided information about their confidence in performing SMT using different impulse forces of 200N, 400N, and 800N with a pre-established pre-load and a time-to-peak force < 150ms. SMT impulse forces of 200N, 400N, and 800N were targeted on a Human Analogue Mannequin positioned prone on a force-sensing table. We described the confidence levels and SMT force-time characteristics and assessed their association using linear mixed models. We re-ran the models interacting with SMT experience. The order of the three SMT impulse forces was randomly performed. Participants and outcome assessors were blinded to force-time characteristics recordings.
Results: One-hundred-and-forty-nine participants provided usable data. Participants were confident in delivering 200N and 400N impulse forces. However, confidence decreased for 800N forces. Accordingly, participants performed impulse forces close to the 200N and 400N but had difficulty accurately modulating to 800N forces. A positive association was found between confidence and the ability to modulate their force-time characteristics, especially keeping the same pre-load force, keeping the time to peak force < 150ms, and providing the 800N impulse force. This association was not moderated by experience.
Conclusions: Students were more confident in their abilities to perform lower SMT forces but lacked confidence in their abilities to perform higher (800N) forces. This aligned with their skills, as many struggled to apply 800N force. However, students who had higher confidence levels generally performed better overall. There was substantial variability in SMT force-time characteristics, which may have implications for adverse events and patient satisfaction. Some of this variability could be attributed to students' confidence. Thus, further investigations are necessary in undergraduate settings to implement and optimize these findings.
Registration: https://osf.io/6f7d5.
Competing Interests: Declarations Ethics approval and consent to participate This study was reviewed and approved by the CMCC Research Ethics Board (REB approval #2311B02). All participants reviewed and signed an electronic informed consent prior to participating in the study. Consent for publication Not applicable. Declaration of generative AI and AI-assisted technologies in the writing process During the preparation of this work the authors used GrammarlyGO in order to optimize grammar and proofread. After using this tool, the authors reviewed and edited the content as needed and takes full responsibility for the content of the publication. Competing interests The Canadian Memorial Chiropractic College (CMCC) commercializes the Force Sensing Table Technology (FSTT®) system, which was used in this study. None of the authors received any compensation related to the sale of FSTT® units, and CMCC, as an institution, did not have any influence in designing or conducting this study. The authors declare no other conflicts of interest.
(© 2024. The Author(s).)
Databáze: MEDLINE
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