Biomedical subjects

Kenneth Sorrels

Publications and source records attributed to Kenneth Sorrels.

3 recordsLinked to original sources

PubMedDate not supplied

Procedural skills in spinal manipulation: do prerequisites matter?

BACKGROUND CONTEXT: Spinal manipulation has undergone a resurgence of interest. Developing evidence suggests a relationship between safety, skill and clinical outcome. Training programs are variable and range from extensive formalized curricula to weekend seminars and individual demonstrations. Systematic study of a relationship between prerequisites and skill development has not been conducted. PURPOSE: This project evaluated programmatic differences in prerequisites of students during their training for spinal manipulation with respect to quantitative biomechanical evidence of procedural control and skill of performance of a novel task. STUDY DESIGN/SETTING: The research used an experimental design comparing two cohorts involved in separate training programs at different institutions that had distinguishing characteristics in methods of prerequisites to manipulation training. METHODS: A common manipulation procedure (L4 mamillary push [L4MP]) was chosen as a standard test maneuver. Performance of the procedure on initial effort by two cohorts of students (n=38 vs n=39) entering into training for lumbar spine procedures was measured. Comparisons were made based on quantitative biomechanical parameters to assess control and skill. Results were compared with a cohort of experts as a reference standard. RESULTS: Significant differences were observed between the performance measures of the two cohorts. The more skilled performance group was more similar to the expert reference standard than was the lesser skilled group. CONCLUSIONS: The duration, extent and content of prerequisites for learning the dynamic and complex manual skills for spinal manipulation can significantly influence the level of skill attainment even early in the course of training.

Adult↗

PubMedDate not supplied

Quantitative feedback versus standard training for cervical and thoracic manipulation.

OBJECTIVE: To quantify elements of spinal manipulation therapy performance and to test the strategy of combined rehearsal and quantitative feedback as a means of enhancing student skill development for cervical and thoracic manipulative procedures. DESIGN: Randomized, controlled study. SETTING: Chiropractic college. SUBJECTS: Thirty-nine chiropractic student volunteers entering the manipulation technique training course. METHODS: Student performance of cervical and thoracic spinal manipulation therapies were quantified at the beginning, middle, and end of a trimester using a Leader 900 Z series manipulation table (Leader International, Port Orchard, Wash) embedded with an AMTI force plate. Passive loads acting through the targeted (C2 or T7) functional spinal units were estimated using inverse dynamics. Participating students rehearsed the index transverse (C2) and single pisiform-transverse (T7) procedures following either the standard curriculum alone or a modified curriculum adding the Dynadjust Instrument training aid (Labarge, Inc.), as assigned on a randomized basis. Student t and chi-square tests were used to explore and describe biomechanical parameter changes over time as the semester progressed. RESULTS: Significant changes in performance between the standard curriculum and modified curriculum (with the Dynadjust) were observed for several, but different, biomechanical parameters of cervical and thoracic procedures. CONCLUSION: This project used a rehearsal program that provided quantitative feedback on an empirically defined schedule that was self-administered by the student. Results demonstrated significant changes in performance of spinal manipulation by students using the Dynadjust Instrument versus those who did not. Using quantitative feedback provided from training aids and biomechanical measurement systems, future training programs may be optimized and tested.

Adult↗

PubMedDate not supplied

Developing skilled performance of lumbar spine manipulation.

OBJECTIVE: To quantify elements of spinal manipulation therapy performance and to test the strategy of combined rehearsal and quantitative feedback as a means of enhancing student skill development. DESIGN: Randomized, controlled study. SETTING: Chiropractic college. SUBJECTS: Thirty-nine chiropractic student volunteers entering the manipulation technique training course participated after providing informed consent. METHODS: Student performance of lumbar spinal manipulation therapy was quantified at the beginning, middle, and end of a trimester with a manipulation table imbedded with an AMTI force plate. Loads acting passing through the L5/S1 functional spinal unit were estimated by inverse dynamics. Participating students rehearsed the mamillary push, diversified procedure following either the standard curriculum alone or a modified curriculum adding a training aid as assigned on a randomized basis. Student's t and chi(2) tests were used to explore and describe biomechanical parameter changes over time as the semester progressed. RESULTS: Significant changes in performance between the standard curriculum and modified curriculum were observed in several biomechanical parameters. CONCLUSION: The reported project used a rehearsal program defined empirically and was self-administered in practice by the student. Results demonstrated significant changes in performance of spinal manipulation by students using the training aid instrument versus those who did not. With quantitative training aids and biomechanical measurement systems, future training programs may be optimized and tested.

Adult↗