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Effect of Feedback on Learning a Vertebral Joint Mobilization Skill

M Lee, BE, PT, is Lecturer, Division of Biomechanics, Department of Biological Sciences, Cumberland College of Health Sciences, PO Box 170, East St, Lidcombe, Sydney, New South Wales, Australia 2141.
A Moseley, BAppSc, PT, is Physical Therapist, Lidcombe Hospital, Joseph St, Lidcombe, Sydney, New South Wales, Australia 2141.
K Refshauge, Graduate Diploma in Manipulative Therapy, PT, is Lecturer, School of Physiotherapy, Cumberland College of Health Sciences.

This study was designed to investigate whether concurrent quantitative feedback of performance could improve the learning of a joint mobilization technique. A group of 110 physical therapy students had been randomly divided into two groups for teaching purposes. All students had previously learned mobilization of peripheral joints and were currently learning spinal mobilization. From one of the groups, 22 students volunteered to comprise a control group, which was taught a spinal mobilization technique in the traditional way. Additional concurrent quantitative feedback of the level of force applied to the patient was given to 31 volunteers from the other group. These students formed the experimental group. A force plate was used for force measurement, and the feedback was given via an oscilloscope. The average force applied by the students' instructors was taken as an "ideal" force. The oscilloscope showed both the applied force and the "ideal" force. Consistency was measured by the variance of the group's performance. Accuracy was assessed by calculating the difference between the applied force and the "ideal" force. Results indicated that this feedback was associated with a significant improvement in accuracy and consistency in the application of the mobilizing force. This improvement was still present at a follow-up test conducted one week later. This result supports a greater use of such feedback in the teaching and practice of joint mobilization techniques, although the need for further research is emphasized.

Key Words: Education: physical therapist, teaching methods • Feedback • Joints • Learning • Manual therapy

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Stanley V Paris
Physical Therapy 1990 70: 103. [Abstract] [PDF]

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