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Adams KR, Kolb WH, Geiser MB, Dolphin M. A novel model for developing thrust joint manipulation skills: a teaching and learning perspective. J Man Manip Ther 2024; 32:412-420. [PMID: 38213135 PMCID: PMC11257007 DOI: 10.1080/10669817.2023.2299184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
Spinal and extremity thrust joint manipulation (TJM) has been shown to be an effective intervention when treating patients with various musculoskeletal conditions. Learning skilled TJM requires the proper execution of many discrete tasks. If any of these are missing, effectiveness and safety may be limited. While it is accepted that practice and feedback are important when physical therapists are learning clinical tasks, the best type of practice has not been identified for learning to perform TJM tasks. In this paper, we propose an educational model for instruction of joint manipulation that: 1) standardizes feedback terminology and 2) describes a core set of four discrete tasks (lift, drop, pull, and combination-rotation) that apply to most TJM tasks. The model includes instructing TJM tasks followed by identifying key errors related to the components of setup and thrust. Once these key errors have been identified, intentional practice activities are provided to address the noted positional and movement errors. Finally, reassessment is performed to determine if errors have diminished. This model is similar to the test-retest approach that is commonly used when treating patients. We hope this educational model will provide a framework for teaching TJM and will also foster future research.
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Affiliation(s)
- Kyle R. Adams
- Doctor of Physical Therapy Department, Baylor University, Waco, TX, USA
| | - William H. Kolb
- Department of Physical Therapy, Radford University, Roanoke, VA, USA
| | | | - Michelle Dolphin
- Department of Physical Therapy, Upstate Medical University, Syracuse, NY, USA
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Degenhardt B, van Dun PL, Jacobson E, Fritz S, Mettler P, Kettner N, Franklin G, Hensel K, Lesondak D, Consorti G, Frank L, Reed WR, MacDonald C, Kremen V, Martin C, Landels B, Standley P. Profession-based manual therapy nomenclature: exploring history, limitations, and opportunities. J Man Manip Ther 2024; 32:96-110. [PMID: 38104312 PMCID: PMC10795627 DOI: 10.1080/10669817.2023.2288495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE The International Consortium on Manual Therapies (ICMT) is a grassroots interprofessional association open to any formally trained practitioner of manual therapy (MT) and basic scientists promoting research related to the practice of MT. Currently, MT research is impeded by professions' lack of communication with other MT professions, biases, and vernacular. Current ICMT goals are to minimize these barriers, compare MT techniques, and establish an interprofessional MT glossary. METHODS Practitioners from all professions with training in manual therapies were encouraged by e-mail and website to participate (www.ICMTConferene.org). Video conferences were conducted at least bimonthly for 2.5 years by profession-specific and interprofessional focus groups (FGs). Members summarized scopes of practice, technique descriptions, associated mechanisms of action (MOA), and glossary terms. Each profession presented their work to the interprofessional FG to promote dialogue, understanding and consensus. Outcomes were reported and refined at numerous public events. RESULTS Focus groups with representatives from 5 MT professions, chiropractic, massage therapy, osteopathic, physical therapy and structural integration identified 17 targeting osseous structures and 49 targeting nonosseous structures. Thirty-two techniques appeared distinct to a specific profession, and 13 were used by more than 1. Comparing descriptions identified additional commonalities. All professions agreed on 4 MOA categories for MT. A glossary of 280 terms and definitions was consolidated, representing key concepts in MT. Twenty-one terms were used by all MT professions and basic scientists. Five terms were used by MT professions exclusive of basic scientists. CONCLUSION Outcomes suggested a third to a half of techniques used in MT are similar across professions. Additional research is needed to better define the extent of similarity and how to consistently identify those approaches. Ongoing expansion and refinement of the glossary is necessary to promote descriptive clarity and facilitate communication between practitioners and basic scientists.
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Affiliation(s)
- Brian Degenhardt
- A.T. Still Research Institute, A.T. Still University, Mesa, AZ, USA
- Department of Osteopathic Manipulative Medicine, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
| | - Patrick L.S. van Dun
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Belgium National Centre, Foundation COME Collaboration, Mechelen, Belgium
| | - Eric Jacobson
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Sandy Fritz
- Health Enrichment Center, School of Therapeutic Massage, Lapeer, MI, USA
| | - Paul Mettler
- DFR Therapy Institute, and Mettler Institute, Chicago, IL, USA
| | - Norman Kettner
- Department of Radiology, Logan University, Chesterfield, MO, USA
| | - G. Franklin
- A.T. Still Research Institute, A.T. Still University, Mesa, AZ, USA
| | - Kendi Hensel
- Department of Family Medicine and Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - David Lesondak
- Department of Family and Community Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Giacomo Consorti
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, Milan, Italy
| | - Leah Frank
- Praxis für Orthopädie, Osteopathie und Sportmedizin, Düsseldorf, Germany
| | - William R. Reed
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL
| | | | - Vaclav Kremen
- Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University in Prague, Prague, Czech Republic
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Crystal Martin
- Department of Family Medicine and Osteopathic Manipulative Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | | | - Paul Standley
- Department of Basic Medical Sciences, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
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