A novel model for developing thrust joint manipulation skills: a teaching and learning perspective
Open accessAbstract
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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A common educational approach to facilitate comprehension and skill acquisition is teaching and practising small series of manual therapy techniques in small groups.
“A common educational approach to facilitate comprehension and skill acquisition is teaching and practising small series of manual therapy techniques in small groups [9].”
From Teaching a single manual therapy technique at a time reduces cognitive load in physiotherapy students: a randomized controlled educational study (2025) · cites this paper as [9]
The cognitive load associated with the acquisition of manual therapy techniques may be considerable, as these techniques are often complex and highly procedural.
“The cognitive load associated with the acquisition of manual therapy techniques may be considerable, as these techniques are often complex and highly procedural [9].”
From Teaching a single manual therapy technique at a time reduces cognitive load in physiotherapy students: a randomized controlled educational study (2025) · cites this paper as [9]
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- Authors
- Adams, K. R., Kolb, W. H., Geiser, M. B., & Dolphin, M.
- Affiliations
- Baylor University (US)
- Radford University (US)
- Regis University (US)
- SUNY Upstate Medical University (US)
- Corresponding author
- Adams, Kyle R.
- Venue
- Journal of Manual & Manipulative Therapy
- Publisher
- Informa UK Limited
- Published
- 2024-01-11
- Volume
- 32
- Issue
- 4
- Pages
- 412-420
- ISSN
- 1066-9817 (ISSN-L)
- 2042-6186
- PMC
- PMC11257007
- OpenAlex
- W4390789667
- Cited by
- 2
- References
- 39
- Citations by year
- 2026: 1 · 2025: 1
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Manual & Manipulative Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- no funding associated with the work
- Topics
- Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Keywords
- deliberate practice, positional error, motion error, musculoskeletal manipulation, educational models
- MeSH terms
- Clinical Competence, Humans, Learning, Manipulation, Orthopedic, Teaching, Models, Educational
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