Use of thrust joint manipulation by student physical therapists in the United States during clinical education experiences

ABSTRACT

Introduction: Thrust joint manipulation (TJM) is used in physical therapy practice and taught in entry-level curricula in the United States (US); however, research regarding implementation by student physical therapists (SPT)s is scarce.

Objectives: To explore the use of TJM in SPT clinical education and factors influencing implementation.

Methods: In a cross-sectional exploratory study, accredited physical therapy (PT) programs in the US (n = 227) were invited to participate in an electronic survey. SPTs were queried about TJM use and their clinical instructor’s (CI) credentials during their final musculoskeletal clinical experience.

Results: Forty-five programs participated in the study, consisting of 2,147 SPTs. Of those, 414 (19.3%) responses were used for analysis and 69% reported using TJM. SPTs who utilized TJM were more likely to have a CI who used TJM (p < 0.001) and/or had advanced certification/training in manual therapy (p < .001). A majority of students agreed or strongly agreed that their academic preparation provided them with clinical reasoning tools (84%) and psychomotor skills (69%) necessary to perform TJM. SPT use of TJM was facilitated by CI clinical practice, SPT competence in psychomotor skill, confidence in clinical reasoning, and practice setting. A main barrier to student use of TJM was CI lack of TJM use.

Conclusions: Clinical practice of the CI appears to be a key factor in determining student use of TJM. Level of evidence: 2b

KEYWORDS:

• Thrust joint manipulation
• clinical Education
• student physical therapist

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No potential conflict of interest was reported by the authors.

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Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Marie B. Corkery

Marie B. Corkery PT, DPT, MHS is a Clinical Professor in the Department of Physical Therapy, Movement and Rehabilitation Sciences at Northeastern University. She completed a Fellowship in Manual Therapy at the Institute of Orthopedic Manual Therapy, Burlington, MA and is a Fellow in the American Academy of Orthopedic Manual Physical Therapists (AAOMPT). Her research interests include the study of flexibility and motor control as it relates to low back pain, and lower extremity dysfunction, and knowledge translation in physical therapy. She is active in the AAOMPT, the APTA of MA and the Academy of Orthopedic Physical Therapy.

Craig P. Hensley

Craig P. Hensley PT, DPT is Assistant Professor in the Department of Physical Therapy and Human Movement Sciences at Northwestern University. He completed his Doctor of Physical Therapy degree [University of Illinois Chicago (UIC)- 2007], Orthopedic Residency (University of Southern California- 2009), and Manual Therapy Fellowship (UIC- 2011). He is a Fellow in the American Academy of Orthopedic Manual Physical Therapists, has several published articles and is coauthoring the funded Clinical Practice Guideline for Medical Screening. He serves on the AAOMPT Research and Practice Affairs Committee, the ABPTRFE Accreditation Committee, and is an External Assessor for IFOMPT.

Christopher Cesario

Christopher Cesario PT, DPT, MBA is the Senior Director of Clinical Education and Associate Clinical Professor In the Department of Physical Therapy Movement and Rehabilitation Sciences at Northeastern University. He received a Bachelor of Sciences in Physical Therapy (Northeastern University), a Master of Business Administration (Boston University), and a Doctor of Physical Therapy (Northeastern University. Dr. Cesario teaches in the administrative classes, focusing on leadership, administrative issues specific to physical therapists and business principles. He has also redesigned the clinical education matching process to be more holistic, using data from both students and clinical partners to find the best matches for all stakeholders.

Sheng-Che Yen

Sheng-Che Yen PT, PhD is an Associate Clinical Professor in the Professor in the Department of Physical Therapy, Movement and Rehabilitation Sciences at Northeastern University. He earned a PhD in Pathokinesiology from New York University in 2010 and completed his postdoctoral fellowship in robotic rehabilitation at Rehabilitation Institute of Chicago/Northwestern University. Dr. Yen’s research interests are in neuromechanics, motor control, and motor learning. He teaches kinesiology and research contents in the Doctor of Physical Therapy program.

Kevin Chui

Kevin Chui PT, DPT, PhD is a director and professor at Pacific University’s School of Physical Therapy & Athletic Training. Dr. Chui earned a PhD in pathokinesiology from New York University and a doctor of physical therapy degree from MGH Institute of Health Professions. He is a geriatric certified specialist, an orthopedic certified specialist, a certified exercise expert for aging adults and a fellow of the American Academy of Orthopedic Manual Physical Therapists.

Carol Courtney

Carol Courtney PT, PhD, ATC is a Professor in the Department of Physical Therapy and Human Movement Sciences at Northwestern University. She studied physical therapy at Washington University, the University of South Australia, and the University of Miami. She is a Fellow in the American Academy of Orthopedic Manual Physical Therapists. Her research investigates the effects of joint injury and osteoarthritis on pain processing and joint function, and modulation of pain mechanisms through non-pharmacologic interventions, including manual therapy and exercise.