title: Inertial sensor real-time feedback enhances the learning of cervical spine manipulation: a prospective study.
abstract: BACKGROUND
  Cervical Spinal Manipulation (CSM) is considered a high-level skill of the central nervous system because it requires bimanual coordinated rhythmical movements therefore necessitating training to achieve proficiency. The objective of the present study was to investigate the effect of real-time feedback on the performance of CSM.
  
  
  METHODS
  Six postgraduate physiotherapy students attending a training workshop on Cervical Spine Manipulation Technique (CSMT) using inertial sensor derived real-time feedback participated in this study. The key variables were pre-manipulative position, angular displacement of the thrust and angular velocity of the thrust. Differences between variables before and after training were investigated using t-tests.
  
  
  RESULTS
  There were no significant differences after training for the pre-manipulative position (rotation p = 0.549; side bending p = 0.312) or for thrust displacement (rotation p = 0.247; side bending p = 0.314). Thrust angular velocity demonstrated a significant difference following training for rotation (pre-training mean (sd) 48.9°/s (35.1); post-training mean (sd) 96.9°/s (53.9); p = 0.027) but not for side bending (p = 0.521).
  
  
  CONCLUSIONS
  Real-time feedback using an inertial sensor may be valuable in the development of specific manipulative skill. Future studies investigating manipulation could consider a randomized controlled trial using inertial sensor real time feedback compared to traditional training.
authors.affiliation: Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (AE-14), Malaga, Spain. acuesta.var@gmail.com.
authors.forename: Antonio I
authors.initials: AI
authors.lastname: Cuesta-Vargas
authors.forename: Jonathan
authors.initials: J
authors.lastname: Williams
mesh_terms: D000328:Adult; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000295:instrumentation / Q000379:methods / Q000592:standards; D026761:Physical Therapy Specialty / Q000193:education* / Q000379:methods; D011446:Prospective Studies; D013334:Students