Do experienced physiotherapists apply equal magnitude of force during a grade I central pa on the cervical spine?

Abstract

Background and purpose: Physiotherapists frequently use central posterior-anterior (PA) joint mobilization techniques for assessing and managing spinal disorders. Manual examination findings provide the basis for the selection of treatment techniques. From the literature it is evident that the level of reliability varies when physiotherapists perform different mobilization techniques. Repeatability of mobilization techniques is important for better physiotherapy management. The aim of the study was to determine whether experienced physiotherapists apply equal magnitude of force during a grade I central PA mobilisation technique on the cervical spine. Another aim was to determine the variation in the magnitude of force
applied by each individual physiotherapist.
Subjects: Sample of convenience, consisting of sixteen (n=16) selected qualified physiotherapists with experience in
Orthopaedic Manual Therapy.
Methods: A grade I central PA was performed on the Flexiforce TM sensors positioned on C6 of the same asymptomatic model to measure the applied magnitude of force. Two separate measurements, each lasting 30-seconds, were obtained.
Results: The average maximum peak force applied by the majority of physiotherapists (87.5%) was between 10.95g
and 72g. The difference in the forces applied for the two measurements ranged between 0.64g and 24.4g. The Bland
Altman scatterplot determined the mean of the difference between measurement one and two, calculated for the group, was zero. When comparing the two measurements, little variation was noted in the forces applied, as well as the coefficient of variation for each physiotherapist.
Conclusion and Discussion: Current results demonstrated good intra-therapist and moderate to good inter-therapist repeatability. Further research is required to generalize results.