Tips for learning to manipulate

This study investigated how using feedback improved the techniques of the students when learning to manipulate. Reassuringly it demonstrates that students were able to generate repeatable force levels when manipulating. Whilst the article does not expand on this further, this suggests improved technique efficacy and medical safety for the patients being manipulated. Practice makes perfect … See what you think!

Effects of practice variability on spinal manipulation learning

Merchand, A et al2017



To evaluate the effects of practice on chiropractic students’ spinal manipulations.


40 students, experimental session including either a variable or a constant practice protocol of 45 SMs. SMs were delivered on a computer-connected device that recorded force-time profiles. Ten SMs with a target peak force of 350-N were performed before practice, immediately following practice, and 2 days later. Mixed-design analyses of variance were used to assess the effect of practice type on SM biomechanical parameters and on the constant, the absolute error (AE), and the variable error (VE). scan after spinal manipulation and at rest (control).


Practice led to significantly more accurate, and consistent performances at the postintervention assessment regardless of practice type. Preload force was higher at the retention assessment than at baseline, while rate of force application significantly decreased between the baseline and the retention assessment.


1 session of SM practice including feedback leads to an increase in manipulation peak force accuracy and consistency, whether or not the practice period included variable practice. The current results confirmed that short practice periods with feedback should be included when learning to manipulate.

  • J Chiropr Educ 2017 Vol. 00 No. 0  DOI 10.7899/JCE-16-8