Award Date


Degree Type


Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy

First Committee Member

Merrill Landers

Graduate Faculty Representative

E. Louis Puentedura

Number of Pages



Background: Spinal thrust joint manipulation (TJM) education is mandatory in all professional entry-level physical therapy programs, yet TJM is under-utilized in daily practice. This descriptive study expands on previous data about how TJM is taught and includes data for the perceived confidence students have when performing TJM.

Methods: A 39-question descriptive survey inquiring about TJM education and selfperceived confidence in performing TJM was distributed via email to 213 accredited physical therapy programs.

Subjects: Respondents ranged in age from 22-45 (mean age=25.61 years). Respondents included 435 professional physical therapy students (84 male, 285 female) who have completed their didactic classes. All participants have completed professional didactic coursework from an accredited physical therapy program in the United States.

Results: Survey results showed that laboratory instruction resulted in more confidence in performing TJM and identifying those likely to respond to TJM than not having the information covered. Several classes of instruction, as opposed to only one class, were more beneficial for confidence levels in identification and performance of TJM. Receiving a TJM benefitted confidence levels performing TJM as well.

Conclusion: No method of instruction type or time leads to more confidence in identifying those likely to benefit from TJM or more confidence in applying TJM. Experiencing a TJM resulted in an increased confidence to perform TJM. Spinal manipulation has been shown to be an effective treatment method and is beneficial to those for whom it is clinically indicated. Since, according to research, TJM is underutilized in clinical practice, it is important to understand how students are taught manipulation techniques.


Chiropractic; Education programs; Entry-level; Health and environmental sciences; Manipulation (Therapeutics) – Study and teaching; Physical therapists; Physical therapy; Spinal adjustment; Spinal manipulation; Thrust joint manipulation


Alternative and Complementary Medicine | Behavior and Behavior Mechanisms | Medical Education | Physical Therapy

File Format


Degree Grantor

University of Nevada, Las Vegas




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