A modern way to teach and practice manual therapy

Review written by Dr Jarod Hall info

Key Points

  1. Traditional systems of manual therapy, including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician centered assessment, pathoanatomical reasoning, and technique specificity.
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Musculoskeletal (MSK) conditions are leading contributors to the burden of global disability and healthcare, and amongst other interventions, manual therapy (MT), has been recommended for the management of people with MSK conditions in multiple clinical guidelines (1-3). Patient perceptions of MT are, however, vague and sit among wider expectations of treatment including education, self-efficacy, the role of exercise, and prognosis (4-5).

This paper set out to review contemporary literature and proposed a revised model to inform the teaching and practice of MT as well as stimulate debate about the future teaching and practice of MT through the proposal of an evidence-informed re-conceptualized model of MT.

Manual therapy has been recommended for the management of people with musculoskeletal conditions in multiple clinical guidelines.
Current and future teachings of manual therapy should involve a revised and reconceptualized framework underpinned by the dimensions of communication, context and person-centered care.


MT has been suggested to be a valuable part of a multimodal approach to managing MSK pain and disability, and the majority of recent systematic reviews of clinical trials report a beneficial effect of MT for a range of MSK

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