Part I: examining the broken history of manual therapy across professions. A survey-based analysis.

Abstract

The historical development of manual therapy is an area of ongoing debate impacting clinical practice, education, and practice regulations. Primary professions utilizing manual therapy include chiropractic, manual medicine, osteopathy, and physiotherapy. A survey was developed to explore perceptions, experiences, and opinions across professions, and was disseminated globally. It was completed by 194 individuals. Results demonstrated this topic is of significance with over 80% reporting that knowledge of historical development informs professional identity. Of the respondents, 64% had over 20 years professional experience. Student participation was low (<1%). Over 95% acknowledged an ancient basis for manual therapy, with 67% emphasizing bonesetter contributions. North America was reported as the primary area for the development of modern manual therapies by all except physiotherapy, which identified Northern Europe. Osteopathy's impact on current practice was recognized, though each profession ranked its own impact highest. Of respondents, 85% agreed there was conflict between professions over history. Thematic elements identified a shift for respondents from their initial education to a more nuanced understanding of the history over time, and an appreciation that there is not one profession that owns or developed manual therapy. Practice limitations were identified, as 19% of respondents reported limitations due to inaccurate historical understanding. This study highlights a lack of historical knowledge and its potential benefits for practice, education, regulation and interprofessional relations if recaptured. (the abstract was rewritten per reviewer comments to reformat).