Barriers and facilitators to the delivery of rehabilitation in health systems by chiropractors: a SWOT analysis of perspectives from a world federation of chiropractic congress workshop.
Jordan A Gliedt, Afua Adjei-Kwayisi, Nora Bakaa, Jean-Luc Gauthier, Brett Guist, Katie de Luca
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Abstract
Background: Global unmet need for rehabilitation remains substantial. Chiropractors commonly manage musculoskeletal conditions that may benefit from rehabilitation. However, barriers and facilitators to chiropractors' delivery of rehabilitation in health systems have yet to be well described. Therefore, this study aimed to identify local, regional, and global barriers and facilitators to the delivery of rehabilitation within health systems.
Methods: Data were collected from participants attending the 18th World Federation of Chiropractic (WFC) Biennial Congress, held in Copenhagen, Denmark, on May 10, 2025. A deductive, manifest-directed content analysis, framed by the Strengths, Weaknesses, Opportunities, and Threats (SWOT) framework, was conducted on responses collected during a rehabilitation workshop. Participants completed free-text responses to four SWOT-based prompts on the delivery of rehabilitation by chiropractors within health systems. Responses were categorized into SWOT domains and coded according to an adaptation of predefined barriers and facilitators to rehabilitation delivery.
Results: A total of 369 responses were recorded and catalogued into strengths (n = 89), weaknesses (n = 103), opportunities (n = 84), and threats (n = 93). Commonly reported strengths included education, clinical, and leadership and policy categories. Weaknesses were primarily related to categories of facilities/logistics, finances, education, and leadership and policy. Opportunities primarily included facilities/logistics, leadership and policy, and education categories. Threats were primarily related to leadership and policy, cultural, and political categories.
Conclusion: This study highlights local, regional, and global factors influencing the delivery of rehabilitation in health systems by chiropractors. Findings underscore the need for targeted implementation strategies, policy advocacy, and expanded professional training to optimize chiropractors' contributions to the global rehabilitation workforce.
期刊介绍：
Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals.
Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches.
Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.
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