Journal of Manual & Manipulative Therapy最新文献

{"title":"Short-term effects of Kinesiotaping combined with a rehabilitation program for rotator cuff-related shoulder pain: a randomized, assessor-blinded clinical trial.","authors":"Trang Ngoc Anh Nguyen, Nam Hoai Nguyen, Duy Kim Vu, Lam Tung Ngoc Cu","doi":"10.1080/10669817.2024.2387913","DOIUrl":"10.1080/10669817.2024.2387913","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the clinical efficacy of Kinesiotaping (KT) combined with a rehabilitation program to reduce symptoms and functional limitations in patients with Rotator Cuff-Related Shoulder Pain (RCRSP) in Vietnam.</p><p><strong>Methods: </strong>In total, 82 participants who were diagnosed with RCRSP were randomly allocated into two groups. Both groups received a standard rehabilitation program; additionally, the intervention group was treated with KT. Outcomes, assessed at baseline, and 3, 7, and 14 days postintervention, included pain intensity (Visual Analogue Scale, VAS), functional disability (Shoulder Pain and Disability Index, SPADI), and active range of motion (ROM).</p><p><strong>Results: </strong>The KT group exhibited significant improvements in all outcome measures. VAS scores decreased by an average of 13.3 points in the KT group at 14 days, which was notably greater than that in the control group (95% CI: -17.77 to -8.82). SPADI scores also improved significantly in the KT group, with reductions of -11.36, -15.27, and -13.3 at days 3, 7, and 14, respectively. Regarding ROM, the KT group showed notable improvements in flexion and external rotation, with flexion ROM differences of 10.78, 10.35, and 11.8 degrees at the respective time points. No significant changes were observed in the abduction or internal rotation ROM. After adjusting for age, baseline scores, and gender, there was a statistically significant interaction between Group and Time on the VAS, SPADI, and ROM abduction.</p><p><strong>Conclusion: </strong>Incorporating KT into a standard rehabilitation program for RCRSP demonstrated enhanced efficacy in reducing pain and improving shoulder function. The results suggest that KT can be a valuable component of the treatment regimen for RCRSP.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"112-121"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141910139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of fascial manipulation on pain: a systematic review with meta-analysis.","authors":"Robert Trybulski, Gracjan Olaniszyn, Małgorzata Smoter, Filipe Manuel Clemente, Andriy Vovkanych, Adrian Kużdzał","doi":"10.1080/10669817.2025.2486110","DOIUrl":"https://doi.org/10.1080/10669817.2025.2486110","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to summarize the effects of fascial manipulation (FM) on pain alleviation in adults, providing valuable insights for future research and practitioners by addressing a significant gap in the existing literature.</p><p><strong>Methods: </strong>Systematic review with meta-analysis. Key databases, including PubMed, Scopus, and Web of Science, were searched for relevant studies. The eligibility criteria required randomized clinical trials involving adults (>18 years) with musculoskeletal pain, who participated in FM, and included either true control or active control groups as comparators. To assess the risk of bias, the PEDro scale was used, while the certainty of the evidence was evaluated using the GRADE scale. Out of the initial pool of 138 studies, 15 were determined to be eligible for inclusion in this systematic review.</p><p><strong>Results: </strong>Results showed significant favoring effect for the FM compared to the active-control group in pain-related outcomes (ES = -0.80, 95% CI -1.30 to -0.29, <i>p</i> = 0.002, I²  = 85%). The certainty of evidence, as determined by the GRADE assessment, was rated as very low.</p><p><strong>Conclusions: </strong>Although the included studies provide evidence of very low certainty - given the small sample sizes, lack of blinding, and significant limitations in the intervention - the meta-analysis suggests that FM may potentially be beneficial in reducing pain associated with various musculoskeletal conditions. However, more robust research is needed to strengthen these findings, with a focus on increasing the number of blinded studies, reducing methodological heterogeneity, and further exploring the underlying mechanisms that may explain the observed trends in the evidence.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does online clinical mentoring for physical therapists enhance clinical practice and patient outcomes? A randomized controlled trial.","authors":"Edmund Leahy, Lucy Chipchase, Rocco Cavaleri, Felicity C Blackstock","doi":"10.1080/10669817.2025.2481605","DOIUrl":"https://doi.org/10.1080/10669817.2025.2481605","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine whether a short-term online clinical mentoring program was more effective than asynchronous online lectures at improving physical therapists' (PT) practice and their patients' outcomes.</p><p><strong>Methods: </strong>In this randomized controlled trial, 27 PTs were randomized with allocation concealment to 6 h of online clinical mentoring sessions (experimental group) or 6-h of asynchronous online lectures (control group). The primary patient outcome was function, assessed using the Patient-Specific Functional Scale (PSFS), evaluated at baseline (initial consultation) and 4-week follow-up. Secondary patient outcomes were the Functional Rating Index (FRI) and Global Rating of Change Scale (GRC). Clinician (PT) outcomes were the 'Clinician Confidence Questionnaire for Patients with Spinal Pain' and the 'Self-Reflection Insight Scale', which were evaluated before and after the professional development interventions by blinded assessors. Linear mixed model regression analysis was used to explore differences in patient outcomes. PT outcomes were analyzed using analyses of covariance to control for any baseline differences.</p><p><strong>Results: </strong>Twenty-three PTs and 122 patients completed follow-up assessments. There were no between-group differences for any patient clinical outcomes (PSFS MD = 0.02, 95% CI -0.83, 0.79, <i>p</i> = 0.95; FRI MD = -3.01, 95% CI -10.71, 4.69, <i>p</i> = 0.42; Global Rating of Change MD = -0.08, 95% CI -1.09, 0.92, <i>p</i> = 0.86). There were also no differences between groups in terms of PTs confidence (MD = -2.17, 95% CI -9.11, 4.76, <i>p</i> = 0.52) or self-reflection insight (MD = 3.66, 95% CI -1.94, 9.27, <i>p</i> = 0.19).</p><p><strong>Conclusion: </strong>A 6-h online clinical mentoring program did not significantly influence PT confidence, self-reflection nor the outcomes of their patients when compared to 6 h of asynchronous online lectures.</p><p><strong>Impact: </strong>The results from this study may inform those designing or seeking professional development. Future online clinical mentoring should consider alternative program designs, target PTs with capacity to improve their patient outcomes, and evaluate effects on patients with chronic pain.</p><p><strong>Trial registration: </strong>ACTRN12622000123741.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the integration of education with exercise beneficial for whiplash-associated disorders? A systematic review and meta-analysis.","authors":"Mario Muñoz-Bustos, Adolfo Soto-Martínez, Andoni Carrasco-Uribarren, Luis Ceballos-Laita","doi":"10.1080/10669817.2025.2475453","DOIUrl":"https://doi.org/10.1080/10669817.2025.2475453","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the effectiveness of exercise combined with educational strategies to exercise alone or educational strategies alone in patients with WAD on pain or disability.</p><p><strong>Design: </strong>Systematic Review and Meta-Analysis.</p><p><strong>Methods: </strong>The MEDLINE, Cochrane, Scopus, PEDro, and Web of Science databases were searched. Clinical trials investigating the effects of education and exercise combined on pain and disability in adults diagnosed with WAD. PEDro, RoB2 and GRADE were used to assess methodological quality, risk of bias and certainty of evidence, respectively. Random-effects models were applied for meta-analysis.</p><p><strong>Results: </strong>Six trials were included in the final review. Education and exercise compared to education alone showed a statistically significant change in pain (MD = -1.00; 95%CI -1.29, -0.71; 2 studies, 212 patients) in the post-treatment period . There was no statistically significant change in pain during the follow-up period. Likewise, education and exercise compared to exercise alone showed a statistically significant change in pain (MD = -0.61; 95%CI -1.00, -0.23; 6 studies, 386 patients), obtained from mid-long follow-up . There was no statistically significant change in pain in the post-treatment period. The resulting significant changes in the pain variable are not clinically relevant. The results show no significant change in disability over any time period. The certainty of the evidence was downgraded to very low for all comparisons.</p><p><strong>Conclusion: </strong>There are no important clinical differences between a combined exercise and education treatment and an education alone or exercise alone treatment in terms of pain and disability in patients with WAD.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical appraisal of methodological and statistical limitations in 'Dry needling of the gluteus-medius muscle, combined with standard care, for chronic low back pain - a pilot randomized sham-controlled trial'.","authors":"Etika Rana, Priyanka Tah, Kashish Arora","doi":"10.1080/10669817.2025.2481601","DOIUrl":"https://doi.org/10.1080/10669817.2025.2481601","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a two-week instrument-assisted soft tissue mobilization and exercise therapy versus sham and exercise on gait kinetics in moderate knee osteoarthritis: a randomized controlled trial.","authors":"Zahra Karimi Soloklo, Sahar Boozari, Sedighe Kahrizi","doi":"10.1080/10669817.2025.2481594","DOIUrl":"https://doi.org/10.1080/10669817.2025.2481594","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis (KOA) is a common joint disease that affects mobility and daily activities. Instrument-assisted soft tissue mobilization (IASTM) is widely used as a conservative treatment due to its potential effects on soft tissues. This study evaluates the effects of IASTM on pain, range of motion (ROM), health status, and gait kinetics in KOA patients.</p><p><strong>Methods: </strong>  Thirty individuals with unilateral KOA were randomized into two groups: IASTM with routine exercises and sham IASTM with exercises, over four sessions in two weeks. Pain, ROM, and WOMAC scores were assessed pre-treatment and 48 hours post-treatment. Gait kinetics, including vertical ground reaction force and knee adduction moment, were measured at three walking speeds (preferred, fixed, and fast) before and after treatment.</p><p><strong>Results: </strong>Mixed ANOVA revealed significant improvements in pain, ROM, and WOMAC scores in both groups. The IASTM group showed greater improvements in pain, knee flexion, ankle plantarflexion, and WOMAC pain scores, as indicated by a significant group*time interaction. For kinetics, the only significant finding was a longer time to heel strike transient in the IASTM group. At fast speed, most kinetic variables increased significantly in both groups.</p><p><strong>Conclusion: </strong>Both IASTM and sham interventions with exercise improved pain and ROM. However, the IASTM group experienced greater improvements. Additionally, IASTM led to a longer time to heel strike transient, suggesting improved shock absorption. Overall, IASTM may serve as a beneficial adjunctive intervention for alleviating symptoms in KOA patients and improving gait under challenging conditions, such as fast-speed walking.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermal temporal summation has good reliability in the lumbar region.","authors":"Max Jordon, Matthew Grubb, Jessica Hackathorne","doi":"10.1080/10669817.2025.2481315","DOIUrl":"https://doi.org/10.1080/10669817.2025.2481315","url":null,"abstract":"<p><strong>Objectives: </strong>Temporal summation (TS) via a thermal stimulus is a form of dynamic quantitative sensory testing that is often used as an indirect measure of central sensitization. While TS is frequently used as an outcome measure to assess the effectiveness of various interventions, the reliability of this measure has yet to be fully assessed in the lumbar spine. Therefore, the primary purpose of this study was to determine the test-retest reliability of TS using a thermal stimulus at the lumbar spine (LS). The secondary purpose was to compare the thermal TS values in the LS to that of the tibialis anterior (TA) and the thenar eminence (TE).</p><p><strong>Methods: </strong>Adults with no activity limiting pain conditions between the ages of 18 and 40 were recruited to participate in this study. TS was measured following a series of heat-pulses administered by the Medoc Thermal Sensory Analyzer-II system. After undergoing an optimization session, TS was taken at the LS, the muscle belly of the TA, and the TE, all on the right side. A second thermal TS measurement was taken once again a week later.</p><p><strong>Results: </strong>A total of 25 (<i>n</i> = 11 female) individuals participated in this study. ICC values in the lumbar spine ranged from moderate to good (0.591 to 0.836) depending on the calculation method. This compared to the TA with ICC values ranging from 0.621 to 0.772 and the TE with values ranging from 0.572 to 0.751. Correlations of the thermal TS values were high between the LS and the TA (<i>r</i> = 0.745), moderate between the TA and the TE (<i>r</i> = 0.631), and weak between the LS and the TE (<i>r</i> = 0.443).</p><p><strong>Discussion/conclusion: </strong>Thermal TS taken at the LS is a reliable measure with ICC values that are comparable to ICC values found at the TA and the TE.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-rater reliability of Mechanical Diagnosis and Therapy (MDT) in evaluating and classifying chronic pelvic pain syndrome.","authors":"Di Wu, Catherine Bednarczyk, Adriana RamonFigueroa, Helen Zhu, Meridith Geer, Richard Rosedale, Shawn M Robbins","doi":"10.1080/10669817.2025.2475456","DOIUrl":"https://doi.org/10.1080/10669817.2025.2475456","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pelvic pain syndrome (CPPS) involves complex interactions between the musculoskeletal system, nervous system, and psychosocial factors. A major challenge in managing CPPS is the lack of reliable assessment and classification systems. The Mechanical Diagnosis and Therapy (MDT) is a widely used and reliable classification system for assessing and managing painful musculoskeletal conditions affecting the spine and extremities. This study's primary objective was to assess the inter-rater reliability of the MDT assessment in diagnosing CPPS using clinical vignettes. Secondary objectives included determining the prevalence of MDT classification categories.</p><p><strong>Methods: </strong>Five MDT clinicians classified clinical vignettes into three categories: 1) Spinal Derangement, 2) Pelvic Floor Contractile Dysfunction, or 3) MDT OTHER subgroups. The vignettes were developed from the McKenzie Pelvic Pain Assessment Form. Inter-rater reliability among clinicians was calculated using the Fleiss kappa statistic with 95% confidence intervals, and Cohen's kappa examined reliability between pairs of raters.</p><p><strong>Results: </strong>A total of 76 vignettes were developed (40 females and 36 males). Good inter-rater reliability was found among clinicians (Fleiss kappa = 0.616, 95% CI = 0.598-0.633, <i>p</i> < 0.001). Inter-rater reliability was higher when classifying female vignettes (Fleiss kappa = 0.658, 95% CI = 0.634, 0.682) than male vignettes (Fleiss kappa = 0.546, 95% CI = 0.519, 0.573). The most common classification was Spinal Derangement (57%), followed by MDT OTHER subgroups (26%) and Pelvic Floor Contractile Dysfunction (17%).</p><p><strong>Conclusions: </strong>The study indicates good inter-rater reliability among MDT clinicians in classifying pelvic pain syndrome. However, clinical vignettes may not fully capture the complexities of real participant interactions, potentially inflating agreement. Future studies should incorporate direct observation of real participant encounters alongside clinical vignettes to improve validity.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the impact of interactive versus traditional e-learning on physiotherapists' knowledge, attitudes, and clinical decision-making in low back pain management: a randomized controlled trial.","authors":"Antoine Fourré, Jef Michielsen, Laurence Ris, Ben Darlow, Rob Vanderstraeten, Hilde Bastiaens, Christophe Demoulin, Nathalie Roussel","doi":"10.1080/10669817.2025.2476670","DOIUrl":"10.1080/10669817.2025.2476670","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the recommendations to use a bio-psycho-social framework, many physiotherapists still manage their patients mainly from a biomedical point of view. The purpose of this study is to analyze the impact of two different e-learning interventions on knowledge, attitudes, and clinical decision-making of physiotherapists managing low back pain (LBP) to increase guideline-consistent care.</p><p><strong>Methods: </strong>Physiotherapists were allocated (1/1) either to an experimental or a traditional e-learning intervention. Baseline and post-intervention assessment included the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), Back Pain Attitudes Questionnaire (Back-PAQ), Neurophysiology of Pain Questionnaire (NPQ), and a clinical vignette. Participants had 2 weeks to complete the post-intervention assessment. Statistics were processed using ANCOVA and Fisher's t-tests.</p><p><strong>Results: </strong>Four hundred nineteen physiotherapists were included in the analysis. Mean scores of HC-PAIRS, Back-PAQ, and NPQ significantly improved post-intervention in both groups. There was a significant effect of the intervention type (experimental versus traditional) on the scores of HC-PAIRS (<i>p</i> < .001; η²_p = .243) and Back-PAQ (<i>p</i> < .001; η²_p = .135) but not on NPQ scores. Return to work, recommendations assessed with the clinical vignette were significantly more guideline-consistent in the experimental group (<i>p</i> < .001) post-intervention.</p><p><strong>Conclusion: </strong>An interactive e-learning intervention which includes concrete clinical examples and focused on patient's reassurance, self-management, and importance of screening psycho-social factors had more impact than a traditional e-learning intervention to enhance physiotherapists' knowledge, attitudes, and clinical decision-making regarding LBP.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information needs for people with neck pain seeking physiotherapy neck manipulation or mobilization: an exploratory study.","authors":"Michelle Lumasag, Anita Gross, Derek Clewley, Pasqualina Santaguida","doi":"10.1080/10669817.2025.2472374","DOIUrl":"https://doi.org/10.1080/10669817.2025.2472374","url":null,"abstract":"<p><strong>Objective: </strong>To explore the foundational needs for a decision aid on receiving physiotherapy neck manipulation and mobilization from a broad age spectrum.</p><p><strong>Method: </strong>An e-survey was conducted from January to 30 April 2024, targeted child/infant-parent dyads, adolescents, adults, and adult-caretaker dyads with neck pain who received physiotherapy treatment in Canada and the United States. The survey method captured knowledge and attitudes to manual therapy, treatment expectations (10 items from the Treatment Expectation Questionnaire (TEX-Q), decision conflict (Decisional Conflict Scale (DCS)) and participant demographics. Descriptive analyses were used to assess responses.</p><p><strong>Results: </strong>Out of 146 participants who started the survey, 48 adults (mean age 48) completed it fully. Due to low response rates, the survey lacked insights into adolescent, child/infant-parent, or adult-caretaker dyads. Most respondents were familiar with mobilization (86%) and manipulation (82%). Mobilization was preferred (67%) and viewed more favorably compared to manipulation (7%), which was seen as riskier. Stroke was identified as the top risk/adverse event for techniques and was more commonly associated with manipulation (52%) than mobilization (25%). Other perceived risks included soreness, pain, headache, stiffness, tenderness, dizziness, and fatigue, reported more often for mobilization (57%) than manipulation (41%). The TEX-Q showed that respondents' treatment expectations were largely met, indicating positive expectations. Additionally, low scores on the DCS subscales and total scores (mean 16.26, SD 21.00) reflected minimal decisional conflict among respondents.</p><p><strong>Conclusion: </strong>The study found that adults with neck pain who received physiotherapy involving neck manipulation or mobilization were well informed about the benefits, risks, and potential major and minor adverse events of their treatment. Their expectations for treatment were generally positive, and they experienced minimal decisional conflict. To further support shared decision-making, we recommend adding a qualitative component, such as structured interviews or focus groups with inter-professional child/infant-parent dyads, to help clinicians improve patient counseling and decision-making guidance.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}