Journal of Manual & Manipulative Therapy最新文献

{"title":"Plantar massage or ankle mobilization do not alter gait biomechanics in those with chronic ankle instability: a randomized controlled trial.","authors":"Raed Alamri, Kimmery Migel, M Spencer Cain, Kyeongtak Song, Brian Pietrosimone, J Troy Blackburn, Jason R Franz, Jaeho Jang, Feng-Chang Lin, Erik A Wikstrom","doi":"10.1080/10669817.2024.2410048","DOIUrl":"10.1080/10669817.2024.2410048","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic ankle instability (CAI) is characterized by persistent neuromechanical impairments following an initial lateral ankle sprain. Ankle joint mobilization and plantar massage have improved the range of motion and static postural control in those with CAI. This study aimed to determine the impact of two-week joint mobilization and plantar massage interventions on gait kinematics and kinetics in individuals with CAI.</p><p><strong>Methods: </strong>A single-blind randomized trial was conducted with 60 participants with CAI, randomized into three groups: joint mobilization (<i>n</i> = 20), plantar massage (<i>n</i> = 20), and control (<i>n</i> = 20). The two treatment groups received six 5-min sessions manual therapy over a 2-week, while the control group received no intervention. Gait biomechanics were assessed on an instrumented treadmill before and after the intervention using 3D kinematics and kinetics analysis. Analyses compared biomechanical outcomes from each treatment group to the control group individually using a 1-dimensional statistical parametric mapping. The alpha level was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Eighteen participants per group were part of the final analysis. No significant main or interactions effects were found for ankle sagittal or frontal plane positions following either intervention (<i>p</i> > 0.05 for all comparisons). COP location relative to the lateral border of the foot also did not change (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The findings suggest that two-week joint mobilization and plantar massage interventions do not significantly alter gait biomechanics in individuals with CAI. These results support the need for gait-specific interventions to modify biomechanics in this population.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"594-601"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401612","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":"Not \"that kind\" of doctor: an exploratory study on Doctor of Physical Therapy-patient introductions in the United States.","authors":"Justin Martino, James M Smoliga, Lance Mabry","doi":"10.1080/10669817.2024.2396706","DOIUrl":"10.1080/10669817.2024.2396706","url":null,"abstract":"<p><strong>Objective: </strong>This exploratory study examined the prevalence and determinants of the use of the title 'doctor' among the United States (U.S.) licensed Doctors of Physical Therapy (DPTs) during patient-provider introductions.</p><p><strong>Methods: </strong>A cross-sectional analysis of DPTs across eight states was conducted. Binary logistic regression analyzed demographic and experience-related factors influencing title use, including years of experience, board certification status, and clinical instructor (CI) experience. Stepwise logistic regression with forward selection identified significant predictors. Beliefs influencing title use were evaluated through descriptive statistics from multiple choice questions with an option for open-ended responses for additional opinions.</p><p><strong>Results: </strong>Of the 1,311 participants who met the inclusion criteria, 19.9% reported using 'doctor' during patient-provider introductions. The odds of using the title increased with age and was higher among males, with age controlled for. Completion of a residency program and not being a CI were also associated with greater odds of title use, with age and sex controlled for. Beliefs about demonstrating expertise, having earned the title, and advancing the profession were primary reasons for using the title, while concerns about patient confusion and therapeutic alliance were reasons for not using it. Both DPTs who did and did not report using the title 'doctor' commonly cited the impact on therapeutic alliance as justification.</p><p><strong>Conclusions: </strong>A minority of our sample of U.S. DPTs use the title 'doctor' during patient-provider introductions, with significant variation across age, gender, and professional experience. Deciding whether to use the title was primarily based on their perceived effects on patient beliefs.</p><p><strong>Discussion: </strong>This is the first study to formally investigate how DPTs refer to themselves during patient-provider introductions. Understanding title use in healthcare can inform best practices during patient interactions. This study provides a foundation for future research on the impact of DPTs mentioning their doctoral title on patient experiences and outcomes.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"630-639"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113375","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 diagnostic validity of the cervical side bend-rotation test for C 1/2 dysfunction.","authors":"Brian T Swanson, Kenneth E Learman, Shannon M Petersen, Bryan O'Halloran","doi":"10.1080/10669817.2024.2430506","DOIUrl":"https://doi.org/10.1080/10669817.2024.2430506","url":null,"abstract":"<p><strong>Introduction: </strong>Neck pain and headaches are common, with a reported lifetime prevalence of up to 66%. Upper cervical segmental dysfunction has been implicated as meaningful in neck pain and multiple headache types. Several tests have been described to assess upper cervical joint dysfunction, including the flexion-rotation test (FRT), the side bend-rotation test (SBRT), and joint play assessment (PA). The purpose of this study was to determine the diagnostic validity of the SBRT to detect C1-2 dysfunction in a sample of people with medically diagnosed sinus headaches and controls.</p><p><strong>Methods: </strong>Design: prospective diagnostic accuracy study, occurring during an observational case-control study in a sample of individuals with medically diagnosed sinus headaches. All participants were assessed using the SBRT, FRT, and C1-2 joint play assessments. The diagnostic accuracy of the SBRT was assessed using a reference standard of concurrent positive FRT (a loss of at least 10° from expected ROM (≤34°)) and restriction of C1-2 joint play. Cut-off scores for the SBRT were determined using ROC curve analysis, and tests of diagnostic accuracy were calculated using 2 × 2contingency tables.</p><p><strong>Results: </strong>A total of 80 individuals (40 headache, 64 female, mean age 32.9 ± 13.8 yrs.) were included in the study. Mean ROM for the tests was: SBRT 31.4 ± 9.4°, FRT 44.9 ± 9.5°, and C1-2 mobility 22 hypomobile/58 normal. An SBRT cutoff score of <25° was confirmed using ROC curves. Using this cutoff score, the SBRT demonstrated 100% sensitivity and 62% specificity to detect C1-2 hypomobility.</p><p><strong>Discussion/conclusion: </strong>The SBRT, using a cutoff score of ≤25°, appears to be a sensitive test to detect C1-2 dysfunction. Based on the strong sensitivity and negative predictive values, scores greater than 25° may effectively rule-out C1-2 dysfunction. The SBRT should be considered as part of a sequential clinical decision-making process when screening for C1-2 dysfunction, although further research is required to improve generalizability of these findings.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733359","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":"Reevaluating clinical significance in lumbar disc herniation treatment: insights from Cohen's d analysis.","authors":"Umesh Kumar Maurya, Adarsh Kumar Srivastav, Digvijay Sharma","doi":"10.1080/10669817.2024.2432520","DOIUrl":"https://doi.org/10.1080/10669817.2024.2432520","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711448","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":"Preoperative Physiotherapy Effects on Hand Function and Quality of Life in Carpal Tunnel Syndrome: 3 - & 6 - month randomized controlled trial.","authors":"Mar Hernández-Secorún, María Orosia Lucha-López, Hugo Abenia-Benedí, María Durán-Serrano, Javier Sami Hamam-Alcober, John Krauss, César Hidalgo-García","doi":"10.1080/10669817.2024.2431596","DOIUrl":"https://doi.org/10.1080/10669817.2024.2431596","url":null,"abstract":"<p><strong>Introduction: </strong>Carpal Tunnel Syndrome (CTS) is a prevalent upper limb mononeuropathy that often leads to delayed surgical intervention, resulting in prolonged symptoms and reduced quality of life.</p><p><strong>Aim: </strong>To describe the effect of a three-session treatment involving nerve mechanical interface mobilization and self-mobilization combined with education in hand function, symptoms, and quality of life of pre-surgical CTS patients at 3 and 6-months follow-ups; 3) A randomized clinical trial was performed in 42 preoperative CTS patients. Patients were randomized into an experimental group, receiving a three-session intervention of education, diacutaneous fibrolysis, and self-mobilization, or a control group receiving standard care. Primary outcomes included the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, while secondary outcomes assessed paresthesia, mechanosensitivity of the median nerve, mechanical threshold with the Semmes Weinstein monofilament, pinch strength, and quality of life, with the short-form-36 & EuroQol-5D.</p><p><strong>Results: </strong>The cohort were predominantly severe CTS patients with associated comorbidities. Statistical improvements were shown for experimental group compared to control group in DASH at 6-month follow-up (<i>p</i> = 0.035; η² = 0.12). Paraesthesia intensity, mechanosensitivity, and quality of life were also significantly improved in the experimental group compared to control group at both 3- and 6-months (<i>p</i> < 0.05). The same occurred for pinch strength at 6 months (<i>p</i> < 0.05). No significant differences were found in mechanical threshold (<i>p</i> > 0.05); 5) The treatment effectively improved hand function, symptoms, and quality of life in preoperative CTS patients, offering a viable alternative during delays in surgical procedures. Nerve mechanical interface treatment could not only help mild to severe CTS patients but might be relevant for severe CTS patients with associated comorbidities.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717187","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":"Part I: examining the broken history of manual therapy across professions. A survey-based analysis.","authors":"Cameron W MacDonald, Robert Parkes, Peter G Osmotherly","doi":"10.1080/10669817.2024.2426750","DOIUrl":"https://doi.org/10.1080/10669817.2024.2426750","url":null,"abstract":"<p><p>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. (<i>the abstract was rewritten per reviewer comments to reformat)</i>.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630363","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":"Part II: Beyond Broken Histories: Reframing Professional Identity and the Historical Genesis of Manual Therapy. Interviews across professions.","authors":"C W MacDonald, R Parkes, P G Osmotherly","doi":"10.1080/10669817.2024.2426051","DOIUrl":"https://doi.org/10.1080/10669817.2024.2426051","url":null,"abstract":"<p><strong>Background: </strong>Perspectives on the historical genesis of manual therapy for chiropractic, manual medicine, osteopathy, and physiotherapy are limited.</p><p><strong>Objective: </strong>This study sought to identify themes and narratives related to the genesis of manual therapy; the potential of a common root for manual therapy in 19^th century Northern Europe; and the potential impact of a current 'broken history' for manual therapy.</p><p><strong>Methods: </strong>An exploratory phenomenological approach was utilized, based upon structured one-hour interviews of 21 professionals across four professions who had previously completed a survey on the historical genesis of manual therapy.</p><p><strong>Results: </strong>Descriptive and hermeneutic themes were developed based upon the lived experience of individuals relating to interview questions and a presented historical narrative. Support for a common genesis in Northern Europe was present within physiotherapists, but for all other professions North America was primary. Multiple themes and quotes of significance were developed from the study, including the importance of history within professional identity. An archetypal analysis was completed to answer specific assumptions related to the historical genesis of manual therapy including points of genesis for manual therapy and scientific necessity within manual therapy.</p><p><strong>Conclusion: </strong>The findings of this study provide new perspectives to consider on the value, criticality, and impact of manual therapy, and its history's for the four professions in practice, education, and regulations.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630364","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":"The McKenzie Method delivered by credentialed therapists for chronic low back pain with directional preference: systematic review with meta-analysis.","authors":"Vicente Hennemann, Patrícia K Ziegelmann, Miriam A Z Marcolino, Bruce B Duncan","doi":"10.1080/10669817.2024.2408084","DOIUrl":"10.1080/10669817.2024.2408084","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effectiveness of the McKenzie Method compared to any conservative interventions on pain and disability in patients with chronic low back pain (LBP) with directional preference (DP).</p><p><strong>Methods: </strong>We searched six electronic databases up to September 2022. Eligible randomized controlled trials were those assessing the McKenzie Method delivered by credentialed therapists for chronic LBP with DP. Two reviewers independently selected studies, extracted data, assessed risk of bias with the revised Cochrane Risk of Bias 2.0 tool and certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.</p><p><strong>Results: </strong>Five trials (<i>n</i> = 743) were included. There was low-certainty evidence that the McKenzie Method, compared to all other interventions combined, produced clinically important reductions in short-term pain (mean difference [MD] -1.11 points on a 10-point scale; 95% CI -1.83 to -0.40) and in intermediate-term disability (standardized mean difference [SMD] -0.53; 95% CI -0.97 to -0.09). Low-to-moderate certainty evidence showed that the McKenzie Method also resulted in clinically important improvements in short-term pain (MD -1.53; 95% CI -2.51 to -0.54) and disability (SMD -0.50; 95% CI -0.74 to -0.25) when compared specifically to other exercise approaches, and in intermediate-term pain (MD -2.10; 95% CI -2.94 to -1.26) and disability (SMD -1.01; 95% CI -1.58 to -0.43) as well as long-term disability (SMD -0,59; 95% CI -1.14 to -0.03) when compared to minimal intervention. Low-certainty evidence showed usually small, clinically unimportant effects in comparison to manual therapy.</p><p><strong>Conclusion: </strong>We found low-to-moderate certainty evidence that the McKenzie Method was superior to all other interventions combined for up to 6 months for pain and up to 12 months for disability, with clinically important differences versus exercise in the short term and versus minimal interventions in the intermediate term. The only clinically important long-term effect was on disability compared to minimal intervention.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394200","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":"The influence of low back pain-related attitudes and beliefs on the clinical decision making of physical therapists.","authors":"Adam Rufa, Gary Brooks, Kyle Adams, Michelle Dolphin","doi":"10.1080/10669817.2024.2346973","DOIUrl":"10.1080/10669817.2024.2346973","url":null,"abstract":"<p><strong>Background: </strong>The LBP-related attitudes and beliefs of clinicians may impact the experience of patients by influencing clinician decision-making and by shaping the attitudes, beliefs, and actions of patients. The purpose of this study was to identify the specific LBP-related attitudes and beliefs of US-based physical therapists and determine if those beliefs correlate with clinical decision-making.</p><p><strong>Methods: </strong>An electronic survey was sent to US-based physical therapists. Attitudes and beliefs were measured using the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain and Impairment Relationship Scale for Physiotherapists (PABS-PT). The survey also included 2 patient vignettes that collected information about clinical decision-making.</p><p><strong>Results: </strong>Complete survey responses were recorded from 420 physical therapists. Eleven of the 27 attitude and beliefs questions were answered in a more biomedically oriented way by at least 20% of respondents. Physical therapist low back pain-related attitudes and beliefs were associated with activity and management strategies for both vignettes in the expected direction. Higher scores on HC-PAIRS and PABS-BM were associated with more restrictive work and activity recommendations, lower-intensity exercise choices, biomechanical rationale for manual therapy and motor control exercises, pathoanatomical-focused education, and use of modalities.</p><p><strong>Conclusion: </strong>Some physical therapists hold biomedically oriented beliefs about the connection between pain and physical activity. Clinician beliefs were associated with activity and work recommendations, and treatment choices. Physical therapists with more biomedically oriented beliefs were more likely to limit physical activity and work, and less likely to incorporate psychologically informed interventions.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"515-523"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857968","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":"Clinical reasoning skills of German and Dutch manual therapists: a cross-sectional study.","authors":"Myrthe Veenstra, Riccarda Klemm, Tibor M Szikszay, Kerstin Luedtke, Andres Jung","doi":"10.1080/10669817.2024.2330775","DOIUrl":"10.1080/10669817.2024.2330775","url":null,"abstract":"<p><strong>Introduction: </strong>Reflective clinical reasoning (CR) is believed to play a crucial role in achieving an efficient therapy process, supported by evidence-based approaches that improve patient outcomes. The aim of this study was to evaluate the CR process of German manual therapists (MTs) using the CR skills of Dutch MTs as a reference.</p><p><strong>Methods: </strong>This cross-sectional study evaluated the CR process and diagnostic ability of German MTs. Dutch MTs served as the reference standard due to their experience with direct access. The CR skills were assessed using the Diagnostic Thinking Inventory (DTI), a questionnaire measuring diagnostic competence. Descriptive and inferential statistics were conducted to compare the groups. Subgroup analyses were performed to analyze the influence of work experience (in years) and the level of education on CR.</p><p><strong>Results: </strong>396 manual therapists (229 German and 167 Dutch) completed the DTI. Dutch MTs revealed higher DTI sum-scores compared to German MTs (<i>p</i> < .001; Cohen´s d = .41). Subgroup analyses regarding professional education revealed no significant differences in DTI sum-scores within German MTs and between both groups. In the subgroup analyses regarding professional experience, differences of moderate effect size were reached between German and Dutch novice MTs (in favor of Dutch novice MTs; <i>p</i> = .001; Cohen´s d = .62), and between German novice MTs and experienced German MTs (in favor of experienced German MTs; <i>p</i> < .001; Cohen´s d = .6).</p><p><strong>Conclusion: </strong>The results suggest that academically educated German and Dutch MTs as well as experienced German and Dutch MTs are similar in terms of their hypothetical-deductive CR skills. In turn, German novice MTs seem to use hypothetical-deductive processing to a lesser extent compared to Dutch novice MTs and experienced German MTs, which in turn may support the hypothesis that the level of professional experience and education has a significant impact on the development of hypothetical-deductive CR skills.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"531-539"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144291","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}