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Basis for spinal manipulative therapy: a physical therapist perspective.
Joel E Bialosky1, Corey B Simon, Mark D Bishop
1Department of Physical Therapy, Center for Pain Research and Behavioral Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, United States. bialosky@phhp.ufl.edu
Summary
Physical therapists use spinal manipulative therapy (SMT) for musculoskeletal pain. This review explores common SMT decision-making models and identifies areas for future research to improve patient outcomes.
Area of Science:
- Physical Therapy
- Musculoskeletal Rehabilitation
- Manual Therapy
Background:
- Spinal Manipulative Therapy (SMT) is a cornerstone of physical therapist practice for musculoskeletal pain.
- Historical influences on SMT clinical decision-making include osteopathic and orthopedic approaches.
- Current practice employs segmental and responder clinical decision-making models.
Purpose of the Study:
- To provide an overview of prevalent physical therapist clinical decision-making approaches for SMT.
- To highlight areas necessitating further investigation to optimize patient responses to SMT.
Main Methods:
- Review of common clinical decision-making models for SMT in physical therapy.
- Analysis of segmental and responder approaches to SMT application.
- Identification of research gaps in SMT clinical practice.
Main Results:
- Segmental approach focuses on vertebral dysfunction to restore mobility and alleviate pain.
- Responder approach categorizes patients based on predicted positive response to SMT.
- Current models guide SMT use but require further refinement.
Conclusions:
- Understanding current SMT decision-making models is crucial for physical therapists.
- Further research is needed to enhance the efficacy and predictability of SMT outcomes.
- Optimizing patient response to SMT requires continued scientific inquiry and clinical refinement.
