Defining Skill in Manual and Manipulative Therapy: Perspectives from Physical Therapists

Area of Science:

• Physical Therapy
• Musculoskeletal Rehabilitation
• Clinical Practice Guidelines

Background:

• Manual and manipulative therapy (MT) is a key intervention in physical therapy.
• Defining and quantifying skill in MT is crucial for consistent patient care and education.
• A statewide survey in Florida aimed to evaluate and define MT skills among physical therapists.

Purpose of the Study:

• To evaluate skill in manual and manipulative therapy as a therapeutic intervention.
• To explore the use of MT in physical therapy practice.
• To understand how physical therapists quantify MT skills for definition development.

Main Methods:

• A statewide survey was developed using the Delphi approach.
• The electronic survey was distributed to licensed physical therapists in Florida.
• Survey questions covered demographics, education, MT use, and Likert scales on skill contributors.

Main Results:

• The response rate was 1.6% (307/19,523); 94% of participants had over 10 years of experience.
• 33.3% use MT on every patient, 38.1% use it at least daily; orthopedics was the most common specialty.
• Key contributors to MT skill include therapeutic alliance, touch, differentiating nuances (grades I-IV), and evidence-based practice adherence.

Conclusions:

• The study provides a definition of MT skill that can inform future research on patient outcomes.
• Further research is needed to determine the impact of these defined MT skills on patient care and physical therapy education.