Manual therapists’ beliefs and use of spinal thrust joint manipulation

Abstract

Introduction

Thrust Joint Manipulation (TJM) is a widely used intervention in spinal care, however there are differences in its use between countries and spinal regions. This survey analyzes the frequency of use of TJM, examines the thoughts about the effectiveness of, and the perceptions of Dutch certified manual therapists regarding safety, comfort, use and barriers related to the application of spinal TJM techniques.

Method

The 19-question e-survey was based on a similar survey in the U.S. Since the Netherlands has a separate professional standard for the upper cervical spine, questions enabled differentiation between upper- and mid/lower cervical spine. The survey was launched during a national manual therapy congress and distributed via social media (April-July 2018). Descriptive analyses, MANOVA and qualitative analyses were used.

Results

From the 211 responses, 150 were male, with a mean age of 44.9 (±11.2) years, a mean clinical experience of 12.8 (±9.6) years as manual therapist, 87% had a master’s degree and 97% worked in a private practice. Except for the upper cervical spine, more than 80% of the participants felt that TJM was safe, were comfortable performing TJM. Overall >80% of participants perform additional screening prior to TJM. Concerns about safety is the greatest barrier for upper cervical TJM.

Discussion

Findings indicate that overall Dutch manual therapists believe TJM to be safe and effective and are comfortable performing them, except for the upper cervical spine, where concerns exist regarding safety and acquiring written informed consent.

Level of evidence

2b.

Keywords:

• Thrust joint manipulation
• manipulation
• manual therapy
• mobilisation
• spine
• survey

Ethical approval

This study was approved by the Medical Ethical Committee of the University Medical Center Groningen, The Netherlands.

Disclosure statement

No potential conflict of interest was reported by the author(s).