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. 2023:20:4.
doi: 10.3352/jeehp.2023.20.4. Epub 2023 Jan 27.

Priorities in updating training paradigms in orthopedic manual therapy: an international Delphi study

Damian Keter  1   2 , David Griswold  2 , Kenneth Learman  2 , Chad Cook  3   4   5
Affiliations

Priorities in updating training paradigms in orthopedic manual therapy: an international Delphi study

Damian Keter et al. J Educ Eval Health Prof. 2023.

Abstract

Purpose: Orthopedic manual therapy (OMT) education demonstrates significant variability between philosophies and while literature has offered a more comprehensive understanding of the contextual, patient specific, and technique factors which interact to influence outcome, most OMT training paradigms continue to emphasize the mechanical basis for OMT application. The purpose of this study was to establish consensus on modifications & adaptions to training paradigms which need to occur within OMT education to align with current evidence.

Methods: A 3-round Delphi survey instrument designed to identify foundational knowledge to include and omit from OMT education was completed by 28 educators working within high level manual therapy education programs internationally. Round 1 consisted of open-ended questions to identify content in each area. Round 2 and Round 3 allowed participants to rank the themes identified in Round 1.

Results: Consensus was reached on 25 content areas to include within OMT education, 1 content area to omit from OMT education, and 34 knowledge components which should be present in those providing OMT. Support was seen for education promoting understanding the complex psychological, neurophysiological, and biomechanical systems as they relate to both evaluation and treatment effect. While some concepts were more consistently supported there was significant variability in responses which is largely expected to be related to previous training.

Conclusion: The results of this study indicate manual therapy educators understanding of evidence-based practice as support for all 3 tiers of evidence were represented. The results of this study should guide OMT training program development and modification.

Keywords: Health education; Musculoskeletal manipulations; Spinal manipulation.

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Conflict of interest statement

Conflict of interest

Chad Cook is the Director of the Center of Excellence in Manual and Manipulative Therapy at Duke University and a portion of his salary is supported by that role. Chad published a book on OMT and a course with AGENCE EBP on Manual Therapy in which he receives royalties. Otherwise, no potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Flow chart for current study protocol (3-round Delphi) including expert panel and workgroup duties. OMT, orthopedic manual therapy.
Fig. 2.
Fig. 2.
Flow chart indicating how levels of consensus were obtained following round 3.
See this image and copyright information in PMC

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