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The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews

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28 March 2025

The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews

Treatment mechanisms are the underlying process or pathway through which a treatment influences the body. This includes molecular, cellular and physiological processes or pathways contributing to treatment effect. Manual therapy (MT) evokes complex mechanistic responses across body systems, interacting with the individual patient and context to promote a treatment response. Challenges arise as mechanistic studies are spread across multiple professions, settings and populations. The purpose of this review is to summarize treatment mechanisms that have been reported to occur with MT application … MORE

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Analgesic effects of non-­ surgical and non-­ interventional treatments for low back pain: a systematic review and meta-­ analysis of placebo-­ controlled randomised trials

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28 March 2025

Analgesic effects of non-­ surgical and non-­ interventional treatments for low back pain: a systematic review and meta-­ analysis of placebo-­ controlled randomised trials

The objectives of this systematic re new and meta-analysis is to investigate the efficacy of non-surgical and non-interventional treatments for adults with low back pain compared with placebo … MORE

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Neuromuscular Response to High-Velocity, Low-AmplitudeSpinal Manipulation—An Overview

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11 March 2025

Neuromuscular Response to High-Velocity, Low-AmplitudeSpinal Manipulation—An Overview

The clinical use of spinal manipulation to treat musculoskeletal conditions has nearly tripled in the United States since 1980, and it is currently recommended by most global clinical guidelines as a conservative treatment for musculoskeletal pain, despite a lack of knowledge concerning its mechanisms of action. This overview highlights evidence of direct neuromuscular responses to high-velocity, low-amplitude spinal manipulation (HVLA-SM) as delivered by chiropractic, osteopathic, and physical therapy clinicians, with an intent to foster greater interprofessional dialogue and collaborative research to better address current gaps in mechanistic knowledge of the neuromuscular response to HVLA-SM. Three databases (PubMed, CINAHL Ultimate (EBSCO), EMBASE (Elsevier)) were searched from 2000 to December 2024 with specific search terms related to thrust HVLA-SM and the neuromuscular response. To focus strictly on neuromuscular responses related to HVLA-SM, this literature overview excluded articles using non-HVLA-SM manual therapy techniques (i.e., massage, non-thrust joint mobilization, and/or combined HVLA-SM with other forms of treatment such as exercise or non-thrust joint mobilization) and studies in which patient-centered outcomes (i.e., pain scores) were the primary outcomes of the HVLA-SM interventions. Pediatric studies, animal studies, and studies in languages other than English were also excluded. One-hundred and thirty six articles were identified and included in this overview. Neuromuscular findings related to HVLA-SM in the areas of electromyography (EMG), muscle thickness, muscle strength, reflexes, electroencephalogram (EEG), and evoked potential were often mixed; however, evidence is beginning to accumulate either in favor of or opposed to particular neuromuscular responses to HVLA-SM as larger and more scientifically rigorous studies are being performed. Recurrent limitations of many HVLA-SM-related studies are small sample sizes, leading to a lack of generalizability, and the non-standardization of HVLA-SM delivery, which has prevented researchers from arriving at definitive conclusions regarding neuromuscular responses to HVLA-SM. Discussions of future neuromuscular research needs related to HVLA-SM are included for clinicians and researchers inside and outside of the field of manual therapy, to advance this field … MORE

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Indigenous Epistemological Frameworks and Evidence-Informed Approaches to Consciousness and Body Representations in Osteopathic Care: A Call for Academic Engagement

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11 March 2025

Indigenous Epistemological Frameworks and Evidence-Informed Approaches to Consciousness and Body Representations in Osteopathic Care: A Call for Academic Engagement

Indigenous perspectives, which emphasize non-materialistic dimensions of healing, such as the interconnectedness of the body, mind, and spirit, align with one foundational principle of osteopathic care. Integrating these perspectives into person-centered care may enhance therapeutic effectiveness by accommodating diverse understandings of health and well-being. This perspective paper explores how various epistemological frameworks, including Indigenous non-materialistic approaches, can inform manual therapy techniques and therapeutic alliances to advance person-centered care … MORE

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Autonomic correlates of osteopathic manipulative treatment on facial functional mapping: an innovative approach based on thermal imaging

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8 March 2025

Autonomic correlates of osteopathic manipulative treatment on facial functional mapping: an innovative approach based on thermal imaging

Osteopathic manipulative treatment (OMT) has shown efficacy in various clinical conditions and age groups. Understanding its neurobiological, particularly autonomic, mechanisms of action remain limited. Preliminary studies suggested a parasympathetic effect of OMT, evidenced by heart-rate-variability analysis. A cross-over RCT on healthy adults was conducted to compare OMT with sham therapy. Thirty-seven participants underwent two sessions (OMT and sham), comprising baseline, tactile treatment, and post-touch. Novel thermal imaging data analyses in combination with seed correlation analyses (SCA) were employed to explore the OMT effects on autonomic parameters. Particularly, the sham group exhibited an elevated warming effect on the cheeks, nose, and chin. Inversely, for the OMT group a conspicuous cooling trend in the nose, but not in the cheeks and chin was observed. Considering SCA maps, the intensity of the correlation for nose tip, glabella and GSR seeds showed higher values in the OMT compared to the sham group. The comparative analysis of thermal maps and SCA results represents a significant advancement in our understanding of the physiological mechanisms underlying OMT’s effects on autonomic functions. By elucidating specific patterns of temperature change, correlation intensity and specific clusters, this research provides valuable insights for optimizing clinical practice and refining theoretical models of manual therapy … MORE

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Insights into how manual therapists incorporate the biopsychosocial-enactive model in the care of individuals with CLBP: a qualitative study

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18 February 2025

Insights into how manual therapists incorporate the biopsychosocial-enactive model in the care of individuals with CLBP: a qualitative study

Chronic low back pain (CLBP) presents a significant challenge for manual therapists. Recent advancements in pain research have highlighted the limitations of the traditional biomedical and biopsychosocial models, prompting the exploration of alternatives. The biopsychosocial-enactive (BPS-E) model has emerged as a promising alternative. This study aims to explore the application of the BPS-E model by manual therapists in managing CLBP and to initiate a meaningful dialogue about its use … MORE

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Prevalence and profile of New Zealand osteopaths treating people experiencing headaches and migraines

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17 February 2025

Prevalence and profile of New Zealand osteopaths treating people experiencing headaches and migraines

Manual and manipulative therapy interventions are commonly sought by individuals experiencing headaches or migraines. Evidence supports the use of manual therapy as part of the management of headache and migraine disorders. Osteopaths are health professionals who provide care for individuals experiencing headaches and migraines. However, there is a lack of data concerning the profile of osteopaths treating these conditions, in addition to their diagnostic and management strategies. The objectives of this study is to describe the prevalence and profile of NZ osteopaths treating people experiencing headaches and migraines. This study is the first to describe this practice … MORE

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Contextual effects in musculoskeletal pain: are we overlooking essential factors?

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17 February 2025

Contextual effects in musculoskeletal pain: are we overlooking essential factors?

The role of contextual effects in musculoskeletal pain research and clinical practice has garnered growing interest in recent years. While ongoing research has advanced knowledge, it has also sparked debate between clinicians, clinical trialists and other researchers. The controversy over contextual effects in musculoskeletal pain research and practice highlights the tension between leveraging their therapeutic potential and minimizing them to preserve treatment specificity … MORE

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Effect of osteopathic manipulative treatment on pain in palliative care patients: a randomized placebo-controlled clinical trial

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17 February 2025

Effect of osteopathic manipulative treatment on pain in palliative care patients: a randomized placebo-controlled clinical trial

Standard osteopathic manipulative therapy (OMT) is used as a supportive care for pain management in cancer patients. The present study aimed to compare the efficacy of OMT with that of a sham treatment to attenuate pain in cancer patients in a palliative care unit … MORE

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Early osteopathic manipulative treatment to prevent cranial positional deformities: A randomized controlled trial

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12 February 2025

Early osteopathic manipulative treatment to prevent cranial positional deformities: A randomized controlled trial

Cranial positional deformities occur frequently in the first months of life. The objective of this study is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) in preventing the onset of positional plagiocephaly and brachycephaly at 4 months in at-risk newborns … MORE

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