A methodological review revealed that reporting of trials in manual therapy has not improved over time

Alvarez, Gerard; Solà, Iván; Sitjà-Rabert, Mercè; Fort-Vanmeerhaeghe, Azahara; Gich, Ignasi; Fernández, Carles; Bonfill, Xavier; Urrútia, Gerard

doi:10.1016/j.jclinepi.2020.01.006

Cited by 20 publications

(21 citation statements)

References 84 publications

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“…A recent review found that trial-based evidence in osteopathy is of poor quality (e.g. inadequate sample size, study length, and controls), and the quality of reporting has not improved over time [ 30 ]. Accordingly, an evident change in strategy and continued effort has been recommended to promote rigorous methodology in the design of future osteopathic research [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Evidence-based practice among Italian osteopaths: a national cross-sectional survey

Cerritelli¹,

Iacopini²,

Galli³

et al. 2021

BMC Complement Med Ther

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Background While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths’ attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context. Methods A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered. Results A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases. Conclusions Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use.

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Section: Discussionmentioning

confidence: 99%

Evidence-based practice among Italian osteopaths: a national cross-sectional survey

Cerritelli¹,

Iacopini²,

Galli³

et al. 2021

BMC Complement Med Ther

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“…Moreover, recent studies investigating disagreements on rating the quality of RCTs included in more than one SR showed that the scores differed substantially where different reviews rate the same article differently [ 102 , 103 ]. Another reason that leads to heterogeneity relates to the incomplete or unclear reporting, as also noted by Alvarez et al [ 11 ]. Consistent with the literature, the studies included in the present overview revealed the same issues, such as high heterogeneity, reporting deficiencies and the same articles rated differently.…”

Section: Discussionmentioning

confidence: 98%

“…The quality of RCTs is a persistent issue in the field of MT. Several studies have shown a low quality of RCTs performed in MT [ 11 , 100 , 101 ]. Our overview identified a high heterogeneity in regards to the quality of the articles included.…”

Section: Discussionmentioning

confidence: 99%

“…It is used by a wide variety of professionals, including physical therapists, osteopaths, and chiropractors, and its use among different age groups and pathologies has been steadily increasing since 2000 [ 10 ]. MT includes a wide range of techniques such as soft tissue techniques, joint mobilisations or manipulations, massage, myofascial release, nerve manipulation, strain/counterstrain, and acupressure [ 11 – 13 ]. Of note, MT consists of applying these techniques and encompasses a person-centred approach based on a diagnostic clinical reasoning process, a conscientious patient/practitioner interaction and paying attention to patient re-education and advice [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Do manual therapies have a specific autonomic effect? An overview of systematic reviews

Roura¹,

Alvarez

Solà

et al. 2021

PLoS ONE

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Background The impact of manual therapy interventions on the autonomic nervous system have been largely assessed, but with heterogeneous findings regarding the direction of these effects. We conducted an overview of systematic reviews to describe if there is a specific autonomic effect elicited by manual therapy interventions, its relation with the type of technique used and the body region where the intervention was applied. Methods We conducted an overview according to a publicly registered protocol. We searched the Cochrane Database of Systematic Reviews, MEDLINE, EPISTEMONIKOS and SCOPUS, from their inception to march 2021. We included systematic reviews for which the primary aim of the intervention was to assess the autonomic effect elicited by a manual therapy intervention in either healthy or symptomatic individuals. Two authors independently applied the selection criteria, assessed risk of bias from the included reviews and extracted data. An established model of generalisation guided the data analysis and interpretation. Results We included 12 reviews (5 rated as low risk of bias according the ROBIS tool). The findings showed that manual therapies may have an effect on both sympathetic and parasympathetic systems. However, the results from included reviews were inconsistent due to differences in their methodological rigour and how the effects were measured. The reviews with a lower risk of bias could not discriminate the effects depending on the body region to which the technique was applied. Conclusion The magnitude of the specific autonomic effect elicited by manual therapies and its clinical relevance is uncertain. We point out some specific recommendations in order to improve the quality and relevance of future research in this field.

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“…Previous authors have suggested that osteopathic care could increase spine range of motion [40][41][42][43] but few studies have focused on functional assessments on patients with bruxism. This is probably due to the difficulty in objectifying dynamic motion without impeding the movement itself [20,44]. Detailed range of motion analysis may nevertheless help identify specific patterns of movement alterations that are not easy to identify with other means of measurement.…”

Section: Introductionmentioning

confidence: 99%

Exploring the utility of motion analysis in osteopathic clinical trials; a school-based pilot study on jaw and cervical range of motion

Bagory¹,

Vaucher

Mhadhbi³

et al. 2021

International Journal of Osteopathic Medicine

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A methodological review revealed that reporting of trials in manual therapy has not improved over time

Cited by 20 publications

References 84 publications

Evidence-based practice among Italian osteopaths: a national cross-sectional survey

Evidence-based practice among Italian osteopaths: a national cross-sectional survey

Do manual therapies have a specific autonomic effect? An overview of systematic reviews

Exploring the utility of motion analysis in osteopathic clinical trials; a school-based pilot study on jaw and cervical range of motion

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