The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

Abstract

Objective: The purpose of this investigation was to establish a baseline of physical therapist education on temporomandibular disorders (TMD)-related topics during credentialed orthopedic manual physical therapy fellowship training and compare it to cervical spine disorders education. Method: An online survey was distributed electronically to each fellowship program credentialed by the American Physical Therapy Association (APTA) and recognized by the Academy of Orthopedic Manual Physical Therapists (AAOMPT). Data were analyzed to compare overall exposure to TMD educational content, including a direct comparison of TMD and cervical spine disorders education. Results: The response rate was 79%. Thirteen programs (87%) reported providing both didactic and clinical training on both TMD and cervical spine disorders. Didactic education for cervical spine disorders ranged from 16-20 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. Clinical education for cervical spine disorders ranged from 11-15 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. The number of hours of exposure during didactic training and the number of patients exposed to during clinical training were significantly different when comparing TMD to cervical spine disorders exposure (P,0.0001). Discussion: The data indicate a lack of uniformity between credentialed fellowship programs in orthopedic manual physical therapy with respect to the extent to which programs expose trainees to evaluation and management of TMD. There is consistency in that all programs provided more training on cervical spine disorders than TMD. Despite a high level of clinical specialization, fellows-in-training receive minimal TMD education.

The status of temporomandibular and cervical spine education in post-professional physical therapy training programs recognized by Member Organizations of IFOMPT: an investigation of didactic and clinical education

“…The Mann-Whitney U test demonstrated statistical significance when comparing TMD and cervical spine disorders education for both the hours of didactic training provided (p < 0.0001) and the number of patients seen during clinical training (p < 0.006). When comparing the current international data-set to the previously reported AAOMPT data-set [14], statistical significance was demonstrated for both didactic (p < 0.0001) and clinical education (p < 0.006) of TMD topics but not for didactic (p = 0.23) or clinical education (p = 0.15) of cervical spine disorders topics. A detailed comparison of exposure to temporomandibular and cervical spine disorders education for both didactic and clinical training is presented in Table 2.…”

“…Exposure to TMD education content was always lower than cervical spine content in the United States [14]. In contrast, some programs in the international data-set reported relatively low content exposure to cervical spine disorders education while some programs reported relatively high exposure to TMD content.…”

“…After the request was reviewed and approved by the IFOMPT Executive Committee, an official list of liaisons from each MO was obtained directly from IFOMPT. Despite being part of that contact list, the liaison for the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) was excluded from participation because programs with the United States were surveyed in a previous study [14]. The remaining list included contacts located in 21 different nations/jurisdictions but only 14 (67%) of the designated liaisons responded when contacted about participation in this survey.…”

“…Consent for participation was obtained by including a question regarding consent at the beginning of the survey. Survey questions had been pilot tested and validated electronically and were the same as those utilized by Shaffer et al [14] so that the data sets could be compared. No attempts were made to rank or individually comment on program responses.…”

“…Despite ample epidemiological data suggesting that both temporomandibular disorders (TMD) [1][2][3][4][5][6][7] and cervical spine disorders [8][9][10][11][12][13] have similarly high prevalence rates, a recent publication identified a widespread discrepancy between the extent to which physical therapists enrolled in post-professional Orthopedic Manual Physical Therapy (OMPT) training programs in the United States are exposed to each of these content areas [14]. For both didactic and clinical education, post-professional students underwent statistically significant lower levels of TMD education in comparison to cervical spine disorders education.…”