Knowledge and use of thoracic manipulations by manual therapists in Belgium and the Netherlands.
Andrei Sokolov, Benoît Beyer, Emiel Van Trijffel and 1 others
PMID 41084909WHAT IT FOUND
Most manual therapists skip standardized pre-screening tools before thoracic manipulation, relying instead on clinical judgment.
While agreement exists on major contraindications like cancer, significant variation remains in how therapists interpret red flags and risk factors.
Key findings
0179% of therapists do not use specific pre-screening tools before performing thoracic manipulations, relying on clinical expertise and examination instead.
02There is substantial variability in how therapists identify contraindications, red flags, and risk factors, despite consensus on conditions like metabolic bone disease.
03Nearly half of the therapists surveyed reported having less than 4 hours of additional training specifically related to the thoracic spine.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The survey was conducted in Dutch, excluding French-speaking therapists in Belgium, which may limit generalizability to the entire Belgian population. Self-reported data may not accurately reflect actual clinical practice due to social desirability bias. The study describes current practices but does not assess patient outcomes or safety incidents, so it cannot confirm whether the lack of standardized screening leads to adverse events. 16 participants were excluded for eligibility reasons, and the inability to contact them for clarification limits the analysis of educational background.
Declared interests
The authors reported no funding associated with this work.
The easy way to misread this
Do not interpret the high agreement on major contraindications as evidence that thoracic manipulation is safe without screening. The study shows that most therapists do not use standardized tools, and variability in identifying other risk factors remains high, which could lead to missed contraindications in individual patients.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →