ABSTRACT
Medical care historically has had a strong association with magic, illusion, and secrecy. Although we profess to be modern healthcare practitioners, utilizing manual therapy techniques, and strive for evidence-based practice, the reality is that one of the most ubiquitous of all manual therapy techniques, manipulation, is obscured by illusive and ill-defined terminology. As a first step in moving from magician to modern clinician, we recently proposed a nomenclature intended to standardize and clarify the terminology used in describing specific manual therapy techniques, recommending the use of 6 key characteristics. The persistent obfuscations appear to be aimed at obscuring the differentiation of manipulation from mobilization. The time has come for a more precise delineation between manipulation and mobilization and to move beyond seeing these valuable interventions simply as some sleight-of-hand technique.J Orthop Sports Phys Ther 2010;40(5):253-255. doi:10.2519/jospt.2010.0105.
Subject(s)
Communication , Manipulation, Orthopedic , Musculoskeletal Diseases/therapy , Practice Patterns, Physicians' , Terminology as Topic , Clinical Competence , Health Knowledge, Attitudes, Practice , Humans , Musculoskeletal Diseases/rehabilitation , Professional-Patient RelationsABSTRACT
We propose describing a manipulative technique using 6 characteristics: Rate of force application: Describe the rate at which the force was applied. Location in range of available movement: Describe whether motion was intended to occur only at the beginning of the available range of movement, towards the middle of the available range of movement, or at the end point of the available range of movement. Direction of force: Describe the direction in which the therapist imparts the force. Target of force: Describe the location to which the therapist intended to apply the force. Relative structural movement: Describe which structure or region was intended to remain stable and which structure or region was intended to move, with the moving structure or region being named first and the stable segment named second, separated by the word "on." Patient position: Describe the position of the patient, for example, supine, prone, recumbent. This would include any premanipulative positioning of a region of the body, such as being positioned in rotation or side bending.
