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ABSTRACT
Objective
The International Consortium on Manual Therapies (ICMT) is a grassroots interprofessional association open to any formally trained practitioner of manual therapy (MT) and basic scientists promoting research related to the practice of MT. Currently, MT research is impeded by professions’ lack of communication with other MT professions, biases, and vernacular. Current ICMT goals are to minimize these barriers, compare MT techniques, and establish an interprofessional MT glossary.
Methods
Practitioners from all professions with training in manual therapies were encouraged by e-mail and website to participate (www.ICMTConferene.org). Video conferences were conducted at least bimonthly for 2.5 years by profession-specific and interprofessional focus groups (FGs). Members summarized scopes of practice, technique descriptions, associated mechanisms of action (MOA), and glossary terms. Each profession presented their work to the interprofessional FG to promote dialogue, understanding and consensus. Outcomes were reported and refined at numerous public events.
Results
Focus groups with representatives from 5 MT professions, chiropractic, massage therapy, osteopathic, physical therapy and structural integration identified 17 targeting osseous structures and 49 targeting nonosseous structures. Thirty-two techniques appeared distinct to a specific profession, and 13 were used by more than 1. Comparing descriptions identified additional commonalities. All professions agreed on 4 MOA categories for MT. A glossary of 280 terms and definitions was consolidated, representing key concepts in MT. Twenty-one terms were used by all MT professions and basic scientists. Five terms were used by MT professions exclusive of basic scientists.
Conclusion
Outcomes suggested a third to a half of techniques used in MT are similar across professions. Additional research is needed to better define the extent of similarity and how to consistently identify those approaches. Ongoing expansion and refinement of the glossary is necessary to promote descriptive clarity and facilitate communication between practitioners and basic scientists.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/10669817.2023.2288495
Additional information
Funding
Notes on contributors
Brian Degenhardt
Brian Degenhardt, DO I am the assistant vice president for osteopathic research at A. T. Still University, director of the Center for Research in Osteopathic Manipulative Medicine (OMM) at the A.T. Still Research Institute, professor in the Department of OMM at the Kirksville College of Osteopathic Medicine and an Osteopathic Heritage Foundation Endowed Chair. I oversee numerous areas of research, particularly directing research in palpatory diagnosis and Osteopathic Manipulative Treatment. I am the director of the practice-based research network called DO-Touch.NET. I am also the co-founded the grass roots organization called the International Consortium on Manual Therapies, a multi-professional organization of manual therapy professionals whose goal is to improve communication and understanding between manual therapy professions, and to establish an ongoing system that promotes collaborative research to advance scientific understanding of the effectiveness and safety of manual therapies. I am a graduate of the Des Moines University College of Osteopathic Medicine and Surgery, completed my residency in OMM and am board certified in Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine.
Patrick L.S. van Dun
Patrick L.S. van Dun, MSc, DO I have a private practice as an osteopath in Mechelen (Belgium) and Habichtswald (Germany). I received my M.Sc. degree in Rehabilitation and Physical Therapy at the Catholic University Leuven in 1989 and completed my osteopathy studies at COC, organized at the Free University of Brussels, in 1993. I am a researcher and Board of Trustees member of the Centre for Osteopathic MEdicine Collaboration (COME), Pescara (Italy), a non-profit research institute. I have a broad interest in osteopathic research but in recent years have focused on osteopathic professional identity, the practice characteristics of European osteopaths and the health economic value of osteopathy.
Eric Jacobson
Eric Jacobson, PhD, MPH I investigate alternative medicine and teach medical anthropology at Harvard Medical School. My dissertation topic was classical Tibetan medicine’s approach to psychiatric illnesses. I was trained by Ida Rolf in 1974 and am the current president of the Ida P. Rolf Research Foundation. In 2015, I completed an NIH-funded clinical trial of Structural Integration as an adjunct to outpatient rehabilitation for chronic low back pain. Prior to that I was a co-investigator on multiple studies of the placebo effect and diagnostic reasoning in acupuncture.
Sandy Fritz
Sandy Fritz, MS LMT, BCTMB I am a licensed massage therapist, board certified through the National Certification Board for Therapeutic Massage & Bodywork and Certified Massage and Bodywork Educator by the Alliance for Massage Therapy Education. I have a Bachelor of Science in Health Sciences and a Master’s in Organizational Leadership. Since 1994 I have authored academic textbooks on massage therapy with Elsevier publishing.
Paul Mettler
Paul Mettler, PT, DPT I graduated from the University of North Dakota with my degree in physical therapy in 1981 and doctor of physical therapy in 2006. I have practiced for 40 years focusing on the care of orthopedic and musculoskeletal conditions. In 1991, I discovered a way to rapidly identify and undo the damage caused by connective tissue inflammatory process. This innovative technique was originally published in Physical Therapy Today titled “The Mettler Release Technique®: A New Manual Therapy,” but since 2018, is now known as Dermal-Fascial Restoration® or DFR®. Through High Frequency Shear Wave Elastography imaging and other imaging approaches, I have been able to show that DFR reduces skin and fascial stiffness and precisely restructures (or restores) the scar tissue that connects injured tissue without causing further injury. This work has been presented at the Fourth International Fascia Research Congress (FRC) in 2015 and at the International Consortium of Manual Therapies (ICMT) Conference in 2022. It was awarded 2nd place for overall clinical usefulness at the FRC and was the overall winner at the ICMT Conference. My current focus is on dermal and fascial clinical research and education through the non-for-profit DFR Therapy Institute in downtown Chicago.
Norman Kettner
Norman Kettner, DC I am a chiropractic physician and board-certified chiropractic radiologist. I served as chair of radiology at Logan Health Centers, Logan University for 35 years. I am currently professor emeritus in the department of radiology. Research work includes functional brain imaging of neuroplastic dynamics in clinical pain with non-pharmaceutical interventions such as acupuncture and manual therapy. My work has been published in journals include Brain, PAIN, Human Brain Mapping and Brain Stimulation.
G. Franklin
G. Franklin, MBA, I am the Data Manager for A. T. Still Research Institute. I am an applied data scientist evaluating methods for delivering scientific content to the general public. My personal goal is to promote the creation of partnerships for diverse viewpoints in the scientific community to ensure equitable access to data.
Kendi Hensel
Kendi Hensel, DO, PhD I am an osteopathic physician, professor and Vice chair of the Department of Family and Osteopathic Manipulative Medicine at the Texas College of Osteopathic Medicine (TCOM), and a Osteopathic Neuromusculoskeletal Medicine (ONMM) residency director. I completed a Combined Family Medicine/ONMM residency at the University of New England. In 2004, I joined the faculty at the TCOM. I have been an investigator and treatment provider on several research studies on Osteopathic Manipulative Medicine (OMM). I received a K23 Mentored Patient-Oriented Research Career Development Award (2006) from the NIH-NCCIH, studying the effects of OMM on pregnant women. I received my PhD in OMM Clinical Research and Education in 2009 from the University of North Texas Health Science Center-Graduate School of Biomedical Sciences. I served as the 2019- 2020 President of the American Academy of Osteopathy, and served 6 years as a Section Editor of the Journal of the American Osteopathic Association. I am currently involved in clinical, educational and research activities at TCOM, and in national efforts to improve the evidence base and utilization of OMT in patient care. My research interests center around mechanistic and clinical effectiveness studies of OMM.
David Lesondak
David Lesondak, BCSI, ATSI I am an Allied Health Member in the Department of Family and Community Medicine at the University of Pittsburgh Medical Center (UPMC). I am the Senior Structural Integrator and Myofascial Specialist at UPMC’s Center for Integrative Medicine. I am the author of Fascia: What it is and Why it Matters. My follow up work as editor, Fascia, Function, and Medical Applications was nominated for a 2021 British Medical Association award. My podcast, BodyTalk with David Lesondak, is listened to in 49 countries. I was also an invited speaker at the 2020 NIH Conference on Myofascial Pain.
Giacomo Consorti
Giacomo Consorti, DO, MSc (Ost) I am an Italian osteopath, professor and researcher. I am the co-founder of the thematic working group Osteopathy Track & Field and coordinator of the Education Department of the Istituto Superiore di Osteopatia (ISO) in Milan. Currently I am an Italian register of Osteopaths board delegate for Osteopathy Europe (OE) and a member of the OE education committee. I am also an ISO delegate to manage relationships with the European Osteopathic Academic Network (OsEAN). In 2012, I began my training in the field of medical pedagogy through the Italian Society of Medical Pedagogy (SIPeM) of which I am currently a member. Within this position, I collaborate in developing and putting on faculty development events at some Italian and European universities. I have participated in the working groups for the drafting of the Core Competence proposal of the Italian osteopath of the ROI and also participated in the working groups for the drafting of the Core Curriculum proposal developed by the Italian Association of Osteopathy Schools (AISO). I enjoy carrying out research activities for the ISO research department and in collaboration with COME Collaboration. Currently I am the official osteopath of Rovellasca Athlethics.
Leah Frank
Leah Frank, DO I am an osteopathic physician, board-certified in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine. I currently work in a private practice in Germany and teach regularly with the Deutsch-Amerikanische Akademie für Osteopathie (DAAO, German-American Academy of Osteopathy). I serve on the DAAO advisory board, leading the task force regarding training German osteopathic physicians in cranial osteopathy. I graduated medical school at the AT Still University Kirksville College of Osteopathic Medicine, where I completed an academic fellowship in Osteopathic Theory and Methods and later held a faculty appointment in the Osteopathic Manipulative Medicine department.
William R. Reed
William R. Reed DC, PhD I am an Associate Professor in the Physical Therapy Department and the Director of the Rehabilitation Science Program at the University of Alabama at Birmingham. My background is as a manual therapy clinician (chiropractor) who after 14 years left a successful private practice to pursue a research career investigating physiological mechanisms underlying manual therapy and physical rehabilitation approaches aimed at alleviating pain and the improving human health. I received a NIH Career Development Award in 2010 to investigate the effects of spinal joint dysfunction on lumbar muscle spindle primary afferent discharge during spinal manipulation in animal models, followed by an NIH R21 award continuing this line of research. I have worked to characterize various animal models of muscular low back pain, so as to investigate mechanisms responsible for musculoskeletal pain relief related to manual therapy interventions. In 2022, my colleagues and I received a NIH U24 award to develop a sustainable research network (ForceNET; https://sites.duke.edu/forcenet/) aimed at developing interdisciplinary collaborations to address current mechanistic knowledge gaps and successfully overcome long-standing barriers in the field of manual therapy.
Cameron MacDonald
Cameron MacDonald, PT, DPT I am currently an associate professor in the Regis University School of Physical Therapy in Denver CO. Following Physiotherapist training in Australia with a musculoskeletal focus, I obtained my Doctorate in Physical Therapy and also completed the Fellowship in Orthopaedic Manual Therapy in 2006 with Regis and currently direct that program and the Orthopaedic Residency. I am dual certified as an orthopedic and geriatric board specialist by the ABPTS. I am currently a PhD candidate University Newcastle, Australia, focusing on the history of manual therapy across professions. Additional lines of research are in dry needling, hip, spinal, shoulder and foot/ankle management. I have 20 publications including regional OMPT management, dry needling and the genesis of manual therapy. I am currently the President of the Program Directors SIG within the AAOMPT. I have presented over 100 posters/platforms/papers at conferences including multiple international presentations with 30 years of clinical practice experience.
Vaclav Kremen
Vaclav Kremen, MScEng, EMBA, PhD I serve as an Associate Professor in the Department of Biomedical Engineering and an Assistant Professor of Neurology at Mayo Clinic in Rochester, MN, USA. In my multifaceted role, I hold the position of Principal Engineer and Research Fellow within the Neurology Department. I am also a Rolfer, have been trained at the European Rolf Association, and actively engage in Rolfing Structural Integration. My commitment to this field extends to my current membership and chairmanship of the Research Committee at the Dr. Ida P. Rolf Institute. My academic contributions include co-authoring over 100 peer-reviewed research papers and several patents. My research interests are rooted in the translation of scientific discoveries into clinical applications.
Crystal Martin
Crystal Martin, DO I am an osteopathic physician board certified in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine. My background prior to medical school is in public health and I completed my residency at AT Still University Kirksville College of Osteopathic Medicine. I am on the faculty of Pacific Northwest University of Health Sciences in Yakima, Washington as the Director of Osteopathic Curriculum within the Department of Family Medicine and Osteopathic Principles and Practice. My current research projects involve chronic pain management, fascia, and adaptive sports medicine. My hobbies include rock climbing, ice climbing, skiing, trail running, and playing the violin.
Bernie Landels
Bernie Landels, BHS. BCSI I am a Board-Certified Structural Integration Practitioner (IASI) and hold a Bachelor of Health Studies majoring in Massage & Neuromuscular Therapy. As a qualified adult educator, I have taught massage for over 25 years and was the Owner/Director of the New Zealand College of Massage (2007-2011). As winner of the Ida P Rolf Research Foundation case study competition, I subsequently had my case study “Structural Integration Case Report: a Global Intervention Challenging the Limitations of Local Rehabilitation” published in the International Journal of Therapeutic Massage and Bodywork. I have served on the Ida P Rolf Research Foundation Board of Directors and am currently a member of the Anatomy Trains Structural Integration teaching faculty. I have published a book for parents and professionals on the importance of movement and milestones with a focus on the structure and function of the feet as a child grows.
Paul Standley
Paul Standley, PhD I earned my doctoral degree in medical physiology at Wayne State University School of Medicine in Detroit, Michigan then completed a post-doctoral fellowship in the Division of Endocrinology and Hypertension at the same institution. I moved to Arizona to become a founding faculty member at Midwestern University’s Arizona College of Osteopathic Medicine where I continued NIH-, AHA -, and AOA-funded research on biomechanical modeling of arterial pressure waveforms and developing in vitro models of myofascial release and other manual therapies. As a founding faculty member of the University of Arizona College of Medicine-Phoenix, I have served 12 years as the founding curricular dean. I am currently a tenured professor of basic medical sciences and physiology and director of the Research Office for Medical Education. I have published extensively in the areas of hypertension, vascular biology, effects of biomechanics on gene expression in bioengineered tissues, and medical education research.