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C. MacDonald1, P. Osmotherly2, R. Parkes3, D. Rivett2
1Regis University, School of Physical Therapy, Denver, United States, 2University of Newcastle, School of Physiotherapy, Newcastle, Australia, 3University of Newcastle, School of Education, Newcastle, Australia
Background: The genesis of manual therapy is contentious for all professions including physiotherapy. The majority of published research on physiotherapy professional history has constituted summaries of prior published material and the opinions of authors. A systematic approach to discover any new narratives in this arena has not been undertaken.
Purpose: This study sought to identify the genesis of manual therapy in Northern Europe, the United States and within the physiotherapy profession, using a hybrid method of historical research.
Methods: A systematic approach, allowing for inductive and deductive reasoning, was used initially based upon selected inclusion criteria. Over 1400 references generated by searching various databases identified 189 primary sources. Evaluation of these sources, through the application of a novel historical source appraisal tool, identified multiple points of bias and attempts to create a historical narrative supporting one profession over others in the development of manual therapy in both Northern Europe and the United States, including Chiropractic, Manual Medicine and Osteopathy. A secondary search, informed by these sources using an abductive approach, allowed for identification of ephemera and other sources. This hybrid approach informed theorization to facilitate emplotment of a new historical narrative.
Results: Analysis of the combined sources presented a new historical narrative. The genesis of manual therapy was identified to be a continuation of the prior work of lay healers, bone-setters, and like regional practitioners in Northern Europe and the United States who had provided manipulative type interventions for at least 1000 years in Europe and more recently in the America’s. Through 19th century industrialization, migration and demands of a developing middle class, influential individuals formed educational institutions and professions that refined these traditional approaches into specialized hands-on treatment for a wide array of musculoskeletal impairments. Competing new professions eagerly claimed the ownership and discovery of manual therapy, and proposed new paradigms for managing sickness and health. The reporting though of the roots of their manual techniques was not as eagerly pursued.
Conclusion(s): Current investigation into the historical development of manual therapy has led to the development of a hybrid method of historical research to empower researchers to make meaningful new discoveries in our profession’s history. The emplotment of findings through theorization allows for the presentation of a new historical narrative that manual therapy was developed from the works of prior lay healers primarily in the 19th century, most notably bone setters in Northern Europe. No one profession can lay claim to the ownership or independent development of manual therapy.
Implications: Understanding the historical development of manual therapy provides significant insights into the development of our profession. The development of a hybrid method of historical research allows for a novel approach which facilitates new insights into our profession’s history and identification of new narratives.
Funding, acknowledgements: Travel and research costs were supported by a stipend from the University of Newcastle, Australia, as part of PhD studies.
Keywords: history, manual therapy, method
Topic: Musculoskeletal
Did this work require ethics approval? No
Institution: University of Newcastle
Committee: Human Research Ethics Committee
Reason: Historical Research, no patient contact or access to medical data, no human experimentation. Narrative review with historical resources.
All authors, affiliations and abstracts have been published as submitted.
