Role of exercise therapy in osteopathic education, treatment and management

Exercise based interventions are common in the treatment of musculoskeletal disorders. These interventions have been investigated in other manual therapy disciplines, but little empirical data exists about. osteopathic approaches to exercise. There is a need to examine the role of exercise in osteopathic undergraduate education and the osteopathic treatment and management of patients in order to identify, clarify and develop upon educational and professional needs of the practising osteopath. The aims of this thesis were to explore the integration of exercise therapy in the undergraduate osteopathic curriculum, gain an understanding of the interpretation and uses of exercise therapy in osteopathic practice and explore potential concordance between education and practice. To provide context for the studies in the thesis, preparatory work included . examining the historical and philosophical developments within osteopathy and the utilisation of exercise therapy and physical activity in wider health care provision. Curriculum evaluation of the intended (content analysis of course documents) delivered (faculty member perspective) and received (student perspective) undergraduate osteopathic curricula revealed the idiosyncratic and sporadic nature of documented and delivered exercise content. The intended curriculum was seen to pertain to academic education whilst the delivered and received curriculum was reflective of clinical education. There was evidence of shared desires from osteopathic students and faculty members who suggested that they would welcome a standardised, experiential, patient centred approach to exercise therapy. The interview study with practitioners revealed a patient centred approach to the use of exercise therapy. However there remains some confusion over the use and understanding of exercise terminology. Paradoxically with the stated patient centred approaches practitioners expressed exercise delivery using paternalistic language. Favoured modes of exercise showed common trends with other manual therapies such as the use of 'core stability' programmes, but bore little resemblance to those delivered during undergraduate education. Exercise therapy and its potential for use is a substantial issue for osteopaths and for education providers in the UK. There is some dissonance between clinicians reported patient centred care approaches and actual delivery of exercise advice. Exercise education in osteopathy and clinical practice are not concordant and clinical aspects of undergraduate education are not documented clearly and are largely opportunistic. There is a need for further consensus about the role of exercise therapy in osteopathic practice and this should be a driver for a more coherent approach across education and practice.EThOS - Electronic Theses Online ServiceGBUnited Kingdo