Assessment of Knowledge, Beliefs, and Attitudes Regarding Spinal Manipulation in Physical Therapists Practicing in Hyderabad

Background: Manual therapy has long incorporated spinal manipulation as an integral technique practiced by physical therapists. Spinal manipulation involves the manual adjustment of vertebrae by passively moving them within their physiological range of motion. This procedure is widely used to restore mobility, and improve pain and functional outcomes in patients with musculoskeletal disorders. Objective: To assess the level of knowledge and awareness among physical therapists in Hyderabad regarding spinal manipulation. Methodology: This cross-sectional study was conducted after obtaining ethical approval from the Institutional Review Board of the Isra Institute of Rehabilitation Sciences. The study was carried out from January to December 2023. Data were collected from various clinical settings across Hyderabad, including hospitals and private physiotherapy clinics. A total of 150 physiotherapists participated in the study, recruited through convenience sampling due to population accessibility. Inclusion criteria were limited to practicing clinical physiotherapists with at least a bachelor’s degree in physiotherapy. This criterion was set to ensure that respondents possessed sufficient academic and clinical knowledge to provide meaningful input regarding spinal manipulation. Exclusion criteria included non-clinical physiotherapists, physiotherapy technicians, and diploma holders, as the focus was specifically on qualified clinicians actively engaged in patient care. Frequencies and percentages were calculated for categorical variables, while means and standard deviations were used for continuous data. Chi-square tests were used to evaluate associations between categorical variables, such as practice setting and use of spinal manipulation. Independent t-tests and one-way ANOVA were applied. Results: The study revealed that only 5.3% of participants had completed orthopedic manual physical therapy specialization, while 94.7% had not received such advanced training. The majority of respondents demonstrated good knowledge of spinal manipulation techniques. Most therapists reported being familiar with clinical prediction rules and acknowledged their use in practice. Conclusion: This study concluded that physical therapists in Hyderabad possess a sound level of knowledge regarding spinal manipulation. The undergraduate physiotherapy curriculum appeared to be the primary source of this knowledge, underscoring its influence on professional practice.