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Linda Woodhouse, Ph.D. (Candidate), B.Sc. (P.T.), Assistant Professor, School of Rehabilitation Science, McMaster University, Hamilton, Ontario Canada

A myriad of different manual therapy treatments are used worldwide to ameliorate pain, reduce impairment, and restore physical function. Included under the rubric of manual therapies are acupuncture, deep friction and massage, mobilization, passive movements, neuromuscular facilitation techniques, percussion, and mobilization therapies to name but a few. Common to all of these therapies is that the therapist or caregiver performs the work, while the patient or client is the passive recipient.

As biological tissues are by and large extremely adaptable, the aim of these therapies is to apply the appropriate stimuli (mode, dose, and duration) to induce biological change at the cellular, tissue and whole body systems levels. These changes may include local responses of underlying bone, joints, and soft tissues (muscle and connective tissues) through to whole body neural, immune, endocrine, circulatory, and lymphatic system responses.

In many areas of manual therapy, clinical practice appears to be a decade or so ahead of the science. Although some clinical evidence (including systematic reviews) for the effectiveness of manual therapies exists, few studies have systematically explored the biological effects of these therapies to elucidate their underlying mechanisms of action. In part, the limitation has been a lack of available instrumentation to objectively quantify in vivo responses to manual therapy stimuli in humans. This session will provide an overview of the contributions that biomechanics and medical imaging have made to our current understanding and highlight some of the limitations and challenges faced in trying to unravel the biological effects of manual therapies.

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