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Orthopaedic Manual Therapy (OMT)

Information about OMT for physical therapists

The definition adopted at the IFOMPT Congress of 2004, which took place at Cape Town, is the following one:

"The Orthopaedic Manual/Manipulative Physical Therapy is a specialized area within the Physical Therapy for the treatment of neuro-musculoskeletal dysfunctions, based on the clinical reasoning and using very specific treatment methods, including manual techniques and therapeutic exercises."

"The Orthopaedic Manual/Manipulative Physical Therapy also includes and it is ruled by the scientific and clinical evidence available and by the biopsicosocial concept of each patient in an individual way".


OMT model at the clinical practice

At the clinical practice, the advanced clinical reasoning process the OMT physical therapist must carry out is essential, because it is directed towards understanding the patient's problem and taking the correct decision in order to provide the best attention possible. These clinical decisions are established taking the patient's physical and clinical features into account, with the aim of making a physiotherapic diagnosis and, as a consequence, establishing the treatment options.

The choosing of some options of treatment, according to the diagnosis, are based on the scientific evidence obtained through the research, that determine which the effectiveness and efficiency of the potential risks of the chosen option in each case is.

Therefore, the Orthopaedic Manual Physical Therapy (OMT) is based on the integration of the following concepts:

a)      Clinical Reasoning

b)     Scientific Evidence

c)      Patient's and concrete case's individual features

The patient plays the most important role and to him is to whom the first two concepts have to adapt.

 

OMT Application at the clinical practice

The OMT application is based on the physical therapist's understanding of the patient's neuro-musculoskeletal state, as well as of his skills related to the function. This concept is essential, and requires an intellectual effort from the physical therapist that has to try to understand the problem the patient presents, mainly from an anatomical and biomechanical point of view but without forgetting the personal and environmental features which may influence the patient.

The physical exam of the patient helps in distinguishing which the dysfunction or limitation is, in which state it is and how much the joint, the muscle, the nervous system and other relevant systems are involved. At the same time, these findings allow deciding if the problem can be treated by the OMT specific technique's application, if it necessary to take some precautions or, if on the contrary, manual therapy is contraindicated in the case.


The OMT Physical Therapist role

An OMT expert physical therapist can act alone, being in this supposed case the main health and attention provider for the patient, or can be part of an interdisciplinary group inside certain health system.

In both cases, it is essential that, following the principles of the clinical reasoning and the scientific evidence, the OMT physical therapist develops some skills and attributes which allow him working in the most effective way, fulfilling the following roles in the OMT practice:

  • The OMT physical therapist as a clinical expert: in the decision making, based on the analysis if the information extracted from the patient's evaluation.
  • The OMT physical therapist as communicator: in the developing of the skills for the treatment success, and, therefore, with the rest of the health personnel.
  • The OMT physical therapist as a collaborator: it is mainly referring to the collaboration he has to carry out with the rest of the health personnel, especially in multidisciplinary teams.
  • The OMT physical therapist as manager: related to the most important position the physical therapist can claim in professional organizations of the health system.
  • The OMT physical therapist as health promoter: understanding this role as a responsibility arising from his knowledge and his activity and directed towards every society level.
  • The OMT physical therapist as apprentice: because of the need and obligation of every physical therapist to have a continued training which allows him updating and gaining new knowledge.
  • The OMT physical therapist as professional: in a constant work in order to reach the excellence in the clinical practice and in the ethical behavior, in the personal development, and in consequence, in the development of the physical therapy as a profession.