Joint Manipulation for Rehabilitation of Musculoskeletal Disorders

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 September 2026 | Viewed by 7106

Special Issue Editors


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Guest Editor
1. Puerta de Hierro Health Research Institute–Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
2. Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL 33965, USA
3. Interdisciplinary Research Group on Musculoskeletal Disorders, 28014 Madrid, Spain
4. Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
Interests: osteoarthritis; rehabilitation; dry needling; ultrasonography; pulmonary rehabilitation; therapeutic exercise
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Guest Editor Assistant
Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL 33965, USA
Interests: physical therapy; spine; rehabilitation; pain management; manipulation; physical examination; posture

Special Issue Information

Dear Colleagues,

In the context of rehabilitation, manual therapy and joint manipulation at varying grades are widely employed to address joint dysfunctions, such as restricted mobility, pain, and diminished function. Despite significant advances in research, the precise benefits of these techniques within clinical rehabilitation remain to be fully elucidated, particularly regarding their neurophysiological impact. This Special Issue invites submissions that provide scientific evidence and new insights into the role of manual therapy in the rehabilitation of musculoskeletal disorders.

We encourage researchers to submit original studies and reviews addressing topics such as:

  • Neurophysiological Effects of Manual Therapy: We invite investigations examining how manual therapy influences the central nervous system, including studies on autonomic markers like heart rate variability and other physiological indicators. This approach can deepen our understanding of the mechanisms underlying the effectiveness of these interventions and their potential to modulate pain responses and other neurological processes. Additionally, original research or systematic reviews or meta-analyses that explore the effects of manipulation on joint structure and connective tissues are welcome, particularly for practitioners interested in understanding the mechanisms and efficacy behind higher-grade manipulations.
  • Impact of Audible Sounds on Clinical Success Perception: Both patients and practitioners hold expectations regarding the audible sounds accompanying joint manipulations, an area that still requires stronger empirical support. We seek studies that investigate the relationship between these audible cues and patient expectations, exploring how they influence perceptions of success and satisfaction with treatment.
  • Combined Rehabilitation Protocols: We welcome manuscripts that explore the effectiveness of protocols combining manual therapy with other interventions, such as exercise and trigger point therapy. This integrated approach aims to offer a more robust and comprehensive recovery, a fundamental area for developing effective, evidence-based treatment protocols.
  • Technological Validation and Precision in Force Application: We also invite studies that validate the use of technological tools to standardize and measure the consistency of applied forces during manipulations. This area of research is crucial for enhancing precision in clinical practice and achieving more predictable, uniform results.

This Special Issue aims to provide clinicians and researchers with evidence-based recommendations to guide the use of manual therapy in managing musculoskeletal disorders. We invite authors to contribute work that expands our knowledge of the current and future role of joint manipulation and supports a more effective, scientifically grounded rehabilitation process.

Dr. Eleuterio A. Sánchez Romero
Guest Editor

Dr. Rob Sillevis
Guest Editor Assistant

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Keywords

  • orthopedic manual therapy (OMT)
  • chronic musculoskeletal pain (CMSP)
  • joint manipulation
  • treatment outcomes
  • evidence-based intervention

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Published Papers (4 papers)

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Research

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19 pages, 3992 KB  
Article
Do Audible Sounds During a Metacarpophalangeal and Metatarsophalangeal Thrust Manipulation Have an Impact on Intra-Articular Joint Space and Brainwave Activity?
by Rob Sillevis, Fransisco Selva-Sarzo, Valerie Weiss and Eleuterio A. Sanchez Romero
Healthcare 2025, 13(5), 554; https://doi.org/10.3390/healthcare13050554 - 4 Mar 2025
Cited by 2 | Viewed by 2744
Abstract
Background: Joint manipulation is commonly used to manage musculoskeletal dysfunctions. Joint manipulation can result in audible sounds. The clinical significance and cause of manipulation sound remain unclear. This study aimed to identify intra-articular distance following a metacarpophalangeal (MCP) II and metatarsophalangeal (MTP) II [...] Read more.
Background: Joint manipulation is commonly used to manage musculoskeletal dysfunctions. Joint manipulation can result in audible sounds. The clinical significance and cause of manipulation sound remain unclear. This study aimed to identify intra-articular distance following a metacarpophalangeal (MCP) II and metatarsophalangeal (MTP) II joint manipulation in healthy subjects. Additionally, the cortical response pattern was measured. Methods: Twenty-five subjects completed this quasi-experimental repeated-measures study protocol. Musculoskeletal ultrasound was used to measure intra-articular joint distance, and a portable EEG device captured brainwave activity. The environment was controlled during testing. Initially, the joint distance of the MCP II and MTP II was measured followed by the recording of initial brainwaves. Following a pre-manipulation hold, a second brainwave measure was taken. After this, each subject underwent a thrust manipulation of either MCP II or MTP II, immediately followed by the next brainwave measurement. One minute later, the final and fourth measurement took place. Results: All subjects regardless of audible sound increased in joint space following both the MCP and MTP joint manipulation. The audible group had more significant EEG changes (p < 0.05) following the MCP manipulation but less following the MTP manipulation. Conclusions: This study supports the tribonucleation theory explaining audible joint manipulation sounds. The manipulation of the MCP II joint resulted in increased Theta wave activity, indicating a state of relaxation, which was larger in the audible group. The MTP II manipulation had decreased cortical effects regardless of the presence of a sound. Despite these findings, the clinical usefulness of audible sounds remains questionable. Full article
(This article belongs to the Special Issue Joint Manipulation for Rehabilitation of Musculoskeletal Disorders)
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Review

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17 pages, 483 KB  
Review
Manual Therapy, Core Training, and Pilates Method Interventions in Dance Rehabilitation: A Scoping Review
by Ioannis Tsartsapakis and Aglaia Zafeiroudi
Healthcare 2026, 14(7), 872; https://doi.org/10.3390/healthcare14070872 - 28 Mar 2026
Viewed by 622
Abstract
Objectives: To map and synthesize the available evidence regarding the use of manual therapy, core stability training, and Pilates Method exercises in the rehabilitation of musculoskeletal conditions in adult dancers. Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. A [...] Read more.
Objectives: To map and synthesize the available evidence regarding the use of manual therapy, core stability training, and Pilates Method exercises in the rehabilitation of musculoskeletal conditions in adult dancers. Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. A systematic search across six electronic databases (PubMed, Scopus, Web of Science, SPORTDiscus, CINAHL, and PEDro) was performed. Study eligibility was strictly guided by the Population–Concept–Context (PCC) framework. Two independent reviewers screened the literature and extracted data. Results: A total of 16 studies met the inclusion criteria, encompassing randomized controlled trials, intervention studies, and case-level reports or series. Interventions primarily addressed chronic ankle instability, low back pain, and post-surgical rehabilitation. Results indicate that while individualized manual therapy and Pilates Method protocols are widely utilized in dance medicine, high-level evidence remains limited. Conclusions: Integrated rehabilitation approaches combining manual therapy with motor control exercises (such as the Pilates Method and core training) appear to have potential utility in supporting the safe return of dancers to performance. However, the current literature is heavily reliant on observational and case-driven evidence, highlighting the need for robust clinical trials to establish standardized, dance-specific rehabilitation guidelines. Full article
(This article belongs to the Special Issue Joint Manipulation for Rehabilitation of Musculoskeletal Disorders)
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Other

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17 pages, 1887 KB  
Systematic Review
Effectiveness of Thoracic Spine Manipulation for the Management of Neck Pain: A Systematic Umbrella Review with Risk of Bias and Methodological and Reporting Quality
by Michael Masaracchio, Kaitlin Kirker, Birendra Dewan and Stephen Caronia
Healthcare 2026, 14(2), 240; https://doi.org/10.3390/healthcare14020240 - 18 Jan 2026
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Abstract
Background/Objectives: The purpose of this umbrella review was to assess the risk of bias and the methodological and reporting quality of systematic reviews that evaluated the effects of thoracic spine manipulation (TSM) on individuals with mechanical neck pain. Methods: To be included, publications [...] Read more.
Background/Objectives: The purpose of this umbrella review was to assess the risk of bias and the methodological and reporting quality of systematic reviews that evaluated the effects of thoracic spine manipulation (TSM) on individuals with mechanical neck pain. Methods: To be included, publications needed to be systematic reviews including studies with participants with neck pain >18 years old; at least two groups where the experimental intervention was TSM; assessed pain and/or function; and were published in English. Reviews limited to narrative, scoping, or retrospective studies, or those with cervical radiculopathy, were excluded. An electronic search was conducted in May 2025 using PubMed, CINAHL (EBSCO Host), and the Cochrane Library to identify relevant articles from inception to May 2025. Quality and risk of bias were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020), and Risk of Bias in Systematic Reviews (ROBIS). Findings were summarized narratively and graphically. Results: Seven reviews (27 unique studies; 1394 participants, aged 18–62 years) met the inclusion criteria. Some evidence supported TSM for short-term improvement in neck pain, but confidence in results was low to critically low based on the AMSTAR 2 results. Four reviews had a high overall risk of bias, and three had a low risk. Reporting compliance varied widely (0–100%). Conclusions: While all the included systematic reviews suggested that TSM is a viable short-term option for individuals with neck pain, the overall confidence in these results ranged from low to critically low, making it difficult to draw firm conclusions about the true benefit of TSM in clinical practice. Registered prospectively in PROSPERO (CRD420251034330). Full article
(This article belongs to the Special Issue Joint Manipulation for Rehabilitation of Musculoskeletal Disorders)
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16 pages, 2166 KB  
Case Report
Tailored Rehabilitation Program and Dynamic Ultrasonography After Surgical Repair of Bilateral Simultaneous Quadriceps Tendon Rupture in a Patient Affected by Gout: A Case Report
by Emanuela Elena Mihai, Matei Teodorescu, Sergiu Iordache, Catalin Cirstoiu and Mihai Berteanu
Healthcare 2025, 13(15), 1830; https://doi.org/10.3390/healthcare13151830 - 26 Jul 2025
Viewed by 1768
Abstract
Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term [...] Read more.
Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring. Full article
(This article belongs to the Special Issue Joint Manipulation for Rehabilitation of Musculoskeletal Disorders)
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