Identifying the basis of manual therapy for the physiotherapy, chiropractic, medical, and osteopathic professions: is there a common genesis from 19th century Northern Europe?

Chiropractic, osteopathy, physiotherapy, and manual medicine all utilize manual therapy as a core component of their practice. The historical narratives and philosophies upon which these professions utilize manual therapy vary and the role of Northern European influences in the 19th century is not clear. This thesis involved multiple studies in a mixed methods approach to explore the narratives around the history of manual therapy, and a potential 19th century genesis. New narratives were developed to compare to contemporary perspectives to study the impacts of new knowledge on individuals and the potential impacts on clinical practice, education, and regulation. The narrative process was supported by the development of a novel historical source appraisal tool (HSAT) to allow for an abductive approach to gather all available resources, including historical ephemera. The narrative developed identified points of inflection where the history of manual therapy turned, and ongoing points of debate which drove ongoing conflict in the historical narrative. A survey was developed which obtained contemporary opinions and perspectives from 194 individuals across all professions globally. The survey identified 21 professionals (8 physiotherapists, 6 chiropractors, 4 osteopaths, 3 manual medicine physicians) who completed structured interviews to inform an exploratory hermeneutical study on the history of manual therapy through the lived experiences of participants. The results included an analysis of the points of inflection and debate, and an analysis of the archetypes of manual therapies history. A common root was identified in the bonesetters of 19th century Europe and the cultural expectations for hands-on care which were present at this time, and likely migrated to the United States. Impacts to individuals, clinical practice, education, and regulations were also identified across professions.