Implementation of the International IFOMPT Cervical Framework: A survey among educational programmes

Nathan Hutting, Rik Kranenburg, Alan Taylor, Wilfred Wilbrink, Roger Kerry, Firas Mourad

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Orthopaedic Manual Therapy (OMT) is a specialized area of physiotherapy for the management of neuromusculoskeletal conditions. Although rare, adverse events after OMT are reported in literature. In 2020, the International Framework for Examination of the Cervical Region for potential of vascular pathologies of the neck prior to OMT Intervention was presented.

OBJECTIVE: To evaluate the knowledge and implementation status of OMT educational programmes regarding the 2020 International IFOMPT Cervical Framework.

METHODS: An international survey with closed- and open-ended questions was conducted among all IFOMPT educational programmes using an online survey. Formal informed consent was requested at the beginning of the survey and all data were collected anonymously.

RESULTS: Thirty-nine educational programmes filled in the survey. Twenty-four programmes (61.5%) had already implemented the new Framework. Four programmes (10.3%) answered that they will not implement the new Framework in their educational programme. Positional testing will be kept in about 54% of the programmes. Craniovertebral ligament testing will be kept in about 90% of the programmes. A considerable number of educational programmes still teach end range manipulations in the middle and lower cervical spine (33.3%) and upper cervical spine (25.5%).

CONCLUSIONS: The dissemination and implementation of the International IFOMPT Cervical Framework among educational programmes has been successful. However, although positional testing and craniovertebral ligament testing are excluded from the Framework, most educational programmes will keep these tests in their curriculum, which raises some concern regarding the success and impact of international consensus frameworks.

Original languageEnglish
Pages (from-to)102619
JournalMusculoskeletal Science and Practice
Early online date7 Jul 2022
Publication statusPublished - 1 Dec 2022


  • orthopedics
  • manual therapy
  • manipulation
  • mobilisation
  • cervical spine
  • examination


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