Learning objective:
Upon completion of this focused symposium, attendees will have knowledge and tools aimed at including person-centered self-management support in OMPT practice.

Description
Musculoskeletal pain conditions are one of the leading contributors to disability worldwide. Orthopedic Manual Physical Therapy (OMPT) is a specialized area of physical therapy for the management of neuro-musculoskeletal conditions, based on clinical reasoning, using highly specific treatment approaches including manual techniques and therapeutic exercises (www.ifompt.org). Contemporary evidence suggests that musculoskeletal practice should incorporate a person-centered approach, including support to self-manage the condition (Lin et al., 2019; Caneiro et al., 2019; Lewis & O’Sullivan, 2018; Hutting et al., 2022-1, Hutting et al., 2022-2, Diener, 2021). Principles of person-centered care include 1) affording people dignity, compassion and respect; 2) offering coordinated care, support or treatment; 3) offering personalized care, support or treatment; and 4) supporting people to recognize and develop their own strengths and abilities to enable them to live an independent and fulfilling life (The Health Foundation, 2016).

Recently, a framework to support clinicians to deliver person-centered care in musculoskeletal was published. This framework consists of three overarching key principles: 1) a biopsychosocial understanding of the person’s experience; 2) person-focused communication; and 3) supported self-management (Hutting et al., 2022-2).

Physical therapists, including OMPT clinicians, are ideally positioned to support people with musculoskeletal conditions in their self-management, and this support is considered important and contributes to the management of musculoskeletal pain conditions (Hutting et al., 2019; Diener 2021). However, it has been reported that physical therapists do not always follow evidence based guidelines (Zadro et al., 2019) and experience difficulties with integrating patient-centered care principles and self-management support into their clinical practice (van den Heuvel et al., 2021; Hutting et al., 2020; Brunnekreef et al., 2022, Monk et al., 2023). Moreover, physical therapists lack confidence and ability in identifying psychosocial factors (Henning & Smith, 2023).

Self-management support is the help given to people that enables them to manage their health on a day-to-day basis. Self-management support can help and inspire people to learn more about their conditions and to take an active role in their health care (Agency for Healthcare Research and Quality, 2020). Self-management support should be provided as part of routine healthcare (Hopkins et al., 2022) and physical therapists should use a self-management approach to personalized treatment for patients with musculoskeletal pain conditions whenever possible (Hutting et al., 2019).

In the 2016 Educational Standards of the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT), patient-centered management, shared decision making and integrating biopsychosocial factors are important components (IFOMPT, 2016). The patient is recognized as an equal partner in their management and is encouraged to actively participate in their treatment and management (IFOMPT, 2016). This implies that, to provide contemporary OMPT, knowledge and skills about providing person-centered care (including a biopsychosocial understanding of the person’s experience, person-focused communication and supported self-management) is needed. Such an approach also complies with a recently proposed new evidence-guided framework for teaching and practice of OMPT. Within this framework, OMPT is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety, comfort, and efficiency. These practical elements are contextualized by positive communication, a collaborative context, and person-centered care (Kerry et al., under review).

Therefore, contemporary knowledge about providing person-centered self-management support in OMPT practice will be provided in this focused symposium. The content of this focused symposium will be largely based on recent important publications about this topic (Hutting et al., 2019; Kongsted et al., 2021; Diener, 2021, Hutting et al., 2022-1, Hutting et al., 2022-2) supplemented with the latest available evidence.

In four linked presentations, evidence based practical recommendations to providing person-centered self-management support will be presented. Topics will include: a framework for delivering person-centered care in musculoskeletal practice, the current state of evidence of self-management for musculoskeletal pain conditions, characteristics of self-management support and suggestions for techniques to make this part of clinical practice, and recommendations to optimize communication and shared-decision making throughout the clinical interaction. Moreover, recently developed tools (e.g. the Self-Management Identification Tool and the Musculoskeletal Self-Management Questionnaire) will be discussed and clinical examples will be provided.

Implications/conclusions
Contemporary evidence suggests that person-centered self-management support should be a cornerstone of musculoskeletal practice, including OMPT. However, while many OMPT clinicians have invested time in developing their manual therapy skills, they may not have considered the adjunctive person-centered self-management support needed in their practice to optimize delivery, patient experience and outcome. Upon completion of this focused symposium, attendees will have knowledge and tools aimed at including person-centered self-management support in OMPT practice. This symposium will be interesting for clinicians, researchers and policymakers and will contribute to the practice of contemporary OMPT.