Table 1 Differences between the educational programs

Physiotherapy undergraduate program

A three-years basis bachelor’s degree achieved through a university program. SM is not part of the core-learning outcome. The educational program is mainly focused on orthopedic and neurological rehabilitation and on other area of physiotherapy (e.g., geriatric, pediatric, etc.)

Musculoskeletal specialization

Orthopaedic Manipulative Physical Therapy is a specialized area of physiotherapy for the management of neuro-musculoskeletal conditions. It is achieved through a 2-year post-graduate university program. Many hours are dedicated to the SM practice. SM practice is driven by the available scientific and clinical evidence, and the biopsychosocial framework of each individual patient drive SM practice

Traditional non-thrust manual therapy

Traditional non-thrust manual therapy (e.g., Maitland, Mulligan, Kaltenborn) uses passive and accessory mobilizations of the spine to treat mechanical pain and stiffness on a biomechanical rationale. The qualification is achieved through some modules of few days

SM practice involves grades mobilization, with SM as last grade of a progression

Osteopathy post-graduate program

Osteopathy is based on the principle that the body has the ability to heal. In Italy, the qualification is achieved through a non-university post-graduate program with variable duration. Osteopathic SM practice focuses on correcting positional fault (namely, osteopathic lesion) to “facilitate” the normal self-regulatory processes of the body for the treatment of existing conditions and to prevent illness

Continuing professional development course on SM

A heterogenous variety of two-day SM course which includes hands-on practical training and didactic lecture instruction. The main difference between the courses is the background/rationale with which they are delivered and lecturers’ experience, ranging from evidence-based, traditional manual therapy, or osteopathy