Manual Therapy Behavior Scale in Physiotherapists

The aim of this study is to develop a scale to assess the manual therapy application behaviors of physiotherapists in Türkiye, based on the Theory of Planned Behavior (Ajzen, 1991). A literature-based item pool will be created, and expert opinion (Delphi method) will be obtained to ensure content validity. The final scale will be administered online to physiotherapists, and construct validity and reliability analyses will be conducted. The study aims to contribute scientifically to the determination of manual therapy application behaviors in physiotherapy practices, the understanding of clinical decision-making processes, and the measurement of behavioral intention. No risks were anticipated for the participants, and data collection was voluntary.

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Key information

Conditions

Attitude of Health Personnel

Age range

22 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Pamukkale University

Denizli, 20160, Turkey (Türkiye)

About this study

Manual therapy is an evidence-based intervention method based on manual techniques widely used by physiotherapists in the treatment of musculoskeletal disorders. However, clinicians' decisions to implement manual therapy are influenced by multidimensional factors such as personal attitudes, professional beliefs, institutional policies, educational experiences, and the culture of clinical practice. The use of behavior-based theoretical models is recommended to evaluate these factors together.

The Theory of Planned Behavior (Ajzen, 1991) is a powerful approach that explains individuals' intentions to perform a specific behavior through variables such as attitude, subjective norm, perceived behavioral control, and intention. Although this theory is frequently used to understand the clinical decision-making processes of healthcare professionals, there is no valid and reliable measurement tool in Turkey for measuring behavior toward manual therapy practices.

This study will develop a new scale adapted to Turkish culture to assess physiotherapists' manual therapy practices in a theoretically based manner. The research will consist of three phases:

Item Development Phase:

The item pool generated through the literature review will be presented to expert physiotherapists.

Expert Panel/Delphi Phase:

Experts will evaluate the items based on content validity, and items will be revised or removed based on consensus. In this phase, the Content Validity Index (CVI) and Content Validity Ratio (CVR) will be evaluated.

Statistical Analysis Phase:

The final scale will be administered online to physical therapists.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Be actively working as a physiotherapist in Turkey (public/private hospital, university hospital, private clinic, etc.)
Have received basic training in manual therapy or have clinical practice experience
Be a healthy adult aged 22 or over
Be able to read and understand Turkish (the survey language is Turkish)
Agree to participate in the study voluntarily and provide individual informed consent

Exclusion criteria

Professionals working in healthcare fields other than physiotherapy
Physiotherapists without manual therapy experience
Participants who complete the survey form incompletely, incorrectly, inconsistently, or provide duplicate entries
Individuals who refuse to provide informed consent
Individuals who withdraw their voluntary consent during the research process

Treatment and study plan

Primary outcomes

Manual Therapy Application Behavior Scale for Physiotherapists

Time frame: One-time evaluation during the data collection period

"Manual Therapy Application Behavior Scale in Physiotherapists" is a 7-point Likert-type (1 = Strongly disagree, 7 = Strongly agree) self-report scale developed based on Ajzen's Planned Behavior Theory. Higher scores reflect more positive attitudes, stronger subjective norms, higher perceived behavioral control, and higher behavioral intentions among physical therapists toward manual therapy. Construct validity will be assessed using internal consistency (Cronbach's alpha), item-total correlations, test-retest reliability, and confirmatory factor analysis.

Sponsors and collaborators

Lead sponsor

Uşak University

Other

Collaborators

Pamukkale University

Registry information

Official study title

Development of a Manual Therapy Application Behavior Scale Among Physiotherapists: A Validity and Reliability Study

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Dec 22, 2025
Registry last updated: Dec 22, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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