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Abstract
Prior studies suggest manual therapy (MT) as effective in the treatment of musculoskeletal
pain; however, the mechanisms through which MT exerts its effects are not established.
In this paper we present a comprehensive model to direct future studies in MT. This
model provides visualization of potential individual mechanisms of MT that the current
literature suggests as pertinent and provides a framework for the consideration of
the potential interaction between these individual mechanisms. Specifically, this
model suggests that a mechanical force from MT initiates a cascade of neurophysiological
responses from the peripheral and central nervous system which are then responsible
for the clinical outcomes. This model provides clear direction so that future studies
may provide appropriate methodology to account for multiple potential pertinent mechanisms.