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Table 2 Characteristics of included studies

From: Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – a mixed methods systematic review

Study (Country) Methods/Study type Study Settings Participants Outcome measure/method of analysis Main findings
Bar-Zaccay & Bailey (2018) [14]
Cross-sectional Survey Online questionnaire (National level) UK osteopaths
N = 107
M = 51
F = 56
PABS-PT (BM and BPS scores)
Descriptive and inferential statistics
UK osteopaths hold strong BM beliefs about pain, however, with an acceptance of the BPS approach
Macdonald et al., (2018) [15]
Cross-sectional Survey Online questionnaire (National level) UK osteopaths
N = 216
M = 118
F = 98
Descriptive statistics
Osteopaths have skills to engage with psychosocial factors of the patients’ pain experience. However, training is required to increase their expertise in knowledge of chronic pain and its management.
Abrosimoff & Rajendran (2020) [31](UK) Semi-structured interviews (individual) Osteopathic educational institution UK osteopaths
N = 8
M = 4
F = 4
Constructivist grounded theory Osteopaths viewed BPS model as essential in navigating a person’s experience of pain, however, the integration of the BPS model into clinical practice is fraught with obstacles.
Formica et al., (2018) [17]
In-depth semi-structured interviews (individual) Controlled interview setting Italian osteopaths
N = 11
M = 9
F = 2
Grounded theory Italian osteopaths displayed a greater orientation towards the biomedical dimension of chronic pain
Delion & Draper-Rodi (2018) [32]
Semi-structured interviews (individual) Teaching centre (university) UK Final year osteopathic students
N = 6
M = 3
F = 2
Constructivist grounded theory Osteopathic students assessed for PS factors throughout the case history and tend to rely on instincts. However, barriers exist for managing PS factors when treating patients with NSLBP.
Draper-Rodi (2016) [33]
Mixed methods Study Online e-learning program
Educational institution
Quantitative strand
N = 45
Qualitative strand
N = 9
Thematic analysis
A 6-week e-learning programme was feasible. The BPS approach was not structural enough.
  1. ABS-mp Attitudes to Back Pain Scale for musculoskeletal practitioners, BM Biomedical, BPS Bio-Psycho-Social, F Female, HC-PAIRS Health Care Providers’ Pain and Impairment Relationship Scale, M Male, N Number of participants, NSLBP Non-Specific Low Back Pain, PABS – PT Pain Attitudes and Beliefs Scale for Physiotherapists, PS Psychosocial, UK United Kingdom