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Conceptions of practice and back pain beliefs among osteopaths in the United Kingdom: a national survey using the Osteo-TAQ and ABS-mp
Journal article   Open access   Peer reviewed

Conceptions of practice and back pain beliefs among osteopaths in the United Kingdom: a national survey using the Osteo-TAQ and ABS-mp

Oliver P. Thomson, Elena Golder, Gopi Anne McLeod, Jerry Draper-Rodi, Steven Vogel and Brett Vaughan
BMC health services research, Vol.First online, pp.1-20
11/09/2026
DOI: https://doi.org/10.1186/s12913-026-15587-8
Appears in  Recent Faculty of Health Publications
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Published (Version of record) Open CC BY-NC-ND V4.0

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Abstract

Osteopathy Conceptions of practice Osteo-TAQ ABS-mp Clinical decision-making Attitude of health personnel Low back pain Health workforce Psychometrics
Background: Variation in clinicians’ approaches to musculoskeletal care may reflect broader practice orientations that shape clinical reasoning, therapeutic interaction and how care is conceptualised and delivered. The Osteopaths’ Therapeutic Approaches Questionnaire (Osteo-TAQ) was developed to measure practitioners’ conceptions of practice, yet little is known about how these relate to clinicians’ beliefs about back pain. This study aimed to describe the conceptions of practice among UK osteopaths and examine their associations with attitudes and beliefs about back pain. Methods: A national cross-sectional online survey of osteopaths registered and practising in the United Kingdom (UK) was conducted. Participants completed the Osteo-TAQ, comprising two subscales representing Professional Artistry (PA) and Technical Rationality (TR), and the Attitudes to Back Pain Scale for Musculoskeletal Practitioners (ABS-mp). Descriptive statistics were calculated for subscale scores. Internal consistency was assessed using McDonald’s omega. Associations between Osteo-TAQ and ABS-mp scores were examined using Pearson’s correlation coefficients with 95% confidence intervals. Results: Of 730 survey records generated, 701 represented eligible consenting respondents, of whom 558 provided complete Osteo-TAQ data and were included in the analysis. Participants commonly endorsed both PA (mean 3.24±0.38) and TR (mean 3.05±0.48), indicating frequent endorsement of both constructs at group level. Internal consistency was acceptable (PA ω=0.88; TR ω=0.85). The two-factor model was theoretically interpretable; however, parallel analysis supported eight factors and CFA fit indices fell outside conventional thresholds, leaving its structural validity uncertain. TR demonstrated moderate to strong positive associations with biomedical back pain beliefs (r=0.61, 95% CI 0.52 to 0.68), while PA showed smaller inverse associations (r=−0.17, 95% CI−0.25 to −0.09) and weak positive associations with psychological dimensions. Conclusions: This national study provides the first large-scale description of UK osteopaths’ conceptions of practice. Osteopathic care is characterised by an integration of relational and biomechanical approaches. Conceptions of practice are distinct from, but meaningfully associated with, clinicians’ beliefs about back pain and may help explain variation in how osteopathic care is conceptualised, reasoned through and reported. These findings have implications for workforce development, professional education, and the organisation of primary care musculoskeletal services.

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