Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2011, Vol. 9 ›› Issue (7): 737-745.doi: 10.3736/jcim20110707

Special Issue: Massages

• Original Clinical Research • Previous Articles     Next Articles

Perception of patients,physiotherapists and traditional Chinese medicine practitioners towards manual physiotherapy and Tuina (Chinese manipulative therapy) in Australia: A qualitative research

 Edwin Yong Miao ()   

  1. M. Modern Traditional Chinese Medical Clinic, Ring wood, Victoria 3134, Australia
  • Received:2011-01-10 Accepted:2011-04-02 Online:2011-07-20 Published:2011-06-15

Objective: The aim of this study is to gain insight and understanding of the perception of Australian patients toward manual therapies. The study also tries to increase our understanding of manual techniques used by manual therapists.
Methods: This is qualitative field research emphasising the sociological perspective, to interpret health services recipients’ meanings in specific social settings. An unstructured interview is the major study design. The interview study method was conducted jointly with clinical observational techniques. A total of 30 subjects who met the selection criteria were selected. Finally 19 patient participants and 5 practitioner participants entered the study.
Results: Most participants in the research got to know physiotherapy through media and referral from general practitioners. After having gained some experience of manual physiotherapy, patients were expecting a fresh approach from Tuina (Chinese manipulative therapy). Although 94% of patient participants were satisfied with Tuina treatment, most of them could not distinguish differences in technique between Tuina and manual physiotherapy. Some patients consider Tuina as a more costly choice. Most practitioners preferred to use stronger pressure-based methods on trigger points while those who had received formal training in Tuina were in favour of much gentler techniques.
Conclusion: Manual physiotherapy is the first-line choice for many Australian patients. Tuina, as a relatively new method, is often considered as the last-resort treatment due to lack of proper private health insurance coverage. However, most patient participants preferred gentler manual methods, such as Tuina, compared with strong force-based approaches. This study stressed patients’ feelings and needs, which may have an impact on clinical outcomes. This study asserts some possible ways to enhance patient care that would include providing relevant education as part of manual therapy courses, encouraging continual development of the therapists and encouraging patient participation in the treatment process.

Key words: Tuina, physicians, traditional Chinese medicine, musculoskeletal manipulations, physical therapy, interview, sociology,medical

Figure 1

A flow chart of methods used in this qualitative study"

Figure 2

A flow chart of the progress of sorting data"

[1] Toomey S . Upwardly mobile[J]. Feel better: Medibank Private Members’ Magazine, 2001,1:22-23
[2] Palmer GR, Short SD. The health workforce. In: Palmer GR, Short SD. Health care and public policy: an Australian analysis(2nd ed)[M]. Melbourne: Macmillan Education Australia Pty Ltd, 1994: 162
[3] Twomey L, Liston CB, Coates R . The role of faculty development in physiotherapy education[J]. Aust J Physiother, 1988,34(4):199-202
doi: 10.1016/S0004-9514(14)60609-7 pmid: 25026163
[4] Gardner H, McCoppin B .Struggle for survival by health therapists, nurses and medical scientists. In: Gardner H. The politics of health: the Australian experience(2nd ed)[M]. Melbourne: Churchill Livingstone, 1995: 371-421
[5] Short SD . Physiotherapy — a feminine profession[J]. Aust J Physiother, 1986,32(4):241-243
doi: 10.1016/S0004-9514(14)60657-7 pmid: 25025222
[6] Farrell JP, Jensen GM . Manual therapy: a critical assessment of role in the profession of physical therapy[J]. Phys Ther, 1992,72(12):843-852
doi: 10.2307/1510565 pmid: 1454860
[7] Victorian Government Department of Human Services. Review of physiotherapists act 1978: discussion paper[M]. Melbourne: Victorian Government Department of Human Services, 1997: 4
[8] Australian Health Workforce Ministerial Council. Communiqué: Design of new national registration and accreditation scheme. (2009-05-08)[ 2011-2-4]. . Communiqué: Design of new national registration and accreditation scheme. (2009-05-08) [2011-2-4]. .
[9] Victorian Ministerial Advisory Committee . Traditional Chinese medicine: report on options for regulation of practitioners[M]. Melbourne: Victorian Government Department of Human Services, 1998: 26-27
[10] Bensoussan A, Myers SP . Towards a safer choice: the practice of traditional Chinese medicine in Australia[M]. Campbelltown: Faculty of Health, University of Western Sydney, 1996
[11] Chinese Medicine Registration Board of Victoria. Spinal manipulation restrictions from July 2010[J]. CMRB Newsletter, 2009,33:5
doi: 10.1111/ggr.2009.33.issue-1
[12] Zhu X, Carlton AL, Bensoussan A . Development in and challenge for traditional Chinese medicine in Australia[J]. J Altern Complement Med, 2009,15(6):685-688
doi: 10.1089/acm.2008.0325 pmid: 19500006
[13] Parsons T. The sick role and the role of the physician reconsidered. In: Parsons T. Action theory and the human condition[M]. New York: Free Press, 1978: 17-34
[14] Polgar S, Thomas SA. Qualitative field research. In: Polgar S, Thomas SA. Introduction to research in the health sciences(3rd ed)[M]. Melbourne: Churchill Livingstone, 1995: 109-124
[15] Polgar S, Thomas SA. Interview techniques and the analysis of interview data. In: Polgar S, Thomas SA. Introduction to research in the health sciences(3rd ed)[M]. Melbourne: Churchill Livingstone, 1995: 137-147
[16] Bailey KD. Observation. In: Bailey KD. Methods of social research(3rd ed)[M]. New York: Free Press, 1987: 238-271
[17] Qiu PR, Chen HP. New compilation of Chinese acupuncture and moxibustion[M]. Shanghai: Shanghai Scientific and Technical Publishers, 1992: 641-654
裘沛然, 陈汉平 . 新编中国针灸学[M]. 上海: 上海科学技术出版社, 1992: 641-654
[18] Wang YK, Liu QZ, Tang Y, Fu JR. Great collections of Chinese Tuina[M]. Shijiazhuang: Hebei Science and Technology Publishing House,1995: 368-489
王云凯, 刘庆忠, 汤毅, 傅均如 . 中华推拿大成[M]. 石家庄: 河北科学技术出版社, 1995: 368-489
[19] Cheek J, Shoebridge J, Willis E, Zadoroznyj M . Society and health: social theory for health workers[M]. Melbourne: Addison Wesley Longman, 1996: 137-147
[1] Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[2] Xue-qing Yu, Shu-guang Yang, Yang Xie, Jian-sheng Li. Traditional Chinese medicine in the treatment of idiopathic pulmonary fibrosis based on syndrome differentiation: Study protocol of exploratory trial. Journal of Integrative Medicine, 2020, 18(2): 163-168.
[3] Chang-quan Ling. Traditional Chinese medicine is a resource for drug discovery against 2019 novel coronavirus (SARS-CoV-2). Journal of Integrative Medicine, 2020, 18(2): 87-88.
[4] Wen Qiang Lee, Jeremy Teoh, Pei Zheng Kenneth Lee, Zhi Xiong Gerard Low, Xueling Sim, Foong Fong Mary Chong, Norbert Ludwig Wagner. Factors influencing communication of traditional Chinese medicine use between patients and doctors: a multisite cross-sectional study. Journal of Integrative Medicine, 2019, 17(6): 396-403.
[5] Mikhail Teppone. Medicine has always been “Modern” and “Scientific” from ancient times to the present day. Journal of Integrative Medicine, 2019, 17(4): 229-237.
[6] Charles Dalcanale Tesser, Ari Ojeda Ocampo Moré, Melissa Costa Santos, Emiliana Domingues Cunha da Silva, Fátima Terezinha Pelachini Farias, Lúcio José Botelho. Auriculotherapy in primary health care: A large-scale educational experience in Brazil. Journal of Integrative Medicine, 2019, 17(4): 302-309.
[7] Rachael Farrington, Ian F.Musgrave, Roger W.Byard. Evidence for the efficacy and safety of herbal weight loss preparations. Journal of Integrative Medicine, 2019, 17(2): 87-92.
[8] Fung-Kei Cheng. An overview of the contribution of acupuncture to thyroid disorders. Journal of Integrative Medicine, 2018, 16(6): 375-383.
[9] Chang-quan Ling, Jia Fan, Hong-sheng Lin, Feng Shen, Zhen-ye Xu, Li-zhu Lin, Shu-kui Qin, Wei-ping Zhou, Xiao-feng Zhai, Bai Li, Qing-hui Zhou, on behalf of the Chinese Integrative Therapy of Primary Liver Cancer Working Group. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. Journal of Integrative Medicine, 2018, 16(4): 236-248.
[10] Razak Mohammed Gyasi, Adjoa Afriyie Poku, Simon Boateng, Padmore Adusei Amoah, Alhassan Abdul Mumin, Jacob Obodai, Williams Agyemang-Duah. Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers. Journal of Integrative Medicine, 2017, 15(1): 44-55.
[11] Xiao Ye. Traditional Chinese medicine in the UK in the past forty years: An interview with Professor Bo-ying Ma. Journal of Integrative Medicine, 2016, 14(2): 77-83.
[12] Qing Ji, Yun-quan Luo, Wen-hai Wang, Xuan Liu, Qi Li, Shi-bing Su. Research advances in traditional Chinese medicine syndromes in cancer patients. Journal of Integrative Medicine, 2016, 14(1): 12-21.
[13] Maria Sousa Cláudia, Coimbra Daniela, Machado Jorge, J. Greten Henry. Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: A randomized controlled trial. Journal of Integrative Medicine, 2015, 13(5): 314-318.
[14] Cláudia Maria Sousa, Luis Moreira, Daniela Coimbra, Jorge Machado, Henry J. Greten. Immediate effects of Tuina techniques on working-related musculoskeletal disorder of professional orchestra musicians. Journal of Integrative Medicine, 2015, 13(4): 257-261.
[15] Bing He, Ge Zhang, Ai-ping Lu. Integrative network analysis: Bridging the gap between Western medicine and traditional Chinese medicine. Journal of Integrative Medicine, 2015, 13(3): 133-135.
Full text



[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)". Journal of Chinese Integrative Medicine, 2008, 6(1): 15-21
[3] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[4] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[5] Guo-hong Yuan, Xiao-jing Pang, He-chao Ma. Synergic effects of Danggui Buxue Decoction in reducing toxicity of cytoxan in tumor-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 83-88
[6] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. Guiding principles of clinical research on mild cognitive impairment (protocol). Journal of Chinese Integrative Medicine, 2008, 6(1): 9-14
[7] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[8] Xin-jun Wang, Ling-ling Wang . A mechanism of endogenous opioid peptides for rapid onset of acupuncture effect in treatment of depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1014-1017
[9] Bo Wang , Wei Yan , Li-hui Hou, Xiao-ke Wu. Disorder of Tiangui (kidney essence) and reproductive dysfunction in patients with polycystic ovary syndrome. Journal of Chinese Integrative Medicine, 2010, 8(11): 1018-1022
[10] Ya-hui Liang , Ping Li, Jing-xia Zhao, Xin Liu, Qi-fu Huang. Acetyl-11-keto-beta-boswellic acid and arsenic trioxide regulate the productions and activities of matrix metalloproteinases in human skin fibroblasts and human leukemia cell line THP-1. Journal of Chinese Integrative Medicine, 2010, 8(11): 1060-1069