• Bianchi M
• Rossettini G
• Cerritelli F
• Esteves JE

• Affiliation / Foundation COME Collaboration. Clinical Human-based Research Department
• Affiliation / Malta ICOM Educational
• Grounded Theory
• Low Back Pain
• Models, Biopsychosocial
• Musculoskeletal Manipulations
• Open Access Document
• Patient-Centered Care

Background: Chronic low back pain (CLBP) presents a significant challenge for manual therapists. Recent advancements in pain research have highlighted the limitations of the traditional biomedical and biopsychosocial models, prompting the exploration of alternatives. The biopsychosocial-enactive (BPS-E) model has emerged as a promising alternative. This study aims to explore the application of the BPS-E model by manual therapists in managing CLBP and to initiate a meaningful dialogue about its use.

Methods: This study adhered to the Standards for Reporting Qualitative Research. Guided by constructivist grounded theory, we conducted semi-structured interviews with ten manual therapists who are experts in the BPS-E model. Data collection, conceptualization, and analysis were systematically carried out to identify key themes and insights.

Results: The core theme identified was “The person-centred approach,” with three subthemes: “Opportunities in implementing the model”, “Utilizing and Integrating Diverse Skills for Holistic Care”, and “Challenges in implementing the model”.

Conclusion: This study provides insights into how manual therapists incorporate the BPS-E model in their practice, demonstrating its advantages over the traditional biopsychosocial model. The findings highlight the need for further research and training to effectively implement the BPS-E model in clinical settings. This research begins an essential discussion on the potential of the BPS-E model to enhance care for CLBP patients.

Author keywords: Biopsychosocial model - Biopsychosocial-enactive model - Chronic low back pain - Manual therapy - Grounded theory - Person-centred care

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