Roger M Engel

• BSc(Hons); DO; DC; PhD
• Macquarie University

Purpose Chronic obstructive pulmonary disease (COPD) is characterized by decreasing exercise capacity and deteriorating quality of life (QoL). Recent evidence indicates that combining exercise with manual therapy (MT) delivers greater improvements in exercise capacity than exercise alone in moderate COPD. The aim of this study was to investigate wh...

Scope of practice has been defined as the activities that an individual health care practitioner is allowed to undertake within a specific profession. The chiropractic profession in Australia does not currently have a documented scope of practice. Informed discussions around scope of practice are hampered by a paucity of literature in this area. Ac...

Background: Many parents seek osteopathic care for their infants with colic. Our aim was to test the effectiveness of usual light touch osteopathic treatment on crying time for infants with ‘colic’. Methods: A superiority, two arm, single blinded (parent) multi-centre (UK, Australia and Switzerland), randomised controlled trial, included healthy i...

Australian osteopaths engage in multidisciplinary care and referrals with other health professionals, including general practitioners (GPs), for musculoskeletal care. This secondary analysis compared characteristics of Australian osteopaths who refer to, and receive referrals from, GPs with osteopaths who do not refer. The analysis was undertaken t...

Scope of practice has been defined as the activities that an individual health care practitioner is allowed to undertake within a specific profession. The chiropractic profession in Australia does not currently have a documented scope of practice. Informed discussions around scope of practice are hampered by a paucity of literature in this area. Ac...

Objectives To describe if there has been a change in the reporting of adverse events associated with spinal manipulation in randomised clinical trials (RCTs) since 2016. Design A systematic literature review. Data sources Databases were searched from March 2016 to May 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro and Cochrane Library. The foll...

Background Massage therapy is a popular intervention for those suffering osteoarthritis, however, there is a paucity of evidence to support its effectiveness in osteoarthritis. A simple measure that could potentially assess the benefits of massage treatment is walking speed which is a predictor of mobility and survival length, particularly in agein...

Introduction: There is significant interest in allied health and the role it plays in health care for rural and remote populations. In Australia, osteopaths are allied health professionals who manage predominantly musculoskeletal complaints using manual therapy, exercise and patient education. Workforce distribution is a significant issue for oste...

Background Leg length inequality (LLI) greater than 20 mm has been associated with low back pain (LBP) and its correction is clinically recommended. Much less is known about the biomechanical effects that LLI below 15 mm has on pelvis orientation. Methods Twenty-two adult participants (8 female) aged between 18 and 30 years without LBP were enroll...

Background: In many countries, it is common for parents to seek osteopathic care for their infants with colic. The aim of this study was to measure the effectiveness of usual light touch osteopathic treatment on crying time for infants with ‘colic’. Methods: Between September 2019 and July 2021, a superiority, two arm, single blinded (parent) multi...

Introduction A well-functioning health system delivers quality services to all people when and where they need them. To help navigate the complex realm of patient care, it is essential that health care professions have a thorough understanding of their scope of practice. However, a lack of uniformity regarding scope of practice across the regulated...

Introduction The World Health Organization describes chiropractic as a health profession that treats the musculoskeletal system and the effects of that system on the function of the nervous system and general health. Notwithstanding such descriptions, scope of practice remains a contentious issue in Australia chiropractic with various authors defin...

Background The importance of breastfeeding and its effect on reducing the burden of disease is recognised globally. The physical aspect of successful breastfeeding is multifactorial. Requiring maternal comfort and confidence and an infant's ability to latch and maintain intra-oral sucking functions. Infants need to have sufficient function of their...

Objective The aim of this study was to assess the agreement between a web-based scoliosis screening tool and a standard screening procedure. Methods Sixty participants were selected (median age, 12 years; 75% were women) and separated into 2 groups: those with unknown spinal curvature status and those with confirmed scoliosis. Each participant was...

Chronic obstructive pulmonary disease (COPD) is responsible for an increasing number of deaths worldwide. Smoking is the most reliable predictor for developing COPD later in life. However, women make up the majority of patients with COPD who have never smoked. There is therefore a need to identify other factors that can predict COPD in women. The a...

p> Purpose: Nasal disuse and mouth breathing are associated with negative structural, functional, postural, occlusal, and behavioural changes. While there is some research to suggest that nasal breathing exercises can reduce mouth breathing, clinical protocols have not been extensively investigated. The purpose of this research was to determine the...

p> Purpose: Nasal disuse and mouth breathing are associated with negative structural, functional, postural, occlusal, and behavioural changes. While there is some research to suggest that nasal breathing exercises can reduce mouth breathing, clinical protocols have not been extensively investigated. The purpose of this research was to determine the...

An amendment to this paper has been published and can be accessed via the original article.

Background Digital health technologies are poised to revolutionise the healthcare industry by improving accessibility to services and patient outcomes. The novel coronavirus disease-19 (COVID-19) pandemic has presented unprecedented challenges for the delivery of allied healthcare and has catalysed rapid adoption of telehealth. As such, allied heal...

Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit...

Background Manual therapy is a cornerstone of chiropractic education, whereby students work towards a level of skill and expertise that is regarded as competent to work within the field of chiropractic. Due to the COVID-19 pandemic, chiropractic programs in every region around the world had to make rapid changes to the delivery of manual therapy te...

The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the number and total cost of services provided were extracted for each man...

Objective The purpose of this article is to compare D. D. Palmer's hypothesis of tone with the modern hypothesis of biotensegrity. Discussion Although researchers have been using the hypothesis of biotensegrity for over 40 years to explain the mechanics of movement within biological systems, it has experienced revived support in the last 25 years....

Background: Better understanding of the dynamics and temporal changes in manual therapy service utilisation may assist with healthcare planning and resource allocation. The objectives of this study were to quantify, describe, and compare service utilisation trends in the manual therapy professions within the Australian private healthcare setting b...

Background Infants who excessively cry, are distressed and unsettled can have a marked impact on family life. One form of support is manual therapy and osteopathic care. There is, however, limited research and debate about the effectiveness of manual therapy and osteopathic care for these infants. Aim To evaluate the effectiveness of osteopathic l...

Background The proportion of people over 65 years of age in Australia is changing at a faster rate than other age groups. As people live longer, the prevalence of chronic disease increases with a corresponding rise in the burden of disease. Musculoskeletal conditions are highly prevalent in the older age groups, and people with these conditions hav...

Background Asthma is a chronic respiratory disease that affects more than 300 million people worldwide. Refractory asthma (RA) is characterized by poor control despite adequate treatment. Conditions like RA have led to a renewed interest in non-conventional approaches to managing asthma such as those used in Traditional Persian medicine (TPM). The...

Objectives: To explore the characteristics of the Australian osteopathy workforce who participate in the management of older patients with musculoskeletal complaints. Design: Secondary analysis of a cross-sectional survey of osteopaths. Setting: The Osteopathy Research and Innovation Network (ORION), an Australian practice-based research network. M...

Background Ageing is associated with a range of anatomical and physiological changes. Establishing whether a change is part of ‘normal’ ageing or the early signs of disease will affect management strategies. Progressive stiffening of the thoracic spine, decreasing chest wall compliance and declining lung function begin as early as 40 years of age....

The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs) reported that a number of GPs still hold negative...

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD...

While spinal manipulative therapy (SMT) is recommended for the treatment of spinal disorders, concerns exist about adverse events associated with the intervention. Adequate reporting of adverse events in clinical trials would allow for more accurate estimations of incidence statistics through meta-analysis. However, it is not currently known if the...

Background: Reporting of adverse events in randomized clinical trials (RCTs) is encouraged by the authors of The Consolidated Standards of Reporting Trials (CONSORT) statement. With robust methodological design and adequate reporting, RCTs have the potential to provide useful evidence on the incidence of adverse events associated with spinal manipu...

Background and objective In chronic obstructive pulmonary disease (COPD), accessory respiratory muscles are recruited as a compensatory adaptation to changes in respiratory mechanics. This results in shortening and overactivation of these and other muscles. Manual therapy is increasingly being investigated as a way to alleviate these changes. The a...

Background While the role of complementary medicine therapies such as chiropractic and osteopathy is yet to be clearly delineated in the Australian context, demand for these services remains high. The attitudes of general practitioners towards chiropractors and osteopaths may have played a part in producing this outcome. However, this view is based...

Objective: The purpose of this study was to compare the effects of 2 different cervical manipulation techniques for mechanical neck pain (MNP). Methods: Participants with MNP of at least 1 month's duration (n = 65) were randomly allocated to 3 groups: (1) stretching (control), (2) stretching plus manually applied manipulation (MAM), and (3) stre...

Background context: Spinal manipulative therapy (SMT) is commonly used to treat spinal disorders. Although clinical practice guidelines recommend the use of SMT in the treatment of neck and back disorders, concerns exist about the nature and incidence of adverse events associated with the intervention. Comprehensive reporting of adverse events in...

Study design: Randomized clinical trial. Objective: To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). Background: The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wa...

Objectives: To evaluate the methodologic quality of the evidence for the use of spinal manipulative therapy (SMT) with and without other therapies in the management of chronic obstructive pulmonary disease (COPD). Design: A systematic review of the literature. Participants: Any participant of a primary research study that investigated the effe...

to the editor: We read with interest the article titled Limitation in tidal volume expansion partially determines the intensity of physical activity in COPD in a recent issue of the Journal of Applied Physiology ([2][1]). The authors should be commended for their study's quality and attention to

Rates of imaging for low-back pain are high and are associated with increased health care costs and radiation exposure as well as potentially poorer patient outcomes. We conducted a systematic review to investigate the effectiveness of interventions aimed at reducing the use of imaging for low-back pain. We searched MEDLINE, Embase, CINAHL and the...

Chiropractors, physiotherapists, and osteopaths receive training in the diagnosis and management of musculoskeletal conditions. As a result there is considerable overlap in the types of conditions that are encountered clinically by these practitioners. In Australia, the majority of benefits paid for these services come from the private sector. The...

The purpose of this preliminary study was to demonstrate the feasibility of a study that measures the short-term effects of a course of manual therapy (MT) and exercise (Ex) in people with moderate chronic obstructive pulmonary disease (COPD). Fifteen participants (9 males; mean age, 56.1 years), with moderate COPD (mean % predicted forced expirato...

Beach drowning in low- and middle-income countries (LMICs) such as the western African nation of Ghana, is a poorly understood problem. A physical site assessment of the Ghana coast was undertaken to determine beach types, hazards, and the potential for implementing community surf education and lifeguarding services. A questionnaire survey was admi...

The objective of this case series is to report the results of spinal manipulative therapy (SMT) for people with chronic obstructive pulmonary disease (COPD) who were older than 65 years. The study design was a prospective case series. Six patients of a long-term care center who were older than 65 years and having COPD underwent a course of 12 SMT s...

A number of predisposing factors are recognised as increasing the risk of developing chronic pulmonary obstructive disease (COPD). There is increasing recognition that COPD may be an inflammatory disease with systemic consequences. However, the trigger for the transition from 'at risk' (stage 0) to COPD state remains unclear. The current approach t...

The objective of this study was to explore the effect of combining manual therapy with exercise on respiratory function in normal individuals. The study design was a randomized control trial. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured in 20 healthy, nonsmoking individuals before and after 3 int...