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