Table 5 Quotes. Opportunities in implementing the Model

P1

“My patients now have more confidence that they can perform normal daily actions that used to scare them. We must not only consider the pain but also the context in which our patients live affects their condition, understood this we will see patients improve.”

P2

The patient is not surprised. Often, there’s amazement in seeing that you have a different approach from what everyone else has tried, and that’s something we, who follow this method, should value because we live in a world where everyone does the same thing.”

P3

“The strengths are clear. I believe the real strength lies in seeing the whole picture of the patient—not just the body, not just the joints, not just the tissues. […] It has definitely improved my clinical outcomes”

P4

“You need to respect the patient’s preferences. If someone strongly believes in the role of manipulation, you can probably try it. It plays a role in neurophysiological and psychosocial modulation. If someone is not comfortable talking, you must respect that as well.”

P5

“With a patient who tends to guard a lot, through a hands-on approach, I can try to help them understand what it means to relax. Moreover, I might teach techniques they can use at home. This creates a window of opportunity for them to feel freer. […] It’s a model used across many professions, leading to a common language. […] I believe it relates much better to how an individual interacts with their environment, and also how the environment can impact them. It helps me understand their contextual, social, family, and socio-economic situation.”

P6

“For example, consider an athlete who has suffered a knee ligament injury. Of course, the biological factor is crucial, but during the healing process, other aspects also become significant, as training and playing are social activities. Mood can fluctuate due to biological factors, such as endorphins. […] Ultimately, you access the person through their physical side, which can enable you to connect with other dimensions of that individual.”

P8

“The strengths lie in viewing the patient not as a body segment but as a whole, allowing us to recognize the uniqueness of each patient. This way, we can see three cases of lower back pain (LBP) behaving differently. Since I realized its importance, my patients are also more satisfied “

P9

“Over the years, I have refined my way of working. I believe I have always used this frame of reference. I’ve probably begun to not neglect biology but to re-evaluate it in my decision-making process, making it a bit less burdensome.”

P10

“I’m not saying that one is better than the other, because it’s not, but the enactive model, with the integration of the environment, could offer added value.”