{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:57:04Z","timestamp":1791223024281,"version":"4.1.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In 2004, the Universit\u00e9 libre de Bruxelles (ULB, Belgium) launched Europe\u2019s first comprehensive university\u2011based osteopathy program, a six\u2011year curriculum intended to set an international standard for training osteopaths in the primary care management of functional musculoskeletal pain and disorders. This study describes the socio\u2011professional profile of ULB\u2011trained osteopaths in Belgium by graduation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All contactable ULB graduates (n\u2009=\u2009277; 83.9%) were invited to complete a voluntary, online cross\u2011sectional survey (49 items) disseminated via cohort\u2011personalized institutional emails between February and April 2024. Descriptive statistics were produced, and associations with time since graduation were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 156 graduates responded (56.3%), of whom 148 (94.9%) reported currently practicing as osteopaths. Respondents were predominantly female (60.9%) and aged 25\u201334 years (77.5%). Most practiced in French\u2011speaking Belgium (75.5%), while 17.6% worked abroad. The majority were full\u2011time self\u2011employed (92.6%), working in private offices (66.7%) and in multidisciplinary settings (68.6%), including private (53.2%) and public (15.4%) institutions. With increasing time since graduation, the number of concurrent workplaces decreased (p\u2009&lt;\u20090.01), whereas financial independence (p\u2009&lt;\u20090.01) and perceived professional achievement (p\u2009&lt;\u20090.001) increased. Most osteopaths reported meeting their objectives within five years of practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first socio\u2011professional profile of university\u2011trained osteopaths in Belgium details where graduates practice and how career trajectories evolve across graduation cohorts. While the ULB program fosters integration of osteopaths in multidisciplinary teams, the absence of equivalent university education in the Dutch-speaking regions leads to important regional disparities. These findings may inform stakeholders and policy makers considering future regulation of osteopathic practice in Belgium and other countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0359658","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:36:02Z","timestamp":1791221762000},"page":"e0359658","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Twenty years of university-graduated osteopaths in Belgium: A cross-sectional survey"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-2444","authenticated-orcid":true,"given":"David","family":"Zarka","sequence":"first","affiliation":[{"name":"Universit\u00e9 libre de Bruxelles (ULB)","place":["Brussels, Belgium"],"department":["Osteopathic Sciences Research Unit (URSO), Faculty of Human Movement Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Denaeyer","sequence":"additional","affiliation":[{"name":"Universit\u00e9 libre de Bruxelles (ULB)","place":["Brussels, Belgium"],"department":["Osteopathic Sciences Research Unit (URSO), Faculty of Human Movement Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludivine","family":"Lahaeye","sequence":"additional","affiliation":[{"name":"Universit\u00e9 libre de Bruxelles (ULB)","place":["Brussels, Belgium"],"department":["Osteopathic Sciences Research Unit (URSO), Faculty of Human Movement Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Salem","sequence":"additional","affiliation":[{"name":"Universit\u00e9 libre de Bruxelles (ULB)","place":["Brussels, Belgium"],"department":["Osteopathic Sciences Research Unit (URSO), Faculty of Human Movement Sciences"]},{"name":"Haute Ecole Bruxelles \u2013 Brabant","place":["Bruxelles, Belgium"],"department":["D\u00e9partement des Sciences de la Motricit\u00e9"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Bengoetxea","sequence":"additional","affiliation":[{"name":"Universit\u00e9 libre de Bruxelles (ULB)","place":["Brussels, Belgium"],"department":["Osteopathic Sciences Research Unit (URSO), Faculty of Human Movement Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"pone.0359658.ref001","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12998-016-0087-x","article-title":"Understanding clinical reasoning in osteopathy: A qualitative research approach","volume":"24","author":"S Grace","year":"2016","journal-title":"Chiropr Man Therap"},{"key":"pone.0359658.ref002","doi-asserted-by":"crossref","first-page":"102616","DOI":"10.1016\/j.ctim.2020.102616","article-title":"Effectiveness of osteopathic interventions in chronic non-specific low back pain: A systematic review and meta-analysis","volume":"56","author":"F Dal Farra","year":"2021","journal-title":"Complement Ther Med"},{"key":"pone.0359658.ref003","doi-asserted-by":"crossref","first-page":"101655","DOI":"10.1016\/j.ctcp.2022.101655","article-title":"Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis","volume":"49","author":"F Dal Farra","year":"2022","journal-title":"Complement Ther Clin Pract"},{"issue":"17","key":"pone.0359658.ref004","first-page":"2442","article-title":"Effectiveness of osteopathic manipulative treatment in adults with irritable bowel syndrome: A systematic review and meta-analysis","volume":"11","author":"F Buffone","year":"2023","journal-title":"Healthcare (Basel, Switzerland)"},{"key":"pone.0359658.ref005","unstructured":"OIA. 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