JOSPT Insights

Whether you work in a solo private practice, or a large health network, no doubt you're considering costs when it comes to deciding what to change and perhaps what to implement - or de-implement - in your practice. Perhaps you're in the position of making decisions on behalf of a health service or you are trying to quantify and communicate the costs and benefits of treatments you study in a research setting? Today is part 1 of a 2-part chat with Dr Codie Primeau about health economics in musculoskeletal rehabilitation, which has something for everyone working in health care. We're covering how to read a health economics analysis to decide whether the analysis can help you navigate the complex decisions you're grappling with. Dr Primeau is a physiotherapist and Assistant Professor in the School of Physical Therapy at Western University in London, Canada, and an Affiliate Scientist with Arthritis Research Canada. His research focuses on arthritis, chronic pain, and pelvic health, using a blend of qualitative and quantitative methods to improve patient care and outcomes, including health economics evaluation. ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/

Wondering about whether large language models (generative AI) like ChatGPT, Co-Pilot or Claude, to name just a few, could add value to your clinical practice? Drs Mark Vorensky and Daniel Peredo (Rutgers University; NYU Langone Health) discuss the field of 'prompt engineering' - the approach to structuring and crafting the instructions (a.k.a. prompt) given to a generative AI model, to describe the task that the AI should perform. The quality of the output from generative AI is highly dependent on how the model is prompted. So, if you're looking to get the best out of generative AI, tune in! ------------------------------ RESOURCES Improving ChatGPT's performance using the CRISPE framework: https://www.jospt.org/doi/10.2519/josptmethods.2025.0151 Neck pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2017.0302

How do you think about supporting athletes to return to running after injury? Andrew Mitchell is someone who has thought about it a lot, and refined his approach over years of practice in top football/soccer. In today's episode, Andrew outlines the 5 elements of his criteria-based approach. Andrew is a sports physiotherapist and strength & conditioning practitioner with experience working in the hospital, private practice and professional sport arenas, including in the English Premier League, the German Bundesliga and the European Champions League. ------------------------------ RESOURCES Evidence-informed return-to-running framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0115 Criteria-based return-to-performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240 On the path to perfoming after injury (ep 193): https://pod.link/1522929437/episode/NmEzODliMjAtYmIyZi00YzkwLWIwMzctNjU3NzI4NTY3ZWUz

What's the latest thinking in managing patellofemoral pain? Drs Erin Macri (Erasmus MC University Medical Centre, The Netherlands) and Harvi Hart (Michigan State University) join JOSPT Insights ahead of the International Patellofemoral Research Network meeting to share the latest in patellofemoral research, and what it means for clinical practice. ------------------------------ RESOURCES JOSPT Insights Ep 229: Best practice in managing patellofemoral pain, with Dr Brad Neal: https://pod.link/1522929437/episode/ZDBkY2Q0ZDYtMzNhZS00OWVjLWJlYTQtNTYwMzBkZTVhM2Iw Patellofemoral pain CPG: https://www.jospt.org/doi/10.2519/jospt.2019.0302 Clinical priorities for psychological factors in patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.10647 Prognosis for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2025.13491 Find out more about the International Patellofemoral Research Network's work: https://ipfrn.org/

Recurrent back pain is common, and debilitating for some people. What if there was a simple, low cost way to prevent these recurring flare ups of back pain? Dr Tash Pocovi (Macquarie University, Sydney, Australia) explains the research she's been leading to test a walking + education program for preventing recurrent back pain. Dr Pocovi's research focuses on improving how low back pain is managed, and especially how it is prevented. ------------------------------ RESOURCES Walking, cycling and swimming for nonspecific low back pain systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10612 WalkBack trial: https://pubmed.ncbi.nlm.nih.gov/38908392/ Effect of WalkBack on duration and severity of recurrences of back pain: https://www.jospt.org/doi/10.2519/jospt.2025.13361

The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is live! Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice. Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider. ------------------------------ RESOURCES Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall) ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005 Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/ TENDINopathy Severity Assessment - Achilles (TENDINS-A) outcome measure: https://www.jospt.org/doi/10.2519/jospt.2023.11964

The anterior talofibular ligament (ATFL) and the Achilles tendon captures much of our ankle attention. As JOSPT Insights listeners know, there's plenty more to the ankle than the ATFL. Today, Liz Bayley shares her approach to diagnosing, managing and ideally, preventing ankle pain in active people. Liz covers diagnosing the problem, where imaging fits, and how to support return to function, including high-level sport. Liz is a former professional dancer, who now works as a dance-specialist physiotherapist. Her clinic is in London's West End, in close proximity to the freelance professional and student dancers she works with, at Trinity Laban Conservatoire of Music and Dance, and on 'Matilda The Musical' in Covent Garden. ------------------------------ RESOURCES Lateral ankle ligament sprains clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2021.0302 Updated model of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/31162943/ Predictors of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/26912285/ Intrinsic foot muscle training systematic review: https://pubmed.ncbi.nlm.nih.gov/35724360/ Neuromuscular electrical stimulation for foot intrinsic muscles: https://pubmed.ncbi.nlm.nih.gov/35142810/

Clinicians appreciate the value of a trustworthy clinical practice guideline for helping guide decisions in practice. Professor François Desmeules (University of Montréal) led an international team of shoulder experts who synthesised the latest evidence on diagnosing and non-surgically managing rotator cuff tendinopathy. Today he shares the headlines of the CPG and explains how the guideline group made sense of all the evidence to come up with recommendations for assessment, diagnosis, treatment and prognosis, including return to sport. ------------------------------ RESOURCES Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182

Today, we continue the conversation on the latest consensus for managing acute and degenerative meniscus tears. We jump into non-surgical treatment, and all the return to sport considerations for athletes and active people with meniscus injury. Dr Arielle Giordano (University of Delaware) shares the results of the EU-US Meniscus Rehabilitation Consensus. ------------------------------ RESOURCES EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539 DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/ Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/ Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245 Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0

Clinical Practice Guidelines (CPGs) are an incredible resource for clinicians of all experience levels—synthesizing all the research on a topic and packaging it into bite-sized recommendations and flow charts. But how often are clinicians adhering to these guidelines? In today’s episode, Dr Maggie Horn (Duke University) walks us through her research team’s work to assess if, how, and when clinicians follow CPG recommendations. The team worked with clinicians in their hospital system to embed templates in the EMR, and used self-report strategies to answer these questions, specifically for the neck pain CPG. Dr Horn reviews the neck pain CPG, how the research team evaluated adherence, and what the findings mean for CPGs and clinicians. ------------------------------ RESOURCES Neck pain clinical practice guideline (revised in 2017): https://www.jospt.org/doi/10.2519/jospt.2017.0302 Translating the neck pain CPG into practice framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0101