Today's episode builds on last week's discussion of how changes in the way that the nervous system works after injury can compensate for impairments like joint instability, pain and muscle inhibition. Dr Meredith Chaput (University of Central Florida) extends the 5 phases of the visual-cognitive control chaos continuum, to link the ways to assess for cognitive compensations and how to progressively load the visual-cognitive system during sports injury rehabilitation. ------------------------------ RESOURCES From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443 The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Sports injury rehabilitation has moved well beyond simply focusing on physical function and recovery. There's various emphases on psychological responses to injury, mental readiness to return to sport, and now, the visual-cognitive components of recovery and return to sport. Today, Dr Meredith Chaput (University of Central Florida) introduces the visual-cognitive control chaos continuum as a framework for sports injury rehabilitation. Her research uses functional MRI to evaluate neuroplasticity after knee injuries, focusing on understanding how people use visual attention to compensate for motor control, and how rehabilitation may better target these compensations. ------------------------------ RESOURCES From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443 The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Dr. Jean-François Esculier, a physiotherapist and leader of the Research & Development team at The Running Clinic, shares his expertise on running and knee health. He debunks common myths about running causing knee damage, highlighting that recreational runners often have fewer issues than sedentary individuals. The discussion covers practical advice for those with osteoarthritis, emphasizing strength training and tailored techniques. Esculier also presents valuable educational resources designed to reshape public perceptions about running and joint health.

The relationship between musculoskeletal pain and mental distress is complex. Sometimes it can feel challenging to know where to start when supporting people to get their life back when they're struggling with chronic or persistent pain. Today, Dr Pavlos Bobos (Western University, Canada) shares his own story of recovery from serious musculoskeletal injury, and how that experience drives the work he does now as a researcher. He discusses the results of a network meta-analysis of digital interventions for managing musculoskeletal pain and depression. ------------------------------ RESOURCES Network meta-analysis of digital interventions: https://www.jospt.org/doi/10.2519/jospt.2024.12216

Dr Belinda Lawford from The University of Melbourne discusses the benefits of telerehabilitation for managing chronic knee pain. Topics include patient perceptions, advantages for clinicians, embracing telehealth for osteoarthritis, equity in telehealth services, and the effectiveness of telehealth in rehabilitation practice.

What are the pros and cons of using AI chatbots in musculoskeletal rehabilitation? What are chatbot applications in education, clinical practice, and research? How does the chatbot advice compare to the recommendations of trusted clinical practice guidelines? Dr Giacomo Rossettini shares the results of 2 new papers from his research team to answer these questions. This episode is about the best ways clinicians can think about using AI chatbots to advance their clinical practice, while avoiding the pitfalls. ------------------------------ RESOURCES Pros and cons of AI chatbots in musculoskeletal rehabilitation practice: https://www.jospt.org/doi/10.2519/jospt.2023.12000 ChatGPT vs. CPGs for managing lumbosacral radicular pain: https://www.jospt.org/doi/10.2519/jospt.2024.12151

Surveys of elite adult athletes reveal high use of analgesics, particularly non-steroidal anti-inflammatory drugs (NSAIDs). While medications like paracetamol have a generally low risk profile, certainly compared with NSAIDs or opioids, using pain medications to mask an injury or prevent pain might increase the risk of injury or make an existing injury worse. Julie Pedersen - physiotherapist and PhD student (University of Southern Denmark) - is studying what, how, when and why youth athletes use pain medications. Today, Julie discusses how clinicians, coaches, parents and schools can support safe use of analgesics among youth athletes. ------------------------------ RESOURCES Prospective study of Danish youth analgesic use: https://www.jospt.org/doi/10.2519/jospt.2024.12407 Prevalence, frequency, adverse events data from youth athletes: https://pubmed.ncbi.nlm.nih.gov/36100523/

Physiotherapist Rebecca Fechner, Dr Joshua Pate, and Prof. Mick Thacker discuss using AI tools like chatbots for brainstorming and problem-solving in musculoskeletal rehabilitation. They explore the benefits of AI in healthcare tasks such as note-taking, cancer detection, and imaging, emphasizing the need for critical thinking and ethical considerations when utilizing AI in clinical settings.

Welcome to a chat with a physical therapist who is using their orthopaedic and sports skills outside the typical practice environment. Dr Patricia Weber shares her experience as a senior physical therapist in the shock trauma setting–a world that blends orthopedic, neurologic and multi-trauma in a challenging emotional and psychological environment. Dr Weber is a senior physical therapist at the University of Maryland Medical Center. She primarily treats within the R. Adams Cowley Shock Trauma center in downtown Baltimore.

In today's episode, Dr Nathan Vannatta outlines some ethical frameworks that the musculoskeletal rehabilitation clinician might use when working through clinical decisions, including about return to play. Dr Vannatta outlines ethical theories and 4 approaches to bioethics. He explains how one might justify different decisions, depending on the ethical framing, illustrating the complexity of return to play decisions with the clinical example of 'Ellie', who is returning to soccer after ACL reconstruction. ------------------------------ RESOURCES More on ethics frameworks and return to sport decisions: https://www.jospt.org/doi/10.2519/jospt.2024.12310