Musculoskeletal Science and Practice最新文献

{"title":"GPs’ experience of embedded Musculoskeletal Advanced Practice Physiotherapists in Primary Care: A cross-sectional survey with content analysis","authors":"Jordan Hepburn ,&nbsp;Gordon Cameron ,&nbsp;Libby Dale ,&nbsp;Gavin Frizzell ,&nbsp;Amegad Abdelgawad ,&nbsp;Cathy Bulley ,&nbsp;Kerrie Crisp","doi":"10.1016/j.msksp.2025.103285","DOIUrl":"10.1016/j.msksp.2025.103285","url":null,"abstract":"<div><h3>Background</h3><div>General Practices across Scotland have expanded their multi-disciplinary teams (MDTs) to include non-medical allied health professionals (NMAHPs) as part of the 2018 General Medical Services Contract (GMS), including musculoskeletal (MSK) Advanced Practice Physiotherapists (APPs). MDT expansion was hoped to reduce General Practitioner (GP) workloads and release their time to care for patients with complex needs. Published research concerning GPs’ experiences of these roles is conflicting on whether they perceive this to be the case.</div></div><div><h3>Aim</h3><div>To understand GPs’ experience of MSK APPs since their integration within MDTs.</div></div><div><h3>Design and setting</h3><div>Observational study of N = 22 GPs’ from a single health and social care partnership (HSCP) within an NHS Scotland Health Board.</div></div><div><h3>Method</h3><div>Cross-sectional survey study with conceptual analysis of open free-text responses.</div></div><div><h3>Results</h3><div>The majority of GPs’ agreed that MSK APPs: impacted positively on their management of clinical caseloads and diagnostic uncertainty; improved quality of care and system flow for patients with MSK conditions; had been embedded successfully with adequate implementation support, and their role was clear.</div></div><div><h3>Conclusion</h3><div>Findings support the argument that APPs are contributing to the achievement of GMS contract aims. Further research is required to increase the pool of available studies from which evidence-based recommendations can be made to health boards. Consistency in the design and wording of future surveys would improve the level of inference that can be drawn on GPs’ experiences of MSK APP services.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103285"},"PeriodicalIF":2.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality indicators for the community care of MSK conditions: An online modified-Delphi study","authors":"A. Braybrooke ,&nbsp;R. Burgess ,&nbsp;M. Brooks ,&nbsp;A. Banerjee ,&nbsp;J.C. Hill","doi":"10.1016/j.msksp.2025.103283","DOIUrl":"10.1016/j.msksp.2025.103283","url":null,"abstract":"<div><h3>Background</h3><div>Quality indicators can be used within healthcare to measure and benchmark performance. Variations in the access and quality of healthcare for musculoskeletal conditions highlights the need for a nationally agreed set of indicators.</div></div><div><h3>Objectives</h3><div>The study's primary aim was to develop a set of care quality themes and indicators for musculoskeletal community care.</div></div><div><h3>Methods</h3><div>An online Delphi process was used, that included clinicians, managers, researchers, and patients. In round one, participants rated 79 indicators, across six care quality themes, for their importance to quality community musculoskeletal care. Following this, participants discussed the results of the first round in an online panel and then re-rated indicators in a second-round survey. The panel discussion focused on a) the importance rating of indicators, and b) the wording of care quality themes. Consensus for high importance was set at ≥60% in both rounds of the study.</div></div><div><h3>Results/findings</h3><div>Forty-six individuals participated in the first round of the study, with 21 participating in the second round. After the second round, six care quality themes emerged: 1) Optimising patient access and assessment, 2) Optimising patient education, self-management, and rehabilitation, 3) Optimising personalised care, 4) Optimising diagnosis, imaging, investigation, and referrals, 5) Optimising patient experience and outcomes, and 6) Population health relevant to musculoskeletal conditions. Within the six themes, 59 indicators were ranked as highly important.</div></div><div><h3>Conclusions</h3><div>This study has developed a set of care quality themes and indicators for community musculoskeletal care. In the next stage of indicator development, real-world data will be used to validate the indicators across several constructs.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103283"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of a qualitative visual method for diagnosing forward head posture","authors":"Shohei Shibasaki ,&nbsp;Tomonori Kishino ,&nbsp;Yoriko Sei ,&nbsp;Keiichiro Harashima ,&nbsp;Konomi Sakata ,&nbsp;Hiroaki Ohnishi ,&nbsp;Takashi Watanabe","doi":"10.1016/j.msksp.2025.103282","DOIUrl":"10.1016/j.msksp.2025.103282","url":null,"abstract":"<div><h3>Introduction</h3><div>Forward head posture (FHP) is quantitatively diagnosed by measuring the craniovertebral angle (CVA). A qualitative visual method has recently been introduced but the validity of this method has not been confirmed. The present study aimed to clarify the validity of the visual method, using CVA methods as a standard.</div></div><div><h3>Methods</h3><div>CVAs were measured photographically, adopting reported criteria of less than 53° or 55° to diagnose FHP. The visual method defined a positive FHP as the back of participant's head not touching the wall while standing with heels, buttocks and shoulder blades touching the wall. These studies were performed in healthy young adults. Rates of positive FHP were compared between methods. Positive predictive values were then calculated for FHP based on CVA methods.</div></div><div><h3>Results</h3><div>The study population comprised 37 men and 43 women (21 ± 1 years). With the visual method, 41% (33/80) had FHP. With CVA methods using criteria of 53° and 55°, 34% (27/80) and 50% (40/80) displayed FHP, respectively. However, the visual method exhibited a male predominance in the group with FHP compared to that without FHP, together with high body mass index (BMI). Positive predictive values were 0.42 and 0.61 for FHP by CVA methods using criteria of 53° and 55°, respectively.</div></div><div><h3>Conclusion</h3><div>The visual method exhibited positivity rates approximating those using CVA methods of 53° and 55°. However, the relatively low positive predictive values suggested the visual method was inferior to CVA methods, partly due to the increased positivity rate for males with high BMI.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103282"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Headache Society welcomes a physiotherapy special interest group","authors":"Kerstin Luedtke,&nbsp;Zhiqi Liang PhD, MPhty, BAppSci (Phty) FACP,&nbsp;Debora Bevilaqua-Grossi PhD, M.Sci, B.Sc (Phty),&nbsp;Gwendolen Jull AO, MPhty, PhD, FACP","doi":"10.1016/j.msksp.2025.103281","DOIUrl":"10.1016/j.msksp.2025.103281","url":null,"abstract":"","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103281"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions: A systematic review","authors":"Hugo de Amorim ,&nbsp;Marcos de Noronha ,&nbsp;Jayden Hunter ,&nbsp;Stephen Barrett ,&nbsp;Michael Kingsley","doi":"10.1016/j.msksp.2025.103279","DOIUrl":"10.1016/j.msksp.2025.103279","url":null,"abstract":"<div><h3>Background</h3><div>Exercise-based rehabilitation is the first line of treatment for people with musculoskeletal conditions. However, uptake and adherence are suboptimal, compromising the success of rehabilitation.</div></div><div><h3>Objectives</h3><div>To identify the barriers and facilitators that influence adherence to exercise-based rehabilitation in people with musculoskeletal conditions. Additionally, to identify the methods and instruments used to determine these barriers and facilitators.</div></div><div><h3>Design</h3><div>Systematic review</div></div><div><h3>Methods</h3><div>Five databases from inception to May 2024 using terms related to exercise, musculoskeletal conditions, methods, barriers and facilitators. Risk of bias was assessed using either the Newcastle-Ottawa Scale or Cochrane risk of bias tool. Using an inductive thematic approach, barriers and facilitators were grouped into intrapersonal, interpersonal and community factors. Methods/instruments were categorized into three groups, being questionnaires, interviews and focus-groups.</div></div><div><h3>Results</h3><div>Eighty-one of 8380 studies were included. The majority of studies were of good or fair quality (95%). The most frequently identified barriers were lack of time (53%), pain (45%) and health (40%). The most frequent facilitators were self-efficacy (42%), perceived health benefits (32%) and previous experiences (30%). The methods used were interviews (n = 53), questionnaires (n = 44) and focus groups (n = 10).</div></div><div><h3>Conclusion</h3><div>Most barriers and facilitators to exercise were related to intrapersonal factors. Although there is a lack of consistency in instruments used, the reported barriers and facilitators were similar across studies. Clinicians and researchers should consider intrapersonal factors when promoting exercise-based rehabilitation programs. Applying a theoretical framework to investigate barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions might assist practitioners to prioritize their practice.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103279"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous pain modulation is not different in basketball or volleyball athletes with patellar tendinopathy compared to asymptomatic athletic controls","authors":"Patrick Vallance ,&nbsp;Dawson J. Kidgell ,&nbsp;Bill Vicenzino ,&nbsp;Peter Malliaras","doi":"10.1016/j.msksp.2025.103280","DOIUrl":"10.1016/j.msksp.2025.103280","url":null,"abstract":"<div><h3>Background</h3><div>Patellar tendinopathy is highly prevalent in basketball and volleyball athletes. Despite pain being the main symptom reported, underlying mechanisms are unclear.</div></div><div><h3>Objectives</h3><div>Our primary aim was to compare endogenous pain inhibition using a conditioned pain modulation protocol in basketball and volleyball athletes with patellar tendinopathy to asymptomatic athletic controls. Our secondary aim was to compare endogenous pain facilitation using a temporal summation protocol.</div></div><div><h3>Design</h3><div>Cross-sectional case-control.</div></div><div><h3>Methods</h3><div>Twenty-six athletes and 19 asymptomatic controls participated. We calculated the difference in PPT at the patellar tendon over the most painful site (pain site), the ipsilateral tibialis anterior (regional site), and the contralateral elbow lateral epicondyle (remote site), before and after immersion of the hand (ipsilateral to pain site) in painful cold-water. PPT change was used to quantify endogenous pain inhibition. Participants rated pain on a numerical rating scale (NRS; 0 = no pain to 10 = worst pain imaginable) at five, 20, 60 and 120 s during the cold-water immersion task. Change in NRS from five to 20 s quantified temporal summation.</div></div><div><h3>Results</h3><div>Median symptom duration in our patellar tendinopathy group was 39 (IQR 22.5–55.5) months, and 85% experienced symptoms bilaterally. We did not observe alterations in endogenous pain inhibition at any site, or in temporal summation, in athletes with patellar tendinopathy compared to controls (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that altered central nervous system function is not a predominate feature contributing to pain in jumping athletes with patellar tendinopathy. Accordingly, clinicians should view pain as being of a local tissue source if targeting this symptom.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103280"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tactile acuity, left/right judgment performance, motor imagery ability, and pressure-pain threshold in patients with chronic rotator cuff-related shoulder pain: a cross-sectional case-control study","authors":"Nuray Alaca ,&nbsp;Dilek Çağrı Arslan ,&nbsp;Seda Sırlan ,&nbsp;Hacı Ahmet Yarar ,&nbsp;Onur Başcı","doi":"10.1016/j.msksp.2025.103278","DOIUrl":"10.1016/j.msksp.2025.103278","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pain can alter cortical pain representation, and tests like Two-Point Discrimination Test (TPDT), Left/Right Judgment Task (LRJT), motor imagery, and Pressure-Pain Threshold (PPT) can assess these changes. However, their applicability to all pain mechanisms is uncertain.</div></div><div><h3>Objective</h3><div>To compare the TPDT, LRJT, motor imagery ability, and PPT of chronic rotator cuff-related shoulder pain (C-RCRSP) patients with asymptomatic and pain-free controls.</div></div><div><h3>Methods</h3><div>Forty-eight C-RCRSP patients and 45 pain-free controls were assessed using a caliper for TPDT and the Recognize® application for LRJT. Motor ability, PPT, physical function, fear avoidance, pain catastrophizing, and Central Sensitization Inventory (CSI) were also evaluated. As part of the subgroup analysis, C-RCRSP patients were divided into two groups based on their CSI (≥40, n = 19; &lt;40, n = 29).</div></div><div><h3>Results</h3><div>C-RCRSP patients demonstrated higher TPDT thresholds [acromion (F = 5.41, p = 0.001) and deltoid (F = 26.67, p &lt; 0.001)] but no significant differences in LRJT performance [recognition accuracy (F = 2.47, p = 0.063) and response time (F = 0.98, p = 0.414)] than pain-free controls in both shoulder joints. C-RCRSP patients had poorer motor imagery abilities (p &lt; 0.001). The deltoid region PPT differed significantly between the groups (F = 17.45, p &lt; 0.001), but it was not significant for the tibialis anterior region (F = 1.16, p = 0.33). C-RCRSP patients with a CSI≥40 reported higher night pain, reduced shoulder range of motion, slower response times, poorer motor imagery ability, and higher scores on pain-related questionnaires compared to those with a CSI&lt;40 (p = 0.043-&lt;0.001).</div></div><div><h3>Conclusion</h3><div>C-RCRSP patients demonstrated poorer tactile acuity, mechanical sensitivity, and motor imagery ability especially in those with central sensitization, which should be considered in treatment planning.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103278"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do cervical spine angles differ in patients with hypermobility who suffer from neck pain?","authors":"Sibel Suzen Ozbayrak ,&nbsp;Mustafa Ozbayrak","doi":"10.1016/j.msksp.2025.103277","DOIUrl":"10.1016/j.msksp.2025.103277","url":null,"abstract":"<div><h3>Backround</h3><div>There has been a noted increase in the number of patients experiencing chronic neck pain who exhibit diminished cervical lordosis upon radiographic examinations. While neck overuse contributes to this trend, early identification and treatment of predisposing factors such as hypermobility can potentially mitigate this increase.</div></div><div><h3>Objective</h3><div>This study aims to explore the impact of hypermobility on cervical angles, neck disability and health quality in patients experiencing neck pain.</div></div><div><h3>Participants</h3><div>Participants aged between 20 and 40 years with neck pain persisting for more than three months were recruited. Patients were stratified based on hypermobility status. Lateral cervical radiographs were obtained to measure various cervical angles. Disability associated with neck pain and health-related quality of life were assessed. The influence of hypermobility on these parameters in neck pain patients was examined.</div></div><div><h3>Results</h3><div>Hypermobile patients with neck pain exhibited significantly lower C0-2 Cobb angle (Cohen's d: 0.60), decreased C2-7 angle measured by Jackson physiological stress lines (Cohen's d: 0.42), increased cranial tilt (Cohen's d: 0.561), and greater C2-7 sagittal vertical axis (Cohen's d: 0.36) compared to non-hypermobile patients with neck pain. No significant differences were observed in neck disability or health-related quality of life between hypermobile and non-hypermobile neck pain patients. There was a weak association between a more physiologic cervical lordosis and a lower disability scores among hypermobile patients with neck pain.</div></div><div><h3>Conclusion</h3><div>Hypermobility may lead to alterations in cervical spinal angles in young adults with neck pain. Early detection and intervention could help maintain cervical angles and prevent lordosis reduction.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103277"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IFOMPT's Educational Standards and International Monitoring: A member survey and review","authors":"Richard Ellis ,&nbsp;Irene Zeng ,&nbsp;Gwendolen Jull ,&nbsp;Renée de Ruijter ,&nbsp;Laura Finucane ,&nbsp;Rhian Lascelles ,&nbsp;Pierre Röscher ,&nbsp;Paolo Sanzo","doi":"10.1016/j.msksp.2024.103239","DOIUrl":"10.1016/j.msksp.2024.103239","url":null,"abstract":"<div><h3>Background</h3><div>The International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) membership requires accreditation of countries postgraduate musculoskeletal physiotherapy programmes to meet IFOMPT's Educational Standards through International Monitoring. The Educational Standards and International Monitoring are both being reviewed.</div></div><div><h3>Objectives</h3><div>To seek insight and feedback from IFOMPT's membership on the Educational Standards and International Monitoring to inform the current review.</div></div><div><h3>Design</h3><div>Online survey of registered members, external assessors, programme leaders, international delegates.</div></div><div><h3>Method</h3><div>IFOMPT members were invited to participate in the Educational Standards and International Monitoring survey, between December 2023–January 2024. Content validity was assessed to refine the survey. The survey was offered in 14 languages. Descriptive and inferential analyses were used for closed questions; content analysis was used for open questions.</div></div><div><h3>Results</h3><div>869 participants were eligible and completed the survey. IFOMPT's membership clearly valued both the Educational Standards and International Monitoring, and believe they are contemporary and evidence-informed. However, opinion was divided regarding the strengths and weaknesses of the Educational Standards and International Monitoring and whether the Educational Standards represented a minimum or maximum standard. Constructive recommendations were provided for the improvement of the Educational Standards and International Monitoring, including reduction of size and complexity, with increased flexibility to ensure they are fit for purpose into the future and serve towards the growth of IFOMPT.</div></div><div><h3>Conclusions</h3><div>This was the largest member-wide survey of IFOMPT examining the Educational Standards and International Monitoring. The findings of the survey are extremely valuable to inform the current review of the Educational Standards and International Monitoring, particularly given the divided opinion concerning the useability and content of the Educational Standards.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"75 ","pages":"Article 103239"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic reasoning by physiotherapists of musculoskeletal disorders: A phenomenological exploratory study","authors":"Nicholas Mullen ,&nbsp;Samantha Ashby ,&nbsp;Robin Haskins ,&nbsp;Peter Osmotherly","doi":"10.1016/j.msksp.2024.103241","DOIUrl":"10.1016/j.msksp.2024.103241","url":null,"abstract":"<div><h3>Question(s)</h3><div>What are the prognostic reasoning practices of physiotherapists towards musculoskeletal disorders?</div></div><div><h3>Design</h3><div>Exploratory phenomenological study.</div></div><div><h3>Participants</h3><div>15 physiotherapists who currently treat musculoskeletal disorders.</div></div><div><h3>Date analysis</h3><div>Semi-structured interviews were implemented to collect data which was analysed using an inductive coding and thematic analysis approach.</div></div><div><h3>Results</h3><div>Three themes were identified. First, how physiotherapists considered prognosis within clinical practice. Whilst prognosis is an important consideration, in some circumstances it either may not be considered or is implied. Second, how physiotherapists determine prognosis for musculoskeletal disorders. Several factors shaped the ability of physiotherapists to determine prognosis including how they determine prognosis, and the barriers and facilitators towards determining prognosis. Finally, how physiotherapists discuss prognosis with individuals who have a musculoskeletal disorder. These discussions were shaped by the prognostic information provided, as well as the barriers and facilitators towards discussing prognosis.</div></div><div><h3>Conclusion</h3><div>The prognostic reasoning of physiotherapists appears to be influenced initially by whether they consider it or not. It is then shaped by both barriers and facilitators towards determining and discussing prognosis. Facilitators for this prognostic reasoning process appear to be aligned with the biomedical model of health, whilst barriers more aligned with psychosocial factors. To improve prognostic reasoning, physiotherapists should continue to strive to conceptualize prognosis within a biopsychosocial framework. Doing so will improve the ability of physiotherapists to prognosticate, which will subsequently improve outcomes associated with musculoskeletal disorders.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"75 ","pages":"Article 103241"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}