Characteristics of high-performing physical therapists managing cervical and lumbar conditions: a mixed methods review.

Objective: To identify self-reported characteristics of physical therapists who consistently achieve superior outcomes in the management of cervical and lumbar conditions.

Methods: Mixed-methods study combining quantitative analysis of risk-adjusted patient-reported outcome data with qualitative surveys and structured interviews. Clinicians from Jefferson Moss-Magee Rehab were included if their Focus on Therapeutic Outcomes (FOTO) scores for cervical or lumbar patients met or exceeded risk-adjusted national benchmarks from 2021-2023. High-performing therapists were surveyed regarding demographics, clinical experience, post-professional education, and treatment approaches. A subset participated in structured interviews, and thematic analysis was used to identify common characteristics contributing to success.

Results: For the lumbar cohort, 32 therapists met criteria; for the cervical cohort, 11 met criteria. Surveys were completed by 20 lumbar and 6 cervical cohort members; 18 participated in interviews. Thematic analysis revealed four key characteristics among high performers: (1) use of evidence-informed practice, (2) commitment to lifelong learning via post-professional training, (3) strong therapeutic alliance, and (4) clinical experience with spinal conditions.

Discussion/conclusion: Effective management of cervical and lumbar conditions is linked not only to clinical expertise but also to key clinician attributes, such as ongoing professional growth and strong interpersonal skills. These findings may guide professional development and quality improvement efforts in musculoskeletal physical therapy practice.