Management of musculoskeletal conditions with remotely delivered physiotherapy versus face-to-face physiotherapy: process evaluation of the REFORM trial using the Realist Evaluation and the RE-AIM Framework.

Objectives: The objectives of this process evaluation were to explain the results of the REFORM (REhabilitation FOR Musculoskeletal conditions) trial and identify potential facilitators and barriers to the future rollout of a remotely delivered physiotherapy model of care.

Setting: Outpatient physiotherapy units in five government-funded public hospitals in Sydney, Australia.

Design: This process evaluation was run alongside the REFORM trial.

Impact of a Decision Aid on Perceptions of Shared Decision-Making in the Primary Care Management of Patients With Subacromial Pain Syndrome: A Two-Phased Multi-Methods Study.

Background: Subacromial pain syndrome (SAPS) is the most common shoulder pain condition in primary care. Despite the importance of shared decision-making (SDM) being increasingly recognised, its application in SAPS care remains poorly understood. The primary aim of this study was to explore the influence of a decision aid on patient and observer perceptions of SDM, and secondarily to explore correlations between these ratings in the primary care management of patients with SAPS.

Do Italian Physiotherapists Follow Evidence-Based Guidelines When Managing Patients With Low Back Pain? A Cross-Sectional Survey.

Introduction: Guideline-recommended management of low back pain (LBP) is associated with improved patient outcomes and costs. This study aimed to assess Italian physiotherapists' attitudes towards and adherence to LBP clinical practice guidelines (CPGs).

Methods: We conducted an online cross-sectional survey of Italian physiotherapists.

The Clinical Course of Hip and Knee Osteoarthritis in Adults Attending Two Hospital Outpatient Physiotherapy Clinics in NSW: An Evaluation of the Osteoarthritis Chronic Care Program (OACCP).

Background: Osteoarthritis (OA) affects over 700,000 individuals in NSW, with projections estimating an increase to 1 million by 2030. This has led to a significant rise in joint replacement surgeries and associated healthcare costs. Despite guidelines recommending non-surgical care as first line treatment, many patients remain on surgical waiting lists without accessing these treatments.

Remotely delivered physiotherapy for musculoskeletal conditions is cost saving for the health system and patients: economic evaluation of the REFORM randomised trial.

Questions: Is remotely delivered physiotherapy cost saving when compared with usual face-to-face physiotherapy as typically provided in a public hospital outpatient setting? Is remotely delivered physiotherapy cost-effective?

Design: Economic evaluation embedded within a randomised controlled, non-inferiority trial using a health system plus patient perspective.

Participants: Patients with musculoskeletal conditions presenting to Sydney public hospitals for physiotherapy treatment.

Intervention: REFORM was a randomised controlled trial comparing remotely delivered physiotherapy with usual care provided in an outpatient setting.

Non-specific diagnostic labels for musculoskeletal conditions foster positive views about prognosis and non-invasive management but require clear explanation: a systematic review.

Questions: What are patient and public perceptions of diagnostic labels for musculoskeletal pain? How do these labels influence beliefs, emotions and treatment preferences?

Design: Systematic review and qualitative meta-synthesis.

Participants: People with musculoskeletal pain or people presented with hypothetical vignettes of musculoskeletal pain.

Intervention: Diagnostic labels for musculoskeletal pain.

Effectiveness of Choosing Wisely recommendations in reducing physiotherapists' intentions to refer for imaging and use electrotherapy for low back pain: a randomised controlled experiment.

Question: What is the effect of Choosing Wisely recommendations on physiotherapists' intentions to refer for imaging and use electrotherapy for low back pain?

Design: Three-arm parallel-group online randomised controlled trial.

Participants: Physiotherapists who treat people with low back pain.

Intervention: Participants were randomised to receive: (a) two Australian Physiotherapy Association Choosing Wisely recommendations about low back pain, (b) two versions of these recommendations based on previous research and (c) .

The smallest worthwhile effect on pain and function for rotator cuff repair surgery: a benefit-harm trade-off study.

Background: The smallest worthwhile effect (SWE) is the minimum benefit required in addition to that from a comparator for an intervention to be considered worthwhile by patients. We aimed to estimate the SWE for rotator cuff repair (with decompression and debridement) compared to either decompression and debridement alone or to non-surgical treatment for people with atraumatic shoulder pain.

Methods: Benefit-harm trade-off study.

A Codesigned Patient Decision Aid Supports the Decision Quality of Patients Considering Total Knee Arthroplasty: A Randomized Controlled Trial.

Background: The primary aim of this study was to evaluate the effectiveness of a codesigned patient-facing decision aid compared to standard care alone for patients making a high-quality, informed decision regarding the decision to undergo total knee arthroplasty (TKA).

Methods: A double-blind, randomized controlled trial was undertaken in a multisurgeon public hospital arthroplasty clinic and private clinics of orthopaedic surgeons in Australia. A total of 216 patients were randomized before seeing an orthopaedic surgeon to either receive standard care or a printed decision aid in addition to standard care.

Exploring physiotherapist's ability to identify cauda equina syndrome early.

Objectives: To explore the ability of physiotherapists in Saudi Arabia to identify cauda equina syndrome (CES) in a timely manner, and to identify the methods used by physiotherapists to manage patients with suspected CES.

Methods: This study utilized a cross-sectional research design and was conducted in the period May-October 2023. It included licensed physiotherapists working in Saudi Arabia.

The smallest worthwhile effect of surgery versus non-surgical treatments for sciatica: a benefit-harm trade-off study.

Question: What is the smallest worthwhile (SWE) effect of discectomy compared with non-surgical treatments amongst people with sciatica?

Design: Benefit-harm trade-off study.

Participants: People with sciatica of any duration living in Australia and recruited through social media.

Outcome: The outcome of interest was leg pain intensity.

Mapping the Choosing Wisely campaigns in physical therapy: Are we missing an opportunity to reduce low-value care?

Background: The Choosing Wisely campaign (CWC) aims to reduce low-value care by encouraging healthcare professionals and patients to discuss unnecessary tests and treatments. While this campaign has been adopted in various medical fields, its implementation in physical therapy is still emerging.

Objectives: To (i) identify physical therapy associations participating in the CWC and (ii) characterize the content of their recommendations.

Social Media Posts About Medical Tests With Potential for Overdiagnosis.

Importance: Social media is an influential source of medical information, but little is known about how posts discuss medical tests that carry potential for overdiagnosis or overuse.

Objective: To investigate how social media posts discuss 5 popular medical tests: full-body magnetic resonance imaging, the multicancer early detection test, and tests for antimullerian hormone, gut microbiome, and testosterone.

Design, Setting, And Participants: This cross-sectional study assessed posts on Instagram and TikTok between April 30, 2015, and January 23, 2024, that discussed full-body magnetic resonance imaging, the multicancer early detection test, and tests for antimullerian hormone, gut microbiome, and testosterone.

Development of a decision aid for Australian carers of children with cerebral palsy and their community clinicians, about selective dorsal rhizotomy surgery.

Purpose: Develop and user-test a patient decision aid about selective dorsal rhizotomy (SDR) surgery for carers of children with cerebral palsy (CP) and clinicians treating children with CP.

Method: This study utilised a mixed-methods design. Stage One developed the prototype.

Exploring the decisional needs of patients living with subacromial pain syndrome: A qualitative needs assessment study.

Background: There are a variety of different treatments for patients living with subacromial pain syndrome (SAPS). All treatments have small to moderate effect sizes, and it is challenging when healthcare practitioners and patients need to decide on which treatment options to choose. The aim of this study was to explore and understand the decisional needs of patients with SAPS, to inform and support the decision-making process.

Development of a patient decision aid for people with chronic low back pain and degenerative disc disease considering lumbar fusion: A mixed-methods study.

Objectives: To develop and user-test a patient decision aid providing evidence-based information for people with chronic low back pain (LBP) and degenerative disc disease considering lumbar fusion.

Design: Convergent parallel mixed methods study.

Setting: A prototype patient decision aid was developed, guided by the International Patient Decision Aid Standards (IPDAS) criteria, a multidisciplinary steering committee, and insights from previous studies.

Effectiveness of a physiotherapist-led triage and treatment service on WAITing time for adults with musculoskeletal pain referred to Australian public hospital physiotherapy clinics: a protocol for the WAIT-less trial.

Introduction: Musculoskeletal pain is the second leading cause of disease burden in Australia, and there is a need to investigate new models of care to cope with the increasing demand for health services. This paper describes the protocol for a randomised controlled trial investigating whether a physiotherapist-led triage and treatment service is non-inferior for improving function at 6 months and superior for reducing treatment waiting times, compared with usual care for patients with musculoskeletal pain referred to public hospital outpatient physiotherapy clinics.

Methods And Analysis: A total of 368 participants (184 per arm) will be recruited from six public hospitals located in metropolitan Sydney, Australia.

The effectiveness of education for people with shoulder pain: A systematic review.

Objectives: To investigate the effectiveness of education for people with shoulder pain.

Design: Systematic review LITERATURE SEARCH: We searched several databases (e.g.

The brief pain inventory-Interference Subscale has acceptable reliability but questionable validity in acute back and neck pain populations.

Background: The Brief Pain Inventory-Interference Subscale (BPI-IS) is a subscale of the BPI assessment tool developed to rapidly assess the impact of a person's pain on their function. It is uncertain whether it has one or two factors, and whether it has acceptable clinimetric properties in a mixed spinal pain (back and/or neck) population.

Objectives: To determine the clinimetric properties of the BPI-IS in a population with mixed spinal pain.

The Influence of "Labels" for Neck Pain on Recovery Expectations Following a Motor Vehicle Crash: An Online-Randomized Vignette-Based Experiment.

To (1) investigate whether different labels for neck pain after a motor vehicle crash (MVC) influenced recovery expectations and management beliefs, (2) explore reasons for low recovery expectations and greater likelihood for lodging a claim, and (3) explore the moderating effect of neck pain history and sociodemographic characteristics. Online randomized experiment with nested qualitative content analysis. We randomized 2229 participants from the general population (mean age: 46.

Process and implementation evaluation of a virtual hospital model of care for low back pain (Back@Home).

Objectives: Low back pain was the sixth most common reason for an ED visit in 2022-2023 in Australia, one-third of these patients were subsequently admitted to hospital. Therefore, we have assessed whether some patients could be diverted to alternate clinical pathways, via admission to a virtual hospital (rpavirtual), and be cared for remotely in their own homes.

Methods: Ethics approval was granted for protocols X21-0278 & 2021/ETH10967 and X21-0094 & 2021/ETH00591.

Do infographics 'spin' the findings of health and medical research?

Objective: To compare the prevalence of 'spin', and specific reporting strategies for spin, between infographics, abstracts and full texts of randomised controlled trials (RCTs) reporting non-significant findings in the field of health and medicine and to assess factors associated with the presence of spin.

Design: Cross-sectional observational study.

Data Source: Publications in top quintile health and medical journals from August 2018 to October 2020 (Journal Citation Reports database).

People With Acute Low Back Pain Have Concerns That May Not Be Addressed by Guideline-Recommended Advice: A Mixed-Methods Study.

To investigate what concerns people with acute low back pain (LBP) and explore whether demographic and clinical factors were associated with having concerns about LBP. Mixed-methods study. We included participants aged ≥18 years with acute LBP (LBP≤6 weeks).

Equity in Choosing Wisely and beyond: the effect of health literacy on healthcare decision-making and methods to support conversations about overuse.

Objective: To (a) examine whether the effect of the Choosing Wisely consumer questions on question-asking and shared decision-making (SDM) outcomes differs based on individuals' health literacy and (b) explore the relationship between health literacy, question-asking and other decision-making outcomes in the context of low value care.

Methods: Preplanned analysis of randomised trial data comparing: the Choosing Wisely questions, a SDM video, both interventions or control (no intervention). Randomisation was stratified by participant health literacy ('adequate' vs 'limited'), as assessed by the Newest Vital Sign.