JOSPT Insights JOSPT

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.

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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.

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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/

There's plenty of work going into how AI can make health care better - including in recording consultation notes, or making early cancer diagnoses, or opening up low cost ways of doing musculoskeletal imaging.

The technology and applications of AI in healthcare changes just about every week. Today, we're exploring generative AI as a help, not a hindrance to musculoskeletal rehabilitation practice.

Physiotherapists Rebecca Fechner (Queensland Paediatric Persistent Pain Service), Dr Josh Pate (University of Technology Sydney) and Professor Mick Thacker (Royal College of Surgeons Ireland) talk about ways to use chatbots and generative AI to generate ideas and solve clinical problems.

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RESOURCES

The Prompt Engineering Guide is a deep dive into how to craft effective prompts for generative AI: https://www.promptingguide.ai/

More on the science of active inference: https://pubmed.ncbi.nlm.nih.gov/25563935/

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.

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RESOURCES

More on ethics frameworks and return to sport decisions: https://www.jospt.org/doi/10.2519/jospt.2024.12310

Specialist shoulder physiotherapists, Marianne van Gastel and Karin Hekman, are back for the second part of their discussion on rehabilitation for peple with anterior shoulder dislocation and Bankart repair.

Marianne and Karin share how they use a psychologically-informed practice type of approach to support athletes and patients to work through and overcome anxiety and apprehension.

The chat focuses on supporting patients to return to high levels of function, including sport, after their shoulder surgery.

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RESOURCES

Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106
To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/