Translating the Neck Pain Clinical Guidelines Into Practice: An Integrated Framework Approach
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2025-04
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<jats:p> OBJECTIVE: To evaluate the implementation of the Academy of Orthopaedic Physical Therapy Neck Pain Clinical Practice Guidelines (CPGs) in a physical therapy department and assess adherence to evidence-based recommendations. </jats:p><jats:p> DESIGN: Prospective observational cohort study. </jats:p><jats:p> METHODS: The implementation strategy was guided by integration of the Donabedian Quality of Care Model and the Knowledge to Action Framework, incorporating a needs assessment, active training modules, self-audits, and electronic health record integration. Descriptive statistics characterized providers, compliance, and treatment adherence by impairment-based category. Chi-squared tests compared provider outcomes postimplementation. </jats:p><jats:p> RESULTS: Twenty physical therapists participated comprising 67 patients for a total of 132 patient visits. The mean difference in confidence ratings across CPG components was +5.41 points (95% confidence interval: 3.79, 7.03) on the visual analog scale; however, this was not statistically significant ( P>.05). Compliance with outcome measure collection and CPG-recommended evaluation components was 92% (186/202) and 77% (213/278), respectively. Adherence to recommended interventions varied between impairment-based category, ranging from 46% to 68%. </jats:p><jats:p> CONCLUSION: While providers were generally confident in applying the Neck Pain CPG, adherence in a clinical setting was suboptimal. The study underscores the importance of evaluating barriers and facilitators, tailored strategies, and refining implementation processes to improve guideline adherence and improve outcomes. JOSPT Open 2025;3(2):99-106. Epub 3 January 2025. doi:10.2519/josptopen.2025.0101 </jats:p>
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Ramirez, Michelle M, Marissa Carvalho, Derek Clewley, Katie Pruka, Steven Z George and Maggie E Horn (2025). Translating the Neck Pain Clinical Guidelines Into Practice: An Integrated Framework Approach. JOSPT Open, 3(2). pp. 99–106. 10.2519/josptopen.2025.0101 Retrieved from https://hdl.handle.net/10161/34246.
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Steven Zachary George
Dr. George’s primary interest is research involving biopsychosocial models for the prevention and treatment of chronic musculoskeletal pain disorders. His long term goals are to 1) improve accuracy for predicting who is going to develop chronic pain; and 2) identify non-pharmacological treatment options that limit the development of chronic pain conditions. Dr. George is an active member of the American Physical Therapy Association, United States Association of the Study of Pain, and International Association for the Study of Pain.
Dr. George’s research projects have been supported by the National Institutes of Health, Department of Defense, and Orthopaedic Academy of the American Physical Therapy Association. Dr. George and his collaborators have authored over 330 peer-reviewed publications in leading medical, orthopaedic surgery, physical therapy, rehabilitation, and pain research journals. He currently serves as Editor-in-Chief for the Physical Therapy & Rehabilitation Journal. Dr. George has also been involved with clinical practice guideline development for the Academy of Orthopaedic Physical Therapy and the American Psychological Association.
Dr. George has been recognized with prestigious research awards from the American Physical Therapy Association, American Pain Society, and International Association for the Study of Pain. For example from the American Physical Therapy Association: he was named the 21st John H.P. Maley Lecturer, recognized as a Catherine Worthingham Fellow in 2017, and selected for the Marian Williams Award for Research in Physical Therapy in 2022.
Maggie Elizabeth Horn
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