Return to Sport Clinical Decision Making in Orthopaedic and Sports Medicine Physical Therapy: A Survey of Practicing Clinicians

OBJECTIVE: To investigate whether a physical therapist’s (a) pre-licensure professional entry-level degree or certification or (b) years of clinical experience in orthopedic or sports medicine practice was associated with the accuracy of return-to-sport (RTS) decision-making when presented with cases that may require withholding unrestricted sport participation. DESIGN: Survey-based comparative observational design METHODS: Eight case studies provided synopses of musculoskeletal conditions. Each synopsis included psychometric and physical performance measures drawn from current literature. Respondents indicated whether they ‘would’ or ‘would not’ advise the athlete to return to sport. A score of 1 was assigned when a respondent’s return-to-sport decision aligned with the group consensus based on established criteria for each case; a score of 0 was given when it did not. Demographics included professional entry-level physical therapy education, years of experience, completion of post-professional education (e.g., academic doctoral degree [PhD, EdD, DSc] or residency/fellowship training) or post-professional credentials such as an American Board of Physical Therapy Specialty (ABPTS) specialist certification. Two-way ANOVA tested the effects of professional entry-level education and clinical experience on correct response rates; t-tests compared outcomes between those with advanced credentials and those without. RESULTS: Among 242 responses, the mean consensus score was 5.2/8. Professional entry-level physical therapy education, clinical experience, and their interaction showed no significant effect (p<0.05). Respondents with academic doctorates had a mean score of 5.8/8, and those with ABPTS scored 5.3/8. Respondents without additional credentials had a mean score of 4.6/8. CONCLUSION: Post-professional education, and physical therapy specialty certification were significantly associated with return-to-sport decision-making accuracy among physical therapists. Years of experience and pre-licensure professional entry-level degree or certification were not associated with decision accuracy.