Decision Support Tools

Why Patients Rapidly Change After Initiating Treatment: What We Think We Know and What We Likely Don’t
By: Chad Cook, PT, PhD, FAPTA Background: The completion of our SS‑MECH trial [1] in the fall of 2025 marked the 20th clinical trial for…
Risk Stratification versus Risk Adjustment: Both are Important but They are Not the Same Thing
By: Chad E Cook, PT, PhD, FAPTA Background: In 2011, I was part of a team of researchers who looked at very large datasets and…
What Really Happens When We Use Manual Therapy? A Fresh Look at the Mechanisms Behind Hands-On Approaches
Authors: Damian Keter DPT, PhD, Chad Cook PT, PhD, FAPTA Manual therapy (MT) has been part of musculoskeletal care for centuries, yet one question continues…
When the Numbers Don’t Move: Understanding Ceiling Effects, Floor Effects, and Limited Score Spread in MSK Patient‑Reported Outcomes
By: Chad Cook PT, PhD, FAPTA Introduction: I recently responded to a very supportive post on Linked-In that discussed a study we published two years…
Why Individualized Treatment Effects Matter More Than Averages in Musculoskeletal Care
By: Chad Cook PT, PhD, FAPTA Introduction: Imagine being able to say: “Based on your profile, you’re likely to respond better to graded activity than…
Spinal Manipulation: Lack of Precision Doesn’t Mean Lack of Skill
By: Mark Shepherd, PT, DPT, DSc Spinal thrust manipulation has been used for centuries, with evidence supporting its inclusion in neck and low back guidelines.1,2…