Clinical research and open knowledge work
Alejandro Zubrisky, BPT, physiotherapist at Recovery TLV (a private 1:1 clinic in Tel Aviv), maintains an open clinical knowledge project on decision-making in musculoskeletal physiotherapy — specifically, when treatment should be continued, modified, reassessed, referred or discontinued when a patient does not respond as expected.
Proposed MSK Physiotherapy Non-Response Decision Framework
An open, auditable framework that proposes how to interpret insufficient response to musculoskeletal physiotherapy — across pain, function, range of motion, strength, adherence-adjusted progress and clinical risk — rather than by persistent pain alone. It maps a small set of decisions: continue, modify, reassess, refer or discharge.
This is a proposed clinical decision framework, not a clinical practice guideline. It is published openly for transparency and discussion; it does not replace individual clinical judgement or medical evaluation. A patient-facing summary is available at when to continue, change or stop physiotherapy.
Open resources
- Source repository (open, MIT): github.com/recoverytlv/physio-decision-models
- Archived software (DOI): 10.5281/zenodo.20683788
- Author identifier: ORCID 0009-0003-1069-937X
The repository holds the clinical decision models. This page references and summarises them; it does not reproduce the full clinical content.
What this is — and what it is not
- It is: an open, traceable and citable professional/academic reference work on clinical decision-making in musculoskeletal physiotherapy.
- It is not: individual medical advice, a guarantee of outcome, or a self-diagnosis guide. Clinical decisions require individual assessment by a qualified professional.
References
The decision principles on this page draw on established clinical-practice guidelines and peer-reviewed evidence. All references verified on PubMed.
- Tuttle N. Is it reasonable to use an individual patient's progress after treatment as a guide to ongoing clinical reasoning?. Journal of Manipulative and Physiological Therapeutics 2009. PubMed · DOI
- van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, Peter WF. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care 2020. PubMed · DOI
Author: Alejandro Zubrisky, BPT — Licensed Physiotherapist (Israel Ministry of Health license 10-120163) · ORCID 0009-0003-1069-937X · Founder & Clinical Physiotherapist, Recovery TLV.
Last reviewed: 2026-06-14.
Disclaimer: This page is educational and reflects a proposed clinical decision framework. It is not a clinical practice guideline and does not replace individual clinical judgement or medical evaluation. For personal advice, consult a licensed physiotherapist or physician.
Contact Recovery TLV · Yaakov Apter 9, Tel Aviv · +972-50-717-1222