Hello, and welcome to the monthly episode of Spinal Columns, the official newsletter of CANSpine. We're recording on Sunday, March 1, 2026. CANSpine is part of the School of Physical Therapy in the Faculty of Health Science at Western University. Today, we're bringing you three updates from the group.

First up, we're looking at a common question from patients and their families: When and how can an adolescent with scoliosis return to sports after spinal fusion? A study in PLOS One, led by Tucker and colleagues, aimed to develop an international consensus on this. Our colleague, Alison Rushton, also contributed to this work. The researchers used a multi-round Delphi study, surveying an international panel of expert surgeons and physiotherapists. The participants were asked to rate their agreement on statements about post-operative care to see where consensus could be found. The study resulted in 71 consensus statements that offer guidance on a graded return to sports, exercise, and physical activity following spinal fusion. The findings also noted that while surgeons showed consensus, there was some divergence among physiotherapists on certain points, which suggests a need for further exploration.

Shifting focus now to low back pain, a research protocol in PLOS One asks: How do patients experience advanced physiotherapy for low back pain in two different countries? This work, led by Davis and with contributions from our colleague Alison Rushton, outlines a plan for a qualitative multiple case-study. The research will compare care pathways for people with low back pain in Ontario, Canada, and England. Using questionnaires and interviews with both patients and advanced practice physiotherapists, the study will gather information on the patient experience. The plan is to then conduct a cross-case analysis to compare these experiences between the two countries.

That focus on patient experience leads directly into our final update, which addresses a related question: What makes patients satisfied with specialist physiotherapy: the person or the process? A systematic review in PLOS One, led by Davis and our own Alison Rushton, examined this. The researchers synthesized evidence from 35 different studies, combining findings from both quantitative and qualitative research to evaluate patient satisfaction. Their analysis found that both the human attributes of the physiotherapist and the system attributes of the service contribute to high patient satisfaction. Human attributes included communication skills and clinical competence, while system attributes involved fast access to care and convenient location. The review's conclusion suggests that the advanced practice physiotherapists themselves are integral to patient satisfaction, though it also notes that the certainty for the quantitative evidence is very low.

And that brings us to the end of this month's updates. We began with efforts to create an international consensus for adolescents returning to sport after spinal fusion. We then moved to a plan for a study that will compare the experiences of people with low back pain in Canada and England. Finally, we looked at a review identifying what contributes to patient satisfaction with physiotherapy. Across these reports, we see a thread that connects the creation of clinical guidelines with the understanding of a person’s journey through the healthcare system. The research discussed today suggests that a patient's experience is shaped by factors ranging from the practitioner's communication skills to the accessibility of the service itself.

Thank you for listening to Spinal Columns: Official Newsletter of CANSpine.