Artificial Intelligence (AI) Chatbots (e.g., ChatGPT, Microsoft Bing, and Google Bard) can emulate human interaction and may support physiotherapy education. Despite growing interest, physiotherapy students’ perspectives remain unexplored. This study investigated Italian physiotherapy students’ knowledge, use, and perception of the benefits and limitations of AI Chatbots. A cross-sectional study was conducted through Survey Monkey from February to June 2024. One thousand five hundred and thirty-one physiotherapy students from 10 universities were involved. The survey consisted of 23 questions investigating: (a) respondent characteristics, (b) AI Chatbot knowledge and use, (c) perceived benefits, and (d) limitations. Multiple-choice and Likert-scale-based questions were adopted. Factors associated with knowledge, use, and perceptions of AI were explored using logistic regression models. Of 589 students (38%) that completed the survey, most were male (n = 317; 53.8%) with a mean age of 22 years (SD = 3.88). Nearly all (n = 561; 95.3%) had heard of AI Chatbots, but 53.7% (n = 316) never used these tools for academic purposes. Among users, learning support was the most common purpose (n = 187; 31.8%), while only 9.9% (n = 58) declared Chatbot use during internships. Students agreed that Chatbots have limitations in performing complex tasks and may generate inaccurate results (median = 3 out of 4). However, they neither agreed nor disagreed about Chatbots’ impact on academic performance, emotional intelligence, bias, and fairness (median = 2 out of 4). The students agreed to identify the risk of misinformation as a primary barrier (median = 3 out of 4). In contrast, they neither agreed nor disagreed on content validity, plagiarism, privacy, and impacts on critical thinking and creativity (median = 2 out of 4). Young students had 11% more odds of being familiar with Chatbots than older students (OR = 0.89; 95%CI 0.84–0.95; p = < 0.01), whereas female students had 39% lesser odds than males to have used Chatbots for academic purposes (OR = 0.61; 95%CI 0.44–0.85; p = < 0.01). While most students recognize the potential of AI Chatbots, they express caution about their use in academia. Targeted training for students and faculty, supported by institutional and national guidelines, could guarantee a responsible integration of these technologies into physiotherapy education. Not applicable.

Neck pain is one of the most common musculoskeletal disorders in clinical practice. However neck pain may mask more serious pathology. Although uncommon in most musculoskeletal physiotherapy practices, it is possible to encounter rare and extremely life-threatening conditions, such as craniovertebral congenital anomalies. Basilar invagination is an abnormality where the odontoid peg projects above the foramen magnum and is the commonest malformation of the craniocervical junction. Its prevalence in the general population is estimated to be 1 %. Furthermore, it is a well-recognised cause of neck pain insomuch as it can be easily overlooked and mistaken for a musculoskeletal disorder. Diagnosis is based on the patient’s symptoms in conjunction with magnetic resonance imaging (MRI). If life-threatening symptoms, or pressure on the spinal cord are present, the recommended treatment is typically surgical correction. This case report describes the history, relevant examination findings, and clinical reasoning used for a 37 year old male who had the chief complaint of neck pain and occipital headache. After the history and the physical examination, there were several key indicators in the patient’s presentation that appeared to warrant further investigation with diagnostic imaging: (1) the drop attack after a triggering event (i.e., heading a football), (2) several episodes of facial numbness immediately and shortly after the trauma, (3) the poorly defined muscle upper extremity muscle weakness, and (4) the modification of symptoms during the modified Sharp-Purser test. Therefore, the decision was made to contact the referring neurosurgeon to discuss the patient’s history and his physical examination. The physician requested immediate cervical spine MRI, which revealed a “basilar impression”. This case report highlights the need for more research into a number of issues surrounding the prevalence, diagnosis, and the central role of primary care clinicians such as physiotherapists. Furthermore it underlines the importance of including Basilar invagination in the differential diagnosis. Physiotherapists working within a direct access environment must take a comprehensive history and be capable of screening for non-musculoskeletal medical conditions (on a systems, not diagnosis level) in order to avoid providing potentially harmful musculoskeletal treatments (e.g., cervical mobilization or manipulation, stretching, exercise) to patients with sinister medical pathologies, not benign musculoskeletal disorders.

A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = −1.23; 95% IC −1.73, −0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains.

This systematic review with meta-analysis aimed to assess the effectiveness of electrophysical agents in improving pain, function, disability, range of motion, quality of life, perceived stiffness, and time to recovery in subjects with frozen shoulder (FS). A thorough search of MEDLINE, Cochrane Library, PEDro, and EMBASE yielded 1143 articles, of which 23 randomized controlled trials were included. Risk of bias (RoB) was assessed through Cochrane Risk of Bias 2 tool. The certainty of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The analysis included a total of 1073 subjects. None of the studies were judged as low RoB. Potentially clinically significant differences were observed in pain at 6 weeks and 5 months after extracorporeal shockwave therapy (ESWT), and in disability up to 3 months with laser therapy, albeit with uncertain results due to the high RoB and to the study heterogeneity. Ultrasound (US) therapy did not yield significant differences in any outcomes. The certainty of evidence was very low. Based on the high heterogeneity and low quality and certainty of evidence, ESWT, laser, and US cannot be recommended for FS treatment. Caution should be exercised in interpreting the findings.