EVALUATION OF PHYSIOTHERAPY-BASED RECOVERY PROTOCOLS FOR SPORTS-ASSOCIATED MUSCULOSKELETAL INJURIES

Abstract

Background: Sports-related musculoskeletal injuries are prevalent and costly; however, variability in physiotherapy recovery protocols limits evidence-based practice. Objective: To evaluate the effectiveness of physiotherapy-based recovery protocols on return-to-sport (RTS) outcomes and reinjury risk in athletes. Methods: In a multicenter prospective cohort study, 240 athletes with acute/subacute injuries were assigned to Criterion-Based (n = 82), Time-Based (n = 79), or Technology-Integrated (n = 79) protocols. Primary outcomes were time to RTS and 12-month reinjury. Mixed-effects modeling, Cox regression, and thematic analysis were applied. Results: Technology-Integrated and Criterion-Based protocols achieved faster RTS (10.1 and 11.3 weeks) than Time-Based (14.8 weeks; p < .001), with lower reinjury rates (8.9% and 11.0% vs. 22.8%; p = .013). Higher baseline function, psychological readiness, and adherence predicted better outcomes. Qualitative data supported clear milestones and integrated support. Conclusion: Criterion-based, technology-enhanced, and biopsychosocially informed physiotherapy protocols optimize RTS efficiency and reduce reinjury. Standardized, adaptable frameworks are recommended for clinical implementation.