Implications for future research
There has been a shift in clinical practice guideline recommendations for musculoskeletal conditions over the last few decades away from recommendations for medicines and surgery and instead toward physical and psychological management. This shift has and will likely continue to result in more people with musculoskeletal conditions seeking treatment from physical therapists. It is thus important to consider strategies that can guide physical therapists away from providing low-value care. Our study highlights that refining the original Choosing Wisely recommendations - by providing more detail, using positive framing where possible, and providing alternatives to low-value care – is an important step towards increasing adoption of these recommendations among physical therapists, and more broadly future studies could explore how this simple, low-cost strategy could support the adoption of recommendations.