Scholars@Duke
Derek James Clewley

Derek James Clewley

Assistant Professor in Orthopaedic Surgery
Orthopaedic Surgery, Physical Therapy
derek.clewley@duke.edu
311 Trent Drive, Durham, NC 27710

Selected Publications

The person-centered hypothesis framework: Advancing clinical reasoning in musculoskeletal pain management.

Journal Article Musculoskelet Sci Pract · November 2025 INTRODUCTION: The Person-Centered Hypothesis (PCH) framework is a structured clinical reasoning model designed to enhance "in action" reasoning in person-centered care (PCC). The PCH integrates elements of the biopsychosocial model, pain phenotyping, and c ... Full text Link to item Cite

Information needs for people with neck pain seeking physiotherapy neck manipulation or mobilization: an exploratory study.

Journal Article J Man Manip Ther · October 2025 OBJECTIVE: To explore the foundational needs for a decision aid on receiving physiotherapy neck manipulation and mobilization from a broad age spectrum. METHOD: An e-survey was conducted from January to 30 April 2024, targeted child/infant-parent dyads, ad ... Full text Link to item Cite

Quality of clinical practice guidelines for frozen shoulder: a systematic review.

Journal Article Physiother Theory Pract · July 2025 OBJECTIVE: Perform a systematic critical appraisal of current clinical practice guidelines (CPGs) for frozen shoulder. LITERATURE SURVEY: Systematic review of CPGs (PROSPERO number CRD42022368775). Inclusion criteria- CPGs written in English providing guid ... Full text Link to item Cite

Caution is necessary in interpreting musculoskeletal physiotherapy intervention outcomes: a methodological review of physiotherapy neuromusculoskeletal reviews.

Journal Article J Man Manip Ther · June 2025 OBJECTIVES: The physiotherapy literature lacks high-quality, registered systematic reviews (SRs) and 'trustworthy' randomized controlled trials (RCTs). It is unknown whether considering quality and 'trustworthiness' impact publication bias, heterogeneity, ... Full text Link to item Cite

Author response to Eric Saedt "Spinal mobilization in infants reconsidered".

Journal Article The Journal of manual & manipulative therapy · February 2025 Full text Cite

Manual physical therapy for neck disorders: an umbrella review.

Journal Article J Man Manip Ther · February 2025 INTRODUCTION: Neck pain is a common musculoskeletal disorder, with a prevalence rate (age-standardized) of 27.0 per 1000 in 2019. Approximately 50-85% of individuals with acute neck pain do not experience complete resolution of symptoms, experiencing chron ... Full text Link to item Cite

Evaluation of the Application of Clinical Practice Guideline Recommendations on the Classification of Patients With Neck Pain.

Journal Article HSS J · January 8, 2025 Background: Clinical practice guidelines (CPGs) are developed to synthesize evidence into recommendations for clinical practice. Minimal evidence exists on the evaluation practice of physical therapists in the treatment of patients with neck pain. Purpose: ... Full text Link to item Cite

Spinal manipulation and mobilisation among infants, children, and adolescents: an international Delphi survey of expert physiotherapists.

Journal Article J Man Manip Ther · June 2024 OBJECTIVE: The aim of this study was to establish international consensus regarding the use of spinal manipulation and mobilisation among infants, children, and adolescents among expert international physiotherapists. METHODS: Twenty-six international expe ... Full text Link to item Cite

Spinal manipulation and mobilisation in paediatrics - an international evidence-based position statement for physiotherapists.

Journal Article J Man Manip Ther · June 2024 INTRODUCTION: An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in P ... Full text Link to item Cite

Perceived factors and barriers affecting physiotherapists' decision to use spinal manipulation and mobilisation among infants, children, and adolescents: an international survey.

Journal Article J Man Manip Ther · June 2024 OBJECTIVE: To identify factors and barriers, which affect the utilisation of spinal manipulation and mobilisation among infants, children, and adolescents. METHODS: Twenty-six international expert physiotherapists in manual therapy and paediatrics were inv ... Full text Link to item Cite

Comparing dry needling or local acupuncture to various wet needling injection types for musculoskeletal pain and disability. A systematic review of randomized clinical trials.

Journal Article Disabil Rehabil · February 2024 PURPOSE: Systematically evaluate the comparative effectiveness of dry needling (DN) or local acupuncture to various types of wet needling (WN) for musculoskeletal pain disorders (MPD). METHODS: Seven databases (PubMed, PEDro, SPORTDiscus, CINAHL, Scopus, E ... Full text Link to item Cite

Is there 'trustworthy' evidence for using manual therapy to treat patients with shoulder dysfunction?: A systematic review.

Journal Article PLoS One · 2024 The primary objective of this review was to create a 'trustworthy,' living systematic review and meta-analysis for the application of manual therapy interventions in treating patients with shoulder dysfunction. Included studies were English-language random ... Full text Link to item Cite

3.3 Levels of Evidence

Chapter · January 1, 2024 Full text Cite

Improvements after dry needling for craniofacial pain in a patient with chronic rhinosinusitis: a case report.

Journal Article Physiother Theory Pract · December 2, 2023 BACKGROUND: Typically treated medically, chronic rhinosinusitis (CRS) is a prevalent condition characterized by multiple craniofacial symptoms, some of which may respond favorably to dry needling intervention. OBJECTIVE: To describe the outcomes of a patie ... Full text Link to item Cite

Effect of physical therapy timing on patient-reported outcomes for individuals with acute low back pain: A systematic review with meta analysis of randomized controlled trials.

Journal Article PM R · November 2023 OBJECTIVE: The purpose of this systematic review with meta-analysis was to investigate the effect of early physical therapy (PT) for the management of acute low back pain (LBP) on patient-reported outcomes of pain and disability, compared to delayed PT or ... Full text Link to item Cite

Feeling exhausted: How outpatient physical therapists perceive and manage job stressors.

Journal Article Musculoskeletal Care · September 2023 PURPOSE: Burnout is identified as a workplace problem rather than a worker problem. However, it remains unclear what job stressors are associated with burnout among outpatient physical therapists. Thus, the primary objective of this study was to understand ... Full text Link to item Cite

The influence of pain-related comorbidities on pain intensity and pain-related psychological distress in patients presenting with musculoskeletal pain.

Journal Article Braz J Phys Ther · 2023 BACKGROUND: Musculoskeletal pain (MSP) is the largest contributor to chronic pain and frequently occurs alongside other medical comorbidities. OBJECTIVE: Explore the relationships between the presence of pain-related comorbidities, pain intensity, and pain ... Full text Link to item Cite

Risk factors associated with physical therapist burnout: a systematic review.

Journal Article Physiotherapy · September 2022 BACKGROUND: Studies consistently suggest that work as a physical therapist is associated with burnout, yet no review of the contributing factors has been conducted. OBJECTIVE: To identify and examine the risk factors associated with physical therapist burn ... Full text Link to item Cite

Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review.

Journal Article Implement Sci Commun · June 3, 2022 BACKGROUND: Physical therapy for neck and low back pain is highly variable despite the availability of clinical practice guidelines (CPG). This review aimed to determine the impact of CPG implementation on patient-level outcomes for spinal pain. Implementa ... Full text Link to item Cite

Social determinants of health are associated with physical therapy use: a systematic review.

Journal Article Br J Sports Med · November 2021 OBJECTIVE: The purpose of this systematic review is to identify and summarise the social determinants of health (SDH) cited in the literature and evaluate their association with individuals using physical therapy services. DESIGN: A systematic review using ... Full text Link to item Cite

Youth Distance Running and Lower Extremity Injury: A Systematic Review.

Journal Article Int J Environ Res Public Health · July 15, 2021 Distance running is a popular youth sport. This systematic review identified and examined the effects of youth distance running and lower extremity musculoskeletal injury. Scientific databases were searched from database inception to May 2020. Two hundred ... Full text Link to item Cite

Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.

Journal Article J Orthop Sports Phys Ther · November 2020 OBJECTIVES: To determine the relationship between health care use and the magnitude of change in patient-reported outcomes in individuals who received treatment for subacromial pain syndrome. The secondary objective was to determine the value of care, as m ... Full text Link to item Cite

Using a behavioral model to identify factors associated with choice of provider for neck and low back pain: A systematic review.

Conference Musculoskelet Sci Pract · October 2020 BACKGROUND: It remains unclear as to what factors influence a patient's choice to seek care from a specific healthcare provider for low back and neck pain. OBJECTIVE: Utilize Andersen's Behavioral Model of Health Service Utilization as a conceptual framewo ... Full text Link to item Cite

The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature.

Journal Article Physiother Theory Pract · August 2020 To systematically determine the specific impact of therapeutic alliance (TA) on chronic musculoskeletal pain, identify factors influencing TA between physical therapists and patients with chronic musculoskeletal pain, and determine the working definition o ... Full text Link to item Cite

The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review.

Journal Article Am J Sports Med · June 2020 BACKGROUND: The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this interve ... Full text Link to item Cite

Physical therapy management of pediatric and adolescent neck pain: a call to action

Journal Article Physical Therapy Reviews · September 3, 2019 Background: Neck pain is reported to be as high as 40% in adolescents and can be a precursor to developing adult persistent neck pain. Objectives: To identify and review literature on physical therapy management of pediatric and adolescent neck pain. Metho ... Full text Cite

The Effect of Timing of Physical Therapy for Acute Low Back Pain on Health Services Utilization: A Systematic Review.

Journal Article Arch Phys Med Rehabil · July 2019 OBJECTIVE: To synthesize literature about the effect of early physical therapy (PT) for acute low back pain (LBP) on subsequent health services utilization (HSU), compared to delayed PT or usual care. DATA SOURCES: Electronic databases (MEDLINE, CINAHL, Em ... Full text Link to item Cite

Does Health Care Utilization Before Hip Arthroscopy Predict Health Care Utilization After Surgery in the US Military Health System? An Investigation Into Health-Seeking Behavior.

Journal Article J Orthop Sports Phys Ther · November 2018 BACKGROUND: The influence of prior patterns of health care utilization on future health care utilization has had minimal investigation in populations with musculoskeletal disorders. OBJECTIVES: The purpose of this study was to explore the relationship betw ... Full text Link to item Cite

Leveraging healthcare utilization to explore outcomes from musculoskeletal disorders: methodology for defining relevant variables from a health services data repository.

Journal Article BMC Med Inform Decis Mak · January 31, 2018 Featured Publication BACKGROUND: Large healthcare databases, with their ability to collect many variables from daily medical practice, greatly enable health services research. These longitudinal databases provide large cohorts and longitudinal time frames, allowing for highly ... Full text Link to item Cite

Physical therapists familiarity and beliefs about health services utilization and health seeking behaviour.

Journal Article Braz J Phys Ther · 2018 BACKGROUND: Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. OBJECTIVES: The purposes of this study were to identify physical therapists' characteri ... Full text Open Access Link to item Cite

Health seeking behavior as a predictor of healthcare utilization in a population of patients with spinal pain.

Journal Article PLoS One · 2018 BACKGROUND: The global burden of low back pain is growing rapidly, accompanied by increasing rates of associated healthcare utilization. Health seeking behavior (HSB) has been suggested as a mediator of healthcare utilization. The aims of this study were t ... Full text Link to item Cite

Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review.

Journal Article J Man Manip Ther · July 2017 Background: Shared Decision-Making (SDM) is a dynamic process by which the health care professional and the patient influence each other in making health-related choices or decisions. SDM is strongly embedded in today's health care approaches, and is advoc ... Full text Link to item Cite

Neck Pain: Revision 2017.

Journal Article J Orthop Sports Phys Ther · July 2017 The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World H ... Full text Link to item Cite

Nonsurgical Management of Midsubstance Achilles Tendinopathy.

Journal Article Clin Podiatr Med Surg · April 2017 Midsubstance Achilles tendinopathy is one of the most common lower leg conditions. Most patients can recover with nonsurgical treatment that focuses on tendon loading exercises and, when necessary, symptom modulating treatments such as topical, oral, or in ... Full text Link to item Cite

Complaints of Upper Extremity Numbness and Tingling Relieved With Dry Needling of the Teres Minor and Infraspinatus: A Case Report.

Journal Article J Orthop Sports Phys Ther · April 2017 Study Design Case report. Background Abnormal sensation, such as numbness or tingling, is traditionally thought to originate from neural compression. There is limited evidence to support reports of abnormal sensation arising from a trigger point. Case Desc ... Full text Link to item Cite

Trigger point dry needling as an adjunct treatment for a patient with adhesive capsulitis of the shoulder.

Journal Article J Orthop Sports Phys Ther · February 2014 STUDY DESIGN: Case report. BACKGROUND: Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. CASE DESCRIPTION: The patient was a 54 ... Full text Link to item Cite