From Lab to Life: A Global, Person-Centered Approach to Musculoskeletal Care����Federico Moscogiuri�IFMRS��UTA College of Nursing and Health Innovation�CLINICAL TRANSLATIONAL RESEARCH FORUM �3 December 2025��

www.ifmrs.org

@IFMRSGlobal

Overview

• Musculoskeletal (MSK) conditions: the big picture
• The IFMRS: a genuinely collaborative forum
• Key areas of work, and key initiatives
• Successful coalition building: a practical case study
• Looking ahead, and what you can do

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Musculoskeletal (MSK) conditions: the big picture

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Why “MSK”?

• Extremely broad and varied, encompassing eg osteoporosis, OA, RA, back pain, spondyloarthropathies, rare diseases
• BUT there are some key commonalities → We need an approach which is person-centred, holistic and systemic

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• A person-centred approach requires us to understand how diseases and medical conditions affect people in practice, including their quality of life.
• A holistic approach requires us to adopt a biopsychosocial perspective and understand comorbidities, including around mental health.
• A systemic approach requires us to understand how different parts of the body actually work together as a system
• Commonalities of experience: pain, mobility,
• Scientific commonalities: inflammation

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Why collaborate?

Musculoskeletal conditions��The Problem

• Common conditions affecting most people at some time
• Affect all ages but increase with aging
• Cause pain and physical limitations
• Prevent people doing their everyday tasks
• Often long term problems
• Effective ways of preventing and treating them
• Most healthcare providers have very limited understanding of them
• As a result, MSK conditions, and MSK research and practice, continue to be universally under-recognised and under-prioritised.
• …Leading to a large and growing burden of disability that could be prevented

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Musculoskeletal conditions greatest cause of disability

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Years Lived with Disability (YLDs) %: global by cause, 2019�

Mental 18.4%

MSK 18.5%

Back pain greatest cause of YLDs (7.41%)

Mental 14.59%

MSK 17.11%

Musculoskeletal conditions are the greatest cause of disability worldwide and 1^st or 2^nd in high, middle and low income countries

MSK health declines over the life course�

Intrinsic capacity and functional ability are lost with ageing

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Musculoskeletal conditions typically characterized by pain (often persistent) and limitations in mobility and dexterity, reducing people’s ability to work and participate in society (WHO).

Other MSC’s

Low back pain

OA

RA

Gout

Neck pain

+ fragility fractures

The impact � – the human and financial consequences

Person

Caregivers

Health care system

National economy

Lower quality of life

(pain, restriction of activities)

Caregiver time

Health care costs

Work disability

Social support

Why does it matter to policy makers?��Health challenges in 2025 and beyond

• Increased longevity resulting in ageing populations
• Unhealthy lifestyles
• Obesity
• Physical inactivity
• Accumulating multimorbidities
• Inequality in access to health care

→ Living longer, but not healthier

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• Economic climate
• Need to control health and social care costs
• Need to extend working lives

The challenge for the MSK community

• There is insufficient interdisciplinary collaboration within the field of MSK practice and research.

→ Shared vision. Common ground

→ Why do we do what we do?

• Treating the disease (or the bone) but not the patient
• We do not have a shared understanding or narrative around MSK
• Lack of understanding of the holistic nature of MSK conditions
• Assumptions around MSK conditions as an inevitable part of ageing
• Need to effect change throughout national health systems

→ How do we ensure equity of care and access to advances being made in prevention, treatment and rehabilitation of MSK conditions?

→ How do we enable people to do what they need and want to do at all ages without being limited by pain at all stages of life?

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The solution

• Collaborative, interdisciplinary working across research & clinical practice; across disciplines; with the patient voice
• A clear, compelling narrative supported by strong evidence – of unmet need, and of the benefits to healthcare systems and economies (not just healthcare economies) of investing in MSK
• A preventive approach to reduce the burden of avoidable disability
• Understand the personal impact of
• Physical aspects of MSK
• Biopsychosocial aspects of MSK
• Understand relationships, and how these different elements interact as part of a system – hence “MSK”
• A sense of urgency

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Personal impact: the physiology of MSK disease

• How do bone cells works?
• How do bone and muscle work together? …And joints and ligaments?
• How does the immune system interact with the musculoskeletal system?
• How does nutrition impact on the musculoskeletal system?
• What is the impact of comorbidities?
• What kind of things do healthcare professionals need to look out for?
• How can we stimulate beneficial mechanisms and prevent, or mitigate the impact of, detrimental ones?
• What actually improves people’s health and quality of life?

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→ MSK research, basic and clinical

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Personal impact: the biopsychosocial �aspect of MSK conditions

• How do MSK conditions impact on people’s lives?
• Mobility, pain
• What is the relationship between physical MSK health and mental health?
• How do social factors affect MSK health?
• Which non-medical interventions could be effective?
• Social prescribing
• What do people with MSK conditions need?
• Best possible pharmacological treatments
• Best possible care, that meets their needs and preferences.
• The care I need and no less, the care I want and no more
• Integrated, holistic care through shared decision-making
• The right care in the right place at the right time
• No decision about me, without me
• Information and support to self-manage

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→ The patient experience, and voice. “No decision about me, without me”

Duque et al., JNHA 2021

Osteosarcopenia: A vicious cycle

Osteosarcopenia: joint risk factors and clinical outcomes

Kirk et al. J Cachexia, Sarcopenia and Muscle, 2021

Franulic et al., Mech Ageing Dev. 2024

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The IFMRS: a genuinely collaborative forum

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The IFMRS

The IFMRS is a global, non-profit federation of musculoskeletal (MSK) research societies, covering all forms of MSK conditions, from common to rare conditions, and all aspects of research, from basic to clinical.

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Our Purpose is to promote excellence in the field of musculoskeletal science, in order to improve the prevention and treatment of all musculoskeletal conditions worldwide.

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Our Values: 

• Scientific excellence and rigor
• Diversity, equity and inclusivity
• Global collaboration
• Transparency

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Bringing together:

• All parts of the MSK community
• All parts of research and practice
• All parts of the world

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• At the same time

The solution: “macro” (policy) level

• Changing the narrative
• Global, regional and national actions plans, implemented locally
• A multidisciplinary approach, with person-centred pathways and models of care (and SDM, self-mgmt….)
• Promoting collaboration, overcoming fragmentation
• Prevention - primary, secondary and tertiary – and early intervention
• Reducing avoidable disability: keeping people active for longer
• Not just treating MSK diseases, but promoting MSK health

The solution: What can we do?

Knowledge

→ Advance knowledge

→ “Pool” knowledge

→ Make knowledge accessible

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Network

→ Talk to each other

→ Identify, promote and disseminate good practice

→ Encourage innovation

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Influence

→ Make common cause with those who share our goals

→ Seek creative solutions

→ Speak with one voice

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Priorities

• Actively influence at WHO level with partner organisations
• Deepen and extend our educational offer and grow our international network particularly in low- and middle-income countries (LMICs)
• Global Action Plan implementation
• Joint webinars
• Mentoring network
• Coordinate activities aimed at supporting early and mid-career researchers
• Continue to grow and diversify our membership and partners, and strengthen collaboration between key groups in MSK
• Continue to develop and expand our online resources

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Key areas of work, and key initiatives

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1. What are we doing about Influencing?

• WHO: osteoporosis survey, MoU, healthy ageing and rehabilitation
• Rehabilitation 2030
• Virtual World Summit

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• We must have a common understanding and a common narrative of the basics, such as what are MSK conditions and what we want.

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• Providing the evidence of the burden, what can be achieved and the need for change

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Universal health coverage and integrated, people-centered health services

• Universal health care requires a shift from health systems designed around diseases and health institutions towards health systems designed for people.
• Integrated person-centred care systems can generate significant benefits to the health and health care of all people.
• Person-centred care 
• prioritizes the individual's needs, preferences, and values in all aspects of their care. 
• involves actively engaging individuals in their own care plan, �ensuring they have a voice and are treated with respect and �dignity. 
• aims to empower individuals and improve their overall �well-being by tailoring care to their specific circumstances. 

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A Global Framework for MSK Health

http://www.gmusc.com/global-strategy-to-improve-musculoskeletal-health/

• The World Rehabilitation Alliance (WRA) is a WHO global network of stakeholders whose mission is to support the implementation of the Rehabilitation 2030 Initiative through advocacy activities. It focuses on promoting rehabilitation as an essential health service that is integral to Universal Health Coverage and to the realization of Sustainable Development Goal 3 Ensure healthy lives and promote well-being for all at all ages. 

WHO Package of Interventions for Rehabilitation

2. What are we doing about Knowledge?

• Resources: MSK KP, Virtual Library, HubLE “legacy”
• Webinars: FGL, ISS, ORS, XLH…
• Joint sessions at member conferences
• Speaking at member conferences
• Fleisch Workshops
• NEW:
• Rare MSK Diseases Education Portal
• Online journal abstract initiative

www.mskkp.org

Imaging Beyond Intent: Advancing Diagnostics�with Opportunistic Imaging

Register Today!

Wednesday, June 11, 2025

2:00-3:00 pm U.S. ET

Robert Boutin, MD

Stanford University

Implementation

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Miriam A. Bredella, MD, MBA

NYU Langone Health & Grossman School of Medicine

Vascular Calcification

Angela M. Cheung, MD, PhD, FRCPC

University of Toronto

Bone

John Shepard, PhD

University of Hawaii

Body Composition

Speakers

3. What are we doing about Networks?

• Improving the reach, quality and user experience of digital comms
• Graphical displays
• More proactive and targeted content
• Virtual Roundtables on Education in MSK Research
• Global Action Plan on Education in MSK Research
• Active engagement of MSK professionals in LMICs
• Online space for collaboration and information-sharing
• NEW:
• IFMRS Ambassadors
• IFMRS Networks

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Annual Roundtables on Education in �MSK Research

• Virtual 3-hour workshops open to the entire global musculoskeletal community, including researchers, HCPs and academics, with a focus on low- and middle-income countries (LMICs). 
• An opportunity to engage in dialogue, share examples of good practice, and collaboratively address challenges in MSK education. 
• 5 roundtables since 2021, with up to 60 participants from up to 34 countries
• Multilateral, interdisciplinary dialogue
• An “eye-opener”

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Summary

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• A framework for tackling the biggest challenges regarding education, knowledge-sharing and collaborative working for MSK research
• A shared vision around interdisciplinary research and “equitable knowledge ecosystems”
• Key recommendations for all parts of our global community
• The culmination of many rounds of discussion with a very broad range of stakeholders from across the world
• A “living document,” co-produced by global stakeholders
• Focus on where the need is greatest, esp LMICs

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www.ifmrs.org

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Context

• Large disparities in resources, infrastructure and access to knowledge across the global MSK community, and a continuing divide between professions and information channels. This impairs the effective sharing and application of knowledge to the clinical management of MSK conditions.
• We need to foster a “culture of research” nationally and internationally based on high-quality education, including both formal and informal training, to improve clinical management and outcomes in MSK conditions.
• The plan aims to provide a blueprint for action and to be a catalyst for a more collaborative way of working.

Global Action Plan Key sections

1. Achieving the vision: key elements of success
1. Two sets of goals: a) the international and national government levels, and b) the national and local level.

2. Achieving the vision: practical solutions for MSK research

• Specific recommendations for action. Two sets of actions, by key groups: a) national MSK organizations and institutions, and b) MSK professionals.

3. Practical resources

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2.2 MSK professionals should:

• 1 Join existing local and national MSK research societies and organizations
• 2 Participate in international fora and make active use of digital knowledge platforms, particularly the IFMRS Knowledge Network: www.ifmrs.org/#knowledge-network,
• 3 Use and share local data, evidence and examples of best practice to help develop the international body of knowledge
• 4 Make connections locally and nationally with other key professionals, and create local MSK networks where possible
• 5 Be ambassadors for this action plan and the initiatives and resources developed by the MSK community

Joint webinars: �Orthopaedic Research Society

• Evolved out of the roundtable workshops
• Hosted by Dr. Albert Macha, surgeon at Muhimbili Orthopaedic Institute, Tanzania
• Topic: Global Perspectives on Orthopaedic Research: Tools for Success
• 2 webinars:
• Balancing clinical practice and research
• Collecting, organizing & publishing orthopaedic data

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NEW! IFMRS Ambassadors & �IFMRS Networks

• Key individuals across the world whose role will be to foster engagement and collaboration across the MSK community
• Lead on the development of IFMRS Networks, particularly in LMICs.
• Networks:
• May be national or regional
• Are designed to a) support the engagement of key individuals from those areas in our work, b) facilitate the sharing of knowledge and implementation of the Global Action Plan; and c) support the establishment of stronger local structures, such as an MSK research society, over time.

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Global & local networks

• Globally:
• Forge relationships with, and look for opportunities to collaborate with, MSK organisations and alliances at the regional and global level
• Locally:
• Implement the Global Action Plan – and share the learning
• Talk to other professional groups, as well as patient groups. Break down the silos.
• Look for, and create, opportunities for joint initiatives
• Diversify our stakeholders

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“Good things happen when you bring different people around the table”

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Successful coalition building:

a practical case study

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Collaboration in practice: the ARMA experience (1)

• An alliance of ~40 organisations including professional, research and patient organisations
• Mission: all people living with MSK conditions receive the best possible care, by promoting interdisciplinary collaboration.
• Identical to the IFMRS
• Provided the blueprint for the Global Alliance for Musculoskeletal Health
• Like a United Nations for the MSK community in the UK
• Different, often professionally biased definitions and views about MSK conditions
• Competition for influence
• Some member organisations did not want ARMA to succeed
• Historical lack of focus and impact

Collaboration in practice: the ARMA experience (2)

• Emphasised transparency and democracy
• Created a shared, neutral space for discussion Everyone, large and small, had an equal voice around the table.
• Created a strategic plan through an inclusive process of co-production, achieving buy-in and shared ownership of the plan.
• “What success looks like”, and how we’re going to measure it
• Chose to focus on
• Providing added value (through amplification & spearheading) and avoiding duplication
• Identifying and promoting scalable examples of good practice: “what good looks like”
• “Big wins” for the whole community

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Collaboration in practice: the ARMA experience (3)

• 2012: used the ARMA Annual Lecture to invite the new Director for Long-Term Conditions in the NHS as a speaker
• 2013: Achieved the creation of the first-ever post of National Clinical Director for MSK conditions
• Worked closely with the NCD to deliver practical change
• Established a project on developing Clinical Networks, reflecting the NSH agenda of integrated, person-centred care, and established a strategic partnership with the NHS to deliver it nationally
• Produced a blueprint for local networks of professionals
• Practical examples of good practice
• National seminars to share god practice and cement the project
• 2014: hosted an MSK World Summit with key people from the UK as well as the WHO, European Union

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Lessons from the ARMA experience

• Collaboration doesn’t happen on its own
• You can’t make anyone do anything
• Need to overcome professional territoriality, competition and egos
• Everyone wants to be the first violin in the orchestra
• Competing for money and influence creates divisions and distrust
• Need a neutral space around a shared agenda
• We all benefit when we collaborate. Going it alone is not going to work.
• Decision-makers want
• To speak with one organisation, not 40
• Practical solutions to big problems
• Partners who can provide solutions - and do the leg work
• Remember your core purpose. Stay the course. Ignore the distractions.
• When it works, it really works
• Success breeds success

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Looking ahead, and what you can do

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Opportunities

• Impact of MSK conditions getting harder to ignore
• People are living longer, and living with more co-morbidities, almost always including ay least one MSK condition
• Inability to work, and dependence on health & care system, is expensive.
• MSK conditions are foundational to many others
• Risk factors for stroke, diabetes
• Strong links between OA and obesity
• A population health approach
• There are some big wins in MSK, eg fracture prevention, early intervention, lifestyle factors, occupational health

Current priorities

• Influence at WHO level with partner organisations
• Memorandum of Understanding
• Joint webinars and events; input consultation on osteoporosis
• Provide new resources and opportunities for early and mid-career researchers
• Continue to grow and diversify our membership and partners, and strengthen collaboration between key groups in MSK
• Develop an education hub around rare MSK diseases
• Deliver joint initiatives with our member societies, eg thematic webinars
• Deliver a virtual World Summit
• Launch a new Ambassadors program and create new IFMRS Networks, especially for low and middle income countries

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What can YOU do?

• Organizationally:
• Engage with us
• Invite others to engage with us
• Help us increase our visibility and the use of our resources, especially in Latin America
• Individually:
• Engage with your member societies, and encourage them to collaborate widely
• Talk to your peers in other professions
• Use and share our resources, follow us online, share what we share, participate in our online events
• Consider being an Ambassador

Get involved

• Access our resources: www.ifmrs.org

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• Follow us on:
• Twitter (@IFMRSGlobal)
• LinkedIn (MSK News by IFMRS, and IFMRS)
• Bluesky (@ifmrs.bsky.social)
• Sign up for our newsletter www.ifmrs.org/news

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• Interested in joining or partnering with us?
• → Email me: ceo@ifmrs.org

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THANK YOU!

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