Physiotherapy [JOURNAL]
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200 papers
Development and implementation of a physiotherapy exercise intervention with tailored support for exercise adherence for people with vertebral fragility fractures (OPTIN trial).
Newman M, Room J, Hannink E … +1 more , Barker KL
Physiotherapy · 2025 Mar · PMID 39612555 · Publisher ↗
OBJECTIVES: The OsteoPorosis Tailored exercise adherence INtervention (OPTIN) trial is a two-arm, multi-centre randomised controlled trial. It compares the effectiveness of physiotherapy exercise rehabilitation with inte...
OBJECTIVES: The OsteoPorosis Tailored exercise adherence INtervention (OPTIN) trial is a two-arm, multi-centre randomised controlled trial. It compares the effectiveness of physiotherapy exercise rehabilitation with integrated support for exercise adherence, to physiotherapy exercise rehabilitation alone, for people with vertebral fragility fracture (VFF) and back pain. This paper describes the development of the physiotherapist-led adherence enhanced intervention. METHODS: We used an intervention mapping approach and followed Medical Research Council guidelines for developing complex interventions. We co-created the intervention involving expert clinicians, service managers, researchers, and adults with long-term musculoskeletal conditions, including osteoporosis. We identified a theoretical framework, reviewed the evidence, used a feasibility study, and considered clinical practice and deliverability within UK National Health Service (NHS) outpatient physiotherapy secondary care. Through a collaborative workshop, we refined the intervention, involved patients again and re-tested the intervention. Finally, we manualised the intervention, produced patient and physiotherapist materials and trained physiotherapists for delivery. RESULTS: The OPTIN intervention uses a motivational interviewing approach and captures information about patient goals, barriers, and facilitators to exercise. Physiotherapists assess exercise capability, opportunities and motivation and utilise at least three behaviour change approaches, selecting from an intervention toolkit of nine approaches to support exercise behaviour. Ninety minutes of additional physiotherapy are provided to deliver the intervention, integrated within the assessment and six follow-up visits. CONCLUSIONS: A theory-informed intervention to support exercise adherence was developed and delivered by physiotherapists trained in the intervention to older adults with VFF and back pain in the intervention arm (n = 63) of the OPTIN trial. TRIAL REGISTRATION NUMBER: ISRCTN 14465704. CONTRIBUTION OF PAPER.
Pre-registration student research placements within KNOWBEST: a service evaluation.
Minns Lowe CJ, Rose J, Roscoe S … +1 more , Heneghan N
Physiotherapy · 2025 Mar · PMID 39603887 · Publisher ↗
Pre-registration student placements have traditionally been based in clinical settings. Recently, practice-based learning has evolved to include additional settings, including research, leadership and management. The KNO...
Pre-registration student placements have traditionally been based in clinical settings. Recently, practice-based learning has evolved to include additional settings, including research, leadership and management. The KNOWBEST (Knowledge, Behaviours And Skills Required of the Modern Physiotherapy Graduate) project incorporated research placements for five pre-registration students. The aims of this project were to develop, implement and evaluate research placements within a UK pre-registration physiotherapy program, to add to the limited information available for HEI and supervisors. The paper includes placement content, reflections and evaluations from the perspective of the students, supervisors and Practice Team Lead. Students and staff were highly positive about research placements. Student's spoke of the importance of their immersive experience on placement, valuing the variety of learning experiences, opportunities to lead and the development of transferable skills. Students found that research and clinical placements, whilst different, were also similar in important ways. Students appreciated how research placements developed their abilities to provide evidence-based practice as clinicians. This paper does not provide definitive placement guidance, it provides information gleaned from direct experience for teams planning research placements. It identifies and reports areas the team found challenging, to facilitate discussion and debate as the profession actively diversifies and expands practice-based learning.
Reference values for mobility in typically developing school-aged children: a cross-sectional study.
Chiu HC, Ada L, Cherng RJ
Physiotherapy · 2025 Mar · PMID 39577021 · Publisher ↗
OBJECTIVE: To generate data for tests of mobility in typically developing children, and thereby establish reference values against which scores for children with a health condition can be compared. DESIGN AND SETTING: A...
OBJECTIVE: To generate data for tests of mobility in typically developing children, and thereby establish reference values against which scores for children with a health condition can be compared. DESIGN AND SETTING: A cross-sectional study was carried out at 12 primary schools. PARTICIPANTS: In total, 1512 typically developing children aged 6 to 12 years (50% female) participated in this study. METHODS: Performance on four tests (Times-Sit-to-Stand Test, 10-m Walk Test, 6-minute Walk Test and Stairs Test) was measured to encompass various aspects of everyday mobility (standing up from a chair, walking short and long distances, and climbing stairs). RESULTS: Generally, scores increased with age, except for the Times-Sit-to-Stand Test which was stable at a mean of 1.1 (standard deviation 0.2) stands/second. Multiple regression revealed that sex made a significant contribution to the most challenging mobility tests. Visual examination showed that at approximately 11 years of age, scores for males began to exceed those for females, such that males walked 0.24 m/second [95% confidence interval (CI) 0.14 to 0.33] faster at their fastest speed and climbed 0.16 more stairs/second (95% CI 0.09 to 0.22) than females. CONCLUSIONS: Data from this study have determined the reference values for mobility in typically developing school-aged children, using tests commonly applied in the clinic. With these values, the status and progress of children with a health condition may be determined accurately. CONTRIBUTION OF THE PAPER.
Explorations of strategies for inclusion for newly qualified physiotherapists from racially minoritised groups in a large, urban NHS Trust, UK.
Turner C, Bhandari T, Jones GD … +3 more , Jones J, Gleave L, Hammond JA
Physiotherapy · 2025 Mar · PMID 39566341 · Publisher ↗
OBJECTIVES: The study aimed to i) understand the experiences of newly qualified physiotherapists from racially minoritised backgrounds in a large hospital physiotherapy department and ii) co-create and implement inclusiv...
OBJECTIVES: The study aimed to i) understand the experiences of newly qualified physiotherapists from racially minoritised backgrounds in a large hospital physiotherapy department and ii) co-create and implement inclusive strategies to affect work culture. DESIGN: The project used an action research design with co-creation principles and was in 3 phases. Phase 1 explored the experiences of inclusion for newly qualified racially minoritised staff, using focus groups and transcripts analysed thematically. The themes identified were used to co-create strategies for inclusion that were implemented in Phase 2 and evaluated Phase 3. SETTING: A large urban teaching hospital physiotherapy department in the UK. PARTICIPANTS: Participants were invited to join focus groups for newly qualified racially minoritised staff, newly qualified white staff, or senior staff. RESULTS: Phase 1 findings are reported here, while phases 2 and 3 are reported elsewhere. Seventeen newly qualified physiotherapists (eight racially minoritised, nine white colleagues) and ten senior physiotherapists participated in seven focus groups. Thematic analysis identified four themes; 1) Fear spectrum: all colleagues struggled to find a common ground for discussing race, 2) Race as an additional burden for racially minoritised staff in belonging in the department, 3) Contradiction between the organisation culture and impact on racially minoritised staff, and 4) Consistent work practices give an illusion of inclusion. CONCLUSIONS: The findings reflect previous studies that racially minoritised physiotherapists experience additional burdens not fully understood by their white peers. There are implications for the department which are currently being enacted and evaluated and will be reported elsewhere. CONTRIBUTION OF THE PAPER.
Comments on: "Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial".
Rashid FA, M RP
Physiotherapy · 2026 Jun · PMID 39550282 · Publisher ↗
Abstract loading — click title to view on PubMed.
A cardiac rehabilitation programme based on neuromuscular training improves the functional capacity of patients with acute coronary syndrome: a preliminary randomised controlled trial.
Valtueña-Gimeno N, Fabregat-Andrés Ó, Martínez-Hurtado I … +4 more , Martínez-Olmos FJ, Lluesma-Vidal M, Arguisuelas MD, Ferrer-Sargues FJ
Physiotherapy · 2025 Mar · PMID 39549308 · Publisher ↗
OBJECTIVES: To evaluate the effects of a cardiac rehabilitation programme based on neuromuscular training (NMT) compared with classic rehabilitation strength training (CRST) in patients diagnosed with acute coronary synd...
OBJECTIVES: To evaluate the effects of a cardiac rehabilitation programme based on neuromuscular training (NMT) compared with classic rehabilitation strength training (CRST) in patients diagnosed with acute coronary syndrome (ACS). DESIGN: Preliminary randomised, double-blinded, parallel clinical trial. SETTING: University health clinic in Valencia, Spain. PARTICIPANTS: Thirty patients with ACS. INTERVENTIONS: Patients were assigned to one of two groups at random: the NMT group (n = 15) and the CRST group (n = 15). All patients attended the 20 sessions of the exercise programme. MAIN OUTCOME MEASURES: The primary outcome was the Incremental Shuttle Walk Test (ISWT). The secondary outcomes were the Chester Step Test (CST), the 30-Second Chair Stand Test (30CST), and hip flexor dynamometry. Assessments were made at baseline, immediately post-treatment, and at 6-month follow-up. RESULTS: The NMT group showed a greater improvement in the ISWT than the CRST group, both at post-treatment {mean 648 [standard deviation (SD) 197] vs 493 (SD 219), mean difference 155, 95% confidence interval (CI) -1 to 310} and at follow-up [732 (SD 183) vs 518 (SD 222), mean difference 214, 95% CI 61 to 367]. The secondary outcomes showed significant between-group differences in favour of the NMT group at 6-month follow-up, except for the 30CST. CONCLUSIONS: These preliminary findings indicate that a cardiac rehabilitation programme based on NMT may improve functional capacity in terms of patient performance, cardiorespiratory fitness and muscle strength. Moreover, the improvements were maintained at medium-term follow-up. This could help improve the design of rehabilitation sessions, considering factors associated with performing everyday activities in patients affected by ACS. CLINICAL TRIAL REGISTRATION NUMBER: NCT04246008. CONTRIBUTION OF THE PAPER.
Reliability and validity of the L test in people with multiple sclerosis.
Eldemir K, Eldemir S, Ozkul C … +2 more , Irkec C, Guclu-Gunduz A
Physiotherapy · 2025 Mar · PMID 39541755 · Publisher ↗
OBJECTIVES: Functional mobility is an essential factor affecting the activities of daily living in people with multiple sclerosis (PwMS). The L test is a comprehensive assessment tool for functional mobility that incorpo...
OBJECTIVES: Functional mobility is an essential factor affecting the activities of daily living in people with multiple sclerosis (PwMS). The L test is a comprehensive assessment tool for functional mobility that incorporates sit-to-stand, transfers and bidirectional turning. The purpose of this study was to determine the psychometric properties of the L test in PwMS. DESIGN: Cross-sectional study. PARTICIPANTS: Thirty-four PwMS [Expanded Disability Status Scale (EDSS) score 0 to 5] and 34 healthy controls were included in this study. MAIN OUTCOME MEASURES: The L test was administered along with the timed up and go (TUG) test, 10-m walk test (10-MWT), 6-minute walk test (6-MWT), timed 360 degree turn test, and EDSS by the same rater. Fall history was recorded to categorize PwMS with and without a history of falls. The L test was repeated after 1 week to determine test-retest reliability. RESULTS: The L test showed excellent test-retest reliability (intraclass correlation coefficient 0.995). The minimum detectable change for the L test time was 1.4 seconds. The L test demonstrated significant positive correlations with the TUG test, timed 360 degree turn test and EDSS score, and significant negative correlations with the 10-MWT and 6-MWT (P < 0.001). Significant differences in the L test times were found between PwMS and healthy controls, and between PwMS with a history of falls and those without a history of falls (P < 0.05). The cut-off time of 14.7 seconds on the L test was found to best discriminate between PwMS and healthy people, while 16.4 seconds was found to best discriminate between PwMS with a history of falls and those without a history of falls. CONCLUSION: The L test is a reliable and valid tool for the assessment of functional mobility in PwMS. CLINICAL TRIAL REGISTRATION NUMBER: NCT05641714. CONTRIBUTION OF THE PAPER.
Content analysis of current role/job descriptors for Band 5/junior physiotherapists and mapping of these to Physiotherapy Professional standards of practice.
Minns Lowe CJ, Clements B, Heneghan N … +3 more , Atkinson K, Patel R, Beeton K
Physiotherapy · 2026 Jun · PMID 39482154 · Publisher ↗
BACKGROUND: KNOWBEST was a mixed methods study exploring the KNOWledge, BEhaviours and Skills required of the modern physioTherapy graduate. OBJECTIVES: To undertake a content analysis of current role descriptors (RDs) f...
BACKGROUND: KNOWBEST was a mixed methods study exploring the KNOWledge, BEhaviours and Skills required of the modern physioTherapy graduate. OBJECTIVES: To undertake a content analysis of current role descriptors (RDs) for Band5/junior physiotherapists and map these to the knowledge, skills, behaviours and attributes required for contemporary physiotherapy practice. DESIGN: Content analyses and mapping. SETTING: All health care settings: PARTICIPANTS: Available RDs for newly qualified/Band 5 physiotherapists across a representative range of roles and settings for this stage of a physiotherapist's career across the UK and all health care settings. METHODS: Job descriptors were obtained using three approaches 1) via direct upload to the study website, 2) on-line searches of job vacancies, 3) directly emailing managers to fill any gaps in representativeness. Data regarding knowledge, skills, behaviours and attributes were extracted, coded (BC) and checked (CML). DATA ANALYSES: Documentary content analyses and mapping of these to Professional Standards of practice. RESULTS: 19 RDs were analysed. High expectations of behaviours and attributes, and extensive pre-requisite knowledge and skills were identified and detailed. Considerable variability was seen across RDs, at least seven being suited to more highly specialist and/or experienced staff. Equality, diversity and inclusivity concerns were evidenced. Active research was not included in many RDs and not mentioned in any standards. Digital learning and skills were not strongly evidenced. CONCLUSIONS: A review of Band 5/Junior post and RD requirements is recommended including a standard template developed to promote equity. Professional standards emphasise some pillars of practice, such as clinical, more than others. CONTRIBUTION OF THE PAPER.
A core capability framework for physiotherapists to deliver quality care when working with people living with dementia and their families/caregivers: an international modified e-Delphi study.
Taylor ME, Sverdrup K, Ries J … +13 more , Rosendahl E, Tangen GG, Telenius E, Lawler K, Hill K, Toots A, Hobbelen H, Dal Bello-Haas V, Hall A, Hunter SW, Goodwin VA, Whitney J, Callisaya ML
Physiotherapy · 2025 Mar · PMID 39476455 · Publisher ↗
OBJECTIVE: What are the core capabilities physiotherapists need to deliver quality care when working with people with dementia and their families/caregivers? DESIGN: A three-round modified e-Delphi study. PARTICIPANTS: P...
OBJECTIVE: What are the core capabilities physiotherapists need to deliver quality care when working with people with dementia and their families/caregivers? DESIGN: A three-round modified e-Delphi study. PARTICIPANTS: Panel members were physiotherapists experienced in working with people with dementia and/or educating and/or researching in the dementia field. METHODS: A steering group (16 international physiotherapists and a consumer) developed a draft framework including 129 core capabilities across 5 domains for panel members to rate their appropriateness for inclusion as a core capability to provide high quality care to people with dementia and their caregivers/families. The RAND/UCLA method was used to assess consensus. RESULTS: Thirty-five physiotherapists from 11 countries participated in Round 1, 31 (89%) in Round 2 and 28 (80% of Round 1) in Round 3. All core capabilities were rated appropriate for inclusion in each round. Panel members recommended wording refinements across the rounds and suggested 51 core capabilities for consideration. Three rounds were needed to reach consensus, resulting in 137 core capabilities rated appropriate for inclusion across 5 domains: 1) Knowledge and understanding, n = 36; 2) Assessment, n = 39; 3) Management, interventions and prevention n = 40; 4) Communication, therapeutic relationship and person-centred care, n = 17; and 5) Physiotherapists self-management and improvement, n = 5. CONCLUSIONS: This e-Delphi study outlines the core capabilities physiotherapists need to provide high quality care to people with dementia and their families/caregivers. These core capabilities can be used by physiotherapists to help identify knowledge/skill gaps, as well as by educators to improve their training of undergraduate and postgraduate students, and clinicians. CONTRIBUTION OF PAPER.
Dementia content and delivery in physiotherapy curricula: an international study of entry level physiotherapy programmes in Ireland the United Kingdom and New Zealand.
O'Sullivan T, Foley T, Timmons S … +1 more , McVeigh JG
Physiotherapy · 2024 Dec · PMID 39395362 · Publisher ↗
OBJECTIVES: Physical impairments associated with dementia include reduced gait speed, and diminished postural control, which can lead to an increase in falls and hip fractures. Physiotherapy can play a key role in many a...
OBJECTIVES: Physical impairments associated with dementia include reduced gait speed, and diminished postural control, which can lead to an increase in falls and hip fractures. Physiotherapy can play a key role in many aspects of dementia care, including falls risk prevention, gait re-education and end of life care. However, there is a lack of dementia education in entry level physiotherapy programmes. The aim of this study was to map the dementia content and delivery in the current undergraduate and entry level physiotherapy curricula in Ireland the United Kingdom and New Zealand. DESIGN: This cross-sectional survey-based study was distributed via the online survey tool Qualtrics XM. The survey was designed using the map of Kern's curriculum design framework. SETTING: Higher educational institutes (HEIs) that offered an undergraduate (BSc) and/or MSc (entry level) physiotherapy programmes in Ireland United Kingdom and New Zealand were included. PARTICIPANTS: The academic lead for dementia education in the HEI was invited to participate in the survey. RESULTS: Of the 69 eligible HEIs contacted, 49 responded, giving a response rate of 71%. Different sources informed curriculum design, including patient and public involvement, published guidelines and policies and expert clinicians. The time allocated to dementia teaching across the curricula varied, with under half of the programmes only allocating two hours. The lack of service user input was seen as a perceived weakness of many programmes as was the non-standardisation and generalisability of teaching. CONCLUSION: Whilst dementia education is included in many HEI programmes, we need to consider more time, a curriculum that meets learner's needs and include the patient voice. Further research is needed to develop bespoke dementia curricula specific to physiotherapy. CONTRIBUTION OF THE PAPER.
Translating a Clinical Practice Guideline to a Portuguese, Spanish and English Practice Brief to promote exercise therapy for paediatric Charcot-Marie-Tooth disease.
de Paula CS, Donlevy G, Cardoso J … +5 more , Cornett KMD, Kennedy R, Yiu EM, Mattiello-Sverzut AC, Burns J
Physiotherapy · 2024 Dec · PMID 39395361 · Publisher ↗
BACKGROUND: Implementing scientific knowledge in clinical practice is a challenge. In this context, the effective dissemination of scientific findings is of utmost importance. OBJECTIVE: The aim of this study was to deve...
BACKGROUND: Implementing scientific knowledge in clinical practice is a challenge. In this context, the effective dissemination of scientific findings is of utmost importance. OBJECTIVE: The aim of this study was to develop a Practice Brief in Portuguese, Spanish and English based on a previously published Clinical Practice Guideline to promote safe and effective exercise for children and young people with Charcot-Marie-Tooth disease and related neuropathies (CMT). METHODS: The Practice Brief was developed by eight health professionals from Brazil and Australia with English, Portuguese, and Spanish translations. The target audience chosen were the medical and allied health professionals involved in the rehabilitation of paediatric CMT. The content was based on the world first "Clinical Practice Guideline for the management of paediatric Charcot-Marie-Tooth disease" [1]. The layout of the Practice Brief was designed according to the criteria for the development of educational materials. The disclosure plan for the Practice Brief involves its publication on University and Hospital websites, www.ClinicalOutcomeMeasures.org and through social media platforms such as ResearchGate, Instagram, Facebook and Twitter, as well as in print format for CMT patient care centres. RESULTS: The English, Portuguese and Spanish versions of the Practice Brief is organised into six sections about assessment, exercise and physical rehabilitation, of which one is focused on progressive resistance exercises for the foot dorsiflexor muscles. CONCLUSION: We developed a Practice Brief in three languages (English, Portuguese and Spanish), synthesising the main recommendations for exercise and related rehabilitative therapies for paediatric CMT from a published clinical guideline.
Predictive factors and dose-response effect of rehabilitation for upper limb induced recovery after stroke: systematic review with proportional meta-analyses.
Salvalaggio S, Gianola S, Andò M … +9 more , Cacciante L, Castellini G, Lando A, Ossola G, Pregnolato G, Rutkowski S, Vedovato A, Zandonà C, Turolla A
Physiotherapy · 2024 Dec · PMID 39395360 · Publisher ↗
BACKGROUND AND PURPOSE: To date, factors with predictive value for upper limb (UL) recovery after stroke are acknowledged, but little is known on clinical features predicting outcome in response to rehabilitation. The pu...
BACKGROUND AND PURPOSE: To date, factors with predictive value for upper limb (UL) recovery after stroke are acknowledged, but little is known on clinical features predicting outcome in response to rehabilitation. The purpose of this review is to investigate whether any factor allows identification of Responders to rehabilitation, and whether clinically important recovery of motor function relies on modalities and dose of intervention received, at different times after stroke. METHODS: A systematic review with proportional meta-analysis was conducted. Longitudinal single-cohort studies on patients undergoing rehabilitation after stroke were included. Predictive features investigated in the included studies were reported. The primary outcome was the Fugl-Meyer Assessment for Upper Extremity, and effect sizes (ES) of different rehabilitation doses were calculated. RESULTS: Only 6% of the included studies (n = 141) investigated predictive factors. Studies providing more than 30 hours of therapy induced small to large clinical effect (ES from 0.38 to 0.88). Task-oriented approach led to the largest effect, both in the subacute (ES = 0.88) and chronic (ES = 0.71) phases. Augmenting interventions provided higher effect in the chronic rather than subacute phase. Integrity of the corticospinal tract, preservation of arm motor function and specific genetic biomarkers were found to be associated with motor recovery DISCUSSION AND CONCLUSIONS: Trials on motor recovery after stroke should incorporate analysis of factors associated with rehabilitation outcomes. Task-oriented interventions should be delivered more than 30 hours (high dose) to induce the greatest improvement. SYSTEMATIC REVIEW REGISTRATION NUMBER: Systematic Review Registration Number PROSPERO CRD42021258188. CONTRIBUTION OF THE PAPER.
The effects of a prescribed exercise programme in people with metastatic breast cancer: a systematic review.
O' Riordan JMCV, McCullagh R, Murphy PJ … +3 more , Sheill G, Horgan F, French HP
Physiotherapy · 2024 Dec · PMID 39395359 · Publisher ↗
OBJECTIVE: To synthesise available evidence on the effects of a prescribed exercise programme in People with Metastatic Breast Cancer (PwMBC). DATA SOURCES: Medline, Embase, CINAHL, Web of Science and Scopus were searche...
OBJECTIVE: To synthesise available evidence on the effects of a prescribed exercise programme in People with Metastatic Breast Cancer (PwMBC). DATA SOURCES: Medline, Embase, CINAHL, Web of Science and Scopus were searched up to January 2024. STUDY SELECTION: Randomised controlled trials (RCTs) recruiting PwMBC to an exercise intervention were included. The primary outcome was Quality of Life (QOL). Secondary outcomes included physical performance, muscle health, cancer-related fatigue (CRF) and physical activity (PA). STUDY APPRAISAL AND SYNTHESIS METHODS: Meta-analysis was not possible due to the low number of included studies. We calculated the effect size (ES), with 95% confidence intervals (95% CIs) of individual studies, adjusting for small sample size. Cohen's criteria for small (0.2 to 0.5), moderate (0.5 to 0.8) and large (>0.8) describe the size of the effect. Risk of bias (ROB) was assessed using the Cochrane (ROB) version 1 tool. RESULTS: Three RCTs (n = 149 PwMBC) were included. Results showed no significant between-group effects in the primary outcome, QOL. Whilst effects in favour of prescribed exercise were observed in CRF (ES 1.3, 95% CI 0.06 to 2.35) and PA (ES 0.83, 95% CI 0.14 to 1.42) in two separate studies, as the lower bound of the 95% CI did not reach Cohen's threshold, there is considerable uncertainty regarding the treatment effect. CONCLUSIONS: There is currently insufficient evidence to support the use of prescribed exercise to improve QOL, physical performance, muscle health, CRF and PA in PwMBC. Further high-quality trials are required to investigate the effectiveness of exercise interventions in PwMBC. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022304528. CONTRIBUTION OF THE PAPER.
Barriers, facilitators and referral patterns of general practitioners, physiotherapists, and people with osteoarthritis to exercise.
Bhardwaj A, Hayes P, Browne J … +6 more , Grealis S, Maguire D, O'Hora J, Dowling I, Kennedy N, Toomey CM
Physiotherapy · 2024 Dec · PMID 39393262 · Publisher ↗
BACKGROUND: Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments...
BACKGROUND: Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments for OA. OBJECTIVE: To identify barriers and facilitators of GPs, PTs and PwOA to uptake of and referral to exercise treatments for OA. METHODS: An online survey was circulated to GPs, PTs, and PwOA in Ireland from March to September 2021. Data were collected on demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. Frequency distributions were used to illustrate demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. RESULTS: 388 stakeholders responded (GPs = 148; PTs = 154; PwOA = 86). Barriers and facilitators were related to (1) stakeholder (e.g., patient tiredness and fatigue), (2) healthcare setting (e.g., appropriate referrals from GP or other sources), and (3) treatment (e.g., low-cost community-based exercise programmes) factors. While 91% of GPs would refer PwOA to physiotherapy if no barriers existed, only 60% would in their current practice. Only 33% of PwOA reported receiving a GP referral to physiotherapy. CONCLUSION: Stakeholder, healthcare setting and treatment barriers and facilitators of GPs, PTs, and PwOA influence uptake of and referral to exercise treatments for OA. Future strategies Future strategies addressing these factors may improve implementation of guideline-based management for OA. CONTRIBUTION OF THE PAPER.
The evaluation of daily activity questionnaire for stroke survivors: cross-cultural adaptation, content validity and digitisation.
Gilanliogullari N, Prenton S, Prior Y
Physiotherapy · 2024 Dec · PMID 39388787 · Publisher ↗
OBJECTIVE: The study's objective was to culturally adapt and digitise the Evaluation of Daily Activity Questionnaire (EDAQ), originally designed for rheumatoid arthritis and various other musculoskeletal conditions, crea...
OBJECTIVE: The study's objective was to culturally adapt and digitise the Evaluation of Daily Activity Questionnaire (EDAQ), originally designed for rheumatoid arthritis and various other musculoskeletal conditions, creating a version for stroke survivors (EDAQ-SS). This adaptation also aimed to develop a comprehensive electronic Patient Reported Outcome Measure (ePROM) intended to refine stroke survivors' self-assessment of their daily activity limitations. MATERIALS AND METHODS: Cross-cultural adaptation of the EDAQ was completed by a review of expert panel, which included healthcare professionals to increase the clarity and relevancy of the items, followed by cognitive debriefing interviews with British stroke survivors to rate their understanding of the questionnaire items. After developing the paper version of the questionnaire, this was digitised (eEDAQ-SS) and disseminated online via the Stroke Survivors Hub (SSHUB). Content validity of the EDAQ-SS was evaluated using the International Classification of Functioning (ICF) Core Set for Stroke. RESULTS: The expert panel meeting (n:11) and cognitive debriefing interviews with stroke survivors (n:10) resulted in an EDAQ-SS with 160 items across 15 domains, which was understandable and relevant to stroke survivors. The SSHUB was deemed to be a user-friendly platform, providing easy access to eEDAQ-SS and aid self-assessment of daily activities of stroke survivors. Mapping the EDAQ-SS items to the ICF Core Set for Stroke demonstrated good content validity with 44/55 matching categories. CONCLUSION: The EDAQ-SS offers a comprehensive measure for self-assessment, which may serve to guide stroke survivors' self-management by overcoming limitations of existing PROMs. Further psychometric testing of the EDAQ-SS and wider testing of the digital version is recommended. CONTRIBUTION OF THE PAPER.
Do individuals with ankle instability show altered lower extremity kinematics and kinetics during walking? A systematic review and meta-analysis.
Luan L, Orth D, Newman P … +3 more , Adams R, El-Ansary D, Han J
Physiotherapy · 2024 Dec · PMID 39383551 · Publisher ↗
OBJECTIVE: To determine if individuals with chronic ankle instability (CAI) demonstrate altered lower extremity kinematics and kinetics during walking. DATA SOURCES: Relevant studies were sourced from PubMed, Embase, Coc...
OBJECTIVE: To determine if individuals with chronic ankle instability (CAI) demonstrate altered lower extremity kinematics and kinetics during walking. DATA SOURCES: Relevant studies were sourced from PubMed, Embase, Cochrane Library, Web of Science, EBSCO and PEDro. STUDY SELECTION: Kinematic and kinetic studies involving joint angle and/or joint moment measured in individuals with CAI were included. STUDY APPRAISAL AND SYNTHESIS METHODS: The Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tool was used to assess literature quality. Weighted mean differences (WMDs) in joint angles and moments between CAI and controls were analyzed as continuous variables. RESULTS: 1261 articles were screened, with a final selection of 13 studies involving 729 participants. Compared to non-CAI controls, CAI participants showed significantly greater ankle inversion angle (degree) (WMD: 3.71, 95% CI: 3.15 to 4.27, p < 0.001), hip adduction angle (degree) (WMD: 1.60, 95% CI: 0.09 to 3.11, p = 0.04), and knee valgus moment (N m/kg) (WMD: 0.07, 95% CI: 0.01 to 0.13, p = 0.02) during walking. Additionally, there were no consistent findings or specific altered patterns in other lower extremity joint angles, or moment changes, regardless of the motion plane (sagittal, coronal, horizontal), for CAI compared with controls. CONCLUSIONS: This review provides further evidence of altered lower limb kinematics and kinetics in the frontal plane in CAI participants during certain walking phases, which may partially explain the high level of recurrent ankle sprains observed in the CAI population, and support hip abduction and ankle eversion motor control exercises for CAI rehabilitation. SYSTEMATIC REVIEW REGISTRATION NUMBER: Systematic Review Registration Number PROSPERO CRD42023420418. CONTRIBUTION OF THE PAPER.
Optimal days of application of kinesiotaping for the treatment of lumbo-pelvic pain during pregnancy. A systematic review and dose-response meta-analysis.
Salazar-Méndez J, Núñez-Cortés R, Cuyul-Vásquez I … +7 more , Sazo-Rodriguez S, Calatayud J, Guzmán-Muñoz E, Aguayo A, Carrasco B, González A, Suso-Martí L
Physiotherapy · 2024 Dec · PMID 39383550 · Publisher ↗
OBJECTIVE: To determine the optimal dose and short-term effectiveness of kinesiotaping (KT) on pain intensity and disability in pregnant women with lumbo-pelvic pain. DATA SOURCES: MEDLINE (via PubMed Central), CINAHL, E...
OBJECTIVE: To determine the optimal dose and short-term effectiveness of kinesiotaping (KT) on pain intensity and disability in pregnant women with lumbo-pelvic pain. DATA SOURCES: MEDLINE (via PubMed Central), CINAHL, Epistemonikos, Scopus, and Web of Science from inception to 21st March 2023. STUDY SELECTION: We included randomized controlled trials (RCT) conducted on pregnant women with lumbo-pelvic pain treated with KT. DATA EXTRACTION: The outcomes included pain intensity and disability. ROB-2 and GRADE were used to assess the risk of bias and the certainty of the evidence, respectively. A random effects meta-analysis was performed using the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). The dose-response association was evaluated using a restricted cubic spline model. DATA SYNTHESIS: Seven RCTs involving 527 patients were included. Meta-analysis revealed a statistically significant effect in favor of KT on pain intensity (SMD = -1.71; 95% CI = -2.51 to -0.90; P = <0.001) and on disability (SMD = -1.15; 95% CI = -2.29 to -0.02; P = <0.001). The total duration of KT use ranged from 5 to 35 days. It was estimated that a dose of 5-10 days exceeded the minimal clinically important difference (MCID) for pain intensity (mean difference at 10 days = -2.63; 95% CI = -3.05 to -2.22). Low certainty of evidence was identified for both outcomes. CONCLUSIONS: In pregnant women with lumbo-pelvic pain, the use of KT for 5 to 10 days produces a short-term reduction in pain intensity that exceeds the MCID, with a low certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: Systematic Review Registration Number PROSPERO CRD42023388174. CONTRIBUTION OF PAPER.
Exploring the effectiveness of circuit training rehabilitation on balance, gait, and fatigue in multiple sclerosis: a systematic review and meta-analysis.
Cardini R, Corrini C, Bertoni R … +3 more , Anastasi D, Cattaneo D, Gervasoni E
Physiotherapy · 2024 Dec · PMID 39357272 · Publisher ↗
BACKGROUND: People with Multiple Sclerosis (PwMS) often experience imbalance, gait dysfunction, and fatigue. Circuit Training (CT) can be viable for improving balance, gait, and fatigue in MS. To the author's knowledge,...
BACKGROUND: People with Multiple Sclerosis (PwMS) often experience imbalance, gait dysfunction, and fatigue. Circuit Training (CT) can be viable for improving balance, gait, and fatigue in MS. To the author's knowledge, no studies have systematically reviewed the existing literature evaluating the effectiveness of CT in PwMS. OBJECTIVES: To investigate the effectiveness of CT in improving balance, gait, and reducing fatigue in PwMS and provide a quantitative and qualitative synthesis of Randomized Controlled Trials (RCTs). DATA SOURCES: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Google Scholar, and PEDro Database (Dec 2021 to May 2024). STUDY SELECTION: RCTs using CT in PwMS including balance, gait, or fatigue outcomes. DATA SYNTHESIS: Search inclusion criteria were: i) available full text, ii) CT rehabilitation, iii) balance, gait, or fatigue measured as outcomes, and iv) articles in English. Full text articles were analyzed by two screeners. If there was disagreement regarding inclusion, a further reviewer was consulted. No discrepancies were found. RESULTS: We identified 878 studies, 14 studies were eligible including 716 PwMS with a mean (standard deviation) age of 49.9 (10.9) years, disease duration of 10.8 (7.2) years, and Expanded Disability Status Scale score of 4.3 (0.9) points. RevMan 5.4.1 was used to run the meta-analysis. We found a significant overall effect on Berg Balance Scale (Mean Difference (MD) = 6.07 points, 95%CI:1.40,10.75; p = 0.01) and in Fatigue Severity Scale (MD = 0.98 points, 95%CI:0.30,1.66; p = 0.005) in favor of CT. We did not find a significant effect in Timed Up and Go (MD = 0.46 second, 95%CI:-0.04,0.96; p = 0.07), in Six-Minute Walk Test (MD = 17.46 m, 95%CI:-8.06,42.97; p = 0.18), and in Modified Fatigue Impact Scale (MD = 3.34 points, 95%CI:-0.41,7.09; p = 0.08) in favor of CT. We assessed methodological quality using RoB 2.0, and quality of evidence using GRADE. LIMITATIONS: Small number of studies, all identifying having some risk of bias. CONCLUSION: Circuit training can have positive effects on PwMS in terms of increasing balance, gait, and reducing fatigue. Further research is needed. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021286834. CONTRIBUTION OF THE PAPER.
'A challenge to my professional identity'- resisting the shift from over-management to self-management for back pain within an implementation trial: a qualitative study.
Feldman R, Pincus T, Ben Ami N
Physiotherapy · 2024 Dec · PMID 39357271 · Publisher ↗
OBJECTIVE: The Enhanced Transtheoretical Model Intervention (ETMI) is based on behavioral models and focuses on guiding Chronic Low Back Pain (CLBP) patients to self-manage symptoms and engage in recreational physical ac...
OBJECTIVE: The Enhanced Transtheoretical Model Intervention (ETMI) is based on behavioral models and focuses on guiding Chronic Low Back Pain (CLBP) patients to self-manage symptoms and engage in recreational physical activity. While there is promising evidence that ETMI benefits patients, it is unclear how challenging it might be to implement widely. This investigation focused on the perceptions of physiotherapists trained to deliver ETMI for CLBP. DESIGN: A Qualitative study comprised of semi-structured interviews (July to November 2023). Interviews were audio-recorded, transcribed, coded, and analyzed thematically by two independent researchers. SETTING: Data were obtained as part of a large implementation study evaluating the uptake and impact of ETMI amongst physiotherapists in a large public healthcare setting. PARTICIPANTS: 22 physiotherapists trained to deliver the ETMI approach and chose to use it with at least one patient. RESULTS: While physiotherapists acknowledged the evidence base behind ETMI and the clarity of the approach, they struggled to adapt it to routine delivery. Exploration of the reasons for this identified an overarching meta-theme, 'A challenge to my professional identity', and three main themes consisting of 1) interventions such as ETMI contradicted my training. 2) I am ambivalent/ do not accept evidence that contradicts my habitual practice, and 3) I am under-skilled in psychological and communication skills. CONCLUSION: This study highlights the reluctance of physiotherapists to implement evidence-based interventions such as ETMI, which fundamentally challenge their traditional practice and therapeutic identity. The shift from over-management by experts seeking cures to supporting self-management was not palatable to physiotherapists. The challenge of embracing a new professional identity must be addressed to enable a successful implementation of the approach. CONTRIBUTION OF THE PAPER.
Psychologically-enhanced cardiac rehabilitation for psychological and functional improvement in patients with cardiovascular disease: a systematic review with meta-analysis and future research directions.
Wrzeciono A, Mazurek J, Cieślik B … +3 more , Kiper P, Gajda R, Szczepańska-Gieracha J
Physiotherapy · 2024 Dec · PMID 39098055 · Publisher ↗
OBJECTIVE: To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease. DATA SOURCES: A sy...
OBJECTIVE: To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease. DATA SOURCES: A systematic search was performed in PubMed, Scopus, Cochrane Library, Embase, and Web of Science, up to January 31, 2024. STUDY SELECTION: Two reviewers independently identified randomized clinical trials that evaluated the effectiveness of psychologically-enhanced CR in improving psychological and functional outcomes in patients with cardiovascular disease. The search yielded 1848 results. Finally, data from 14 studies (1531 participants) were included in the review. DATA EXTRACTION AND DATA SYNTHESIS: Information regarding cardiac rehabilitation phase, duration of the intervention, group characteristics, measured outcomes, and the conclusions drawn by the authors was extracted. The Revised Cochrane risk-of-bias tool for Randomized Trials was used to evaluate the methodological quality. RESULTS: Pooled results indicate that psychologically-enhanced CR is more effective than specific cardiac training alone in maintaining lower resting blood pressure, with a mean difference of -3.09 (95% CI: -5.18 to -1.00). Furthermore, psychologically-enhanced CR shows superiority in improving patients' quality of life compared to specific cardiac training alone, with a standardized mean difference of 0.15 (95% CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise tolerance, and blood lipid profile did not show significant differences between the two treatment conditions. CONCLUSION: Psychologically-enhanced CR shows a positive effect on reducing resting blood pressure and improving the quality of life. However, the supportive methods were of limited effectiveness in addressing the psychological aspects of health. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022304063. CONTRIBUTION OF THE PAPER.
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