Physical Therapy[JOURNAL]
Sun
200 papers
Intrarater and Interrater Reliability and Concurrent Validity of the 3-Meter Backward Walk Test in Non-frail, Pre-frail, and Frail Older Adults in Residential Care Homes.
Kapan A, Ristic M, Konrad A … +1 more , Waldhoer T
Phys Ther · 2025 Jun · PMID 40324212 · Full text
IMPORTANCE: Assessing backward walking ability in older adults is crucial due to its strong association with balance, mobility, and fall risk. The 3-meter backward walk test (3MBWT) provides a quick and valid tool for th...
IMPORTANCE: Assessing backward walking ability in older adults is crucial due to its strong association with balance, mobility, and fall risk. The 3-meter backward walk test (3MBWT) provides a quick and valid tool for this purpose. OBJECTIVE: The objective of this study was to assess the reliability and validity of the 3MBWT and to determine its effectiveness in differentiating between different levels of frailty. DESIGN: This study used a cross-section design. SETTING: The study was carried out in residential care homes for older adults. PARTICIPANTS: Participants were able to walk with or without assistance and were excluded if they had a Mini-Mental State Examination score ≤ 17. INTERVENTIONS: Participants underwent the 3MBWT and the 10-meter walk test (10MWT). In addition, the Short Physical Performance Battery (SPPB) was administered. MAIN OUTCOME(S) AND MEASURE(S): Frailty was assessed using the SHARE-FI instrument, with participants classified as non-frail, pre-frail, or frail. Reliability of the 3MBWT was assessed using intraclass correlation coefficient (ICC [3,1]), and concurrent validity was assessed using the 10MWT and SPPB. Fall history over the past year was obtained from medical records and participant interviews. RESULTS: Participants (n = 217) were categorized as non-frail (27%), pre-frail (31%), or frail (42%). The average 3MBWT times were 5.0, 5.9, and 11.8 seconds for participants who were non-frail, pre-frail, and frail, respectively. The 3MBWT showed good to excellent intrarater reliability (ICC = 0.89-0.93) and excellent interrater reliability (ICC = 0.90-0.99). It showed strong correlations with the 10MWT (r = 0.91) and SPPB walking speed (r = 0.94), and a negative correlation with the SPPB total score (r = -0.86). Moderate correlations were found with the Falls Efficacy Scale International (r = 0.71) and Multidimensional Fatigue Inventory (r = 0.61), and a high correlation with falls in the last 12 months (r = 0.74). CONCLUSIONS: The 3MBWT is a reliable tool for assessing physical performance and differentiating levels of frailty in older adults, with a strong association with fall history. RELEVANCE: The 3MBWT offers clinicians a quick, simple, and valid tool for assessing older adults in residential care.
Deconstructing the Role of the Physical Therapy Profession in Disability Acceptance for People With Stroke.
Schwab-Farrell SM, Whalen Smith CN, Dunning K
Phys Ther · 2025 Jul · PMID 40324211 · Publisher ↗
The lowest degree of disability acceptance has been found among people with a history of stroke. Disability acceptance involves adapting to disability-related changes and coming to terms with losses to redefine and live...
The lowest degree of disability acceptance has been found among people with a history of stroke. Disability acceptance involves adapting to disability-related changes and coming to terms with losses to redefine and live a meaningful new life. Across many movement-related disabilities and chronic conditions, disability acceptance has been positively associated with psychological well-being, social and physical functioning, and adjustment. Further, self-acceptance of disability is an important factor in rehabilitation and recovery. There is a growing need for physical therapy to engage with disability acceptance and understand the role of physical therapists and physical therapist assistants in facilitating disability acceptance after stroke. The purpose of this Perspective article is to critically evaluate the role of the physical therapy profession in disability acceptance for people with stroke. The article first reflects on ways in which the physical therapy profession has historically (and unintentionally) created obstructions to disability acceptance after stroke. The authors discuss assumptions implicitly underpinning physical therapist practices for stroke that are consistent with normalization tendencies, medicalized approaches to disability, and the mechanical body. The authors then present new and alternative approaches that can be applied in physical therapy to better facilitate disability acceptance after stroke, focusing on mindfulness-based interventions and a celebration of unique movement strategies of people with disability (ie, movement "improvisation"). The Perspective concludes with practical strategies for clinicians to employ in an effort to better foster disability acceptance poststroke. Impact The physical therapy profession may play an important and unique role in facilitating disability acceptance poststroke. supporting disability acceptance after stroke requires physical therapists and physical therapist assistants to critically reflect on ways in which the profession may unintentionally impede acceptance and consider new and alternative approaches to promote acceptance in clinical practice.
Transforming Care: Implications of Glucagon Like Peptide-1 Receptor Agonists on Physical Therapist Practice.
Mulcahy J, DeLaRosby A, Norwood T
Phys Ther · 2025 Jun · PMID 40305684 · Full text
The goal of this perspective is to bring awareness to the prevalence of glucagon-like peptide 1 receptor agonist (GLP-1 agonist) use, medication side effects, intervention considerations, and the role of the physical the...
The goal of this perspective is to bring awareness to the prevalence of glucagon-like peptide 1 receptor agonist (GLP-1 agonist) use, medication side effects, intervention considerations, and the role of the physical therapist in supporting their patients in their health journey when taking these medications. Management of obesity and diabetes is undergoing significant change with the increasing prevalence of GLP-1 agonist medications. This class of medications, which 1-in-8 adults in the United States report having taken, is becoming a critical component of obesity management, affecting the physiology and psychology of weight loss in novel ways. Due to the prevalence of musculoskeletal conditions in patients with diabetes and obesity, physical therapists can play a crucial role in the comprehensive care of patients on GLP-1 agonist therapy. This perspective explores the practice implications for managing patients living with obesity and/or diabetes who are taking GLP-1 agonists by describing the impact of GLP-1 agonists; the challenges of GLP-1 agonist use; and the considerations for recommending physical activity to patients using these medications. Physical therapists are well equipped to assist this population of patients by implementing strategies that enhance mobility, alleviate pain, prevent injury, mitigate lean muscle mass loss, and promote metabolic health, while adapting to the evolution of health and function patients experience while on GLP-1 agonist medications. As use of these drugs is expected to expand to other health conditions, there is a pressing need for physical therapists to adapt their practices to support the long-term health goals of their patients and ensure optimal patient outcomes.
Patient Experiences of a Group Intervention Integrating Vestibular Rehabilitation, Body Awareness, and Cognitive Behavioral Therapy for Long-Lasting Dizziness: A Focus Group Study.
Magnussen LH, Wilhelmsen KT, Råheim M
Phys Ther · 2025 Jul · PMID 40302052 · Full text
OBJECTIVE: Long-lasting dizziness is a distressing and disabling condition frequently accompanied by psychological and physical discomfort, and if untreated, could evolve into a complex, self-perpetuating condition chall...
OBJECTIVE: Long-lasting dizziness is a distressing and disabling condition frequently accompanied by psychological and physical discomfort, and if untreated, could evolve into a complex, self-perpetuating condition challenging treatment. A treatment approach addressing psychological, physical, and social ailments in connection with long-term dizziness has been developed. The objective of this study was to explore experiences and perceptions of participants with long-lasting dizziness who have engaged in a group-based intervention approach that combines principles from vestibular rehabilitation (VR), body awareness therapy (BA), and cognitive behavioral therapy (CBT) in primary care. METHODS: The study is rooted in an interpretative approach. Fifteen participants, 10 women and 5 men, aged 38 to 71 years, were interviewed in 3 focus groups. Data were analyzed by systematic text condensation, a 4-step thematic cross-case strategy suitable for exploratory investigations. RESULTS: Four main themes emerged from the analyses: (1) to share and feel understood when struggling with dizziness; (2) the exercises: body perceptions and challenging one's own limits to control dizziness; (3) increased self-knowledge helps to process anxiety and challenge avoidance behavior; (4) changing habits is hard work, but necessary to recover from dizziness. CONCLUSIONS: This novel group-based VR-BA-CBT treatment for individuals with long-lasting dizziness offered valuable peer support, shared learning, and learning in action providing new understanding. The VR-BA-CBT treatment includes a comprehensive and holistic approach addressing physical, psychological, and social challenges. IMPACT: Through knowledge about dizziness triggers, participants learn new strategies to confront previously avoided activities. The approach holds promise to be implemented in primary care physical therapy settings.
Physical Function Differences by COVID-19 Status: A Cross-sectional Analysis From the RECOVER Adult Cohort.
Kulik GL, Zheng T, Jolley SE … +20 more , Ashktorab H, Brim H, Feuerriegel EM, Hafner JW, Hess R, Horne BD, Hornig M, Johnson B, Kim C, Laiyemo AO, McComsey GA, Nikolich JŽ, Reid K, Scherry J, Sherif ZA, Tran HG, Verduzco-Gutierrez M, West S, Erlandson KM, RECOVER Adult Cohort Consortium
Phys Ther · 2025 Jul · PMID 40302048 · Full text
IMPORTANCE: Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection. OBJECTIVE: The...
IMPORTANCE: Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection. OBJECTIVE: The objective was to characterize physical function impairment among adults with and without SARS-CoV-2 infection. DESIGN: This study was a retrospective, cross-sectional analysis. SETTING: Researching COVID to Enhance Recovery (RECOVER) initiative, a multi-site observational study in the United States (ClinicalTrials.gov: NCT05172024). PARTICIPANTS: Participants were adults ≥18 years old with and without SARS-CoV-2 infection. EXPOSURES: Groups were defined based on COVID-19 status at enrollment: never diagnosed (control), diagnosed with COVID-19 ≤ 12 weeks (recent COVID-19), or > 12 weeks prior to enrollment (remote COVID-19). The RECOVER-Adult Long COVID Index was used to further characterize by Index ≥12 versus 0. MAIN OUTCOMES/MEASURES: Physical function (main outcome) was assessed by number of repetitions on a 30-second sit-to-stand test (30STS). RESULTS: 30STS assessments at enrollment were available from 11,578 participants. 30STS repetitions were lowest in the remote COVID-19 group (n = 4942) with 11.5 (SD = 4.2) repetitions compared to 12.5 (SD = 4.7) repetitions among controls (n = 1887) or 12.2 (SD = 4.5) in recent COVID-19 (n = 4698). Remote COVID-19, but not recent COVID-19, was associated with lower physical function in the adjusted model (-0.61 repetitions; SD = 0.21). Those with RECOVER Long COVID Research Index ≥12 performed 1.6 (SD = 0.2) fewer repetitions than those with an Index equal 0. CONCLUSIONS: Physical function impairment did not show clinically meaningful group differences between RECOVER Adult Cohort participants by COVID-19 status, or by Long COVID Index. Individual responses over time or in response to an intervention may be more clinically relevant. RELEVANCE: In the RECOVER adult cohort, overall physical function differences by time since COVID-19 or by Long COVID Index were small. Individualized assessments are needed to determine functional impairment following COVID-19 diagnosis and subsequent steps for rehabilitation interventions.
Exploring the Beliefs, Perceptions, and Experiences of Individuals With Tendinopathy: A Systematic Review and Meta-Ethnography of Qualitative Studies.
Mesiha MS, Obst SJ, Randall S … +3 more , Rebar AL, Dittman CK, Heales LJ
Phys Ther · 2025 Jul · PMID 40293393 · Full text
IMPORTANCE: This study systematically examines the effects of tendinopathy on patients' quality of life and investigates their experiences with rehabilitation. OBJECTIVE: This study aimed to synthesize qualitative resear...
IMPORTANCE: This study systematically examines the effects of tendinopathy on patients' quality of life and investigates their experiences with rehabilitation. OBJECTIVE: This study aimed to synthesize qualitative research exploring the beliefs, perceptions, and experiences of individuals living with tendinopathy by employing a systematic review with meta-ethnography. DATA SOURCES: Studies were identified from 4 databases (CINAHL, EMBASE, Scopus, and ProQuest One Academic). STUDY SELECTION: Studies were included if they utilized qualitative methods to investigate beliefs, perceptions, and/or experiences of participants with clinically diagnosed tendinopathy. DATA EXTRACTION AND SYNTHESIS: Data synthesis was completed using the 7 phases of meta-ethnography and reported using the meta-ethnography reporting guidelines. Risk of bias was assessed using the Joanna Briggs Checklist for Qualitative Studies. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). MAIN OUTCOMES(S) AND MEASURE(S): Twenty-three studies were included (rotator cuff [n = 12]; Achilles [n = 6]; gluteal [n = 2]; lateral elbow [n = 2]; and mixed tendinopathies [n = 1]). Methodological quality of included studies varied. Moderate confidence in review findings 1 and 2 and high confidence in review finding 3. RESULTS: Qualitative synthesis identified 3 themes: (1) I need to understand why my tendon hurts (participants wanted clarity regarding the cause of symptoms); (2) I want to fix my tendon, but I don't know how (participants had varied beliefs regarding optimal management and how to reduce their pain); and (3) I am uncertain whether my lifestyle will return to normal (participants felt frustrated with the negative impact that tendinopathy had on their life). CONCLUSION AND RELEVANCE: This review provides insights into the lived experiences of individuals with tendinopathy. The review advocates for clearer communication and education regarding causes and optimal management of tendinopathy. Participants' varied beliefs and uncertainties about treatment efficacy suggest that health care providers consider individualized evidence-based guidance to improve patient outcomes.
Optimal Dose of Aerobic Exercise Programs to Reduce Pain Intensity and Improve Health Status in Patients With Fibromyalgia: A Dose-Response Meta-Analysis.
Núñez-Cortés R, Suso-Martí L, Almonacid-Lleida J … +6 more , Salazar-Méndez J, López-Bueno R, Cruz-Montecinos C, Andersen LL, Ramírez-Vélez R, Calatayud J
Phys Ther · 2025 Jun · PMID 40272395 · Publisher ↗
OBJECTIVE: The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia. DATA SOURCES: Data sourc...
OBJECTIVE: The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia. DATA SOURCES: Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024. STUDY SELECTION: Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included. DATA EXTRACTION: Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model. DATA SYNTHESIS: Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = -0.67; 95% CI = -0.70 to -0.65) and a total duration of 600 min (SMD = -0.65; 95% CI = -0.69 to -0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = -1.14; 95% CI = -1.19 to -1.09) and 1200 min total duration (SMD = -1.08; 95%CI = -1.13 to -1.02). Additionally, a minimum dose of 65 min per week (SMD = -0.62; 95% CI = -0.6 to -0.69) and a total duration of 950 min (SMD = -0.61; 95% CI = -0.60 to -0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = -1.77; 95% CI = -1.89 to -1.65) and 3000 min of total duration (SMD = -1.43; 95% CI = -1.54 to -1.31). CONCLUSION: These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia.
Understanding Barriers to the Use of a Low Back Pain Clinical Practice Guideline in Physical Therapist Practice: A Mixed-Methods Approach.
Schumacher MR, Cottone KA, Siviter LM … +3 more , Rentmeester CJ, Rhon DI, Young JL
Phys Ther · 2025 Jul · PMID 40272392 · Publisher ↗
IMPORTANCE: Low adherence rates to low back pain (LBP) clinical practice guidelines (CPGs) by physical therapists have been reported in the United States; however, no studies have explored barriers to their use. OBJECTIV...
IMPORTANCE: Low adherence rates to low back pain (LBP) clinical practice guidelines (CPGs) by physical therapists have been reported in the United States; however, no studies have explored barriers to their use. OBJECTIVE: The aim of this study was to explore perceived barriers physical therapists face for implementing the most recent LBP CPG from APTA Orthopedics academy. DESIGN: This was a convergent parallel mixed-methods design. SETTING: This was completed virtually. PARTICIPANTS: A total of 173 United States outpatient physical therapists completed the survey, with 20 participating in focused interviews. INTERVENTION(S) OR EXPOSURE(S): Participants completed an online survey and semi-structured virtual interviews. MAIN OUTCOME(S) AND MEASURE(S): The primary outcomes were the top barriers identified through survey data and thematic analysis of interviews. A thematic analysis was implemented for the qualitative analysis. A binary logistic regression was used to model relationships between demographic variables, barriers, and CPG use. RESULTS: Six themes related to barriers to CPG implementation were identified through interviews, including a lack of individualized care, a lack of skills/confidence, patient expectations/perceptions, previous experience, time limitations, and proper understanding of the guidelines. Participants who completed an orthopedic residency program were more likely to report the barrier of "difficulties with 1-on-1 care" (OR = 8.70, 95% CI = 2.12-39.22). Individuals practicing between 1 and 5 years (OR = 7.49, 95% CI = 1.39-52.75) compared to 20+ years, and those reporting regular use of the CPG (OR = 5.81, 95% CI = 1.99-21.51) were more likely to report the barrier of "concern for patient's response." CONCLUSION: Novice clinicians and those who completed orthopedic residency reported specific barriers to CPG use. Six major themes related to barriers for implementing the CPG were identified, consistent with majority of the barriers reported in the survey, demonstrating the convergence of analyses. The most common barrier was the perception of sacrificing individualized care. IMPACT: This study may help improve adoption and implementation of CPGs in real-world clinical practice settings.
Author Response to Kleebayoon and Wiwanitkit.
Gimmon Y, Arbel Y, Shmueli L
Phys Ther · 2025 Jun · PMID 40272391 · Full text
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Patient and Clinician Perceptions of a "People-Like-Me" Tool for Personalized Rehabilitation After Total Knee Arthroplasty: A Qualitative Interview Study.
Churchill L, Graber J, Mealer M … +4 more , Thigpen CA, Matlock DD, Bade MJ, Stevens-Lapsley JE
Phys Ther · 2025 May · PMID 40272381 · Full text
OBJECTIVE: The author team developed a decision support tool to help physical therapists address the varied expectations and recoveries of the total knee arthroplasty (TKA) population. The purpose of this study was to ex...
OBJECTIVE: The author team developed a decision support tool to help physical therapists address the varied expectations and recoveries of the total knee arthroplasty (TKA) population. The purpose of this study was to explore patients' and clinicians' perceptions and experiences with the tool during rehabilitation after TKA. METHODS: The tool was piloted in 2 outpatient physical therapy clinics. An in-depth semi-structured interview was conducted with patients who underwent TKA and were exposed to the tool during rehabilitation, and with clinicians who used the tool with patients after TKA. Two members of the research team coded the interview data using a descriptive content analysis. RESULTS: Sixteen patients and 10 clinicians were interviewed. Four common themes were identified: (1) expectations: most patients and clinicians felt the tool provided patients with valuable feedback for managing recovery expectations; (2) motivation: patients and clinicians felt the tool motivated patients to participate in rehabilitation by providing positive reinforcement and/or a form of competition; (3) influence on practice: some patients and clinicians indicated that the tool helped guide treatment decisions or provided opportunities for patient education, but most felt it did not influence clinical decision making; and (4) clarity and comprehension: the majority of patients understood the tool's "take-home" message, however, some patients and clinicians felt the use of percentiles, line graphs, and medical jargon decreased patients' clarity and comprehension of the tool. CONCLUSIONS: Overall, participants reported that the tool helped to shape patients' expectations for postoperative recovery and increase patient motivation to participate in rehabilitation. Participants had mixed perceptions on how the tool influenced clinical care. Finally, participants identified some limitations in patient comprehension of the tool, which will inform future revisions to the tool to accommodate varying levels of health literacy. IMPACT: A clinical decision support tool that provided individualized projections of TKA recovery was helpful to patients and clinicians during TKA rehabilitation to set expectations and increase patient motivation. Revisions to the tool and how it is implemented may enhance its future utility and potential to impact clinical practice.
The Emperor's New Reporting Guidelines: Are We Fooling Ourselves?
Hoogeboom TJ, Hacquebord S
Phys Ther · 2025 Apr · PMID 40269506 · Publisher ↗
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On "Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial." Avila L, da Silva M, Neves M, et al. Phys Ther. 2024;104:pzad105. https://doi.org/10.1093/ptj/pzad105.
He WC, Luo J
Phys Ther · 2025 Jun · PMID 40244043 · Publisher ↗
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On "Evaluating the Potential of Large Language Models for Vestibular Rehabilitation Education: A Comparison of ChatGPT, Google Gemini, and Clinicians." Arbel Y, Gimmon Y, Shmueli L. Phys Ther. 2025;105:pzaf010. https://doi.org/10.1093/ptj/pzaf010.
Kleebayoon A, Wiwanitkit V
Phys Ther · 2025 Jun · PMID 40226878 · Publisher ↗
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Author Response to Luo and He.
Avila L, da Silva MD, Neves ML … +5 more , Abreu AR, Fiuza CR, Fukusawa L, de Sá Ferreira A, Meziat-Filho N
Phys Ther · 2025 Jun · PMID 40226875 · Publisher ↗
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Effects of Whole-Body Vibration Therapy on Physical Function in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Huang CH, Chen CY, Lin HW … +6 more , Chiu YF, Lin LF, Tam KW, Lu TW, Chiang SW, Kuan YC
Phys Ther · 2025 Jun · PMID 40214179 · Publisher ↗
OBJECTIVE: Although whole-body vibration (WBV) is often employed alongside traditional physical therapies to treat cerebral palsy, its effects on motor function remain unclear. Therefore, this study investigated the effe...
OBJECTIVE: Although whole-body vibration (WBV) is often employed alongside traditional physical therapies to treat cerebral palsy, its effects on motor function remain unclear. Therefore, this study investigated the effects of WBV either alone or in combination with other therapies in children with cerebral palsy, compared with control groups that underwent traditional physical therapy or remained untreated. METHODS: We analyzed randomized controlled trials published up to September 2024 that assessed motor function in WBV and control groups, including those receiving conventional physical therapy or no intervention. Articles were retrieved from PubMed, EMBASE, Scopus, and the Cochrane Library. The random-effects model was used to analyze the outcomes of these trials. RESULTS: Our search yielded 23 studies involving 729 participants. Compared with the control group, the WBV group exhibited significantly greater improvements in walking speed (pooled mean difference: 14.26 cm/s [95% CI = 6.45 to 22.08 cm/s]), Timed "Up & Go" test (TUG) results (pooled mean difference = -2.52 seconds [95% CI = -3.66 to -1.37 seconds]), Gross Motor Function Measure scores (total score: pooled mean difference = 0.69 [95% CI = 0.30 to 1.08]; dimension D: pooled mean difference = 3.41 [95% CI = 0.53 to 6.29]; dimension E: pooled mean difference = 3.28 [95% CI = 1.36 to 5.20]), and overall stability index values (standardized mean difference = -1.20 [95% CI = -2.28 to -0.11]). The Modified Ashworth Scale results varied between the muscle groups, and no intolerable adverse effects of WBV were reported. CONCLUSION: WBV improves postural control and motor performance in children with cerebral palsy by enhancing walking speed, TUG performance, and gross motor function without causing intolerable adverse effects. However, the certainty of the current evidence on the topic is very low or low. Additional well-structured trials are required to determine the optimal intensity of WBV treatment. IMPACT: Given its therapeutic benefits and safety, WBV may be considered as an adjunctive therapy for managing cerebral palsy, particularly for children with spastic cerebral palsy.
Feasibility of Direct-Access Physical Therapy for Concussion Management in the Pediatric Emergency Department: A Pilot Implementation Study.
Gagnon I, Turner M, Lacasse-Courchesne A … +10 more , McKee M, Tang ML, Sajjadi M, Friedman D, Hahn M, Osseiran L, Brody D, Beaulieu C, Greenstone I, Plotnick LH
Phys Ther · 2025 May · PMID 40214177 · Full text
OBJECTIVES: The objective of this study was to determine the feasibility of implementing an interdisciplinary approach to concussion assessment and management, including direct-access pediatric physical therapy in the pe...
OBJECTIVES: The objective of this study was to determine the feasibility of implementing an interdisciplinary approach to concussion assessment and management, including direct-access pediatric physical therapy in the pediatric emergency department (PED), with regard to parental satisfaction with early concussion management, documentation of clinical information for prognosis, and service organization metrics. METHODS: This was a single-center retrospective analysis of prospectively collected data. Patients <18 years old presenting to the PED with a suspected concussion were included and either received care using the interdisciplinary model of care (pediatric physical therapy + usual care) or usual care alone, depending on their time of presentation to the PED (12 hours/week of pediatric physical therapy coverage). Clinical and administrative data were collected from the participants' medical record. In addition, a random sample of participants received a quality improvement survey administered over the phone. RESULTS: Three hundred and forty-seven patients were included in the study population (mean [SD] age = 7.56 [5.62] years), and 81 were seen by the pediatric physical therapist. Those seen by the pediatric physical therapist had a significantly higher average satisfaction score for the Family domain (94.69 [11.60]) of the Pediatric Quality of Life Health care Satisfaction scale, than those who were not (89.02 [20.17]), as well as for Overall satisfaction (pediatric physical therapy = 95.45 [12.34] vs usual care = 89.21 [21.21]). Prognostic information was collected more systematically in patients seen by the pediatric physical therapist. CONCLUSIONS: The presence of a pediatric physical therapist in the PED could improve early management of children presenting for suspected concussions. Further research will help determine factors related to sustainability and prepare for broader implementation. IMPACT: Physical therapists, shown to be a positive addition in adult emergency departments, mostly for musculoskeletal conditions, were introduced in a PED in an interdisciplinary model of concussion care and were associated with improvements in satisfaction, clinical information documentation, and service organization. LAY SUMMARY: The study investigated whether direct access to pediatric physical therapy in the pediatric emergency department (PED) would enhance parental satisfaction, early concussion management, documentation, and service organization. Conducted at a single center, it analyzed data from patients under 18 years old with suspected concussions, comparing those who received care from a pediatric physical therapist plus usual care to those who received only usual care. Results showed that parents of children seen by the pediatric physical therapist reported higher satisfaction, and prognostic information was more systematically collected, suggesting that incorporating pediatric physical therapists into the PED could improve overall care and service organization.
Motivation Matters: Elucidating Factors Driving Exercise in People With Parkinson Disease.
Cools CI, Kotz SA, Bloem BR … +2 more , Duits AA, de Vries NM
Phys Ther · 2025 Jun · PMID 40207869 · Full text
OBJECTIVE: Despite the known benefits of exercise for people with Parkinson disease (PwP), activity levels are not sustained over time due to various motivators and barriers impacting exercise adherence. Previously, stud...
OBJECTIVE: Despite the known benefits of exercise for people with Parkinson disease (PwP), activity levels are not sustained over time due to various motivators and barriers impacting exercise adherence. Previously, studies on exercise adherence in PwP explored such barriers without describing or providing specific questions related to the determinants of motivation. Exercise adherence in PwP can be improved by addressing 3 key perspectives on motivation: personal factors (age, sex, premorbid motivation level, time when PwP started exercising, exercise before diagnosis, self-compassion), disease-related factors (perceived disease severity, depression score), and environmental factors (distance to exercise therapy, weather conditions, encouragement received from partners). METHODS: Six hundred seventy-two PwP from the Netherlands participated in an online survey that comprised questionnaires on demographics, depression, self-compassion, perceived disease severity, and additional questions on sports, motivation, and barriers related to sports. A multiple regression analysis was applied with current motivation as an outcome measure, and age, sex, perceived disease severity, premorbid motivation, depression, self-compassion, age starting exercising, and exercise before diagnosis as determinants. RESULTS: The results revealed that current motivation levels to exercise are associated with higher levels of premorbid motivation (b = 0.14), greater self-compassion (b = 0.32), lower age (b = -0.03), lower perceived disease severity (b = -0.10), and lesser degrees of depression (b = -0.10). Barriers stopping PwP from exercising were fatigue, weather conditions, and having less energy for other activities after exercising. CONCLUSION: Understanding these motivational factors and barriers helps shape and promote better exercise adherence and thereby ascertain greater symptomatic benefits for PwP. IMPACT: This study outcome gives health care professionals insight into determinants of motivation and exercise adherence, which will help enabling tailored approaches for improved engagement.
Relationship Between Fear of Movement and Physical Activity in Patients With Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta-Analysis.
Goubran M, Farajzadeh A, Lahart IM … +2 more , Bilodeau M, Boisgontier MP
Phys Ther · 2025 Jun · PMID 40188486 · Full text
OBJECTIVE: Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physic...
OBJECTIVE: Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physical activity. This study aims to examine whether this fear of movement is negatively associated with physical activity across several health conditions and what factors may influence this relationship. METHODS: Five databases were searched for studies including both a measure of fear of movement and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between fear of movement and physical activity. RESULTS: Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a negative correlation between fear of movement and physical activity (r = -0.19 [95% CI = -0.26 to -0.13]; I2 = 85.5%). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions but not in patients with chronic or acute pain. CONCLUSIONS: Our results suggest that higher levels of fear of movement are associated with lower levels of physical activity in several health conditions that are not necessarily painful. IMPACT: Fear of movement should be dissociated from pain and considered in relation to specific health conditions when implementing exercise therapy. Fear of movement may have prognostic and therapeutic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition.
Shared Decision-Making in Physical Therapist Care for People With Shoulder Problems: An Observer-Based Analysis of Audio-Recorded Consultations.
Hacquebord S, Kiers H, van der Wees P … +1 more , Hoogeboom TJ
Phys Ther · 2025 Jun · PMID 40184686 · Full text
OBJECTIVE: Despite the substantial diagnostic and therapeutic uncertainties in the decision-making process, it remains largely unclear to what extent shared decision-making (SDM) is applied in physical therapist care for...
OBJECTIVE: Despite the substantial diagnostic and therapeutic uncertainties in the decision-making process, it remains largely unclear to what extent shared decision-making (SDM) is applied in physical therapist care for people with shoulder problems. The purpose of our study was to determine to what extent SDM is part of the decision-making process in initial physical therapist consultations of people with shoulder problems and to identify factors associated with the level of SDM. METHODS: In this cross-sectional study, the level of SDM was measured by assessing audio-recorded initial physical therapist consultations of people with shoulder problems using the 5-item Observing Patient Involvement in SDM tool (OPTION-5; 0-100, higher OPTION scores indicate higher level of SDM). Associations between the level of SDM and the characteristics of patients, physical therapists, and consultations were assessed using multilevel analysis. RESULTS: A total of 100 initial physical therapist consultations of 41 participating physical therapists were included. The mean OPTION-5 score was 27 (range = 5-70). On none of the individual items of the OPTION-5, the highest score "exemplar effort" was observed. The multilevel analysis showed that 3 determinants were associated with higher level of SDM: younger age of the patient (b = -1.8; 95% CI = -3.1 to -0.4), longer duration of the consultation (b = 5.5; 95% CI = 2.7 to 8.3), and higher level of education of the physical therapist (b = 9.1; 95% CI = 2.7 to 15.4). CONCLUSIONS: The level of SDM in daily physical therapist practice for people with shoulder problems leaves room for improvement. Future research should focus on strategies to improve the application of SDM in physical therapist care for people with shoulder problems. The determinants such as duration of the consultation, and the level of education of the physical therapist might provide guidance in developing these strategies for improving the application of SDM. IMPACT: The findings of this study give insight into the limited application of SDM in physical therapy for people with shoulder problems. Duration of the consultations and level of education of the physical therapist impact the level of SDM.
Correction to: Feasibility of a Multidomain Resiliency Assessment in Patients With Advanced Heart Failure Requiring Surgery: A Pilot Study.
Phys Ther · 2025 Apr · PMID 40181684 · Full text
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