Physical Therapy[JOURNAL]
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200 papers
Meeting Physical Activity Guidelines for Persons With Multiple Sclerosis Reduces Fatigue Severity and Impact: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Abou L, Murphy T, Truong E … +1 more , Peters J
Phys Ther · 2025 Jun · PMID 40167216 · Full text
OBJECTIVE: Regular physical activity is a recommended behavioral goal for persons with multiple sclerosis. This review aimed to determine the effect of interventions that met physical activity guidelines for persons with...
OBJECTIVE: Regular physical activity is a recommended behavioral goal for persons with multiple sclerosis. This review aimed to determine the effect of interventions that met physical activity guidelines for persons with multiple sclerosis on fatigue measures and to compare the magnitudes of the effect sizes for meeting these guidelines with the minimal clinically important differences for fatigue measures. METHODS: The search was conducted in PubMed, Embase, Web of Science, SPORTDiscus, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO from inception to October 2024. Only randomized clinical trials that explicitly met physical activity guidelines and evaluated fatigue were included. Two independent reviewers screened articles for inclusion and evaluated the risk of bias of included trials using the Cochrane risk-of-bias tool for randomized trials. Findings were summarized, and a meta-analysis was conducted. Fatigue measures included the Fatigue Severity Scale, Fatigue Impact Scale, and modified Fatigue Impact Scale. The Grading of Recommendations, Assessment, Development and Evaluation was used to evaluate the quality of the evidence. The review protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42023387305). RESULTS: Twenty-two randomized clinical trials with 920 participants were included in the review; 17 studies were included in the meta-analysis. Findings indicated that interventions meeting physical activity guidelines for at least 4 weeks significantly reduced fatigue severity (standardized mean difference = -1.46; 95% CI = -2.11 to -0.81) and fatigue impact measured with the modified Fatigue Impact Scale (mean difference = -11.88; 95% CI = -20.57 to -3.19) and Fatigue Impact Scale (mean difference = -21.08; 95% CI = -31.01 to -11.15). All findings were clinically relevant, with effect sizes exceeding the established minimal clinically important differences for the fatigue measures. Some methodological concerns were noted, and the evidence level ranged from very low to moderate. CONCLUSIONS: Evidence suggests that engaging in physical activity for at least 150 minutes per week or 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week results in clinically significant reductions in fatigue severity and impact necessary to improve the quality of life of persons with multiple sclerosis. IMPACT: Fatigue is a highly prevalent symptom associated with poor outcomes, including falls, activity restrictions, pain, cognitive problems, functional limitations, and mortality risk among persons with multiple sclerosis. Our study suggests that adhering to physical activity guidelines developed for persons with multiple sclerosis clinically reduces the severity and impact of fatigue. This regimen includes engaging in physical activity for at least 150 minutes per week or participating in 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week.
Characteristics, Trends, and Implications of Hybrid Doctor of Physical Therapy Programs in the United States.
Gagnon K, Bachman T, Garrigues A
Phys Ther · 2025 Mar · PMID 40167210 · Publisher ↗
IMPORTANCE: Hybrid Doctor of Physical Therapy (hDPT) programs, which combine online and in-person instruction, are becoming an increasingly common model for delivering physical therapist education. Understanding their ch...
IMPORTANCE: Hybrid Doctor of Physical Therapy (hDPT) programs, which combine online and in-person instruction, are becoming an increasingly common model for delivering physical therapist education. Understanding their characteristics, trends, and implications is critical to guiding their development and ensuring equitable and effective educational outcomes. OBJECTIVE: The objective of this study was to examine characteristics and trends in hybrid education programs through a secondary analysis of publicly available data. DESIGN: This study involved a secondary analysis of publicly available data on hDPT programs in the United States. SETTING/PARTICIPANTS/INTERVENTION: The study included accredited, candidate, and developing hDPT programs in the United States and involved descriptive analyses of program-level data. MAIN OUTCOMES AND MEASURES: Key variables included institution type, institution and program characteristics, admissions and enrollment data, and program outcomes. RESULTS: There are 33 hDPT programs at 25 unique institutions in the United States, located in 21 states. hDPT programs enroll a more racially and ethnically diverse body compared to national averages. Mean hDPT program cohort size was 32% larger than national average. Mean first-time pass rate for the National Physical Therapy Examination (NPTE) for hDPT graduates was reported at 71%, while ultimate pass rates, graduation rates, and employment rates ranged from 96% to 99%. Mean program duration and costs were consistent with national averages. CONCLUSION AND RELEVANCE: hDPT programs demonstrate potential to broaden access and diversity in the physical therapy profession. Standardized data collection and further research are essential to exploring these challenges and supporting development of accessible, equitable, and high-quality hybrid education pathways in physical therapy.
Effectiveness of home-based Rehabilitation on Activities of Daily Living in Patients With Stroke: Systematic Review and Meta-Analysis.
Do Y, Lim Y, Jin S … +1 more , Lee H
Phys Ther · 2025 Jun · PMID 40167208 · Publisher ↗
OBJECTIVE: This systematic review compared the effectiveness of home-based rehabilitation with that of hospital-based rehabilitation and usual care on activities of daily living (ADL) independence in patients with stroke...
OBJECTIVE: This systematic review compared the effectiveness of home-based rehabilitation with that of hospital-based rehabilitation and usual care on activities of daily living (ADL) independence in patients with stroke. METHODS: Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library databases were searched for studies published between January 2000 and January 2024. This review was registered in the International Prospective Register of Systematic Reviews. Randomized controlled trials on home-based rehabilitation of patients with stroke were included. The included studies investigated ADL independence, upper limb function, mobility, balance, aerobic endurance, and quality of life. Two independent researchers extracted data using an extraction form and assessed the risk of bias and quality of evidence. RESULTS: Forty-six studies were included in the qualitative synthesis, and 34 studies were included in the quantitative synthesis using Review Manager software 5.4. ADL independence was not significantly different between patients receiving home-based rehabilitation and hospital-based rehabilitation (standardized mean difference (SMD) = 0.17 [95% CI = 0.00 to 0.34], I2 = 29%). However, a significant difference was observed between home-based rehabilitation and usual care (SMD = 1.24 [95% CI = 0.69 to 1.79], I2 = 91%). CONCLUSION: Home-based rehabilitation is comparable to hospital-based rehabilitation and more effective than usual care and should be considered for patients with stroke after discharge to facilitate effective recovery. However, the high overall risk of bias requires cautious interpretation. IMPACT: Home-based rehabilitation can be an effective alternative method for improving ADL independence in patients with stroke by providing a familiar and convenient environment.
An Improvement Science Framework to Advance Sense of Belonging for Physical Therapist Students From Minoritized Backgrounds.
Naidoo K, Powell C, Jette DU
Phys Ther · 2025 Jun · PMID 40156931 · Publisher ↗
To better serve an increasingly racially and ethnically diverse United States population, the physical therapy profession has been focused on increasing the diversity of the physical therapy workforce and increasing recr...
To better serve an increasingly racially and ethnically diverse United States population, the physical therapy profession has been focused on increasing the diversity of the physical therapy workforce and increasing recruitment of racially and ethnically minoritized (REM) students in Doctor of Physical Therapy (DPT) programs. In contributing to the goal of a diverse, equitable, and inclusive profession, DPT programs must admit, support, retain, and graduate individuals who represent diversity in its many aspects. However, factors such as a lack of REM mentors and decreased sense of belonging contribute to disparate academic outcomes for REM DPT students. Although educators must act to implement innovative strategies to support a sense of belonging among students who have been historically marginalized, a systematic approach to decision-making, action, and analysis is needed when dealing with a complex problem with multifaceted causes and multiple possible solutions. Improvement science is a continuous improvement approach that uses a series of data-informed processes and the expertise of multiple stakeholders to promote equity in education, offering a framework for seeing the problem from the perspective of REM DPT students. Plan-Do-Study-Act (PDSA) cycles offer the opportunity to introduce educational changes on a smaller scale to evaluate variation prior to applying it to a larger setting. This perspective highlights a series of PDSA cycles trialing interventions aimed at decreasing barriers to success and improving a sense of belonging for REM DPT students. Even in the face of structural and institutionalized barriers, leveraging an improvement science framework can help ensure that change is meaningful and lasting.
A National Profile of Older Physical Therapy Users in France: Results of the 2015 Capacities, Aids, and Resource Representative Survey.
Jacob L, Pichon R, Jamal K … +1 more , Landré B
Phys Ther · 2025 May · PMID 40156926 · Publisher ↗
OBJECTIVE: Older adults-a highly heterogeneous group with complex health challenges-are often overlooked in the field of physical therapy despite their already important and growing numbers. This study aimed to estimate...
OBJECTIVE: Older adults-a highly heterogeneous group with complex health challenges-are often overlooked in the field of physical therapy despite their already important and growing numbers. This study aimed to estimate the use of physical therapy in the older population and compare the characteristics and health profiles of older adults who consult physical therapists with those who do not consult physical therapists. METHODS: Data from the French 2015 Capacities, Aids, and Resources survey, a large-scale survey with representative sampling weights, was used. It includes community-dwelling and institutionalized older adults aged 60 to 109 years. The main outcome measures were diseases (16 components), clinical symptoms (10 components), functional limitations (16 components), and geriatric syndromes (5 components). RESULTS: Among the 12,043 older adults included, 26.5% received treatment from a physical therapist, with 23.9% being 80 years or older. They had worse outcomes across all indicators. Rheumatology disorders (55.9%; OR = 2.26; 95% CI, 1.96-2.60), fatigue (48.3%; OR 1.84; 95% CI, 1.61-2.11), lower limb limitations (58.3%; OR = 2.64; 95% CI, 2.28-3.06), difficulty washing (34.1%; OR = 3.03; 95% CI, 2.54-3.61), difficulty with transportation (52.5%; OR = 2.46; 95% CI, 2.09-2.88), and multimorbidity (68.1%; OR = 2.07; 95% CI, 1.78-2.40), were the most common conditions in disease, symptoms, mobility, basic and instrumental activity limitations, and geriatric syndromes in this population. Several clinical situations were also uncommon but highly related to requiring physical therapeutic care such as having bedsores (OR = 2.67; 95% CI, 1.81-3.97) or Parkinson's disease (OR = 3.08; 95% CI, 2.08-4.55). They also accumulate more deficiencies in a 70-item frailty index than their counterparts in every age group and in every disease subgroup, suggesting a more complex health profile than older adults not requiring physical therapists. CONCLUSION: More than a quarter of older adults consulted a physical therapist. These patients showed complex profiles that simultaneously combine diseases, symptoms, geriatric syndromes, and limitations. IMPACT: These complex profiles and large-scale demographic changes underway are key challenges in the evolution of a profession that has a significant focus on disability.
On "Accreditation Can Advance Excellence in Physical Therapist Education: A Call to Action." Nordstrom T, Jette DU, Deusinger SS, et al. Phys Ther. 2024;104:pzae051.
Gleeson PB, Dunn S, Herr R
Phys Ther · 2025 Mar · PMID 40156885 · Publisher ↗
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Increasing Methodological Transparency and Openness in Rehabilitation-Related Health Services Research Using Claims Data: A Case Example.
Freburger JK, Mormer ER, Ressel K … +5 more , Johnson AM, Pastva AM, Bushnell CD, Duncan PW, Jones SB
Phys Ther · 2025 Mar · PMID 40143430 · Full text
Health insurance claims are a rich source of information for health services researchers and can provide evidence to understand issues related to access, efficiency, and effectiveness of care. While numerous studies have...
Health insurance claims are a rich source of information for health services researchers and can provide evidence to understand issues related to access, efficiency, and effectiveness of care. While numerous studies have examined rehabilitation utilization using Medicare, Medicaid, and/or private insurance claims data, these studies typically lack detail on approaches used to identify rehabilitation services. The primary objectives of this perspective are: (1) to raise awareness of the need for and importance of methodological transparency and openness in rehabilitation-related health services research using claims data and (2) to provide a case example by sharing the details of a method for identifying community-based physical therapy and occupational therapy in Medicare claims. General decisions made in claims-based analyses are discussed and then illustrated with the approach used for identifying community-based therapy claims within the context of a secondary analysis of data from a large, multicenter pragmatic clinical trial. Specific decisions made and challenges encountered are discussed, and recommendations are made for future work in this area. Sharing methodological details, data when possible, and metadata on approaches for conducting rehabilitation-related health services research can enhance its validity, rigor, and-ultimately-overall value. Rehabilitation health services researchers are encouraged to make greater efforts to share information on their methodological approaches using claims data and other data relevant to health services research.
Physical Therapist Interventions to Prevent Postpartum Urinary Incontinence: A Systematic Review.
Cabrera-Martos I, Cortés-Alcaraz C, Jiménez-López P … +3 more , López-López L, Torres-Sánchez I, Díaz-Mohedo E
Phys Ther · 2025 May · PMID 40114296 · Publisher ↗
IMPORTANCE: Postpartum urinary incontinence has a negative impact on the quality of life of women. OBJECTIVE: This systematic review aimed to describe and synthesize the scientific evidence on the effects of physical the...
IMPORTANCE: Postpartum urinary incontinence has a negative impact on the quality of life of women. OBJECTIVE: This systematic review aimed to describe and synthesize the scientific evidence on the effects of physical therapy in preventing postpartum urinary incontinence. DATA SOURCES: The following databases were searched up to April 2023: PubMed/MEDLINE, Web of Science, ScienceDirect, PEDro, CINAHL, and Scopus. STUDY SELECTION: Studies were included if they were randomized controlled trials; included women during pregnancy or at postpartum period; conducted a physical therapist intervention; and studied the prevention of postpartum urinary incontinence. DATA EXTRACTION AND SYNTHESIS: Two researchers extracted information of the descriptive characteristics of the studies and the interventions, variables, main outcomes, and results. MAIN OUTCOME AND MEASURES: Main outcomes were variables related to postpartum urinary incontinence. Quality appraisal was conducted using the PEDRO and Cochrane Risk of Bias 2.0 tools. RESULTS: Among the 2067 studies initially identified, 9 met the inclusion criteria. The main interventions include pelvic floor muscle exercises, electrical stimulation, and perineal massage. The studies demonstrated a positive impact on postpartum urinary incontinence incidence and related symptoms in most of the studies included. However, the heterogeneity presented in the characteristics of the sample, protocol, and outcome measures limited the conclusions reached. Quality assessment revealed moderate to high methodological quality in 90% of trials using the PEDro scale, while 70% presented a high risk of bias according to the Cochrane tool. CONCLUSIONS AND RELEVANCE: Physical therapist interventions, particularly pelvic floor muscle exercises, may have a positive effect in preventing postpartum urinary incontinence compared to usual care or no intervention. However, the heterogeneity and limited number of studies emphasize the need for more high-quality randomized controlled trials.
Author Response to Ferro et al.
Whalen Smith CN, Havercamp SM, Kennedy W … +4 more , Feldner HA, Herrman D, Sloane BM, Weinstein FH
Phys Ther · 2025 May · PMID 40112287 · Publisher ↗
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On "Detecting Artificial Intelligence-Generated Personal Statements in Professional Physical Therapist Education Program Applications: A Lexical Analysis." Hollman JH, Cloud-Biebl BA, Krause DA, Calley DQ. Phys Ther. 2024;104(4):pzae006. https://doi.org/10.1093/ptj/pzae006.
Daungsupawong H, Wiwanitkit V
Phys Ther · 2025 Apr · PMID 40111086 · Publisher ↗
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On "Physical Therapists in Primary Care in the United States: An Overview of Current Practice Models and Implementation Strategies" O'Bright K, Peterson S. Phys Ther. 2024;104(12):pzae123. 10.1093/ptj/pzae123.
Paci M, Cordani C
Phys Ther · 2025 May · PMID 40111076 · Publisher ↗
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Empowering Graduates: Strategies and Recommendations for Student Loan Forgiveness and Repayment Solutions in Physical Therapist Education.
Mischke JJ, Papa EV
Phys Ther · 2025 Mar · PMID 40111068 · Publisher ↗
The escalating costs of Doctor of Physical Therapy (DPT) education, combined with stagnant salaries, have led to considerable financial strain for physical therapy graduates, with many incurring substantial student debt....
The escalating costs of Doctor of Physical Therapy (DPT) education, combined with stagnant salaries, have led to considerable financial strain for physical therapy graduates, with many incurring substantial student debt. Data from the 2023 Commission on Accreditation in Physical Therapy Education report highlights the alarming rise in tuition fees, which, along with the high reliance on loans, has led to an average DPT debt of over $100,000. This burden is compounded by the impact on employment decisions, with a significant portion of physical therapists reporting debt-related anxiety and career limitations. Despite initiatives like the American Physical Therapy Association's Financial Solutions Center and various loan repayment programs, many graduates remain uninformed about alternatives to traditional loans. This Perspective builds on previous research by offering 5 case-based scenarios along with actionable recommendations to alleviate the debt burden, including promoting employer-sponsored debt-relief programs, enhancing financial literacy, and engaging in legislative advocacy for policy reforms. By encouraging proactive steps at the individual and organizational levels, the authors aim to provide tangible solutions to address the growing crisis of student debt in physical therapy and ensure a more financially secure future for graduates.
Reporting and Methodological Qualities of Systematic Reviews in Rehabilitation Journals After 2020: A Cross-Sectional Meta-Epidemiological Study.
Tsuge T, Yamamoto N, Tomita Y … +5 more , Hagiyama A, Shiratsuchi D, Kato Y, Taito S, Yorifuji T
Phys Ther · 2025 Apr · PMID 40089987 · Publisher ↗
OBJECTIVES: The aim of this study was to investigate the reporting and methodological qualities in systematic reviews (SRs) of rehabilitation journals following updating to the use of the Preferred Reporting Items for Sy...
OBJECTIVES: The aim of this study was to investigate the reporting and methodological qualities in systematic reviews (SRs) of rehabilitation journals following updating to the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. METHODS: SRs with pairwise meta-analyses on the effects of health interventions were selected, which were published in rehabilitation journals in 2020, 2021, and 2022 using MEDLINE (PubMed). Exposure was defined as reporting use of the PRISMA 2020 statement. A comparison group consisted of SRs that did not use the PRISMA 2020 statement. The adherence of the PRISMA 2020 items, PRISMA 2020 for abstracts, and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 items were evaluated. RESULTS: Thirteen thousand, three hundred eighty-one articles were identified after conducting a search on April 2, 2023. The study included 100 articles each that used and those that did not use the PRISMA 2020 statement. Of 41 items in the PRISMA 2020 statement, 48.8% (20/41) adhered to ≥80% of each item for those that used the PRISMA 2020 statement and 41.5% (17/41) in those that did not use the PRISMA 2020 statement. The PRISMA 2020 statement did not lead to any major improvement, and only a slight improvement of 9.8% (4/41) was observed when compared with those that did not use the PRISMA 2020 statement. Similarly, no item improved in the PRISMA 2020 for abstracts, and only 5.6% (1/18) improved in the AMSTAR 2 items. CONCLUSION: This study showed that reporting use of the PRISMA 2020 statement did not result in any major improvements; however, only a slight improvement was observed in the reporting and methodological qualities of SRs in rehabilitation journals. Researchers should adhere to each item in the PRISMA 2020 statement in SRs published in rehabilitation journals. IMPACT: The reporting and methodological quality of systematic reviews in rehabilitation journals is insufficient. It is important to improve the reporting and methodological quality of systematic reviews in rehabilitation journals. It is recommended that researchers not only declare their reporting use of the PRISMA 2020 statement, but also adhere to each item correctly.
On "Training an Anti-Ableist Physical Therapist Workforce: Critical Perspectives of Health Care Education That Contribute to Health Inequities for People With Disabilities" Whalen Smith CN, Havercamp SM, Tosun L, et al. Phys Ther. 2024;104:pzae092. 10.1093/ptj/pzae092.
Ferro AM, Mercado J, Quinn L
Phys Ther · 2025 May · PMID 40089986 · Publisher ↗
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Does Inspiratory Threshold Loading and Visual Tasking Affect Visual Attention Accuracy?
Schan S, Ali-Hassan Y, Loebach B … +8 more , Bahl A, O'Quinn E, Kulkarni M, Van Hollebeke M, Rassam P, Mori T, Rozenberg D, Reid WD
Phys Ther · 2025 Apr · PMID 40089893 · Full text
OBJECTIVE: Dyspnea is commonly experienced in adults who are young and have different health conditions (asthma, obesity, panic disorders) and may impede not only physical exertion but also cognitive function such as vis...
OBJECTIVE: Dyspnea is commonly experienced in adults who are young and have different health conditions (asthma, obesity, panic disorders) and may impede not only physical exertion but also cognitive function such as visual attention. To test this, visual attention was evaluated using the Multiple Object Tracking Test (MOT) alone and combined with low or moderate inspiratory threshold loading (ITL). METHODS: Using a pretest-posttest design, we evaluated 25 participants who were healthy and 19 to 31 years old. Visual attention accuracy was quantified using the MOT, wherein participants tracked moving disks on a computer monitor. Participants performed 5 single or dual tasks in random order: MOT; low ITL of 20 cm H2O (ITL20); moderate ITL of 40 cm H2O (ITL40); dual task: MOT plus ITL20 (MOT + ITL20); and dual task: MOT plus ITL40 (MOT + ITL40). Dyspnea intensity measured with the Borg Dyspnea Scale and emotional response measured with the Self-Assessment Manikin (SAM) were evaluated at baseline and for single and dual tasks. RESULTS: Compared to single task MOT, dual tasks induced lower MOT scores with moderate loads (MOT + ITL40) resulting in lower scores than dual task low ITL (MOT + ITL20). Exertional dyspnea intensity and SAM affective measures increased during ITL and dual tasks compared to baseline. Moreover, higher dual task MOT scores were related to greater inspiratory muscle strength and to more positive affect evaluated by SAM. CONCLUSIONS: Individuals experiencing inspiratory muscle loading and associated dyspnea demonstrated decreased visual attention accuracy, which was accentuated by higher inspiratory loads, lower respiratory muscle strength, and higher emotional response. IMPACT: Although physical activity is often prescribed according to the musculoskeletal or cardiovascular stress, the cognitive interference of how dyspnea compromises cognitive function should be considered. The inability to attend to visual detail during added respiratory loads with associated dyspnea should be considered during assessment and treatment planning. A physical-cognitive approach to prescription of physical function may ensure more transferability to daily activities.
The Case for Aggregated Rehabilitation-Relevant Data Across Health Care Systems and Settings.
French MA, Johnson JK, Kean J … +2 more , Freburger JK, Young DL
Phys Ther · 2025 Apr · PMID 40089892 · Full text
Health care value, quantified as outcome per unit cost, requires knowing which outcomes are influenced by which intervention at what cost. The value of rehabilitation is still largely unknown. Much of the reason for this...
Health care value, quantified as outcome per unit cost, requires knowing which outcomes are influenced by which intervention at what cost. The value of rehabilitation is still largely unknown. Much of the reason for this limited evidence is historically poor standardization and collection of rehabilitation interventions, and objectively measured outcomes across care settings, care providers, and health care systems. The purposeful standardization and aggregation of rehabilitation-relevant data about interventions, cost, and outcomes from routine clinical practices offers potential to understand and improve the value of rehabilitation. This perspective details the critical need for rehabilitation-relevant data that are aggregated across settings, providers, and systems and proposes 3 options to meet this need, including (1) integrating rehabilitation-relevant data into existing research registry databases that are condition specific, (2) adding rehabilitation-relevant data to federally funded research networks, and (3) creating a novel rehabilitation registry database. There must be continued pursuit of discovering which rehabilitation interventions achieve which specific outcomes, in which settings, for which patients, and at what costs. Successfully aggregating rehabilitation-relevant data is critical for generating evidence that answers these key questions about the value of rehabilitation.
Clinical Assessment of Walking Capacity in People With Parkinson Disease: Are 2 Minutes Sufficient?
Johansson H, Rennie L, Grooten WJA … +1 more , Leavy B
Phys Ther · 2025 May · PMID 40089877 · Full text
OBJECTIVE: Walking capacity progressively declines in people with Parkinson disease (PD), and assessment of walking is imperative for monitoring disease progression and evaluating intervention efficacy. The main aim of t...
OBJECTIVE: Walking capacity progressively declines in people with Parkinson disease (PD), and assessment of walking is imperative for monitoring disease progression and evaluating intervention efficacy. The main aim of this study was to explore whether the 2-minute walk test (2MWT) could be substituted for the 6-minute walk test (6MWT) as a measure of walking capacity in people with PD. We also sought to investigate construct and known-groups validity of the 2MWT. METHODS: A cross-sectional analysis based on data from the Supported Home Training in Everyday Life for Parkinson Disease trial was conducted in a hospital setting. Sixty-three people with idiopathic, mild to moderate PD (29 women; mean age = 69.2 years) were included. Spatiotemporal gait parameters during the 2MWT and the 6MWT were captured by wearable sensors. Linear regression was used to analyze the association between distances walked, whereas paired-samples t tests and repeated-measures analysis of variance were used to explore mean differences in gait parameters. RESULTS: Distance walked over the 2MWT was very strongly associated with the 6MWT. Gait speed was higher during the shorter test, and several speed-related parameters significantly differed between the tests. There was a trend over the 6MWT, whereby participants performed better during the last 2 minutes of the test. Analyses revealed convergent, discriminant, and known-groups validity of the 2MWT. CONCLUSION: These findings suggest that the 2MWT adequately captures walking capacity among people with mild to moderate PD and demonstrates robust convergent validity and ability to discriminate between people at different levels of disease severity. IMPACT: The 2MWT is a sufficient and valid alternative for physical therapists who wish to assess walking capacity in people with mild to moderate PD.
Treatment Decision-Making for Anterior Cruciate Ligament Rupture From the Perspective of Physical Therapists in Australia: A Mixed Methods Study.
Filbay SR, Rooney J, Hoffmann T … +4 more , Edib Z, Teo PL, Hinman RS, Bennell KL
Phys Ther · 2025 May · PMID 40080635 · Full text
IMPORTANCE: In Australia, few people with acute anterior cruciate ligament (ACL) rupture are managed with rehabilitation alone despite clinical trials demonstrating similar outcomes to ACL reconstruction (ACLR). The reas...
IMPORTANCE: In Australia, few people with acute anterior cruciate ligament (ACL) rupture are managed with rehabilitation alone despite clinical trials demonstrating similar outcomes to ACL reconstruction (ACLR). The reasons for the low uptake of rehabilitation alone for the treatment of acute ACL rupture in Australia are unclear. OBJECTIVES: The objectives of this study were to evaluate physical therapists' beliefs and the information they provide to patients about treatment options for ACL rupture, and to explore ACL rupture treatment decision-making from the perspective of physical therapists. DESIGN: The design was a mixed-methods convergent parallel design comprising an Australia-wide survey (n = 246) and semi-structured interviews (n = 10). PARTICIPANTS: Participants included physical therapists who manage people with ACL rupture in Australia. MAIN OUTCOMES: The survey contained 41 items that assessed demographics, treatment of ACL rupture, referral pathways, treatment beliefs, and the information provided to patients with ACL rupture. RESULTS: Physical therapists' beliefs about treatment options varied and did not always reflect the information they provided to patients. Although 60% agreed that ACLR and rehabilitation-alone result in similar outcomes on average, only 37% reported regularly informing patients about this. To return to pivoting/contact sport, 23% believed that ACLR was required and 79% informed patients that ACLR was the best treatment to do so. Physical therapists felt that rehabilitation-alone is underutilized as a treatment for ACL rupture. Physical therapists encountered barriers to offering and providing rehabilitation-alone for ACL rupture, reflected in 7 qualitative themes: preference for surgery reflecting societal beliefs; more weight given to surgeon's opinion; unbalanced information from surgeon; referral pathways; uncertain recovery timeline; beliefs about treatment suitability; and knowledge and experience. CONCLUSIONS: Physical therapists had mixed beliefs about treatment options and the information provided to patients was not always evidence based. Physical therapists felt that nonsurgical management was underutilized, and experienced barriers to offering and providing non-surgical management of ACL rupture in clinical practice. RELEVANCE: Informed decision-making can only occur if accurate, evidence-based information about ACL rupture treatment options is provided to patients. These findings may be used to guide professional development for physical therapists and inform strategies to improve evidence uptake by physical therapists.
Transforming Ableism in Physical Therapist Education One Student at a Time: A Case Report of a Student With Blindness.
Flores MB, Sawyer KE, Campbell DF … +1 more , Manella KJ
Phys Ther · 2025 May · PMID 40079131 · Publisher ↗
INTRODUCTION: The prevalence of students with disabilities in physical therapist education programs in the United States is <1%. This case report explored the experiences surrounding a specific, unique individual student...
INTRODUCTION: The prevalence of students with disabilities in physical therapist education programs in the United States is <1%. This case report explored the experiences surrounding a specific, unique individual student with blindness or visual impairment (BVI) within the context of an entry-level physical therapist program. The purpose was not merely to describe 1 student's journey but to capture the complex dynamics and shifts in perceptions of students, faculty, staff, and clinicians. This case report retrospectively explored the perceptions of these individuals before, during, and after interactions with the student and examined ableist assumptions expressed by some individuals that vision is essential for Doctor of Physical Therapy (DPT) students and clinical practice. METHODS: A recent DPT graduate (pseudonym J.M.) with BVI classified as "near total blindness," is now a licensed, full-time employee at an outpatient orthopedic clinic. We surveyed 36 individuals (20 students, 11 faculty, 2 staff, and 3 clinical instructors) who interacted with J.M. as a student, asking their perceptions about the education, clinical skills, and employment potential of a DPT student with BVI. RESULTS: An increase toward more favorable perceptions of individuals with BVI was exhibited for all of 10 Likert scale questions (X2[2] = 38.00 to 59.42). Qualitative analysis revealed 3 themes: accommodations, personal qualities, and setting with an overarching theme of an approbative shift in perceptions. DISCUSSION: The shift in perceptions about vision as essential for physical therapist practice is important and suggests that physical therapist education program applicant qualifications and essential functions regarding vision should be considered within the context of reasonable accommodations, individual characteristics, and lived experiences. IMPACT: Redefining physical therapist education program applicant qualifications and essential functions regarding vision may be warranted. For clinical instructors, the benefits may outweigh the challenges of mentoring a student with accommodations for BVI.
Current and Projected Future Supply and Demand for Physical Therapists From 2022 to 2037: A New Approach Using Microsimulation.
Zarek P, Ruttinger C, Armstrong D … +4 more , Chakrabarti R, Hess DR, Manal TJ, Dall TM
Phys Ther · 2025 Mar · PMID 40037340 · Full text
IMPORTANCE: Projections of physical therapist supply and demand provide critical insights into workforce trends, including factors that may influence possible shortages. OBJECTIVE: This study evaluates the current and fo...
IMPORTANCE: Projections of physical therapist supply and demand provide critical insights into workforce trends, including factors that may influence possible shortages. OBJECTIVE: This study evaluates the current and forecasted adequacy of the physical therapist workforce in the United States to meet the evolving health care needs of the population. DESIGN: This is a cross-sectional study that combines survey data, analysis of administrative databases, and microsimulation modeling. SETTING: The study evaluates future demand for physical therapists across all employment and care delivery settings. Projections of supply and demand are compared to assess workforce adequacy nationally and by state through 2037. PARTICIPANTS: Supply modeling incorporates a representative sample of physical therapists from each state, derived from the Federation of State Boards of Physical Therapy (FSBPT) counts and demographic data from the American Physical Therapy Association (APTA) member database. An online survey administered in April 2024 to APTA members (n = 1759 completed surveys, 18% response rate) collected data on demographics, practice characteristics, workload, hours worked, and retirement intentions. INTERVENTION: The study examines key factors influencing the physical therapist workforce, including demographics, care delivery patterns, workload, hours worked, and provider retention. MAIN OUTCOMES: The study forecasts annual full-time equivalent (FTE) physical therapist supply and demand through 2037, with state-level analysis and additional forecasts for alternative forecast scenarios. RESULTS: In 2022, there were an estimated 233,890 FTE physical therapists in the workforce. A projected shortfall of 12,070 FTEs (5.2%) in 2022 was identified relative to population demand. Although projected supply growth from 2022 to 2037 (39,170 FTEs) exceeds demand growth (36,280 FTEs), a national shortfall remains in most forecast scenarios. By 2037, the physical therapist supply is expected to reach 273,070 FTEs, while demand will increase to 282,230 FTEs, resulting in a projected shortfall of 9120 FTEs (3.3%) in the main scenario. CONCLUSIONS: Unless measures are implemented to boost the number of physical therapists entering or re-entering the workforce, or policies are enacted to improve retention, the national shortfall is likely to persist, further exacerbating access to care challenges. RELEVANCE: This study underscores the need for targeted policy interventions to address workforce shortages and additional research into health care workforce forecasting.
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