Physical Therapy最新文献

{"title":"Depressive Symptoms and Physical Activity Mediate the Adverse Effect of Pain on Functional Dependence in Patients With Arthritis: Evidence From the Canadian Longitudinal Study on Aging.","authors":"Miriam Goubran, Zachary M Allen, Martin Bilodeau, Matthieu P Boisgontier","doi":"10.1093/ptj/pzaf120","DOIUrl":"https://doi.org/10.1093/ptj/pzaf120","url":null,"abstract":"<p><strong>Importance: </strong>Arthritis is a chronic condition affecting hundreds of millions of people worldwide, often leading to pain and functional limitations.</p><p><strong>Objective: </strong>This study aimed to investigate the direct and indirect effects of pain on functional dependence in individuals with arthritis. Depressive symptoms and physical activity were examined as potential mediators of this relationship.</p><p><strong>Design: </strong>This study was a longitudinal cohort study.</p><p><strong>Setting: </strong>The study setting included community-dwelling adults participating in the Canadian Longitudinal Study on Aging.</p><p><strong>Participants: </strong>This study included a total of 6972 participants with arthritis including 4930 with osteoarthritis and 694 with rheumatoid arthritis.</p><p><strong>Exposure: </strong>The exposure was the usual presence of pain or discomfort at baseline, with depressive symptoms (CESD-10) and physical activity (PASE) tested as mediators.</p><p><strong>Main outcome and measure: </strong>The main outcome was functional dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL) at follow-up, measured with a modified version of the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire (OARS).</p><p><strong>Results: </strong>Baseline pain was positively associated with depressive symptoms (b = 0.356 [95% CI = 0.310 to 0.402]) and negatively associated with physical activity (b = -0.083 [95% CI = -0.125 to -0.042]). Functional dependence at follow-up was significantly predicted by baseline pain (log OR = 0.607 [95% CI = 0.261 to 0.952]), depressive symptoms (log OR = 0.358 [95% CI = 0.184 to 0.533]), and physical activity (log OR = -0.598 [95% CI = -0.818 to -0.378]). Mediation analysis showed that 23.3% of the total effect of pain on functional dependence was accounted for by the indirect effect through depressive symptoms (16.2%), physical activity (6.3%), and their serial combination (0.8%).</p><p><strong>Conclusions: </strong>The presence of pain at baseline was associated with higher odds of functional dependence in basic and instrumental activities of daily living after a mean follow-up period of 6.3 years, with depressive symptoms and lower physical activity acting as mediators.</p><p><strong>Relevance: </strong>The findings highlight the need for arthritis care to extend beyond pain management by incorporating strategies that address depressive symptoms and promote physical activity to preserve functional independence.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Physical Therapist Treatment in Addition to Usual Podiatry Management of Plantar Heel Pain: Economic Evaluation of a Randomized Clinical Trial.","authors":"Shane M McClinton, Bryan C Heiderscheit, Timothy W Flynn, Daniel Pinto","doi":"10.1093/ptj/pzaf119","DOIUrl":"https://doi.org/10.1093/ptj/pzaf119","url":null,"abstract":"<p><strong>Importance: </strong>Plantar heel pain (PHP) contributes to reduced quality of life and is costly to manage. Persons with PHP are infrequently referred to a physical therapist after presenting to primary care or podiatry.</p><p><strong>Objective: </strong>The study objective was to compare the cost-effectiveness of usual podiatry care (uPOD) plus physical therapist treatment with that of uPOD alone in the management of PHP.</p><p><strong>Design: </strong>A cost-effectiveness analysis from societal and health care sector perspectives and a 3-year time horizon was performed alongside a randomized clinical trial. Intention to treat was used as the base case, and sensitivity analyses were used to assess the impact of adherence to treatment (ie, per protocol) and PHP-specific costs.</p><p><strong>Setting: </strong>The setting was a multidisciplinary outpatient clinic in the United States.</p><p><strong>Participants: </strong>Participants were 95 eligible patients with PHP.</p><p><strong>Interventions: </strong>uPOD consisted of a stretching handout, medication, injections, and orthotics; uPOD plus physical therapist treatment also included physical therapist intervention consisting of manual therapy, exercise, foot taping, and iontophoresis.</p><p><strong>Main outcomes and measures: </strong>Cost-effectiveness was determined by between-group differences in costs relative to quality-adjusted life-years (QALYs). Cost-effectiveness at different thresholds of decision maker willingness to pay was illustrated using the cost-effectiveness acceptability curve.</p><p><strong>Results: </strong>uPOD plus physical therapist treatment reduced societal costs by $2708 (95% CI = -$294 to $5709) relative to uPOD and increased QALYs by 0.09 (95% CI = -0.01 to 0.18). The cost-effectiveness acceptability curve demonstrated 98%, 99%, and 97% probabilities of cost-effectiveness of uPOD plus physical therapist treatment in the base-case, per-protocol, and PHP-specific cost analyses using a willingness-to-pay threshold of $50,000 per QALY.</p><p><strong>Conclusions: </strong>Adding physical therapist treatment to uPOD lowered total costs and improved quality of life despite increased short-term health care utilization. Results were not altered when considering adherence to treatment or PHP-specific costs.</p><p><strong>Relevance: </strong>This study informs shared decision-making between providers and patients with PHP about the costs and benefits of adding physical therapist treatment and provides support for the economic value of physical therapist treatment for PHP.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate, Intensity, Disability, and Characteristics of Back Pain in Children 0 to 18 Years Old Referred to Pediatric Orthopedics for Spinal Concerns.","authors":"Karina A Zapata, Brandon A Ramo, Chan-Hee Jo, Jason R Petrasic","doi":"10.1093/ptj/pzaf106","DOIUrl":"10.1093/ptj/pzaf106","url":null,"abstract":"<p><strong>Importance: </strong>The rate of back pain in children is unclear.</p><p><strong>Objective: </strong>This study evaluated the rate, intensity, disability, and characteristics of back pain across the pediatric age span in children referred with spinal concerns.</p><p><strong>Design: </strong>This study used a retrospective design.</p><p><strong>Setting: </strong>This was completed at a tertiary pediatric orthopedic institution in the United States.</p><p><strong>Participants: </strong>Seventeen thousand nine hundred eleven children (6621 male and 11,280 female) ages 0 to 18.9 with any spinal condition from July 2018 to April 2022 were evaluated.</p><p><strong>Main outcomes: </strong>All children/caregivers were asked yes/no, \"Is back pain a significant concern at today's visit or the past 6 months?\" Beginning in February 2020, children who reported back pain were assigned the 9-item Oswestry Disability Index (ODI-9). Beginning in April 2021, all children ages 5 and above were assigned 3 patient-reported outcomes measurement information system (PROMIS) pediatric measures: pain interference, mobility, and anxiety.</p><p><strong>Results: </strong>Forty-two percent (7580/17,911) of all children with spinal concerns reported back pain which increased from about 20% at age 2 to about 30% by age 7 to 40% by age 13 to at least 55% by age 16. Back pain intensity averaged 2.0 out of 5. ODI-9 scores averaged minimal disability (18%). Female sex (odds ratio [OR] = 1.36), public insurance type (OR = 1.33), increased age (OR = 1.16), higher PROMIS pain interference scores (OR = 1.13), increased body mass index (BMI) percentile (OR = 1.01), and lower PROMIS mobility scores (OR = 0.98) were associated with the presence of back pain.</p><p><strong>Conclusions: </strong>Four in 10 children referred with spinal concerns report back pain, which increases with female sex, public insurance type, age, BMI percentile, and worse PROMIS pain interference and mobility scores. Quantifying the functional, mental health, and socioeconomic burden of back pain can help prioritize multidisciplinary interventions.</p><p><strong>Relevance: </strong>Clinicians need to pay attention to the likelihood of back pain in a younger demographic than traditionally thought.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Tendon Tissue and Shoulder Disability Change During an 8-Week Exercise Intervention for Rotator Cuff Tendinopathy: An Observational Study.","authors":"Oscar Vila-Dieguez, Matt D Heindel, Mark C Zipser, Kameron Mortazavi, Kornelia Kulig, Greg Bashford, Wendy Mack, Lori A Michener","doi":"10.1093/ptj/pzaf107","DOIUrl":"10.1093/ptj/pzaf107","url":null,"abstract":"<p><strong>Importance: </strong>Understanding how tendon structure relates to disability improvement during exercise interventions in rotator cuff tendinopathy is essential for optimizing individualized treatment strategies.</p><p><strong>Objective: </strong>The objectives of this study were to characterize changes in supraspinatus tendon thickness and internal architecture over an 8-week resistive exercise intervention and evaluate the relationship between these changes and patient-reported shoulder disability.</p><p><strong>Design: </strong>This was a prospective longitudinal observational study.</p><p><strong>Setting: </strong>The settings were a university-based research laboratory and virtual supervision in participants' homes.</p><p><strong>Participants: </strong>Forty-seven adults with unilateral rotator cuff tendinopathy were the study participants.</p><p><strong>Intervention: </strong>The intervention was an 8-week progressive resistive exercise program, supervised twice weekly by a physical therapist.</p><p><strong>Main outcomes and measures: </strong>Primary outcomes were the Pennsylvania Shoulder Score, supraspinatus tendon thickness, and internal tendon architecture assessed using the peak spatial frequency radius via ultrasound. Measurements were taken at baseline and at 2, 4, and 8 weeks. Linear mixed-effects models were used to assess changes and associations.</p><p><strong>Results: </strong>Significant improvements from baseline were observed for the Pennsylvania Shoulder Score at 2, 4, and 8 weeks. Tendon thickness decreased significantly; changes in internal tendon architecture were not significant. A decrease in tendon thickness was associated with an improved Pennsylvania Shoulder Score at 2 weeks but not at 4 and 8 weeks.</p><p><strong>Conclusions: </strong>Reductions in tendon thickness were associated with improved shoulder outcomes within the first 2 weeks of the intervention. Internal tendon architecture remained unchanged over the intervention. These findings suggest that tendon variables included in this study may be relevant only early in the intervention and that other factors should be investigated across different times of the intervention.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response to Shoemaker Et al.","authors":"Patrick Zarek, Clark Ruttinger, David Armstrong, Ritashree Chakrabarti, Douglas R Hess, Tara Jo Manal, Timothy M Dall","doi":"10.1093/ptj/pzaf114","DOIUrl":"https://doi.org/10.1093/ptj/pzaf114","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On \"Seeing Past the Event Horizon: A Framework for Integrating Artificial Intelligence and Machine Learning into Physical Therapy.\" Morelli N. Phys Ther. 2025;105;pzae137. https://doi.org/10.1093/ptj/pzae137.","authors":"Kelly N Daley","doi":"10.1093/ptj/pzaf118","DOIUrl":"https://doi.org/10.1093/ptj/pzaf118","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On \"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, Et al. Phys Ther. 2025 Mar 3;105(3):pzaf014. 10.1093/ptj/pzaf014.","authors":"Michael J Shoemaker, Todd Sander, Sara Arena, Jennifer Blackwood, Kim Ferreira, Amy E Heath, Kristina Reid, Debbie Silkwood-Sherer, Susannah L Steele","doi":"10.1093/ptj/pzaf113","DOIUrl":"https://doi.org/10.1093/ptj/pzaf113","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behaviorally Informed Interventions to Promote Activity in the Home and Community for Adults with Neurological Disorders: A Systematic Review and Meta-Analysis.","authors":"Amber LaMarca, Rania Karim, P T Gwendolyn Larsen, Ivy Tse, Stephen WechslerPT, Lynne V Gauthier, Julie Keysor","doi":"10.1093/ptj/pzaf117","DOIUrl":"https://doi.org/10.1093/ptj/pzaf117","url":null,"abstract":"<p><strong>Importance: </strong>Physical activity can improve clinical outcomes among people with neurological conditions; however, people with these conditions rarely engage in recommended levels of activity. Remote monitoring (RM) with the incorporation of behavior change strategies is purported to be an effective approach to promote increased physical activity in the home setting, however, its effectiveness in promoting activity for people with neurological conditions is unclear.</p><p><strong>Objectives: </strong>The objectives of this review were to examine the effectiveness of behaviorally informed RM interventions on physical activity in the home and community and to identify usage and impact of specific behavior change techniques (BCTs) implemented with RM interventions.</p><p><strong>Data sources: </strong>PubMed, PsycINFO, and CINAHL were searched in March 2024.</p><p><strong>Study selection: </strong>This study included a selection of randomized controlled trials on behaviorally informed RM interventions that use wearable sensors or digital applications to target physical activity for patients with neurological diseases.</p><p><strong>Data extraction and synthesis: </strong>Data extraction was performed by 2 independent reviewers and data synthesis was performed with random effects meta-analysis. Behavior change techniques were classified using Michie's Behavior Change Technique Taxonomy. Promising BCTs were identified by examining the proportion of statistically significant studies for each technique. Risk of bias was assessed with the Risk of Bias 2 tool.</p><p><strong>Main outcomes and measures: </strong>The main outcomes and measures included physical activity measured by self-report and accelerometers.</p><p><strong>Results: </strong>Fourteen studies were included with some concerns of bias, encompassing individuals with multiple sclerosis, stroke, Parkinson disease, and spinal cord injury. Behaviorally informed RM interventions resulted in statistically significant improvements in self-reported physical activity (SMD = 0.27, 95% CI = 0.06 to 49]), but not accelerometry outcomes (SMD = 0.52, 95% CI = -0.07 to 1.11). Promising BCTs included self-monitoring, problem solving, goal setting, graded tasks, social support, and adding objects to the environment.</p><p><strong>Conclusions and relevance: </strong>Remote monitoring shows initial promise to increase physical activity of people living with neurological conditions when paired with behavior change consultation.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness is Independently Associated With Functioning in the Oldest Old: A Cross-Sectional Study Using Data From the Survey of Health, Ageing and Retirement in Europe.","authors":"Karina Bertoldi, Ariele Barreto Haagsma, Rafaella Stradiotto Bernardelli, Leandro Zen Karam, Laura Coll-Planas, Fernando Tadeu Trevisan Frajacomo, Javier Jerez-Roig, Cristina Pellegrino Baena","doi":"10.1093/ptj/pzaf116","DOIUrl":"https://doi.org/10.1093/ptj/pzaf116","url":null,"abstract":"<p><strong>Importance: </strong>Functionality is crucial for older adults' autonomy, and loneliness has emerged as a potential risk factor for chronic diseases. However, its role in functional limitations remains unclear.</p><p><strong>Objective: </strong>The objective of this study was to analyze the association between loneliness and limitations in 1 or more basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in individuals who were 80 years old or older.</p><p><strong>Design: </strong>This was a cross-sectional study using data from wave 8 of the Survey of Health, Ageing and Retirement in Europe.</p><p><strong>Setting: </strong>The study was conducted in 26 European countries.</p><p><strong>Participants: </strong>Participants were 7434 community-dwelling adults who were 80 years old or older.</p><p><strong>Exposure: </strong>Loneliness was assessed using the Three-Item Loneliness Scale, covering companionship, exclusion, and isolation.</p><p><strong>Main outcome and measures: </strong>Functional limitations were defined as difficulty in 1 or more BADL (dressing, walking, bathing, eating, bed transfer, toileting), IADL (map use, preparing a hot meal, shopping, phone use, medication management, housework, finances, transportation, laundry), or in both types of activities (BADL and IADL). Sociodemographic and health-related variables were considered. Logistic regression and multivariate analyses were applied, using the odds ratio (OR) as the effect measure.</p><p><strong>Results: </strong>The mean age was 84.4 (SD = 3.8) years; 58.2% of participants were women, and 52.5% had a low educational level. Loneliness affected 56% of participants, and 66% reported limitations in BADL/IADL. Loneliness was significantly associated with functional limitation in BADL/IADL in both univariate (OR = 2.18 [95% CI = 1.98-2.39]) and multivariate (OR = 1.50 [95% CI = 1.34-1.67]) models, even after adjustment for covariates, with an area under the receiver operating characteristic curve of 76%.</p><p><strong>Conclusions: </strong>Loneliness is significantly and independently associated with limitations in BADL/IADL among the oldest-old.</p><p><strong>Relevance: </strong>These findings highlight the importance of assessing psychosocial factors, such as loneliness, when evaluating functional health in the oldest-old.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Respiratory Exercise for Respiratory Function in Stroke Rehabilitation: A Network Meta-Analysis.","authors":"So Hyun Kim, Sung Hyoun Cho","doi":"10.1093/ptj/pzaf112","DOIUrl":"https://doi.org/10.1093/ptj/pzaf112","url":null,"abstract":"<p><strong>Importance: </strong>Determining the most effective intervention to improve respiratory function is complex.</p><p><strong>Objective: </strong>This study aimed to determine the effectiveness of various cardiorespiratory physical therapist interventions to improve respiratory function in patients with stroke and to prioritize them.</p><p><strong>Data sources: </strong>This network meta-analysis examined randomized controlled trials published between 2000 and 2023.</p><p><strong>Study selection: </strong>Randomized controlled trials that enrolled patients with stroke and examined various cardiorespiratory physical therapist interventions were selected. The interventions included combined aerobic and breathing training, combined inspiratory and expiratory training (CIET), conventional training (CT), expiratory training, ground-based aerobic training (GBAT), inspiratory training (IT), and sham intervention (S).</p><p><strong>Data extraction and synthesis: </strong>Data were independently extracted by 2 authors. Comprehensive Meta-Analysis Software program was used to analyze the data and determine effect sizes.</p><p><strong>Main outcomes and measures: </strong>Outcome variables were maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF).</p><p><strong>Results: </strong>Thirteen studies, involving 416 participants, were selected. CIET was more effective than CT in improving MEP, MIP, and PEF, with Hedges g (g) values of 0.890 (95% CI = 0.560 to 1.220), 0.948 (95% CI = 0.648 to 1.248), and 1.014 (95% CI = 0.636 to 1.391), respectively. IT was more effective than S for MEP (g = 0.582, 95% CI = 0.091 to 1.072) and more effective than CT for MIP (g = 0.934, 95% CI = 0.576 to 1.293). PEF analysis revealed that CIET was more effective than GBAT (g = -1.215, 95% CI = -2.035 to -0.395).Conclusions and Relevance: CIET or IT may improve respiratory function in patients with stroke more effectively than uniformly applied GBAT or CT. CIET and IT are effective regardless of age or intervention duration. Cardiopulmonary training is encouraged during the chronic phase of stroke to improve respiratory muscle strength, with at least 6 weeks of training recommended.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}