Physical Therapy最新文献

{"title":"Sustaining Physical Activity in Chronic Obstructive Pulmonary Disease: A Qualitative Study of Perspectives on a Personalized Community-Based Physical Activity Program (PICk UP).","authors":"Patrícia Rebelo, Dina Brooks, Alda Marques","doi":"10.1093/ptj/pzag051","DOIUrl":"https://doi.org/10.1093/ptj/pzag051","url":null,"abstract":"<p><strong>Importance: </strong>Sustaining pulmonary rehabilitation (PR) benefits in community-dwelling individuals with chronic obstructive pulmonary disease (COPD) is challenging.</p><p><strong>Objective: </strong>The objective of this study was to explore the experiences of individuals with COPD participating in a PersonalIzed CommUnity-based Physical Activities program (PICk UP) and to identify which behavioral change techniques supported sustained physical activity.</p><p><strong>Design: </strong>This was a qualitative pre-post intervention study (NCT04223362 | NCT04711057).</p><p><strong>Setting: </strong>The study was conducted in a community setting.</p><p><strong>Participants: </strong>This study recruited individuals with COPD assigned to the PICk UP intervention.</p><p><strong>Intervention: </strong>Participants enrolled in a 6-month, post-PR, community-based program comprising gym, senior exercise classes, pool exercise classes, or Chi Kung.</p><p><strong>Main outcome and measures: </strong>Participants' perspectives on impacts of the PICk UP program, motivators, facilitators and barriers to adherence were collected through pre-post focus groups. Data were analyzed using deductive and inductive reflexive thematic analysis. The \"capability, opportunity, motivation, behavior\" (COM-B) framework was used to identify behavioral change techniques.</p><p><strong>Results: </strong>Fifteen individuals with COPD participated (14 male, 70 (8) years, FEV1 57.1% (18.1%) predicted). Five main themes emerged, focusing on physical activity choice, barriers, facilitators, effects, and suggestions: (1) one size doesn't fit all; (2) organizational factors and system-level support enabling adherence; (3) it doesn't come easy; (4) a positive feedback cycle sustained physical, psychological and social benefits; and (5) the more, the merrier. The PICk UP intervention supported physical activity through 13 behavioral change techniques, across 5 intervention types (education, persuasion, training, environmental restructuring and enablement), collectively addressing all 6 components influencing behavior.</p><p><strong>Conclusions: </strong>Individuals with COPD reported lasting PR benefits after the PICk UP and were willing to remain physically active. Participants emphasized the importance of diverse physical activity options and support from peers, health, and fitness professionals.</p><p><strong>Relevance: </strong>To sustain physical activity beyond PR, interventions should prioritize intersectoral partnerships and embed ongoing social support. These findings underscore PICk UP's effectiveness, positioning it as a promising and replicable model for promoting long-term physical activity in individuals with COPD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856962","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":"Frequency and Severity of Adverse Events Associated With Dry Needling: A Systematic Review and Meta-Analysis.","authors":"Gabriel Rabanal-Rodríguez, Manuel Anxo Simón-Alonso, Marcos José Navarro-Santana, César Fernández-de-Las-Peñas, Daniel Albert-Lucena, María José Díaz-Arribas, Juan Antonio Valera-Calero, Gustavo Plaza-Manzano","doi":"10.1093/ptj/pzag050","DOIUrl":"https://doi.org/10.1093/ptj/pzag050","url":null,"abstract":"<p><strong>Importance: </strong>Dry needling (DN) is widely used in musculoskeletal practice. However, the incidence and severity of adverse events (AEs) associated to DN remain unclear.</p><p><strong>Objective: </strong>The objective was to report the frequency and severity of AEs related to DN.</p><p><strong>Design: </strong>This was a systematic review with meta-analysis.</p><p><strong>Setting: </strong>Following the PRISMA checklist, PubMed, Web of Science and Scopus databases were systematically searched from September 2024 to April 2025.</p><p><strong>Studies and intervention: </strong>Case reports, case series, surveys, observational studies, and randomized clinical trials conducted on humans, applying DN and assessing associated AEs, were collected.</p><p><strong>Main outcomes and measures: </strong>Methodological quality and risk of bias were assessed using the Joanna Briggs Institute tool, the AXIS tool, the PEDro scale and the Newcastle-Ottawa scale. Data was screened and extracted by 2 independent investigators, consulting a third researcher in case of doubts. The information was analyzed and classified in separate tables detailing the characteristics of the sample, the interventions, the AEs, and the methodological quality from the different types of studies.</p><p><strong>Results: </strong>A total of 59 articles were included, comprising 25 patients in case reports and case series, 1947 patients in randomized clinical trials and prospective observational studies and 2380 professionals in surveys. DN was found to commonly produce minor AEs, ranging from 0% to 48.15% per treatment and from 2.56% to 72.73% throughout a clinician's career. Major AEs per treatment are uncommon (0%-0.43%) but are reported by 0.98% to 39.14% of professionals when assessing their complete clinical practice.</p><p><strong>Conclusions and relevance: </strong>While DN is widely used and generally associated with minor AEs, this review highlights the potential for rare although serious complications.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841351","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":"Next generation trial design for intensive care unit rehabilitation.","authors":"Amy Nordon-Craft, Patricia J Ohtake, James M Smith, Heidi J Engel, John D Lowman, Marc Moss, Amy M Pastva","doi":"10.1093/ptj/pzag036","DOIUrl":"10.1093/ptj/pzag036","url":null,"abstract":"<p><p>The last 20 years have seen an explosion of research devoted to understanding the feasibility, safety, implementation, and patient and system outcomes of physical rehabilitation for patients who are critically ill in the intensive care unit (ICU). Multiple systematic reviews and meta-analyses have shown ICU physical rehabilitation to be feasible, safe, contribute to reduced ICU and hospital stays, reduce days on mechanical ventilation, and improve functional level outcomes at ICU and hospital discharge. These data demonstrate that ICU physical rehabilitation offers transformative potential for improving functional independence and quality of life in patients who are critically ill. However, significant barriers persist in translating evidence from randomized controlled trials into routine clinical practice. These barriers include patient heterogeneity, inconsistent intervention protocols and reporting, and systemic obstacles to implementation. This article provides perspective on these key challenges and proposes strategies for designing next-generation trials. Impact: Survivors of critical illness often face lasting physical, cognitive, and mental health challenges, and physical rehabilitation in the ICU can improve recovery. This article explores the importance of tailoring physical rehabilitation to individual needs and proposes new research methods to improve the design and outcomes of future ICU trials. By addressing challenges, the authors provide practical solutions to make ICU rehabilitation more accessible and effective. These insights aim to enhance recovery and quality of life for ICU survivors.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662641","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":"News from the Foundation for Physical Therapy Research, May 2026.","authors":"","doi":"10.1093/ptj/pzag037","DOIUrl":"https://doi.org/10.1093/ptj/pzag037","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841363","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":"Author Response to Wang et al.","authors":"Kaitlyn S Foster, Daniel I Rhon","doi":"10.1093/ptj/pzag045","DOIUrl":"https://doi.org/10.1093/ptj/pzag045","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778573","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":"Supporting Family Care Partners During Physical Therapy Care.","authors":"Gretchen Guttendorf Tucker, Jasmine K Cooper, Denise Orwig, Jason R Falvey","doi":"10.1093/ptj/pzag048","DOIUrl":"https://doi.org/10.1093/ptj/pzag048","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778597","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 \"Does Treating Low Back Pain with Therapeutic Exercise Reduce the Risk of Subsequent Lower Extremity Injury? A Population-Level Cohort Analysis.\" Foster K, Wang-Price S, Weber M, Et al. Phys Ther. 2025;105(11):pzaf122. Https://Doi.Org/10.1093/Ptj/pzaf122.","authors":"Gang Wang, Yafei Kong, Yunchao Wang","doi":"10.1093/ptj/pzag044","DOIUrl":"https://doi.org/10.1093/ptj/pzag044","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778570","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":"Gait Adaptability Training for Individuals with Non-Progressive Neurological Conditions: A Scoping Review of Intervention Characteristics and Outcome Measures.","authors":"Nicole Cesca, Matthew G Heffernan, Sydney Winokur, Katherine Chan, Clara Pujol-Fuentes, Kristin E Musselman","doi":"10.1093/ptj/pzag038","DOIUrl":"https://doi.org/10.1093/ptj/pzag038","url":null,"abstract":"<p><strong>Importance: </strong>Gait adaptability is essential for safe walking. Impairments after non-progressive neurological conditions contribute to walking limitations and fall risk. Advances in virtual/augmented reality-based treadmills/walkways have increased interest in gait adaptability assessment and training, making a review timely.</p><p><strong>Objective: </strong>The objectives were as follows: (1) Explore the characteristics and outcomes of physical interventions used to improve gait adaptability for individuals with non-progressive neurological conditions; and (2) Identify the outcome measures and tasks used to track changes with interventions incorporating gait adaptability training.</p><p><strong>Data sources: </strong>A comprehensive search was conducted in 6 databases: CINAHL Complete, Embase, Emcare Nursing, Medline ALL, PEDro, and Web of Science Core Collection, from inception to September 8, 2025.</p><p><strong>Study selection: </strong>Studies that involved adults with non-progressive neurological conditions, incorporated walking with environmental/task changes, targeted gait adaptability, and included >2 training sessions were included.</p><p><strong>Data extraction and synthesis: </strong>Study/participant characteristics, interventions, and outcomes were extracted. Methodological quality was assessed using the Modified Downs and Black checklist. Interventions were categorized into 6 groups, and their alignment with 9 gait adaptability domains was evaluated. Outcome measures were identified and classified based on relevance to gait adaptability.</p><p><strong>Results: </strong>Twenty-nine studies (881 participants: 743 stroke, 132 spinal cord injury, 6 acquired brain injury) were included. The most common interventions were skilled overground/community walking and treadmill training with virtual/augmented reality. Obstacle negotiation was the most frequently targeted gait adaptability domain. Interventions that incorporated gait adaptability training led to improvements in walking outcomes such as speed and endurance. The most common outcome measures-10-Meter Walk Test, Timed Up and Go, and 6-Minute Walk Test-do not directly assess gait adaptability.</p><p><strong>Conclusions and relevance: </strong>Interventions that incorporated gait adaptability training included a broad range of overground and treadmill training approaches, and improved walking ability. Future trials should include measures that directly assess multiple domains of gait adaptability.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675850","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":"Primary Care Physical Therapy: 2025 Consensus Definition.","authors":"Katie O'Bright, Alyson M Cavanaugh, Ashley Cassel, Jennifer C Turner, David Macchia, Evan E Kelley, Layne Compton, Riley J Luetkenhaus, Steven Wentz, Micah A K M Wong","doi":"10.1093/ptj/pzag035","DOIUrl":"https://doi.org/10.1093/ptj/pzag035","url":null,"abstract":"<p><p>Over several decades, the American Physical Therapy Association (APTA) has been prompted with numerous motions in its House of Delegates to elaborate on the role of physical therapists in primary care. The 2025 APTA House of Delegates adopted a motion recognizing primary care physical therapy (PCPT) as an area of specialty and residency practice. One of the most common inquiries presented to the 2022 to 2025 APTA Federal Primary Care Special Interest Group (PC-SIG) board members was \"how is primary care physical therapy (PCPT) defined?\" As this practice area develops, it was determined that a consensus definition would prove to be an invaluable resource to ensure consistent language and knowledge translation. Therefore, the purpose of this project was to develop a consensus definition for PCPT.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675791","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":"Toward a shared framework for therapeutic pain education: a Delphi-based international consensus.","authors":"Silvia Di-Bonaventura, Francisco Gurdiel-Álvarez, Álvaro Reina-Varona, Ferran Cuenca-Martínez, Josué Fernández-Carnero, Mónica Grande-Alonso, Eva Huysmans, Roy La Touche, Federico Montero-Cuadrado, Rodrigo Nuñez-Cortes, Joaquín Pardo-Montero, Alba Paris-Alemany, Emilio L Puentedura, Felipe J J Reis, Giacomo Rossettini, Cormac G Ryan, Anabela G Silva, Luís Suso-Martí, Paul van Wilgen, Amarins Wijma, Kory Zimney, Raúl Ferrer-Peña","doi":"10.1093/ptj/pzag029","DOIUrl":"10.1093/ptj/pzag029","url":null,"abstract":"<p><strong>Importance: </strong>Persistent pain is a global cause of disability, affecting daily life and physical, psychological, and social functioning. While biomedical approaches may alleviate symptoms, they often overlook psychological, behavioral, and contextual contributors. Recently, therapeutic pain education has emerged as a key non-pharmacological strategy; however, consensus on its core content and implementation is still lacking.</p><p><strong>Objective: </strong>The objective was to reach an international expert consensus on the core components of therapeutic education programs for individuals with persistent pain.</p><p><strong>Design: </strong>The study consisted of a 3-round Delphi consensus study.</p><p><strong>Setting: </strong>An international, online Delphi modality was performed.</p><p><strong>Participants: </strong>Twenty-one multidisciplinary experts from 10 countries (high- to middle-income ratio: 19/2) were included in the present study.</p><p><strong>Intervention(s) or exposure(s): </strong>Participation consisted of a structured Delphi process of 1 open-ended round and 2 structured rounds using a 4-point Likert scale, organized across 8 predefined domains.</p><p><strong>Main outcome and measure(s): </strong>The main outcome was expert agreement on core components of therapeutic pain education, defined as an Aiken V value ≥0.7 with their 95% confidence interval exceeding this threshold. The process was organized around 8 domains: topic areas, patient/learner characteristics, materials and resources, activities, dosage and frequency, learning outcomes, context/environment, and adherence assessment.</p><p><strong>Results: </strong>The experts, with a mean of 20 years of clinical experience (SD = 9.6) and 15 years of research experience (SD = 6.4), reached agreement on 35 items. Experts highlighted core content such as neuroplasticity, pain-related beliefs, emotional regulation, and behavior change. They recommended assessing motivation, readiness to change, expectations, tailoring interventions to patient profiles, using explicit, evidence-based materials, including graded exposure and pacing, adjusting dosage according to engagement, ensuring a safe, welcoming, private environment, and assessing changes in beliefs, functioning, and lifestyle.</p><p><strong>Conclusion: </strong>This study provides an internationally validated framework for designing and implementing therapeutic education programs for individuals with persistent pain.</p><p><strong>Relevance: </strong>By translating expert consensus into practical components, it bridges the gap between theory and clinical practice, supporting consistent, patient-centered strategies and informing future implementation and research.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499657","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}