Physical Therapy最新文献

{"title":"News From the Foundation for Physical Therapy Research, February 2025.","authors":"","doi":"10.1093/ptj/pzaf003","DOIUrl":"https://doi.org/10.1093/ptj/pzaf003","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492556","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":"Physical Therapy for Mild Traumatic Brain Injury: Why Wait for a Faster Rate?","authors":"Steven Z George","doi":"10.1093/ptj/pzaf009","DOIUrl":"10.1093/ptj/pzaf009","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557414","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":"Why This, Why Now? Author Response to Stilwell et al and Beneciuk et al.","authors":"David A Nicholls","doi":"10.1093/ptj/pzae174","DOIUrl":"10.1093/ptj/pzae174","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824429","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":"Chronic Underrepresentation of Females and Women in Stroke Research Adversely Impacts Clinical Care.","authors":"Julia S Dahlby, Lara A Boyd","doi":"10.1093/ptj/pzae155","DOIUrl":"10.1093/ptj/pzae155","url":null,"abstract":"<p><p>Unequal sex and gender sample sizes in rehabilitation studies have implications for the generalizability of the evidence and for the clinicians that utilize their recommendations. Physical therapists rely on evidence-based guidelines to tailor their assessments and interventions to optimize outcomes for patients. We currently know that females and women have worse stroke outcomes and prognoses than their counterparts, however, rehabilitation guidelines remain the same for all individuals. Notably, stroke prevention and acute care has recently shifted to include female- and women-oriented guidelines, however, rehabilitation guidelines have not yet caught up. This article summarizes the key differences that females and women with stroke experience, how they may impact recovery, and calls for researchers and rehabilitation professionals to consider sex and gender when working with patients who've had a stroke. Doing so will improve the lives for those with stroke and maximize treatment options and rehabilitation outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682252","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":"Optimizing the Accuracy and Precision of the Minimal Detectable Change Statistic: Secondary Analysis of Test-retest Data From the NIH Toolbox Study.","authors":"Jeremy Graber, Brian J Loyd, Thomas J Hoogeboom, Caitlin J Miller, Andrew J Kittelson","doi":"10.1093/ptj/pzae170","DOIUrl":"10.1093/ptj/pzae170","url":null,"abstract":"<p><strong>Objective: </strong>The minimal detectable change (MDC) statistic is often used by clinicians to monitor change in patients. However, the way in which the MDC is traditionally calculated might be suboptimal in terms of accuracy and precision, potentially resulting in erroneous clinical decisions. This study compared the performance of the MDC statistic as traditionally calculated to that of 2 regression-based alternatives.</p><p><strong>Methods: </strong>This analysis used test-retest data from adults who participated in usual walking speed (n = 169) or grip strength (n = 178) assessments as part of the NIH Toolbox Study. Three approaches for MDC calculation were compared: the traditional approach (MDCTrad), simple linear regression (MDCSLR), and generalized additive models for location, scale, and shape (MDCGAMLSS). These approaches were compared in terms of accuracy and precision across all levels of measurement and separately for initial test values above and below the median.</p><p><strong>Results: </strong>Each of the 3 approaches accurately modeled detectable change thresholds when performance was averaged across all test values. However, MDCTrad demonstrated inaccuracies when performance was considered separately for initial test values below or above the median. For walking speed, average precision improved by 12% with MDCSLR and 16% with MDCGAMLSS, compared to MDCTrad. For grip strength, average precision improved by 3% with MDCSLR and 21% with MDCGAMLSS, compared to MDCTrad.</p><p><strong>Conclusion: </strong>MDCSLR and MDCGAMLSS appeared to more accurately and precisely model detectable change thresholds, compared to MDCTRAD. In general, MDCGAMLSS demonstrated the best overall performance in this within-sample analysis.</p><p><strong>Impact: </strong>Improved precision and accuracy in detectable change thresholds for walking speed or grip strength might facilitate clinicians' ability to promptly detect a decline in function and intervene and to confidently detect improvements in function over time.</p><p><strong>Lay summary: </strong>This study compared the performance of the MDC statistic as traditionally calculated to 2 regression-based alternatives.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688541","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":"Recommendations for Mobilization and Manipulation Treatment and Screening for Vascular Complications in Clinical Practice Guidelines for Neck Pain: A Systematic Review.","authors":"Renske Peters, Joannes Hallegraeff, Bart Koes, Emiel van Trijffel","doi":"10.1093/ptj/pzae179","DOIUrl":"10.1093/ptj/pzae179","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to determine the methodological quality of international clinical practice guidelines (CPGs) and the clinical credibility and implementability of recommendations regarding manipulation or mobilization treatment recommendations proposed in CPGs for the management of people with neck pain. A secondary aim of this review was to provide an overview of recommendations for manipulation or mobilization in patients with neck pain. Manipulation or mobilization treatment of patients with neck pain is under debate for its potential risk of serious adverse events. Serious adverse events are rare, but it is the clinicians' responsibility to thoroughly screen patients at risk of vascular complications. A third aim of this review was to describe the extent to which the included guidelines inform clinical practice about screening for the risk of complications due to vascular pathology in the cervical spine.</p><p><strong>Methods: </strong>A systematic review of 13 electronic databases and 4 repositories was performed for potentially relevant guidelines published between January 1, 2000 and September 22, 2022. Two reviewers independently appraised eligible guidelines using Appraisal of Guidelines for Research and Evaluation II (AGREE II) and Appraisal of Guidelines for Research and Evaluation: Recommendation EXcellence (AGREE-REX) criteria. A best evidence synthesis was performed, and screening of risk factors was assessed.</p><p><strong>Results: </strong>A total of 19 CPGs were included, of which 5 were of high quality. All high-quality guidelines recommend the use of manipulation or mobilization, with or without exercise. Eight (42%) guidelines described the screening of risk factors for adverse events. Two (11%) guidelines met the a priori defined criteria for screening and scored present and complete.</p><p><strong>Conclusion: </strong>International CPGs consistently recommend the use of manipulations and mobilizations in the treatment of neck pain. There is a notable absence of recommendations regarding the identification of patients at risk for vascular complications.</p><p><strong>Impact: </strong>The findings of this study allow guideline developers to improve the quality of future neck pain guidelines and consider including vascular screening tools. Furthermore, it proposes recommendations to physical therapists interested in applying manipulations and mobilizations in the treatment of patients with neck pain.</p><p><strong>Lay summary: </strong>International clinical practice guidelines consistently recommend the use of manipulations and mobilizations in the treatment of neck pain. There is a notable absence of recommendations regarding identifying patients at risk for vascular complications.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952994","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":"Online Graded Motor Imagery Is Effective in Women Diagnosed With Pelvic Pain: A Randomized Controlled Trial.","authors":"Aida Lopez-Brull, Borja Perez-Dominguez, Maria Plaza-Carrasco, Cristina Blasco-Ortiz, Blanca Navarro-Ribera, Jose Casaña, Esther Diaz Mohedo, Irmina Nahon","doi":"10.1093/ptj/pzae164","DOIUrl":"10.1093/ptj/pzae164","url":null,"abstract":"<p><strong>Objective: </strong>Effective therapeutic strategies are crucial for managing genito-pelvic pain/penetration disorder (GPPPD), a condition presenting challenges for both patients and health care providers. This study aims to assess the effectiveness of an online graded motor imagery (GMI) program in alleviating pain intensity and improving sexual function in women diagnosed with GPPPD.</p><p><strong>Methods: </strong>Eighty-seven women were randomly assigned to either an online GMI group or a control group. The online GMI protocol involved engaging participants in 2-week segments of left/right judgment exercises, mental simulation of movements, and gradual exposure therapy. After 6 weeks, we assessed pain intensity and sexual function. The control group gained access to the program upon study completion.</p><p><strong>Results: </strong>The online GMI group demonstrated a significant reduction in pain intensity, coupled with improvements in sexual function. Notably, participants with enhanced movement imagery abilities experienced greater improvements, while those with negative beliefs and thoughts regarding vaginal penetration showed lower sexual function scores.</p><p><strong>Conclusion: </strong>An online GMI program is effective in alleviating the pain burden faced by women dealing with GPPPD.</p><p><strong>Impact: </strong>Effectively addressing pelvic pain in patients remains a daunting challenge for physical therapists. Therefore, implementing efficient and easily accessible strategies is crucial. The incorporation of GMI intervention proves to be an effective approach for improving both pain and sexual functioning in women with GPPPD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626228","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":"Modeling Upper Limb Rehabilitation-Induced Recovery After Stroke: The Role of Attention as a Clinical Confounder.","authors":"Silvia Salvalaggio, Simone Gambazza, Martina Andò, Ilaria Parrotta, Francesca Burgio, Laura Danesin, Pierpaolo Busan, Sara Zago, Dante Mantini, Daniela D'Imperio, Marco Zorzi, Nicola Filippini, Andrea Turolla","doi":"10.1093/ptj/pzae148","DOIUrl":"10.1093/ptj/pzae148","url":null,"abstract":"<p><strong>Objective: </strong>People who have survived stroke may have motor and cognitive impairments. High dose of motor rehabilitation was found to provide clinically relevant improvement to upper limb (UL) motor function. Besides, mounting evidence suggests that clinical, neural, and neurophysiological features are associated with spontaneous recovery. However, the association between these features and rehabilitation-induced, rather than spontaneous, recovery has never been fully investigated. The objective was to explore the association between rehabilitation dose and UL motor outcome after stroke, as well as to identify which variables can be considered potential candidate predictors of motor recovery.</p><p><strong>Methods: </strong>People who survived stroke were assessed before and after a period of rehabilitation using motor, cognitive, neuroanatomical, and neurophysiological measures. We investigated the association between dose of rehabilitation and UL response (ie, Fugl-Meyer Assessment for upper extremity [FMA-UE]), using ordinary least squares regression as the primary analysis. To obtain unbiased estimates, adjusting covariates were selected using a directed acyclic graph.</p><p><strong>Results: </strong>Baseline FMA-UE was the only factor associated with motor recovery (b = 0.99; 95% CI = 0.83 to 1.15 points). Attention emerged as a confounder of the association between rehabilitation and final FMA-UE (b = 5.5; 95% CI = -0.8 to 11.9 points), influencing both rehabilitation and UL response.</p><p><strong>Conclusion: </strong>Preserved attention in people who have survived stroke might lead to greater UL motor recovery, albeit estimates have high levels of variability. Moreover, the increase in the dose of rehabilitation can lead to 5.5 points improvement on the FMA-UE, a nonsignificant but potentially meaningful finding. The approach described here discloses a new framework for investigating the effect of rehabilitation treatment as a potential driver of recovery.</p><p><strong>Impact: </strong>Attentional resources could play a key role in UL motor recovery. There is a potential association between amount of UL recovery and dose of rehabilitation delivered, needing further exploration. Preserved attention and rehabilitation dose are candidate predictors of UL motor recovery.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392470","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":"Sitting Together and Reaching to Play Physical Therapy Affects Dyadic Emotional Availability in Children With Neuromotor Delay and Their Families.","authors":"Rebecca M Molinini, Corri Stuyvenburg, Natalie A Koziol, Regina T Harbourne, Lin-Ya Hsu, Michele A Lobo, Sandra L Willett, James A Bovaird, Virginia W Chu, Sarah K Price, Mary S Shall, Stacey C Dusing","doi":"10.1093/ptj/pzae167","DOIUrl":"10.1093/ptj/pzae167","url":null,"abstract":"<p><strong>Objective: </strong>Emotional availability (EA) describes caregiver-child emotional attunement and is critical to fostering adaptive development. Although early physical therapist interventions adopt a family centered approach, the impact of interventions on families is often not quantified. This study compares EA in dyads receiving usual care-early intervention (UC-EI) versus sitting together and reaching to play (START-Play) in addition to UC-EI.</p><p><strong>Methods: </strong>Data were drawn from 106 children with neuromotor delay who were 7 to 16 months old at baseline (mean = 10.5 months) and from their caregiver (91% were mothers). The EA Scale, Fourth Edition, was scored from 5-min videotaped interactions collected at baseline and at 3, 6, and 12 months after baseline. Piecewise multilevel modeling controlling for baseline age and motor delay estimated short- and long-term effects between treatment groups. Additionally, within-group change over time was analyzed to understand if groups differed in direction of EA trajectories. Analyses were run aggregated across all participants and stratified by baseline severity of motor delay or caregiver reported education.</p><p><strong>Results: </strong>When comparing EA between groups, there were significant positive short- and long-term effects of START-Play on adult EA (gs > 0.38), sensitivity (gs > 0.26), structuring (gs > 0.43), and nonintrusiveness (gs > 0.36). For dyads with mild or significant motor delay or whose parent reported less than a bachelor's degree at baseline, positive effects of START-Play were observed.</p><p><strong>Conclusion: </strong>Results support important clinical implications for the positive effect of START-Play on EA. Similar child-level treatment effects highlight that the key difference between START-Play and UC-EI may lie in the way intervention affects caregivers. START-Play may be more beneficial to dyads with higher versus lower risks to EA.</p><p><strong>Impact: </strong>Early physical therapist interventions can have a significant impact on parents, children, and the parent-child relationship. Measuring the effect of these interventions on the relationship is critical to optimizing the delivery of family centered care.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441463","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":"Essential Competencies for Oncology in Physical Therapist Professional Education Programs: Results of a Mixed Methods Modified Delphi Study.","authors":"Shana E Harrington, Christopher M Wilson, Margaret E Rinehart-Ayres, Frances Westlake, Lisa VanHoose","doi":"10.1093/ptj/pzae146","DOIUrl":"10.1093/ptj/pzae146","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to establish consensus-based competencies for oncology within physical therapist professional education programs in the United States.</p><p><strong>Methods: </strong>A mixed-methods approach implementing a sequential exploratory design that included 3 phases was used to establish oncology competencies for physical therapist professional education programs. Participants in each phase were physical therapists representing diverse practice settings, experience levels, and geographical regions. Student physical therapists were included in phases 2 and 3. Three online focus groups were followed by an in-person group discussion to establish cancer-related themes, domains of practice, and competencies. Participants evaluated the competencies in a 3-round modified Delphi study for relevance and clarity. Each competency required 80% consensus using a Likert scale (1 = not at all relevant/clear, 5 = extremely relevant/clear). It was not accepted if a competency did not meet the 80% threshold by the end of round 3.</p><p><strong>Results: </strong>Six domains of practice and 28 competencies were developed and evaluated. Within the 6 domains, 21 competencies were accepted: general cancer concepts (n = 4), musculoskeletal system (n = 3), neurologic system (n = 5), integumentary system (n = 2), cardiovascular and pulmonary system (n = 5), and involvement of multiple systems across the lifespan (n = 2). Along with the 21 competencies, participants also recommended 11 overarching oncology themes to incorporate into physical therapist professional education programs. Delivering cancer content using a body systems approach was recommended.</p><p><strong>Conclusion: </strong>As the number of survivors of cancer continues to grow, integration of these essential competencies within physical therapist professional education programs will improve the profession's capacity to provide quality care to meet the societal need of persons living with and beyond cancer.</p><p><strong>Impact: </strong>Academic and clinical educators should integrate these competencies to ensure that physical therapist professional education programs appropriately prepare physical therapists for providing care for persons living with and beyond cancer across the lifespan.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392468","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}