Physical Therapy最新文献

{"title":"On \"Functional classification of hemiparetic gait based on paretic leg extension angle and gastrocnemius muscle activity.\" Tsushima Y, Fujita K, Saiki Y, Hayashi K, Kobayashi Y. Phys Ther. 2026;106:pzag015. https://doi.org/10.1093/ptj/pzag015.","authors":"Paul S Sung","doi":"10.1093/ptj/pzag082","DOIUrl":"https://doi.org/10.1093/ptj/pzag082","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017791","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":"Movement matters: the path to professional impact.","authors":"Christopher M Powers","doi":"10.1093/ptj/pzag086","DOIUrl":"10.1093/ptj/pzag086","url":null,"abstract":"<p><p>Christopher M. Powers, PT, PhD, FAPTA, the 57th McMillan Lecturer, is a professor and associate chair in the Division of Biokinesiology and Physical Therapy at the University of Southern California in Los Angeles, California. Dr Powers is internationally recognized for his expertise and leadership in human movement science, and his research has advanced our understanding of lower-extremity biomechanics and their role in musculoskeletal injury. His work has shaped evidence-based approaches to preventing and treating knee pain and sports-related injuries. He has authored more than 230 peer-reviewed publications that have been cited more than 30,000 times, underscoring the broad impact of his scholarship across rehabilitation science, sports medicine, and orthopedics. His research contributions have been recognized with multiple awards from APTA. His sustained leadership and service to the profession are equally notable. Dr. Powers has received service awards from both APTA and the California Physical Therapy Association, reflecting his long-standing commitment to advancing physical therapy through organizational leadership and professional advocacy. He has served as the president of the California chapter of the APTA and as president of the Academy of Physical Therapy Research. He currently serves as vice president of the Foundation for Physical Therapy Research, where he continues to champion the profession's scientific research and its translation into improved patient care.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040175","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":"One-year health care utilization following physical therapist evaluation in a veterans affairs emergency department.","authors":"Emily E Stone, Vanessa L Richardson, Debashis Ghosh, Liza M Creel, Shane M O'Malley, Jennifer E Stevens-Lapsley, Lauren M Abbate","doi":"10.1093/ptj/pzag079","DOIUrl":"10.1093/ptj/pzag079","url":null,"abstract":"<p><strong>Importance: </strong>Emergency department (ED) care for musculoskeletal pain is associated with higher healthcare utilization compared to other entry points into the healthcare system. Emergency department physical therapists are associated with decreased healthcare utilization in the ED; however, long-term healthcare utilization after the ED visit is understudied.</p><p><strong>Objective: </strong>The objective was to study the association between an ED physical therapist visit and 1-year physical therapist visit utilization and total musculoskeletal healthcare utilization.</p><p><strong>Design: </strong>This study used a retrospective cohort design.</p><p><strong>Setting and participants: </strong>This study included Veterans presenting to a single Veterans Health Administration ED with a primary diagnosis of musculoskeletal pain.</p><p><strong>Intervention(s) or exposure(s): </strong>Veterans who saw an ED physical therapist (EDPT group) from October 2022 to September 2023 were randomly sampled and age, sex, and ICD-10 ED primary diagnosis code matched to veterans without an EDPT visit.</p><p><strong>Main outcome(s) and measure(s): </strong>The primary outcome was 1-year physical therapist visits after initial ED visit. Secondary outcomes included: 1-year utilization of physician specialty care visits, advanced imaging (magnetic resonance imaging and computed tomography), high-risk prescription (opioids, benzodiazepines, and skeletal muscle relaxants), and ED return visit for the initial ED diagnosis.</p><p><strong>Results: </strong>Physical therapist visits did not differ between groups (mean [SD]: EDPT = 2.89 [5.02] vs matched control = 2.69 [5.15]). Emergency department physical therapist was associated with lower rates of physician specialty visits (rate ratio: 0.52 [0.33 to 0.81]) and lower odds of specialist referral (odds ratio: 0.32 [0.16 to 0.63]) and advanced imaging (odds ratio 0.41 [0.21 to 0.84]). Emergency department physical therapist was not significantly associated with high-risk medication prescriptions or return visits to the ED.</p><p><strong>Conclusions and relevance: </strong>Emergency department physical therapist was significantly associated with reduced specialist services and advanced imaging during the year after the initial ED visit. These findings support physical therapists in the ED as a strategy that may reduce unnecessary healthcare utilization for Veterans with musculoskeletal pain.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631413","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":"Characteristics of outpatient care settings associated with implementation outcomes for a Group Physical Therapy program.","authors":"Kelli D Allen, Leah L Zullig, Sara Webb, Lauren M Abbate, Livia Anderson, Lindsay A Ballengee, Cynthia J Coffman, Graham Cummin, Susan N Hastings, Helen Hoenig, Jaime M Hughes, Natalie K Fullenkamp, Nina Sperber, Matthew Tucker, Courtney H Van Houtven, Amy Webster, Connor Drake","doi":"10.1093/ptj/pzag089","DOIUrl":"10.1093/ptj/pzag089","url":null,"abstract":"<p><strong>Importance: </strong>Novel care models, like group-based physical therapy (Group Physical Therapy), improve outcomes and operational efficiency, but implementation is challenging and understudied.</p><p><strong>Objective: </strong>The objective was to assess associations of organizational and contextual characteristics with implementation of Group Physical Therapy for knee osteoarthritis.</p><p><strong>Design: </strong>This study involved secondary analysis of a cluster randomized hybrid type III implementation trial.</p><p><strong>Setting: </strong>The study involved outpatient physical therapy departments in the Department of Veterans Affairs Health Administration (VHA).</p><p><strong>Participants: </strong>Participants were VHA sites that agreed to deliver a Group Physical Therapy program (n = 19).</p><p><strong>Exposures: </strong>Exposures included facility organizational and contextual characteristics.</p><p><strong>Main outcomes and measures: </strong>Implementation outcomes were adoption (overall and time to adopt) and penetration (number of veterans enrolled over 12 months). Site characteristics included: Organizational Readiness for Implementing Change (ORIC), organizational resilience via the Benchmark Resilience Tool (BRT), Implementation Climate Scale (ICS), prior implementation experience, enrollment approach (cohort vs rolling entry), delivery modality (in person vs telehealth), rurality, and facility complexity. Descriptive statistics were computed for implementation outcomes.</p><p><strong>Results: </strong>Overall, 14 sites (74%) adopted Group Physical Therapy, and the mean number of days to adopt was 230 (standard deviation [SD] = 74). High rurality sites (serving ≥ 50% rural veterans) were less likely to adopt than low rurality sites (50% vs 80%) and took longer to adopt. Sites delivering Group Physical Therapy via telehealth and those using cohort enrollment were later adopters. High rural sites and those using a cohort enrollment approach had lower penetration. The ORIC, BRT, and ICS scores were all high, and there were no substantial differences in adoption or penetration based on these measures.</p><p><strong>Conclusion: </strong>Rural sites may need additional support when implementing new physical therapy programs. Telehealth delivery and cohort-based enrollment may also present challenges that need to be addressed during pre-implementation planning.</p><p><strong>Relevance: </strong>Results provide considerations for the implementation planning process to bridge the gap from research to real-world clinical practice in the rehabilitation setting.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819119","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":"Personalizing pain management: impact of participant characteristics on the effectiveness of complementary and integrative health versus standard rehabilitation in chronic pain treatment among active-duty service members.","authors":"Tyler Snow, Sotaro Shimada, Diane M Flynn, Jeffrey C Ransom, Honor M McQuinn, Alana D Steffen, Dahee Wi, Larisa A Burke, Ardith Z Doorenbos","doi":"10.1093/ptj/pzag078","DOIUrl":"10.1093/ptj/pzag078","url":null,"abstract":"<p><strong>Importance: </strong>By identifying which factors impact the physical function outcomes of pain therapies, health care providers can more effectively match therapies to individuals. This approach will ultimately improve the overall quality of pain management for diverse patient populations.</p><p><strong>Objective: </strong>The objective of this study was to test the following research question: Does the effectiveness of complementary and integrative health (CIH) versus standard rehabilitative care (SRC) in improving physical function differ on the basis of participant characteristics?</p><p><strong>Design: </strong>The study design was a moderator analysis of data collected during a pragmatic clinical trial using a sequential multiple assignment randomized trial design.</p><p><strong>Setting: </strong>The setting was the Interdisciplinary Pain Management Center at Madigan Army Medical Center.</p><p><strong>Participants: </strong>The participants were a complete case sample of 249 active-duty service members with chronic pain.</p><p><strong>Interventions: </strong>The interventions included a 3-week program of CIH therapies, consisting of twice-weekly chiropractic, acupuncture, yoga, and massage therapies, as well as a 3-week program of SRC, consisting of twice-weekly physical and occupational therapies.</p><p><strong>Main outcomes and measures: </strong>Functional measure t scores were calculated from a treadmill, lift, and carry battery.</p><p><strong>Results: </strong>Multiple linear regression models showed that the effect of CIH versus SRC on the functional performance measure was moderated by race, pain impact, pain catastrophizing, and satisfaction with social roles.</p><p><strong>Conclusions: </strong>CIH interventions may be most effective for individuals who are non-Hispanic White, and SRC interventions may be more effective for individuals who are non-Hispanic Black. Psychosocial factors that may improve intervention effectiveness include lower baseline pain impact and pain catastrophizing and higher satisfaction with social roles.</p><p><strong>Relevance: </strong>This research underscores the importance of tailoring interventions to the individual. By considering individuals' demographics as well as their psychological and social factors, health care providers can more effectively match individuals with the most appropriate treatment approach, ultimately improving outcomes across multiple dimensions of physical function.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670367","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":"News from the Foundation for Physical Therapy Research, September 2026.","authors":"","doi":"10.1093/ptj/pzag080","DOIUrl":"https://doi.org/10.1093/ptj/pzag080","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040188","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":"The Letter (to the Editor).","authors":"Steven Z George","doi":"10.1093/ptj/pzag087","DOIUrl":"10.1093/ptj/pzag087","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866503","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":"Severity of structural lumbar spinal stenosis does not impact responsiveness to exercise-based rehabilitation.","authors":"Bahar Shahidi, Armin Zavareh, Connor Richards, Lissa Taitano, Kamshad Raiszadeh","doi":"10.1093/ptj/pzag084","DOIUrl":"10.1093/ptj/pzag084","url":null,"abstract":"<p><strong>Importance: </strong>Spine pain is a prevalent and costly condition affecting up to 85% of individuals throughout their lifetime, and spinal stenosis is one of the most debilitating sources of spine pain. Although conservative management is the first line of treatment for spinal stenosis, radiographically severe cases often are directly referred to surgical intervention due to the belief that conservative strategies delay necessary treatment. However, no studies support the premise that individuals with more radiographically severe stenosis respond poorly to conservative management.</p><p><strong>Objective: </strong>The purpose of this study was to compare improvements in pain, disability, strength, medication usage, and patient function after an exercise-based physical therapist-led program.</p><p><strong>Design: </strong>This study was a retrospective analysis of a single arm clinical trial.</p><p><strong>Setting: </strong>This was in the setting of an outpatient exercise-based physical therapist-led program.</p><p><strong>Participants: </strong>One thousand eight hundred six individuals with radiographically mild, moderate, or severe lumbar spine stenosis participated in this study.</p><p><strong>Intervention: </strong>The intervention was an exercise-based physical therapist-led program.</p><p><strong>Outcomes and measures: </strong>Outcome measures included pain, low back pain related disability, patient specific function, analgesic medication use, and lumbar extensor strength.</p><p><strong>Results: </strong>Participants demonstrated significant improvements in all variables of interest, and 11.5% of participants reported cessation of narcotic use with treatment. There were no significant differences in treatment response across radiographically mild, moderate, or severe stenosis groups for any outcome.</p><p><strong>Conclusions: </strong>Exercise-based rehabilitation is as beneficial in the short term for individuals presenting for nonoperative care with radiographically severe stenosis compared to their milder counterparts.</p><p><strong>Relevance: </strong>Exercise-based rehabilitation results in the same magnitude of improvement in individuals with chronic low back pain regardless of radiographic severity of spinal stenosis.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697819","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 Sung.","authors":"Yuichi Tsushima, Kazuki Fujita, Yoshitomo Saiki, Koji Hayashi, Yasutaka Kobayashi","doi":"10.1093/ptj/pzag083","DOIUrl":"https://doi.org/10.1093/ptj/pzag083","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017703","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":"Let's do it! Fully embrace movement as our identity.","authors":"Nancy Bloom","doi":"10.1093/ptj/pzag085","DOIUrl":"10.1093/ptj/pzag085","url":null,"abstract":"<p><p>In the 30th Maley Lecture, Nancy Bloom, PT, DPT, MSOT, honors the significant contributions and collaborative spirit of John H. P. Maley in advocating for unity and progress in physical therapy. This lecture traces the history and foundational principles of movement and diagnosis in physical therapy. Despite consensus on our identity as movement experts, challenges remain, including clarity in terminology, the perceived broadness of the movement system concept, differing views on diagnosis, and siloed functions within education and practice. Recommendations to unify the profession and address these challenges are provided. Finally, the lecture stresses the significance of using our title as a Doctor of Physical Therapy to affirm our expertise and elevate the profession's recognition. Through collaborative efforts and a commitment to our professional identity, we can enhance our impact on health outcomes and advance our field.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063704","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}