Physical Therapy最新文献

{"title":"Author Response to Ferro et al.","authors":"Cara N Whalen Smith, Susan M Havercamp, Winston Kennedy, Heather A Feldner, Deana Herrman, Bethany M Sloane, Faye H Weinstein","doi":"10.1093/ptj/pzaf036","DOIUrl":"10.1093/ptj/pzaf036","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670669","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 \"Physical Therapists in Primary Care in the United States: An Overview of Current Practice Models and Implementation Strategies\" O'Bright K, Peterson S. Phys Ther. 2024;104(12):pzae123. 10.1093/ptj/pzae123.","authors":"Matteo Paci, Claudio Cordani","doi":"10.1093/ptj/pzaf039","DOIUrl":"10.1093/ptj/pzaf039","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664236","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":"Treatment Decision-Making for Anterior Cruciate Ligament Rupture From the Perspective of Physical Therapists in Australia: A Mixed Methods Study.","authors":"Stephanie R Filbay, Jane Rooney, Tammy Hoffmann, Zobaida Edib, Pek Ling Teo, Rana S Hinman, Kim L Bennell","doi":"10.1093/ptj/pzaf030","DOIUrl":"10.1093/ptj/pzaf030","url":null,"abstract":"<p><strong>Importance: </strong>In Australia, few people with acute anterior cruciate ligament (ACL) rupture are managed with rehabilitation alone despite clinical trials demonstrating similar outcomes to ACL reconstruction (ACLR). The reasons for the low uptake of rehabilitation alone for the treatment of acute ACL rupture in Australia are unclear.</p><p><strong>Objectives: </strong>The objectives of this study were to evaluate physical therapists' beliefs and the information they provide to patients about treatment options for ACL rupture, and to explore ACL rupture treatment decision-making from the perspective of physical therapists.</p><p><strong>Design: </strong>The design was a mixed-methods convergent parallel design comprising an Australia-wide survey (n = 246) and semi-structured interviews (n = 10).</p><p><strong>Participants: </strong>Participants included physical therapists who manage people with ACL rupture in Australia.</p><p><strong>Main outcomes: </strong>The survey contained 41 items that assessed demographics, treatment of ACL rupture, referral pathways, treatment beliefs, and the information provided to patients with ACL rupture.</p><p><strong>Results: </strong>Physical therapists' beliefs about treatment options varied and did not always reflect the information they provided to patients. Although 60% agreed that ACLR and rehabilitation-alone result in similar outcomes on average, only 37% reported regularly informing patients about this. To return to pivoting/contact sport, 23% believed that ACLR was required and 79% informed patients that ACLR was the best treatment to do so. Physical therapists felt that rehabilitation-alone is underutilized as a treatment for ACL rupture. Physical therapists encountered barriers to offering and providing rehabilitation-alone for ACL rupture, reflected in 7 qualitative themes: preference for surgery reflecting societal beliefs; more weight given to surgeon's opinion; unbalanced information from surgeon; referral pathways; uncertain recovery timeline; beliefs about treatment suitability; and knowledge and experience.</p><p><strong>Conclusions: </strong>Physical therapists had mixed beliefs about treatment options and the information provided to patients was not always evidence based. Physical therapists felt that nonsurgical management was underutilized, and experienced barriers to offering and providing non-surgical management of ACL rupture in clinical practice.</p><p><strong>Relevance: </strong>Informed decision-making can only occur if accurate, evidence-based information about ACL rupture treatment options is provided to patients. These findings may be used to guide professional development for physical therapists and inform strategies to improve evidence uptake by physical therapists.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625624","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":"Feasibility of Direct-Access Physical Therapy for Concussion Management in the Pediatric Emergency Department: A Pilot Implementation Study.","authors":"Isabelle Gagnon, Melissa Turner, Alexandra Lacasse-Courchesne, Meghan McKee, My Lihn Tang, Mona Sajjadi, Debbie Friedman, Marion Hahn, Lina Osseiran, Daniel Brody, Christine Beaulieu, Ilana Greenstone, Laurie H Plotnick","doi":"10.1093/ptj/pzaf051","DOIUrl":"10.1093/ptj/pzaf051","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of this study was to determine the feasibility of implementing an interdisciplinary approach to concussion assessment and management, including direct-access pediatric physical therapy in the pediatric emergency department (PED), with regard to parental satisfaction with early concussion management, documentation of clinical information for prognosis, and service organization metrics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a single-center retrospective analysis of prospectively collected data. Patients &lt;18 years old presenting to the PED with a suspected concussion were included and either received care using the interdisciplinary model of care (pediatric physical therapy + usual care) or usual care alone, depending on their time of presentation to the PED (12 hours/week of pediatric physical therapy coverage). Clinical and administrative data were collected from the participants' medical record. In addition, a random sample of participants received a quality improvement survey administered over the phone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three hundred and forty-seven patients were included in the study population (mean [SD] age = 7.56 [5.62] years), and 81 were seen by the pediatric physical therapist. Those seen by the pediatric physical therapist had a significantly higher average satisfaction score for the Family domain (94.69 [11.60]) of the Pediatric Quality of Life Health care Satisfaction scale, than those who were not (89.02 [20.17]), as well as for Overall satisfaction (pediatric physical therapy = 95.45 [12.34] vs usual care = 89.21 [21.21]). Prognostic information was collected more systematically in patients seen by the pediatric physical therapist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The presence of a pediatric physical therapist in the PED could improve early management of children presenting for suspected concussions. Further research will help determine factors related to sustainability and prepare for broader implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;Physical therapists, shown to be a positive addition in adult emergency departments, mostly for musculoskeletal conditions, were introduced in a PED in an interdisciplinary model of concussion care and were associated with improvements in satisfaction, clinical information documentation, and service organization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;The study investigated whether direct access to pediatric physical therapy in the pediatric emergency department (PED) would enhance parental satisfaction, early concussion management, documentation, and service organization. Conducted at a single center, it analyzed data from patients under 18 years old with suspected concussions, comparing those who received care from a pediatric physical therapist plus usual care to those who received only usual care. Results showed that parents of children seen by the pediatric physical therapist reported higher satisfaction, and prognostic informati","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023928","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":"Transforming Ableism in Physical Therapist Education One Student at a Time: A Case Report of a Student With Blindness.","authors":"Megan B Flores, Kathryn E Sawyer, Derrick F Campbell, Kathleen J Manella","doi":"10.1093/ptj/pzaf028","DOIUrl":"10.1093/ptj/pzaf028","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of students with disabilities in physical therapist education programs in the United States is <1%. This case report explored the experiences surrounding a specific, unique individual student with blindness or visual impairment (BVI) within the context of an entry-level physical therapist program. The purpose was not merely to describe 1 student's journey but to capture the complex dynamics and shifts in perceptions of students, faculty, staff, and clinicians. This case report retrospectively explored the perceptions of these individuals before, during, and after interactions with the student and examined ableist assumptions expressed by some individuals that vision is essential for Doctor of Physical Therapy (DPT) students and clinical practice.</p><p><strong>Methods: </strong>A recent DPT graduate (pseudonym J.M.) with BVI classified as \"near total blindness,\" is now a licensed, full-time employee at an outpatient orthopedic clinic. We surveyed 36 individuals (20 students, 11 faculty, 2 staff, and 3 clinical instructors) who interacted with J.M. as a student, asking their perceptions about the education, clinical skills, and employment potential of a DPT student with BVI.</p><p><strong>Results: </strong>An increase toward more favorable perceptions of individuals with BVI was exhibited for all of 10 Likert scale questions (X2[2] = 38.00 to 59.42). Qualitative analysis revealed 3 themes: accommodations, personal qualities, and setting with an overarching theme of an approbative shift in perceptions.</p><p><strong>Discussion: </strong>The shift in perceptions about vision as essential for physical therapist practice is important and suggests that physical therapist education program applicant qualifications and essential functions regarding vision should be considered within the context of reasonable accommodations, individual characteristics, and lived experiences.</p><p><strong>Impact: </strong>Redefining physical therapist education program applicant qualifications and essential functions regarding vision may be warranted. For clinical instructors, the benefits may outweigh the challenges of mentoring a student with accommodations for BVI.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616786","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 Therapist Interventions to Prevent Postpartum Urinary Incontinence: A Systematic Review.","authors":"Irene Cabrera-Martos, Cristina Cortés-Alcaraz, Paula Jiménez-López, Laura López-López, Irene Torres-Sánchez, Esther Díaz-Mohedo","doi":"10.1093/ptj/pzaf017","DOIUrl":"10.1093/ptj/pzaf017","url":null,"abstract":"<p><strong>Importance: </strong>Postpartum urinary incontinence has a negative impact on the quality of life of women.</p><p><strong>Objective: </strong>This systematic review aimed to describe and synthesize the scientific evidence on the effects of physical therapy in preventing postpartum urinary incontinence.</p><p><strong>Data sources: </strong>The following databases were searched up to April 2023: PubMed/MEDLINE, Web of Science, ScienceDirect, PEDro, CINAHL, and Scopus.</p><p><strong>Study selection: </strong>Studies were included if they were randomized controlled trials; included women during pregnancy or at postpartum period; conducted a physical therapist intervention; and studied the prevention of postpartum urinary incontinence.</p><p><strong>Data extraction and synthesis: </strong>Two researchers extracted information of the descriptive characteristics of the studies and the interventions, variables, main outcomes, and results.</p><p><strong>Main outcome and measures: </strong>Main outcomes were variables related to postpartum urinary incontinence. Quality appraisal was conducted using the PEDRO and Cochrane Risk of Bias 2.0 tools.</p><p><strong>Results: </strong>Among the 2067 studies initially identified, 9 met the inclusion criteria. The main interventions include pelvic floor muscle exercises, electrical stimulation, and perineal massage. The studies demonstrated a positive impact on postpartum urinary incontinence incidence and related symptoms in most of the studies included. However, the heterogeneity presented in the characteristics of the sample, protocol, and outcome measures limited the conclusions reached. Quality assessment revealed moderate to high methodological quality in 90% of trials using the PEDro scale, while 70% presented a high risk of bias according to the Cochrane tool.</p><p><strong>Conclusions and relevance: </strong>Physical therapist interventions, particularly pelvic floor muscle exercises, may have a positive effect in preventing postpartum urinary incontinence compared to usual care or no intervention. However, the heterogeneity and limited number of studies emphasize the need for more high-quality randomized controlled trials.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670579","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 Assessment of Walking Capacity in People With Parkinson Disease: Are 2 Minutes Sufficient?","authors":"Hanna Johansson, Linda Rennie, Wilhelmus J A Grooten, Breiffni Leavy","doi":"10.1093/ptj/pzaf034","DOIUrl":"10.1093/ptj/pzaf034","url":null,"abstract":"<p><strong>Objective: </strong>Walking capacity progressively declines in people with Parkinson disease (PD), and assessment of walking is imperative for monitoring disease progression and evaluating intervention efficacy. The main aim of this study was to explore whether the 2-minute walk test (2MWT) could be substituted for the 6-minute walk test (6MWT) as a measure of walking capacity in people with PD. We also sought to investigate construct and known-groups validity of the 2MWT.</p><p><strong>Methods: </strong>A cross-sectional analysis based on data from the Supported Home Training in Everyday Life for Parkinson Disease trial was conducted in a hospital setting. Sixty-three people with idiopathic, mild to moderate PD (29 women; mean age = 69.2 years) were included. Spatiotemporal gait parameters during the 2MWT and the 6MWT were captured by wearable sensors. Linear regression was used to analyze the association between distances walked, whereas paired-samples t tests and repeated-measures analysis of variance were used to explore mean differences in gait parameters.</p><p><strong>Results: </strong>Distance walked over the 2MWT was very strongly associated with the 6MWT. Gait speed was higher during the shorter test, and several speed-related parameters significantly differed between the tests. There was a trend over the 6MWT, whereby participants performed better during the last 2 minutes of the test. Analyses revealed convergent, discriminant, and known-groups validity of the 2MWT.</p><p><strong>Conclusion: </strong>These findings suggest that the 2MWT adequately captures walking capacity among people with mild to moderate PD and demonstrates robust convergent validity and ability to discriminate between people at different levels of disease severity.</p><p><strong>Impact: </strong>The 2MWT is a sufficient and valid alternative for physical therapists who wish to assess walking capacity in people with mild to moderate PD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634467","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":"On \"Training an Anti-Ableist Physical Therapist Workforce: Critical Perspectives of Health Care Education That Contribute to Health Inequities for People With Disabilities\" Whalen Smith CN, Havercamp SM, Tosun L, et al. Phys Ther. 2024;104:pzae092. 10.1093/ptj/pzae092.","authors":"Agnes McConlogue Ferro, Jillian Mercado, Lori Quinn","doi":"10.1093/ptj/pzaf035","DOIUrl":"10.1093/ptj/pzaf035","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639780","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":"A National Profile of Older Physical Therapy Users in France: Results of the 2015 Capacities, Aids, and Resource Representative Survey.","authors":"Louis Jacob, Romain Pichon, Karim Jamal, Benjamin Landré","doi":"10.1093/ptj/pzaf042","DOIUrl":"10.1093/ptj/pzaf042","url":null,"abstract":"<p><strong>Objective: </strong>Older adults-a highly heterogeneous group with complex health challenges-are often overlooked in the field of physical therapy despite their already important and growing numbers. This study aimed to estimate the use of physical therapy in the older population and compare the characteristics and health profiles of older adults who consult physical therapists with those who do not consult physical therapists.</p><p><strong>Methods: </strong>Data from the French 2015 Capacities, Aids, and Resources survey, a large-scale survey with representative sampling weights, was used. It includes community-dwelling and institutionalized older adults aged 60 to 109 years. The main outcome measures were diseases (16 components), clinical symptoms (10 components), functional limitations (16 components), and geriatric syndromes (5 components).</p><p><strong>Results: </strong>Among the 12,043 older adults included, 26.5% received treatment from a physical therapist, with 23.9% being 80 years or older. They had worse outcomes across all indicators. Rheumatology disorders (55.9%; OR = 2.26; 95% CI, 1.96-2.60), fatigue (48.3%; OR 1.84; 95% CI, 1.61-2.11), lower limb limitations (58.3%; OR = 2.64; 95% CI, 2.28-3.06), difficulty washing (34.1%; OR = 3.03; 95% CI, 2.54-3.61), difficulty with transportation (52.5%; OR = 2.46; 95% CI, 2.09-2.88), and multimorbidity (68.1%; OR = 2.07; 95% CI, 1.78-2.40), were the most common conditions in disease, symptoms, mobility, basic and instrumental activity limitations, and geriatric syndromes in this population. Several clinical situations were also uncommon but highly related to requiring physical therapeutic care such as having bedsores (OR = 2.67; 95% CI, 1.81-3.97) or Parkinson's disease (OR = 3.08; 95% CI, 2.08-4.55). They also accumulate more deficiencies in a 70-item frailty index than their counterparts in every age group and in every disease subgroup, suggesting a more complex health profile than older adults not requiring physical therapists.</p><p><strong>Conclusion: </strong>More than a quarter of older adults consulted a physical therapist. These patients showed complex profiles that simultaneously combine diseases, symptoms, geriatric syndromes, and limitations.</p><p><strong>Impact: </strong>These complex profiles and large-scale demographic changes underway are key challenges in the evolution of a profession that has a significant focus on disability.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743186","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 Continuing Trials of Physical Therapy and Rehabilitation Clinical Trials.","authors":"Steven Z George","doi":"10.1093/ptj/pzaf071","DOIUrl":"10.1093/ptj/pzaf071","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094546","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}