Physical Therapy最新文献

{"title":"Investigating Balance Perception and Balance Performance in Neurological Disorders for Targeted Rehabilitation Strategies.","authors":"Rebecca Cardini, Alessandro Torchio, Irene Aprile, Andrea Turolla, Davide Cattaneo, Elisa Gervasoni","doi":"10.1093/ptj/pzaf075","DOIUrl":"10.1093/ptj/pzaf075","url":null,"abstract":"<p><strong>Importance: </strong>Task-specific balance deficits are common in people with neurological disorders (PwND), significantly affecting their activities of daily living (ADLs). However, the relationship between balance deficits and ADLs measured by patient-reported outcomes is poorly understood, thus limiting the selection of specific static and dynamic tasks to be used to train for a given activity.</p><p><strong>Objective: </strong>The aim of the study was to provide a clinical framework linking ADLs, balance tasks, and balance resources to support clinicians' decision-making when planning task-oriented balance rehabilitation for PwND.</p><p><strong>Design: </strong>This was an observational study with a cross-sectional design.</p><p><strong>Setting: </strong>This study examined clinical contexts involving PwND.</p><p><strong>Participants: </strong>This study involved people with Parkinson disease, stroke, or multiple sclerosis (MS).</p><p><strong>Exposure: </strong>The study used the Activities-Specific Balance Confidence (ABC) Scale for patient-reported outcomes to assess perceived balance during ADLs, and the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) to evaluate static and dynamic balance.</p><p><strong>Main outcomes and measures: </strong>Kendall tau correlations (τ) were used to identify meaningful associations between ABC and BBS-DGI items, matching ADLs with specific balance tasks.</p><p><strong>Results: </strong>The study sample comprised 299 people with Parkinson disease (n = 94), stroke (n = 94), and MS (n = 111) with a median (interquartile range) age of 63 (52.0-71.5) years, all exhibiting moderate to severe balance impairments. Moderate correlations (τ ≥ 0.39) were found between dynamic and semi-dynamic challenging outdoor ADLs with static and dynamic tasks involving sensory orientation and the use of vestibular and proprioceptive systems. Moreover, stability limits-verticality, anticipatory postural adjustments, and stability in gait are the primary balance resources to consider when designing ad hoc rehabilitation interventions.</p><p><strong>Conclusions: </strong>This study establishes associations between specific ADLs and balance tasks, offering a clinical framework to identify relevant balance resources for rehabilitation. It provides clinicians with a structured approach for planning task-oriented, needs-based balance rehabilitation for PwND, focusing on the training of specific balance resources to enhance ADLs.</p><p><strong>Relevance: </strong>This study provides a clinical framework to help clinicians in planning task-oriented and needs-based balance rehabilitation for PwND, suggesting which balance resources should be trained to improve specific ADLs.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161227","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":"Deconstructing the Role of the Physical Therapy Profession in Disability Acceptance for People With Stroke.","authors":"Sarah M Schwab-Farrell, Cara N Whalen Smith, Kari Dunning","doi":"10.1093/ptj/pzaf064","DOIUrl":"10.1093/ptj/pzaf064","url":null,"abstract":"<p><p>The lowest degree of disability acceptance has been found among people with a history of stroke. Disability acceptance involves adapting to disability-related changes and coming to terms with losses to redefine and live a meaningful new life. Across many movement-related disabilities and chronic conditions, disability acceptance has been positively associated with psychological well-being, social and physical functioning, and adjustment. Further, self-acceptance of disability is an important factor in rehabilitation and recovery. There is a growing need for physical therapy to engage with disability acceptance and understand the role of physical therapists and physical therapist assistants in facilitating disability acceptance after stroke. The purpose of this Perspective article is to critically evaluate the role of the physical therapy profession in disability acceptance for people with stroke. The article first reflects on ways in which the physical therapy profession has historically (and unintentionally) created obstructions to disability acceptance after stroke. The authors discuss assumptions implicitly underpinning physical therapist practices for stroke that are consistent with normalization tendencies, medicalized approaches to disability, and the mechanical body. The authors then present new and alternative approaches that can be applied in physical therapy to better facilitate disability acceptance after stroke, focusing on mindfulness-based interventions and a celebration of unique movement strategies of people with disability (ie, movement \"improvisation\"). The Perspective concludes with practical strategies for clinicians to employ in an effort to better foster disability acceptance poststroke. Impact The physical therapy profession may play an important and unique role in facilitating disability acceptance poststroke. supporting disability acceptance after stroke requires physical therapists and physical therapist assistants to critically reflect on ways in which the profession may unintentionally impede acceptance and consider new and alternative approaches to promote acceptance in clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035489","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":"Patient Experiences of a Group Intervention Integrating Vestibular Rehabilitation, Body Awareness, and Cognitive Behavioral Therapy for Long-Lasting Dizziness: A Focus Group Study.","authors":"Liv Heide Magnussen, Kjersti Thulin Wilhelmsen, Målfrid Råheim","doi":"10.1093/ptj/pzaf062","DOIUrl":"10.1093/ptj/pzaf062","url":null,"abstract":"<p><strong>Objective: </strong>Long-lasting dizziness is a distressing and disabling condition frequently accompanied by psychological and physical discomfort, and if untreated, could evolve into a complex, self-perpetuating condition challenging treatment. A treatment approach addressing psychological, physical, and social ailments in connection with long-term dizziness has been developed. The objective of this study was to explore experiences and perceptions of participants with long-lasting dizziness who have engaged in a group-based intervention approach that combines principles from vestibular rehabilitation (VR), body awareness therapy (BA), and cognitive behavioral therapy (CBT) in primary care.</p><p><strong>Methods: </strong>The study is rooted in an interpretative approach. Fifteen participants, 10 women and 5 men, aged 38 to 71 years, were interviewed in 3 focus groups. Data were analyzed by systematic text condensation, a 4-step thematic cross-case strategy suitable for exploratory investigations.</p><p><strong>Results: </strong>Four main themes emerged from the analyses: (1) to share and feel understood when struggling with dizziness; (2) the exercises: body perceptions and challenging one's own limits to control dizziness; (3) increased self-knowledge helps to process anxiety and challenge avoidance behavior; (4) changing habits is hard work, but necessary to recover from dizziness.</p><p><strong>Conclusions: </strong>This novel group-based VR-BA-CBT treatment for individuals with long-lasting dizziness offered valuable peer support, shared learning, and learning in action providing new understanding. The VR-BA-CBT treatment includes a comprehensive and holistic approach addressing physical, psychological, and social challenges.</p><p><strong>Impact: </strong>Through knowledge about dizziness triggers, participants learn new strategies to confront previously avoided activities. The approach holds promise to be implemented in primary care physical therapy settings.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012499","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":"Correction to: Gait Speed Modifies Efficacy of Home-Based Exercise for Falls in Older Adults With a Previous Fall: Secondary Analysis of a Randomized Controlled Trial.","authors":"","doi":"10.1093/ptj/pzaf092","DOIUrl":"10.1093/ptj/pzaf092","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 7","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650132","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, July 2025.","authors":"","doi":"10.1093/ptj/pzaf081","DOIUrl":"https://doi.org/10.1093/ptj/pzaf081","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 7","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732687","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":"Characterization and Related Factors of Postural Control in Adults With Late-Onset Pompe Disease: Cross-Sectional and Case Control Study.","authors":"Théo Maulet, Thomas Cattagni, Sofiane Mahmoudi, Thomas Gandois, Fabien Dubois, Pascal Laforet, Céline Bonnyaud","doi":"10.1093/ptj/pzaf073","DOIUrl":"10.1093/ptj/pzaf073","url":null,"abstract":"<p><strong>Importance: </strong>Adults with late-onset Pompe disease (LOPD) experience lower limb weakness, balance disorders, and recurrent falls. Mechanisms underlying postural control (stability, orientation) and falls in LOPD remain poorly understood. Investigating these aspects is critical to guide care and rehabilitation.</p><p><strong>Objective: </strong>This study compared postural control in participants with LOPD to controls, examining postural and muscular factors linked to falls and muscular contributions to postural alterations.</p><p><strong>Design: </strong>This study was a cross-sectional, case-control study. Postural stability and orientation during stationary standing were evaluated using force platforms and 3D motion analysis under two visual conditions, while maximal muscle strength was measured with an isokinetic dynamometer.</p><p><strong>Setting: </strong>This cross-sectional, case-control study was conducted at a teaching hospital, which was a reference center for neuromuscular disease.</p><p><strong>Participants: </strong>This study involved two cohorts: participants with LOPD and control participants.</p><p><strong>Main outcomes and measure: </strong>Postural stability (center of pressure [COP] displacements, lower limb joint range of motion) and orientation (COP mean position, weight distribution, joint positions) parameters were assessed, alongside falls reported over 3 months and maximal lower limb muscles strength.</p><p><strong>Results: </strong>Compared to 20 controls, 18 adults with LOPD showed impaired postural stability, especially medio-laterally with eyes closed (ES = 0.42-0.83), and an anterior shift of the COP without joint orientation changes. Falls were strongly associated with COP mean velocity (eyes open: ρ = 0.73; eyes closed: ρ = 0.74) and with hip abductor (ρ = - 0.77) and extensor strength (ρ = - 0.79). Hip extensor strength was most strongly associated with COP mean velocity (eyes closed: ρ = - 0.72; eyes open: ρ = - 0.69).</p><p><strong>Conclusions: </strong>Adults with LOPD demonstrate impaired postural stability, especially in the medio-lateral plane with eyes closed, and an anteriorized upright orientation.</p><p><strong>Relevance: </strong>Hip extensor and abductor strength, strongly linked to falls and stability, should be important to target in evaluations and rehabilitation and in studies on new therapies on LOPD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094544","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":"Accuracy of Falls Screening Tools in Adult Patients With Cancer: A Systematic Review.","authors":"Kelli A Nielsen, Michael Foley, Earllaine Croarkin, Patricia Runde, Stephanie Prinster, Laura S Gilchrist","doi":"10.1093/ptj/pzaf068","DOIUrl":"10.1093/ptj/pzaf068","url":null,"abstract":"<p><strong>Importance: </strong>Patients with cancer experience increased falls risk secondary to oncological treatment and cancer-related sequelae.</p><p><strong>Objective: </strong>Identifying diagnostically and prognostically accurate screening tool(s) for falls risk in populations with cancer is an important issue.</p><p><strong>Data sources: </strong>Screening tests were identified in PubMed and CINAHL.</p><p><strong>Study selection: </strong>Two independent reviewers screened citations for inclusion.</p><p><strong>Data extraction and synthesis: </strong>Data extraction was performed by 1 reviewer and verified by a second. Tests were investigated for clinical utility, validity, diagnostic accuracy, and predictive capacity. Recommendations for screening measures were formulated using predetermined criteria.</p><p><strong>Measures: </strong>Falls risk screening tools were identified for populations with cancer.</p><p><strong>Results: </strong>Of 532 articles screened, 24 articles were included. Fifty-five variations of screening measures were identified, of which 47 had sufficient clinical utility. Twenty measures contained data on diagnostic accuracy or predictive capacity. No screening measure met all criteria to be highly recommended for both ruling in and ruling out falls risk currently (diagnostic accuracy) or in the future (predictive capacity). History of falls demonstrated good diagnostic accuracy for ruling in immediate falls risk (specificity 98.9%, positive predictive value 84.6%). A negative falls history was highly indicative of lower future falls risk status (negative predictive value 82.5% to 90.1%). Fear of falling demonstrated accuracy for ruling out immediate risk for falls (negative predictive value 87.0%, sensitivity 88.7%). Strong predictive capacity was demonstrated with the Timed \"Up & Go\" (TUG) Standard (sensitivity 93% at ≤7.8 s, specificity 95% at ≥11.35 s).</p><p><strong>Conclusions: </strong>Based on these results, a history of falls plus either the TUG Standard for those with a history of falls or subjective report of fear of falling for those without a history of falls is recommended for risk screening in populations with cancer.</p><p><strong>Relevance: </strong>Different screening tools are required for immediate versus future falls risk and are setting dependent.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033105","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 Function Differences by COVID-19 Status: A Cross-sectional Analysis From the RECOVER Adult Cohort.","authors":"Grace L Kulik, Tianyu Zheng, Sarah E Jolley, Hassan Ashktorab, Hassan Brim, Elen M Feuerriegel, John W Hafner, Rachel Hess, Benjamin D Horne, Mady Hornig, Brandon Johnson, C Kim, Adeyinka O Laiyemo, Grace A McComsey, Janko Ž Nikolich, Kayleigh Reid, John Scherry, Zaki A Sherif, Huong G Tran, Monica Verduzco-Gutierrez, Shelby West, Kristine M Erlandson","doi":"10.1093/ptj/pzaf063","DOIUrl":"10.1093/ptj/pzaf063","url":null,"abstract":"<p><strong>Importance: </strong>Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection.</p><p><strong>Objective: </strong>The objective was to characterize physical function impairment among adults with and without SARS-CoV-2 infection.</p><p><strong>Design: </strong>This study was a retrospective, cross-sectional analysis.</p><p><strong>Setting: </strong>Researching COVID to Enhance Recovery (RECOVER) initiative, a multi-site observational study in the United States (ClinicalTrials.gov: NCT05172024).</p><p><strong>Participants: </strong>Participants were adults ≥18 years old with and without SARS-CoV-2 infection.</p><p><strong>Exposures: </strong>Groups were defined based on COVID-19 status at enrollment: never diagnosed (control), diagnosed with COVID-19 ≤ 12 weeks (recent COVID-19), or > 12 weeks prior to enrollment (remote COVID-19). The RECOVER-Adult Long COVID Index was used to further characterize by Index ≥12 versus 0.</p><p><strong>Main outcomes/measures: </strong>Physical function (main outcome) was assessed by number of repetitions on a 30-second sit-to-stand test (30STS).</p><p><strong>Results: </strong>30STS assessments at enrollment were available from 11,578 participants. 30STS repetitions were lowest in the remote COVID-19 group (n = 4942) with 11.5 (SD = 4.2) repetitions compared to 12.5 (SD = 4.7) repetitions among controls (n = 1887) or 12.2 (SD = 4.5) in recent COVID-19 (n = 4698). Remote COVID-19, but not recent COVID-19, was associated with lower physical function in the adjusted model (-0.61 repetitions; SD = 0.21). Those with RECOVER Long COVID Research Index ≥12 performed 1.6 (SD = 0.2) fewer repetitions than those with an Index equal 0.</p><p><strong>Conclusions: </strong>Physical function impairment did not show clinically meaningful group differences between RECOVER Adult Cohort participants by COVID-19 status, or by Long COVID Index. Individual responses over time or in response to an intervention may be more clinically relevant.</p><p><strong>Relevance: </strong>In the RECOVER adult cohort, overall physical function differences by time since COVID-19 or by Long COVID Index were small. Individualized assessments are needed to determine functional impairment following COVID-19 diagnosis and subsequent steps for rehabilitation interventions.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975217","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":"Matching Clinical Profiles With Interventions to Optimize Daily Stepping in People With Stroke.","authors":"Kiersten M McCartney, Ryan T Pohlig, Allison E Miller, Elizabeth D Thompson, Darcy S Reisman","doi":"10.1093/ptj/pzaf070","DOIUrl":"10.1093/ptj/pzaf070","url":null,"abstract":"<p><strong>Importance: </strong>Individualizing interventions is imperative to optimize step-activity in people with chronic stroke.</p><p><strong>Objective: </strong>The objective was to group individuals with chronic stroke into clinical profiles based on baseline characteristics and examine if these profiles preferentially benefitted from a specific intervention to improve daily step-activity.</p><p><strong>Design: </strong>This is a secondary analysis of a randomized control trial.</p><p><strong>Setting: </strong>The parent study occurred at 4 outpatient rehabilitation clinics.</p><p><strong>Participants: </strong>Participants had strokes ≥6 months prior to enrollment, were 21 to 85 years old, had walking speeds of 0.3 to 1.0 meters per second, and took <8000 steps-per-day.</p><p><strong>Interventions: </strong>Participants were randomized to high-intensity treadmill training (FAST), a step-activity behavioral intervention (SAM), or a combined intervention (FAST+SAM).</p><p><strong>Main outcome(s): </strong>The primary outcome was the interaction of latent class (clinical profile) and intervention group (FAST, SAM, FAST+SAM) on a change in steps-per-day. Key clinical characteristics to identify the latent classes included walking speed, walking endurance, balance self-efficacy, cognition, and area deprivation.</p><p><strong>Results: </strong>Of the 190 participants with complete pre- and post-intervention data (mean [SD] age, 64 [12] years; 93 females [48.9%]), 3 distinct profiles of people with chronic stroke were identified. Class 1 had the lowest walking capacity (speed and endurance), lowest balance self-efficacy, and highest area deprivation, and the greatest change in step-activity when enrolled in SAM (mean = 1624, 95% CI = 426-2821) or FAST+SAM (mean = 1150, 95% CI = 723-1577]). Class 2 had walking capacity, baseline steps-per-day, and self-efficacy values between Class 1 and 3, and had the greatest change in step-activity when enrolled in SAM (mean = 2002, 95% CI = 1193-2811). Class 3 had the highest walking capacity, highest self-efficacy, and lowest area deprivation and the greatest change in step-activity when enrolled in FAST+SAM (mean = 1532, 95% CI = 915-2150).</p><p><strong>Conclusions: </strong>People with chronic stroke require different interventions to optimize changes in step-activity.</p><p><strong>Relevance: </strong>Clinicians can use clinically relevant measures to personalize intervention selection to augment step-activity in people with chronic stroke.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036990","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":"Using a Discrete Choice Experiment to Elicit Patient Preferences for Physical Therapist Services After Surgery for Breast Cancer.","authors":"Helen McTaggart-Cowan, Kendra Zadravec, Bolette S Rafn, Adam J N Raymakers, Dean A Regier, Kristin L Campbell","doi":"10.1093/ptj/pzaf077","DOIUrl":"10.1093/ptj/pzaf077","url":null,"abstract":"<p><strong>Importance: </strong>Patients often experience challenges accessing physical therapy for breast cancer-related impairments. Eliciting patient preferences for physical therapy can inform design of patient-centered, breast cancer-focused physical therapy programming.</p><p><strong>Objective: </strong>A discrete choice experiment (DCE) was used to elicit patient preferences for physical therapy after breast cancer surgery.</p><p><strong>Design: </strong>Sequential mixed methods identified 7 attributes of physical therapy: education timing; referral method; first appointment timing; physical therapist expertise level; treatment format; treatment frequency; and annual out-of-pocket cost. Respondents chose between 2 physical therapy programs and an opt-out option.</p><p><strong>Settings: </strong>The DCE was administered online.</p><p><strong>Participants: </strong>Participants were adults with breast cancer in Canada.</p><p><strong>Main outcomes and measures: </strong>Responses were analyzed using a mixed logit model. Willingness-to-pay estimates were calculated as the marginal rate of substitution between each attribute level with respect to cost.</p><p><strong>Results: </strong>The DCE was completed by 148 respondents (completion rate: 77.5%). Most were within 3 years post-diagnosis (54.1%), had completed post-secondary education (70.9%), and had annual family incomes over $40,000 (76.5%). Nearly half were referred to physical therapy (48.5%). Respondents preferred to be seen by a physical therapist with expertise in breast cancer (β = .368, SD = 0.091) and to receive more frequent appointments (β = -.011, SD = 0.025).</p><p><strong>Conclusion: </strong>The DCE was capable of eliciting patient preferences for physical therapy after breast cancer surgery. Respondents exhibited preferences for physical therapist expertise level and treatment frequency. Findings from this study will be the first step in informing development of accessible physical therapy programming that is responsive to the needs and preferences of patients with breast cancer.</p><p><strong>Relevance: </strong>This work can inform design of accessible, patient-centered physical therapist services for patients with breast cancer. Receiving timely physical therapy can improve patients' physical function, quality of life, and ability to engage in life roles and activities.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174525","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}