Physical Therapy最新文献

{"title":"The Heart of Movement: What's Love Got to Do With it?","authors":"Terrence M Nordstrom","doi":"10.1093/ptj/pzaf082","DOIUrl":"10.1093/ptj/pzaf082","url":null,"abstract":"<p><p>Terrence M. Nordstrom, PT, EdD, FAPTA, the 56th McMillan Lecturer, is emeritus professor in the Department of Physical Therapy at Samuel Merritt University in Oakland, California, where he has served as a faculty member, director of clinical education, department chair, assistant academic vice president, and vice president of enrollment and student services. During his 24 years of clinical and leadership experience, his research and writing focused on professional education, professional formation and ethics, and academic leadership development. He received his bachelor's degree from the University of California, Santa Cruz; his master's degree in physical therapy from Stanford University; and his doctor of education from the University of San Francisco. His American Physical Therapy Association (APTA) recognitions include being the first vice president and second president of the American Council of Academic Physical Therapy. He currently serves as the finance officer for the California Physical Therapy Association. He has served on many APTA committees and task forces including the Ethics and Judicial Committee. He was a mentor in the APTA Fellowship in Higher Education Leadership from 2017 to 2023 and has been a mentor in the Grant Writing and Mentorship in Education Research program since its inception in 2018. He is a Catherine Worthingham Fellow of APTA and senior fellow and retired scholar of the National Academy of Practice. He was the APTA Academy of Education Pauline Cerasoli Lecturer in 2019.</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":"144286113","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 Longitudinal Course of Physical Activity Behavior Poststroke and Its Variation Across Subgroups: The Norwegian Cognitive Impairment After Stroke Study.","authors":"Geske Luzum, Heather Allore, Ling Han, Ingvild Saltvedt, Xiangchun Tan, Pernille Thingstad, Asta Håberg, Torunn Askim","doi":"10.1093/ptj/pzaf069","DOIUrl":"10.1093/ptj/pzaf069","url":null,"abstract":"<p><strong>Importance: </strong>Despite its importance as a modifiable target poststroke, the longitudinal course of physical activity (PA) is not fully understood.</p><p><strong>Objective: </strong>This study aimed to describe the course of poststroke PA behavior from 3 to 36 months and identify subgroups with different PA patterns using multi-trajectory modeling.</p><p><strong>Design: </strong>A prospective multicenter cohort study design was used.</p><p><strong>Setting: </strong>Follow-up at 3, 18, and 36 months poststroke was community-based.</p><p><strong>Participants: </strong>In total, 277 individuals (age = 70.1 [SD = 10.9]; 116 [41.9%] female) with primarily mild strokes were included. Participants provided at least 2 follow-up periods with accelerometer data each lasting at least 3 consecutive days.</p><p><strong>Main outcomes and measures: </strong>At each follow-up, daily estimates of upright time, time spent in light physical activity (LPA), time spent in moderate physical activity (MPA), step count, and the number of sit-to-stand transitions were measured.</p><p><strong>Results: </strong>Average daily upright time declined by -7.4 min (95% CI = -10.09 to 4.64), and average daily step count declined by -132 steps (95% CI = -176 to -88) each year. Four distinct groups of individuals with different characteristics were identified, following a similar developmental course across PA dimensions over time: one-fourth of the participants (25.6%) were characterized by stable low PA estimates and a tendency to decline over time. Two groups, making up 32.4% and 20.8% of the sample, were characterized by intermediate levels of LPA and MPA, with differing levels of sit-to-stand transitions; and 1 group (21.2% of participants) was characterized by stable high PA duration estimates over time.</p><p><strong>Conclusions: </strong>The overall course of PA poststroke was characterized by a modest decrease over 3 years. Differing PA trajectory groups characterized by different demographic and clinical features highlight the diverse needs for supporting people living with stroke in becoming more active.</p><p><strong>Relevance: </strong>Findings may help clinicians identify subgroups of people with stroke who need extended professional follow-up in long-term rehabilitation.</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/PMC12309381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012376","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":"An Improvement Science Framework to Advance Sense of Belonging for Physical Therapist Students From Minoritized Backgrounds.","authors":"Keshrie Naidoo, Camille Powell, Diane U Jette","doi":"10.1093/ptj/pzaf045","DOIUrl":"10.1093/ptj/pzaf045","url":null,"abstract":"<p><p>To better serve an increasingly racially and ethnically diverse United States population, the physical therapy profession has been focused on increasing the diversity of the physical therapy workforce and increasing recruitment of racially and ethnically minoritized (REM) students in Doctor of Physical Therapy (DPT) programs. In contributing to the goal of a diverse, equitable, and inclusive profession, DPT programs must admit, support, retain, and graduate individuals who represent diversity in its many aspects. However, factors such as a lack of REM mentors and decreased sense of belonging contribute to disparate academic outcomes for REM DPT students. Although educators must act to implement innovative strategies to support a sense of belonging among students who have been historically marginalized, a systematic approach to decision-making, action, and analysis is needed when dealing with a complex problem with multifaceted causes and multiple possible solutions. Improvement science is a continuous improvement approach that uses a series of data-informed processes and the expertise of multiple stakeholders to promote equity in education, offering a framework for seeing the problem from the perspective of REM DPT students. Plan-Do-Study-Act (PDSA) cycles offer the opportunity to introduce educational changes on a smaller scale to evaluate variation prior to applying it to a larger setting. This perspective highlights a series of PDSA cycles trialing interventions aimed at decreasing barriers to success and improving a sense of belonging for REM DPT students. Even in the face of structural and institutionalized barriers, leveraging an improvement science framework can help ensure that change is meaningful and lasting.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743373","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":"Relationship Between Fear of Movement and Physical Activity in Patients With Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta-Analysis.","authors":"Miriam Goubran, Ata Farajzadeh, Ian M Lahart, Martin Bilodeau, Matthieu P Boisgontier","doi":"10.1093/ptj/pzaf050","DOIUrl":"10.1093/ptj/pzaf050","url":null,"abstract":"<p><strong>Objective: </strong>Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physical activity. This study aims to examine whether this fear of movement is negatively associated with physical activity across several health conditions and what factors may influence this relationship.</p><p><strong>Methods: </strong>Five databases were searched for studies including both a measure of fear of movement and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between fear of movement and physical activity.</p><p><strong>Results: </strong>Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a negative correlation between fear of movement and physical activity (r = -0.19 [95% CI = -0.26 to -0.13]; I2 = 85.5%). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions but not in patients with chronic or acute pain.</p><p><strong>Conclusions: </strong>Our results suggest that higher levels of fear of movement are associated with lower levels of physical activity in several health conditions that are not necessarily painful.</p><p><strong>Impact: </strong>Fear of movement should be dissociated from pain and considered in relation to specific health conditions when implementing exercise therapy. Fear of movement may have prognostic and therapeutic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796063","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":"Effectiveness of home-based Rehabilitation on Activities of Daily Living in Patients With Stroke: Systematic Review and Meta-Analysis.","authors":"Yerim Do, Youngeun Lim, Shiyu Jin, Haneul Lee","doi":"10.1093/ptj/pzaf044","DOIUrl":"10.1093/ptj/pzaf044","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review compared the effectiveness of home-based rehabilitation with that of hospital-based rehabilitation and usual care on activities of daily living (ADL) independence in patients with stroke.</p><p><strong>Methods: </strong>Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library databases were searched for studies published between January 2000 and January 2024. This review was registered in the International Prospective Register of Systematic Reviews. Randomized controlled trials on home-based rehabilitation of patients with stroke were included. The included studies investigated ADL independence, upper limb function, mobility, balance, aerobic endurance, and quality of life. Two independent researchers extracted data using an extraction form and assessed the risk of bias and quality of evidence.</p><p><strong>Results: </strong>Forty-six studies were included in the qualitative synthesis, and 34 studies were included in the quantitative synthesis using Review Manager software 5.4. ADL independence was not significantly different between patients receiving home-based rehabilitation and hospital-based rehabilitation (standardized mean difference (SMD) = 0.17 [95% CI = 0.00 to 0.34], I2 = 29%). However, a significant difference was observed between home-based rehabilitation and usual care (SMD = 1.24 [95% CI = 0.69 to 1.79], I2 = 91%).</p><p><strong>Conclusion: </strong>Home-based rehabilitation is comparable to hospital-based rehabilitation and more effective than usual care and should be considered for patients with stroke after discharge to facilitate effective recovery. However, the high overall risk of bias requires cautious interpretation.</p><p><strong>Impact: </strong>Home-based rehabilitation can be an effective alternative method for improving ADL independence in patients with stroke by providing a familiar and convenient environment.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"News From the Foundation for Physical Therapy Research, June 2025.","authors":"","doi":"10.1093/ptj/pzaf067","DOIUrl":"https://doi.org/10.1093/ptj/pzaf067","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Care Physical Therapy and Exercise Therapy for People With Persistent Complaints After a SARS-CoV-2 Infection: Secondary Analysis of the ParaCov Prospective Cohort Study.","authors":"Marissa H G Gerards, Arie C Verburg, Anne I Slotegraaf, Ron van Heerde, Rob A de Bie, Philip J van der Wees, Antoine F Lenssen, Thomas J Hoogeboom","doi":"10.1093/ptj/pzaf065","DOIUrl":"10.1093/ptj/pzaf065","url":null,"abstract":"<p><strong>Importance: </strong>Current insight into recovery and real-world treatment of people with persistent complaints after SARS-CoV-2 infection is limited.</p><p><strong>Objective: </strong>The objective of this study was to describe the content, duration, and reasons for initiating and terminating physical therapist interventions and (factors contributing to) changes in outcomes before and after treatment.</p><p><strong>Design: </strong>This was a prospective cohort study in Dutch primary care allied health care.</p><p><strong>Participants: </strong>Participants were patients receiving allied health care treatment after SARS-CoV-2 infection.</p><p><strong>Intervention: </strong>The intervention was primary care physical therapy.</p><p><strong>Main outcomes and measures: </strong>Self-reported functioning (patient-specific functional scale [PSFS]), 6-min walk test (6MWT), sit-to-stand performance (5 times sit-to-stand [5TSTS]), grip strength, and treatment characteristics were measured pre- and post-treatment. Associations between baseline characteristics, pre-treatment scores, and clinically important improvement on PSFS were calculated.</p><p><strong>Results: </strong>Nine hundred ninety-two patients (mean age 50 years [SD = 13]) were included. Median treatment duration was 24 weeks (IQR = 17-26) and 31 sessions (19-43). Most selected treatment goals were to improve endurance (74%) and physical functioning (72%). In 59% of treatment episodes, therapists reported that patients had achieved the main treatment goal. Mean change scores (95% CIs) were -4.1 points (-4.4 to -3.8) on the PSFS, 70 m (61-78) on the 6MWT, -3.0 s (-3.4 to -2.5) on the 5TSTS, and 3.0 kg (2.1-3.9) on grip strength. Females and participants with worse baseline scores on PSFS had greater odds of reporting a clinically important improvement on the PSFS. Patients with longer 5TSTS times had lower odds.</p><p><strong>Conclusion: </strong>Most patients achieved their treatment goals and demonstrated clinically important improvements on PSFS and 6MWT. This study provides information on the most important therapeutic goals and provides estimates for realistic treatment episodes.</p><p><strong>Relevance: </strong>This article provides insight into real-world physical therapy in patients experiencing persistent complaints after SARS-CoV-2 infection. Additionally, insight into their recovery is provided, showing that patients improve significantly and clinically important on self-reported functioning, 6-min walk test, and sit-to-stand performance.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041906","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 \"Evaluating the Potential of Large Language Models for Vestibular Rehabilitation Education: A Comparison of ChatGPT, Google Gemini, and Clinicians.\" Arbel Y, Gimmon Y, Shmueli L. Phys Ther. 2025;105:pzaf010. https://doi.org/10.1093/ptj/pzaf010.","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1093/ptj/pzaf053","DOIUrl":"10.1093/ptj/pzaf053","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036849","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 \"Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial.\" Avila L, da Silva M, Neves M, et al. Phys Ther. 2024;104:pzad105. https://doi.org/10.1093/ptj/pzad105.","authors":"Wei-Chun He, Jing Luo","doi":"10.1093/ptj/pzaf055","DOIUrl":"10.1093/ptj/pzaf055","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018302","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 Core Set of Outcome Measures to Assess Physical Function for Adults Participating in Physical Therapist Treatment in the Hospital: A Clinical Practice Guideline.","authors":"Kirby P Mayer, Audrey M Johnson, Darby J Smith, Caitlyn M Crandall, Melanie D Johnson, Lindsey E Fresenko, Cayla M Robinson, Lauren E Robinson, Sandra L Kaplan, Sowmya Kumble, Traci L Norris","doi":"10.1093/ptj/pzaf076","DOIUrl":"10.1093/ptj/pzaf076","url":null,"abstract":"<p><strong>Importance: </strong>Outcome measures (OMs) are an integral part of physical therapist practice and implementation can have a multifaceted effect on care delivery.</p><p><strong>Objective: </strong>The objective of this project was to identify a core set of OMs for adults requiring acute care hospitalization in the setting of acute care physical therapist practice.</p><p><strong>Design and setting: </strong>This Clinical Practice Guideline (CPG) focuses on the assessment of physical function within the \"activity\" domain of the International Classification of Functioning, Disability and Health.</p><p><strong>Main outcomes and measures: </strong>The CPG scope was developed with input from interested parties at multiple levels, including Academy of Acute Care Physical Therapy leadership, the CPG Working Group, and consumers of acute care physical therapist practice. A systematic review assessed psychometric data on physical function OMs that included the constructs of bed mobility, transfer ability, and ambulation. The modified Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN-M) was used to examine methodological quality and psychometric strength for each OM. Recommended OMs in the core set met 3 criteria: addressed the established constructs, had strong psychometric properties and methodological quality, and had high clinical utility, defined as minimal time (<20 minutes), low to no cost, and minimal training required for use in clinical practice.</p><p><strong>Results: </strong>Thirty-four OMs were initially identified in the systematic review. Fourteen OMs were considered for the final CPG. In the end, action statements 1 to 3 supported 3 OMs that comprised the acute care core outcome measure set (COMS), and action statements 4 to 8 were recommendations for supplemental OMs that may be performed as additions to augment the COMS. All action statements considered the published evidence, clinical utility, and acute care expertise from the Guideline Development Group. Research recommendations follow each summary of the evidence.</p><p><strong>Conclusions and relevance: </strong>The CPG provides recommendations for COMS to assess physical function in acute care physical therapist practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128309","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}