Physical Therapy最新文献

{"title":"Between the snap and the return: a prospective narrative analysis of four voices from inside anterior cruciate ligament reconstruction recovery.","authors":"Ramana Piussi, Andreas Ivarsson, Urban Johnson, Kristian Samuelsson, Eric Hamrin Senorski","doi":"10.1093/ptj/pzag063","DOIUrl":"10.1093/ptj/pzag063","url":null,"abstract":"<p><strong>Importance: </strong>Anterior cruciate ligament (ACL) injury is a common sports injury with substantial physical and psychological consequences. Qualitative studies have explored patient experiences, but most studies use cross-sectional designs, limiting insight into how experiences evolve throughout rehabilitation.</p><p><strong>Objective: </strong>The purpose of this study was to explore patients' experiences of ACL injury and recovery using a prospective, narrative approach, from injury to achievement of self-defined rehabilitation goals.</p><p><strong>Design: </strong>This was a longitudinal qualitative study with narrative analysis.</p><p><strong>Setting: </strong>The study was conducted at an outpatient sports rehabilitation clinic in Sweden. Participants: Four adults (ages 20 to 29 years; 2 male, 2 female) undergoing ACL reconstruction were included using consecutive sampling.</p><p><strong>Intervention(s) or exposure(s): </strong>Serial 1-to-1 semi-structured interviews were conducted around injury, pre-surgery, early post-surgery, and every 2 months until each participant achieved a rehabilitation goal defined at study entry. Interviews were analyzed using Narrative Oriented Inquiry with attention to story structure, tone, positioning, and context.</p><p><strong>Main outcome(s) and measure(s): </strong>The main outcome were the evolving narratives of participants' recovery experiences, expressed through first-person interpretative stories.</p><p><strong>Results: </strong>The longitudinal narratives revealed shifting identities, emotions, and meanings attached to rehabilitation milestones. One participant described moving from helplessness to renewed athletic identity; another portrayed a pragmatic recovery marked by monotony and team reintegration; a third experienced progress until a second ACL injury reframed priorities; and the fourth navigated prolonged knee pain, missed timelines, and gradual acceptance. Across cases, rehabilitation was experienced not as a linear sequence but as an ongoing negotiation of trust, belonging, and confidence.</p><p><strong>Conclusions and relevance: </strong>Prospective narrative inquiry illuminated how recovery after ACL reconstruction is lived as a personal, evolving story. For physical therapists, recognizing the temporal dynamics of identity, trust, and confidence may support more individualized rehabilitation, complementing standardized protocols. These findings highlight the importance of attending to both physical and narrative dimensions of ACL recovery in clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259248","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":"Describing relationships in doctor of physical therapy clinical education: a multi-site case study investigation.","authors":"Jamie L Greco, Lori Hochman, Donna Applebaum, Christine McCallum","doi":"10.1093/ptj/pzag053","DOIUrl":"10.1093/ptj/pzag053","url":null,"abstract":"<p><strong>Importance: </strong>The changing landscape of health care calls for recalibration of educating the next generation of physical therapists. Physical therapist education programs rely on external clinical entities to prepare students for practice. Descriptions of relationships between academic and clinical entities are scarce despite a national call to explore this concept.</p><p><strong>Objective: </strong>The objective of this study is to describe existing relationships from the perspectives of the multiple key decision makers within Doctor of Physical Therapy clinical education (CE).</p><p><strong>Design: </strong>This study used a qualitative investigation using a multi-site descriptive case study design.</p><p><strong>Setting & participants: </strong>A national call for participants was made to Commission on Accreditation of Physical Therapist Education (CAPTE) accredited programs, that served as cases, followed by purposeful recruitment to achieve maximum variation. Programs varied by categories such as size, public/private institutions, and residential/hybrid programs. Cases included academic and clinical participants associated with a single institution in varied academic and clinical roles as well as students. Participants completed a demographic survey and engaged in an individual virtual semi-structured interview or a focus group. Thematic analysis both within cases and cross cases was followed.</p><p><strong>Main outcomes: </strong>Qualitative themes were reported by participants surrounding their perceptions about the different types of relationships that exist in CE.</p><p><strong>Results: </strong>A total of 10 cases with 88 interview/focus group transcripts were analyzed. Seven themes emerged identifying and describing different relationships in physical therapist CE. Relationship types included: One and Done, Transactional, Collaborative and Trusting, Systems Relationship, Go-to Site, Existing Relationship, and Strained Relationship.</p><p><strong>Conclusions: </strong>A variety of relationships are valuable in professional level CE. Flexibility and customization of relationships are essential to accommodate changing demands of health care, education, and student needs. Further research is needed to optimize communication and efficiency, to ensure the sustainability of relationships and, consequently, the profession.</p><p><strong>Relevance: </strong>This study provides insight into the nature of clinical-academic relationships, contributing to the development of models that may enhance quality and sustainability of CE in physical therapist education.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942589","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":"Maximizing the opportunity for skin cancer screening in physical therapy.","authors":"Michael Robinson","doi":"10.1093/ptj/pzag057","DOIUrl":"10.1093/ptj/pzag057","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006398","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":"Community integration as a key role of the rural primary care physical therapist: a qualitative case study.","authors":"Nathan Brown, Kathryn Zalewski, Marcus Lewis","doi":"10.1093/ptj/pzag065","DOIUrl":"10.1093/ptj/pzag065","url":null,"abstract":"<p><strong>Importance: </strong>Rural communities face poor health outcomes due to limited health care access and provider shortages. Physical therapists are increasingly recognized as potential contributors to primary care delivery, yet little is known about their actual roles in rural settings.</p><p><strong>Objective: </strong>The objective of this study was to explore the unique professional experiences of physical therapists in the rural Upper Midwest.</p><p><strong>Design: </strong>A qualitative, exploratory case study design was used. Data were collected through semi-structured interviews and field observations. Analysis included inductive, in-vivo coding methods and thematic analysis guided by the Culturally Sustaining Pedagogy theoretical framework.</p><p><strong>Setting: </strong>This study was situated in 5 communities in a rural, Upper Midwest state.</p><p><strong>Participants: </strong>Five physical therapists with over 4.5 years of rural clinical experience were included in this study.</p><p><strong>Results: </strong>Four key themes and associated subthemes were derived regarding the role of rural physical therapists: (1) operating as a primary care provider: physical therapists filled primary care roles through rurality-imposed autonomy, health care coordination, and health education; (2) employing a wide breadth of practice: therapists required broad generalist knowledge across practice settings; (3) patient-centeredness: patient-centered care involved fostering cultural norms and decentering of the therapist's own values; and (4) community integration: community engagement beyond their role as a physical therapist and understanding local culture were crucial for community acceptance and providing appropriate care.</p><p><strong>Conclusions: </strong>Physical therapists in rural communities in an Upper Midwest state are fulfilling expanded primary care roles to address health care shortages while deeply integrating within communities to provide appropriate and acceptable care. Their experiences highlight the complexity of rural health care delivery and potential for physical therapists to help alleviate provider shortages.</p><p><strong>Relevance: </strong>As health care shortages persist in rural areas and the understanding the role of the primary care physical therapist continues to grow, this study shows that physical therapists are uniquely positioned to support primary care delivery.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308954","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 \"Chest Binding and the Role of the Physical Therapist: A Commitment to Care.\" Marengo J, Sutkowi-Hemstreet A, Condran C, Goodman N, Offstein K, Nippins M. Phys Ther. 2025;105(12):pzaf132. https://doi.org/10.1093/ptj/pzaf132.","authors":"Kai Schweizer, Brett Buist, Ben Kramer, Claire Munsie, Felicity Austin, Grant Landers, Kemi Wright, Benjamin Quick, Bonnie Furzer","doi":"10.1093/ptj/pzag046","DOIUrl":"https://doi.org/10.1093/ptj/pzag046","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 6","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296092","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":"Role of Thai boxing dance program on fall prevention and physical performance in community-dwelling older adults at risk: a randomized controlled study.","authors":"Pattanasin Areeudomwong, Wiriya Mahikul, Siriyaporn Khunthason, Yadanuch Boonyaratana, Vitsarut Buttagat","doi":"10.1093/ptj/pzag054","DOIUrl":"10.1093/ptj/pzag054","url":null,"abstract":"<p><strong>Importance: </strong>Falls among older adults are a major public health concern, but evidence on Thai boxing dance (TBD) interventions for prevention remains inconclusive.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a 6-month TBD program in reducing fall incidence and improving physical performance, fear of falling, and cognitive function among community-dwelling older adults at risk of falling.</p><p><strong>Design: </strong>This study was a 3-arm parallel-group, assessor-blinded randomized controlled trial.</p><p><strong>Setting: </strong>The study was conducted at 3 primary health care centers in Chiang Rai, Thailand.</p><p><strong>Participants: </strong>Among the 123 participants enrolled, 115 older adults aged ≥60 years were identified as being at risk of falling and completed the study.</p><p><strong>Interventions: </strong>Participants were randomly allocated to 1 of 3 groups: TBD, conventional balance exercise (CBE), or a control group (CG). All groups participated in biweekly sessions over a 24-week period.</p><p><strong>Main outcomes and measures: </strong>Falls were monitored over a 180-day period, whereas physical performance, fear of falling, and cognitive function were assessed at baseline and at the 6-month intervention period.</p><p><strong>Results: </strong>Of the 123 participants, 115 completed the trial. Incident rates of falls in the TBD and CBE group (0.18 and 0.17 per person-month, respectively) were lower than the rate of 0.62 in the CG. The TBD group showed a 76% reduction in the fall rate compared to CG. TBD also led to significantly greater improvements in physical performance, including postural sway, gait parameters, and lower-limb strength, compared with the CG after the 6-month intervention. The CBE group showed greater improvements in gait parameters only. No significant between-group differences were observed in fear of falling or cognitive function.</p><p><strong>Conclusions and relevance: </strong>A 6-month TBD and CBE program reduced falls. TBD improved physical performance more broadly, whereas CBE yielded targeted gait improvements in community-dwelling older adults at risk of falling.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974553","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 value of integrating physical therapists into primary care, including patient outcomes and health care costs: a scoping review.","authors":"Alyson M Cavanaugh, Micah Wong, Katie O'Bright, Dylan Lewis","doi":"10.1093/ptj/pzag052","DOIUrl":"10.1093/ptj/pzag052","url":null,"abstract":"<p><strong>Objective: </strong>Physical therapists have served in primary care roles in the United States military, but the model has yet to be widely adopted in US private, non-governmental health care settings. This review aims to map existing literature regarding the implementation and variations of primary care physical therapy (PCPT) models, assessing health care utilization and patient outcomes.</p><p><strong>Data sources, study selection, data extraction, and synthesis: </strong>We searched 3 electronic databases (PubMed, CINAHL, and Scopus) for studies published from 2014 to 2023 in English language. Studies that evaluated health care utilization/costs or patient outcomes while comparing PCPT with the traditional medical primary care model were included.</p><p><strong>Main outcomes and measures: </strong>Main outcomes included study characteristics (population, setting, and model of PCPT), and reported outcomes relevant to health care utilization/costs and patient outcomes.</p><p><strong>Results: </strong>Of the 3565 publications identified, 39 were included in the scoping review. Seventeen studies contained sufficient detail to describe the integration of physical therapists into primary care, and included approaches such as team-based care, co-location of physical therapists in a primary care clinic, and the use of a formalized triage system at the primary care clinic that directed patients to schedule with a physical therapist first. PCPT models have been described in multiple countries internationally. In the United States, PCPT is largely described in unique payor systems including the military, Veterans Affairs, and employee health settings. PCPT may be associated with lower health care costs and utilization compared to traditional medical primary care, particularly in terms of reduced imaging (17 out of 19 studies) and medication use (11 out of 17 studies), including opioid use (5 out of 5 studies). Patient outcomes appeared similar between PCPT and medical primary care pathway, but less robust evidence is available on the topic.</p><p><strong>Conclusions and relevance: </strong>This scoping review found a variety of PCPT models used in governmental, including military, and civilian settings in the United States and internationally, with evidence suggesting that integrating physical therapists in primary care may result in reduced health care utilization with non-inferior patient outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875254","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":"Frequency and severity of adverse events associated with dry needling: a systematic review and meta-analysis.","authors":"Gabriel Rabanal-Rodríguez, Manuel Anxo Simón-Alonso, Marcos José Navarro-Santana, César Fernández-de-Las-Peñas, Daniel Albert-Lucena, María José Díaz-Arribas, Juan Antonio Valera-Calero, Gustavo Plaza-Manzano","doi":"10.1093/ptj/pzag050","DOIUrl":"10.1093/ptj/pzag050","url":null,"abstract":"<p><strong>Importance: </strong>Dry needling (DN) is widely used in musculoskeletal practice. However, the incidence and severity of adverse events (AEs) associated to DN remain unclear.</p><p><strong>Objective: </strong>The objective was to report the frequency and severity of AEs related to DN.</p><p><strong>Design: </strong>This was a systematic review with meta-analysis.</p><p><strong>Setting: </strong>Following the PRISMA checklist, PubMed, Web of Science, and Scopus databases were systematically searched from September 2024 to April 2025.</p><p><strong>Studies and intervention: </strong>Case reports, case series, surveys, observational studies, and randomized clinical trials conducted on humans, applying DN and assessing associated AEs, were collected.</p><p><strong>Main outcomes and measures: </strong>Methodological quality and risk of bias were assessed using the Joanna Briggs Institute tool, the AXIS tool, the PEDro scale and the Newcastle-Ottawa scale. Data were screened and extracted by 2 independent investigators, consulting a third researcher in case of doubts. The information was analyzed and classified in separate tables detailing the characteristics of the sample, the interventions, the AEs, and the methodological quality from the different types of studies.</p><p><strong>Results: </strong>A total of 59 articles were included, comprising 25 patients in case reports and case series, 1947 patients in randomized clinical trials and prospective observational studies and 2380 professionals in surveys. DN was found to commonly produce minor AEs, ranging from 0% to 48.15% per treatment and from 2.56% to 72.73% throughout a clinician's career. Major AEs per treatment are uncommon (0%-0.43%) but are reported by 0.98% to 39.14% of professionals when assessing their complete clinical practice.</p><p><strong>Conclusions and relevance: </strong>While DN is widely used and generally associated with minor AEs, this review highlights the potential for rare although serious complications.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841351","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 profession knocking at the front door: primary care physical therapy and the hard part that comes next.","authors":"Christopher Bise","doi":"10.1093/ptj/pzag060","DOIUrl":"https://doi.org/10.1093/ptj/pzag060","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"106 6","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296106","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":"Sustaining physical activity in chronic obstructive pulmonary disease: a qualitative study of perspectives on a personalized community-based physical activity program.","authors":"Patrícia Rebelo, Dina Brooks, Alda Marques","doi":"10.1093/ptj/pzag051","DOIUrl":"10.1093/ptj/pzag051","url":null,"abstract":"<p><strong>Importance: </strong>Sustaining pulmonary rehabilitation (PR) benefits in community-dwelling individuals with chronic obstructive pulmonary disease (COPD) is challenging.</p><p><strong>Objective: </strong>The objective of this study was to explore the experiences of individuals with COPD participating in a PersonalIzed CommUnity-based Physical Activities program (PICk UP) and to identify which behavioral change techniques (BCTs) supported sustained physical activity (PA).</p><p><strong>Design: </strong>This was a qualitative pre-post intervention study (NCT04223362|NCT04711057).</p><p><strong>Setting: </strong>The study was conducted in a community setting.</p><p><strong>Participants: </strong>This study recruited individuals with COPD assigned to the PICk UP intervention.</p><p><strong>Intervention: </strong>Participants enrolled in a 6-month, post-PR, community-based program comprising gym, senior exercise classes, pool exercise classes, or Chi Kung.</p><p><strong>Main outcome and measures: </strong>Participants' perspectives on impacts of the PICk UP program, motivators, facilitators, and barriers to adherence were collected through pre-post focus groups. Data were analyzed using deductive and inductive reflexive thematic analysis. The \"capability, opportunity, motivation, behavior\" framework was used to identify BCTs.</p><p><strong>Results: </strong>Fifteen individuals with COPD participated (14 male, 70 [8] years, FEV1 57.1% [18.1%] predicted). Five main themes emerged, focusing on PA choice, barriers, facilitators, effects, and suggestions: (1) one size doesn't fit all; (2) organizational factors and system-level support enabling adherence; (3) it doesn't come easy; (4) a positive feedback cycle sustained physical, psychological, and social benefits; and (5) the more, the merrier. The PICk UP intervention supported PA through 13 BCTs, across 5 intervention types (education, persuasion, training, environmental restructuring, and enablement), collectively addressing all 6 components influencing behavior.</p><p><strong>Conclusions: </strong>Individuals with COPD reported lasting PR benefits after the PICk UP and were willing to remain physically active. Participants emphasized the importance of diverse PA options and support from peers, health, and fitness professionals.</p><p><strong>Relevance: </strong>To sustain PA beyond PR, interventions should prioritize intersectoral partnerships and embed ongoing social support. These findings underscore PICk UP's effectiveness, positioning it as a promising and replicable model for promoting long-term PA in individuals with COPD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856962","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}