Physical Therapy最新文献

{"title":"Author Response to Kumar et al.","authors":"Leonardo Avila, Morgana Duarte da Silva, Marcos Lisboa Neves, Andre Rogerio Abreu, Cibelle Ramos Fiuza, Leandro Fukusawa, Arthur de Sá Ferreira, Ney Meziat-Filho","doi":"10.1093/ptj/pzae162","DOIUrl":"10.1093/ptj/pzae162","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626222","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":"Short-Term Powered Mobility Intervention Is Associated With Improvements in Development and Participation for Young Children With Cerebral Palsy: A Randomized Clinical Trial.","authors":"Heather A Feldner, Samuel W Logan, Sango Otieno, Anna Fragomeni, Carissa Kono, Katie Riordan, Bethany Sloane, Lisa K Kenyon","doi":"10.1093/ptj/pzae152","DOIUrl":"10.1093/ptj/pzae152","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the effects of 2 short-term powered mobility interventions across developmental domains, participation, and perceptions of intervention implementation for young children with cerebral palsy and their families.</p><p><strong>Methods: </strong>This randomized, crossover clinical trial compared 2 powered mobility interventions: the Explorer Mini (Permobil AB, Timra, Sweden) and an adapted ride-on toy car. Analyses included 24 children aged 12 to 36 months, recruited from 3 sites. Each device was trialed in the home for an 8-week period for a total of 16 weeks. Three in-person study visits took place at baseline, crossover, and study completion, and 2 additional virtual check-ins were conducted for each device trial period. Outcome measures included all domains of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4); Child Engagement in Daily Life (CEDL) participation questionnaire; and t3 perceptual implementation measures: Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Analyses included descriptive statistics, 2 by 3 group × time analysis of variance, and post hoc t tests as warranted.</p><p><strong>Results: </strong>Statistically significant mean improvements were observed in all domains of the Bayley-4 and in the self-care subscale of the CEDL regardless of device order. Caregivers ranked both devices as acceptable and feasible to implement, although the Explorer Mini was ranked slightly more favorably than the adapted ride-on toy car, with a device order effect being observed.</p><p><strong>Conclusion: </strong>Short-term powered mobility intervention may advance multiple domains of development and participation for young children with cerebral palsy. Caregivers rated 2 different powered mobility devices favorably as part of their child's early intervention strategies.</p><p><strong>Impact: </strong>This study enhances the quality of evidence available to clinicians and families to support decision-making about powered mobility intervention for young children with motor disabilities, especially those who may be reluctant to begin powered mobility due to stigma or concern for motor skill development.</p><p><strong>Lay summary: </strong>In this study, children with cerebral palsy used 2 different powered mobility devices over 16 weeks. The goal of the study was to understand how powered mobility device use affected the children's movement, communication, learning, and social interactions. The goal was also to understand how caregivers felt about the intervention and device options.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505893","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":"Frailty Is Strongest Need Factor among Predictors of Prehabilitation Utilization for Total Hip or Knee Arthroplasty in Fee-for-Service Medicare Beneficiaries.","authors":"Brocha Z Stern, Graham C Sabo, Uma Balachandran, Raquelle Agranoff, Brett L Hayden, Calin S Moucha, Jashvant Poeran","doi":"10.1093/ptj/pzae183","DOIUrl":"https://doi.org/10.1093/ptj/pzae183","url":null,"abstract":"<p><strong>Objective: </strong>Prehabilitation may have benefits for total hip arthroplasty (THA) and total knee arthroplasty (TKA), given an aging population with multimorbidity and the growth of value-based programs that focus on reducing postoperative costs. We aimed to describe prehabilitation use and examine predictors of utilization in fee-for-service Medicare beneficiaries.</p><p><strong>Methods: </strong>This retrospective cohort study using the Medicare Limited Data Set included fee-for-service Medicare beneficiaries who were ≥ 66 years old and who underwent inpatient elective THA or TKA between January 1, 2016, and September 30, 2021. We assessed predictors of receiving preoperative physical therapist services within 90 days of surgery (prehabilitation) using a mixed-effects generalized linear model with a binary distribution and logit link. We report adjusted odds ratios (ORs).</p><p><strong>Results: </strong>Of 24,602 THA episodes, 18.5% of patients received prehabilitation; of 38,751 TKA episodes, 17.8% of patients received prehabilitation. For both THA and TKA, patients with medium or high (vs low) frailty were more likely to receive prehabilitation (OR = 1.72-2.64). Male (vs female) patients, Black (vs White) patients, those with worse county-level social deprivation, those with dual eligibility, and those living in rural areas were less likely to receive prehabilitation before THA or TKA (OR = 0.65-0.88). Patients who were ≥ 85 years old (vs 66-69 years old) and who underwent THA were also less likely to receive services (OR = 0.84). Additionally, there were geographic differences in prehabilitation utilization and increased utilization in more recent years.</p><p><strong>Conclusion: </strong>The need factor of frailty was most strongly associated with increased prehabilitation utilization. The variation in utilization by predisposing factors (eg, race) and enabling factors (eg, county-level social deprivation) suggests potential disparities.</p><p><strong>Impact: </strong>The findings describe prehabilitation use in a large cohort of fee-for-service Medicare beneficiaries. Although services seem to be targeted to those at greater risk for adverse outcomes and high spending, potential disparities related to access warrant further examination.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877661","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":"Correction to: Exploring Symptom Responses to Upper Limb Neural Test Variations of the Radial Nerve in Patients With Lateral Epicondylalgia: An Observational Study.","authors":"","doi":"10.1093/ptj/pzae163","DOIUrl":"https://doi.org/10.1093/ptj/pzae163","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"104 12","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847382","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":"Improving Function in Older Adults With Hospital-Associated Deconditioning: Lessons Learned Comparing a Randomized Controlled Trial to Real World Practice.","authors":"Alexander J Garbin, Melissa K Tran, Jeremy Graber, Danielle Derlein, Deborah Currier, Rebecca Altic, Robert Will, Ethan Cumbler, Jeri E Forster, Kathleen K Mangione, Jennifer E Stevens-Lapsley","doi":"10.1093/ptj/pzae173","DOIUrl":"10.1093/ptj/pzae173","url":null,"abstract":"<p><strong>Objective: </strong>The optimal approach for improving physical function following acute hospitalization is unknown. A recent clinical trial of home health physical therapy compared a high-intensity, progressive, multi-component (PMC) intervention to enhanced usual care (EUC). While both groups improved in physical function, no between-group differences were observed. However, the EUC group received care that differed from real world practice due to standardized treatments and a higher frequency of visits. This study compared a non-randomized true usual care (TUC) group to the EUC and PMC groups.</p><p><strong>Methods: </strong>Participants in the parent trial were randomly assigned to the EUC group (n = 100) and PMC group (n = 100) following hospital discharge. A subset of eligible patients (n = 55) were concurrently enrolled in the TUC group. Both the PMC and EUC groups received strength, activities of daily living, and gait training that differed in intensity but were matched in frequency and duration. TUC group care was determined by the home health agency. The primary outcome at 60-days was the Short Physical Performance Battery (SPPB).</p><p><strong>Results: </strong>In comparison to the TUC group, the EUC and PMC groups had significantly greater improvements in SPPB score (EUC: +1.04 points [CI = 0.18-1.90]; PMC: +1.12 points [CI = 0.23-2.00]).</p><p><strong>Conclusion: </strong>While participants in the EUC and PMC groups experienced greater functional recovery compared to those in the TUC group, it cannot be determined whether these differences are due to the interventions received or confounding factors associated with the addition of a third, non-randomized, study group during the trial period.</p><p><strong>Impact: </strong>This study illustrates the importance of design and interpretation of control groups for clinical trials. Further, the differences between the TUC group and the enhanced intervention groups warrant future research exploring whether increasing visits and standardizing care improve function in older adults receiving home health physical therapy after hospital associated deconditioning.</p><p><strong>Lay summary: </strong>Participants in the intervention groups received standardized and more therapy than usual care, and experienced greater functional improvements. However, these differences may be due to factors associated with the addition of a non-randomized group during an ongoing clinical trial.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"104 12","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865063","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":"Feasibility of a Multidomain Resiliency Assessment in Patients With Advanced Heart Failure Requiring Surgery: A Pilot Study.","authors":"Karlyn J Green, Rebecca North, Adam D DeVore, Samantha Green, Ashley K Poole","doi":"10.1093/ptj/pzae135","DOIUrl":"https://doi.org/10.1093/ptj/pzae135","url":null,"abstract":"<p><strong>Objective: </strong>The resiliency of patients who have advanced heart failure (HF) and undergo a physical stressor such as heart transplantation or left ventricular assist device implantation has yet to be studied in the physical, cognitive, and psychosocial domains. The primary aim of this pilot study was to assess the feasibility of a multidomain resiliency assessment in patients who have advanced HF and require surgery.</p><p><strong>Methods: </strong>A battery of assessments in each of the domains was completed at baseline before surgical intervention, after intensive care discharge, and 3 and 6 months after surgery. Feasibility was assessed through completion rates, time required to complete the assessments, and qualitative feedback from assessors.</p><p><strong>Results: </strong>Although various completion rates were noted at different time points, high completion rates were seen for grip strength, the modified Fried frailty phenotype, and the Montreal Cognitive Assessment. Additionally, when controlled for patients who were medically restricted from physical function, the Short Physical Performance Battery, gait speed, and the 30-second chair stand test also had high completion rates. A trend toward return to baseline status or an improvement in baseline status was observed in all physical and cognitive assessments and most psychosocial assessments at 3 and 6 months. Minimal change was noted in the Brief Resilience Scale questionnaire.</p><p><strong>Conclusion: </strong>This pilot study demonstrates that a multidomain assessment of resiliency is feasible in patients with advanced HF. Future studies are needed to help determine specific assessments or patient factors that would help predict positive postsurgical outcomes in this population.</p><p><strong>Impact: </strong>This study has implications for clinical practice on the most feasible assessments in multiple domains for patients who have advanced HF and are being evaluated for heart transplantation or left ventricular assist device.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"104 12","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847386","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":"Arriba y Adelante: Looking Outward and Moving Ahead.","authors":"Judith E Deutsch","doi":"10.1093/ptj/pzae156","DOIUrl":"https://doi.org/10.1093/ptj/pzae156","url":null,"abstract":"<p><p>Judith E. Deutsch, PT, PhD, FAPTA, the 55th McMillan Lecturer, is professor and director of the Research in Virtual Environments and Rehabilitation Sciences (Rivers) Lab in the Doctoral Programs in Physical Therapy in the School of Health Professions at Rutgers University. Her current research includes the development and testing of virtual reality, serious games to improve mobility and fitness of individuals with neurologic health conditions, and knowledge translation to strengthen evidence-based practice. Her research has been funded by the National Institutes of Health, the National Science Foundation, and the American Hospital Association. She also has longstanding interest and scholarship in integrating complementary therapies into physical therapy. Dr Deutsch has been recognized with awards for teaching, research, mentoring, service and publications from the American Physical Therapy Association (APTA), Academy of Neurologic Physical Therapy, the New Jersey chapter of APTA, the International Society for Virtual Rehabilitation, the Kessler Institute for Rehabilitation, the University of Southern California, and Rutgers University.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"104 12","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855051","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":"Effectiveness of an Exercise and Educational-Based Prehabilitation Program in Patients With Breast Cancer Receiving Neoadjuvant Chemotherapy (PREOptimize) on Functional Outcomes: A Randomized Controlled Trial.","authors":"Anabel Casanovas-Álvarez, Blanca Estanyol, Magda Ciendones, Josep Padròs, Jordi Cuartero, Agustí Barnadas, Bárbara García-Valdecasas, Rubèn González-Colom, Raquel Sebio-García, Jaume Masià","doi":"10.1093/ptj/pzae151","DOIUrl":"10.1093/ptj/pzae151","url":null,"abstract":"<p><strong>Objective: </strong>The study objective was to determine the effectiveness of a prehabilitation program to decrease postoperative musculoskeletal impairments in patients who have breast cancer and are receiving neoadjuvant therapy (NAT).</p><p><strong>Methods: </strong>Patients who had breast cancer and were receiving NAT before surgery were invited to participate in this randomized controlled trial. Patients randomized to the intervention group participated in a group-based prehabilitation program consisting of Nordic walking, resistance training, and therapeutic education from month 4 of NAT until before surgery. Patients in the control group received usual care (no prehabilitation). The main outcome was arm function measured with the short version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire 1 month after surgery. Other measures included pain, range of motion, functional capacity, cancer-related fatigue, handgrip strength, physical activity, and arm circumferences.</p><p><strong>Results: </strong>A total of 64 patients were randomized during the study period, and 61 completed all assessments. A significant difference in the main outcome (a short version of the DASH questionnaire) was found before surgery as patients in the control group experienced worsening in arm function (mean difference = -9.84, 95% CI = -17.7 to -2). In addition, they also showed increased symptom frequency/severity according to the combined scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (mean difference = +6.7 points, 95% CI = 0.1 to 13.4) compared to the intervention group. Prehabilitation also improved functional capacity (mean difference = 67.6 m, 95% CI = 37.4 to 97.7) and physical activity levels and decreased cancer-related fatigue (mean difference = -1.3, 95% CI = -2.4 to -0.29) compared to the control group but had no effect on other secondary outcomes. After surgery, patients receiving prehabilitation also exhibited greater functional capacity at both 1 and 3 months. No other difference was observed.</p><p><strong>Conclusion: </strong>A prehabilitation program was able to maintain arm function and increase functional capacity while decreasing fatigue in patients with breast cancer receiving NAT.</p><p><strong>Impact: </strong>Prehabilitation programs should be offered to patients with breast cancer to maintain functionality and enhance physical performance before surgery.</p><p><strong>Lay summary: </strong>An exercise program combined with therapeutic education in patients with breast cancer who receive NAT before surgery can improve functional capacity and prevent declines of arm mobility and function.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472419","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":"\"I Have Faith in God That I Will Get Better\"-The Multidimensional Perceptions and Expectations of Patients With Chronic Shoulder Pain: A Qualitative Analysis of Common Sense.","authors":"Letícia Jonas de Freitas, Gisele Harumi Hotta, Rafael Krasic Alaiti, Leandro Fukusawa, Domingo Palacios-Ceña, Anamaria Siriani Oliveira","doi":"10.1093/ptj/pzae132","DOIUrl":"10.1093/ptj/pzae132","url":null,"abstract":"<p><strong>Objective: </strong>This descriptive qualitative study aimed to gain insights into the expectations of individuals with chronic shoulder pain and to investigate how different levels of disability may influence their beliefs and expectations regarding improvement.</p><p><strong>Methods: </strong>This qualitative study utilized the Common Sense Model as its theoretical framework. Conducted within a public physical therapy clinic, individuals with chronic shoulder pain who were awaiting the initiation of the treatment were included. Participants, female and male (aged 30-69 years), were purposefully sampled. Thirty participants, categorized into 2 groups based on the Shoulder Pain and Disability Index (SPADI) scores, underwent semi-structured interviews. Group 1, lower SPADI scores (0-60), had 10 participants, and Group 2, higher SPADI scores (61-100), had 20 participants. Thematic analysis and inductive coding were employed to analyze the interviews.</p><p><strong>Results: </strong>Common themes emerged in both groups: the use of medical terms for understanding the diagnosis and the multidimensional impact of pain. The last 2 themes differed between groups. Notable differences included Group 1's focus on resources for pain relief and positive expectations with physical therapy, while Group 2 emphasized rest, religion as a resource for pain relief, and God's role in improvement.</p><p><strong>Conclusion: </strong>These findings highlight the complexity of beliefs and expectations among patients with chronic shoulder pain. Individuals with greater disability often incorporated religious beliefs into their coping strategies, but they held lower recovery expectations and reported negative treatment experiences. These insights have implications for tailoring patient-centered care approaches.</p><p><strong>Impact: </strong>This study underscores the need for health care providers to consider the multidimensionality of recovery expectations, which can significantly influence patient outcomes. Clinicians can reflect on this knowledge to optimize treatment strategies and improve patient prognosis.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140791","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 Therapists in Primary Care in the United States: An Overview of Current Practice Models and Implementation Strategies.","authors":"Katie O'Bright, Seth Peterson","doi":"10.1093/ptj/pzae123","DOIUrl":"10.1093/ptj/pzae123","url":null,"abstract":"<p><p>In the USA, physician shortages and increases in noncommunicable disease burden have resulted in a growing demand for primary care providers (PCPs). Patients with physical and functional impairments have been especially affected by these challenges. However, physical therapists are well suited to meet patient needs in primary care settings by working alongside PCPs and other primary health care team members. When included in a primary care team, physical therapists can improve patient access to care, optimize care navigation, and reduce the overall cost of care. Therefore, the purpose of the current perspective was to (1) provide an overview of established integrated primary care models in the USA that include physical therapists in the care team and (2) outline operational and practice considerations for health care administrators and professionals interested in integrating physical therapists into primary care teams.</p><p><strong>Impact statement: </strong>Given physician shortages and increasing burden in primary care in the USA, inclusion of a physical therapist in a primary care team can improve patient access to care, optimize care navigation, and reduce the overall cost of care for patients with physical and functional needs.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120442","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}