Physical Therapy最新文献

{"title":"News From the Foundation for Physical Therapy Research, October 2024.","authors":"","doi":"10.1093/ptj/pzae140","DOIUrl":"https://doi.org/10.1093/ptj/pzae140","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"104 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505894","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":"Diversity, Equity, Inclusion, and Antiracism Research in Physical Therapy Over the Last 25 Years: A Scoping Review.","authors":"K Michael Rowley, An Ky, Ndidiamaka D Matthews","doi":"10.1093/ptj/pzae072","DOIUrl":"10.1093/ptj/pzae072","url":null,"abstract":"<p><strong>Objective: </strong>Discussions of the root causes of health disparities and educational inequities often neglect to identify racism as a primary factor. Researchers must take a systems perspective to identify the effects of racism and other forms of systemic oppression on health. It is unclear to what extent this perspective exists in the physical therapy research literature. We conducted a scoping review to quantify and describe the volume of research in physical therapy pertaining to diversity, equity, and inclusion specifically examining race and/or ethnicity and references racism or antiracism.</p><p><strong>Methods: </strong>A systematic search of PubMed and Scopus databases for articles published between 1997 and 2021 was conducted. Articles were screened to ensure they were focused exclusively or primarily on physical therapy and used diversity, equity, and inclusion terms in the context of personal identity factors. This resulted in 158 relevant articles. Each was tagged with an article type and personal identity factor focus.</p><p><strong>Results: </strong>A majority of the included articles were descriptive/observational in nature. The included articles explored various personal identity factors, with race and ethnicity being the most common focus followed by culture, disability, and socioeconomic status. A small proportion of articles explicitly discussed racism or antiracism.</p><p><strong>Conclusion: </strong>These findings highlight the need in physical therapy research for greater attention to racism as a fundamental cause of health disparities and educational inequities. Addressing this gap is crucial for promoting diversity, equity, and inclusion within the field and ultimately achieving optimal health outcomes for marginalized populations.</p><p><strong>Impact: </strong>Including consideration of racism and other forms of systemic oppression in the motivation, design, and interpretation of research in physical therapy will help to make more visible the root causes of inequity and improve our ability to develop effective, multi-level interventions.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071751","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":"Becoming JEDI Warriors in Physical Therapy Research: A Multifaceted Approach.","authors":"Evan V Papa, Rupal M Patel, Nicole Windsor, Carmen Capo-Lugo","doi":"10.1093/ptj/pzae102","DOIUrl":"10.1093/ptj/pzae102","url":null,"abstract":"<p><p>The COVID-19 pandemic and recent incidents of social injustice exposed the systemic racism and discrimination in health care and clinical research that perpetuate systemic inequities. This perspective utilizes the acronym JEDI (justice, equity, diversity, and inclusion) as a vision for addressing inequities in physical therapy research. The need to go beyond diversity and focus on inclusion, equity, and justice is emphasized to achieve transformation within physical therapy research. The prevailing research paradigms are examined, acknowledging that research can perpetuate inequities and reinforcing the importance of integrating JEDI principles into the research process. The underrepresentation of diverse researchers in physical therapy is discussed, as well as the barriers faced by underrepresented researchers and research participants. Funding disparities are also highlighted, emphasizing the need for JEDI principles in research funding practices. How other health professions' associations are addressing JEDI in research is also explored. The authors propose a framework for action, utilizing the concepts of the socioecological model to identify gaps in JEDI within physical therapy research at different levels of influence and conclude by emphasizing the importance of justice in dismantling inequitable systems and urge the physical therapy research community to become JEDI warriors to bring about transformative change.</p><p><strong>Impact: </strong>By championing cultures that value justice, equity, diversity, and inclusion, individuals within the physical therapy research community have the potential to ignite a powerful transformation in society. The authors envision a future where JEDI warriors emerge, embracing the spirit of \"Do or do not. There is no try,\" to forge a research community that is inclusive for all. 1 Drawing inspiration from this mindset, this perspective seeks to empower individuals to harness the force of a JEDI warrior, fostering cultures that value justice, embrace inclusive methodologies, and ensure equitable access to resources and opportunities for researchers and participants.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760243","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":"Identifying Deficits in Hip and Knee Muscle Strength on the Surgical and Nonsurgical Sides in Women up to 12 Months After Total Hip Arthroplasty.","authors":"Junya Sekita, Naonobu Takahira, Hiroyuki Watanabe, Atsushi Kusaba, Saiji Kondo","doi":"10.1093/ptj/pzae099","DOIUrl":"10.1093/ptj/pzae099","url":null,"abstract":"<p><strong>Objective: </strong>Regaining hip and knee muscle strength is important after total hip arthroplasty (THA). However, it is unclear if muscles other than those of the operated hip also lose strength. This study aimed to identify deficits in hip and knee strength on the surgical and nonsurgical sides in female patients up to 12 months after THA.</p><p><strong>Methods: </strong>Participants were 91 female patients who had hip osteoarthritis and underwent unilateral THA. Forty-six community-dwelling women who were asymptomatic were selected as control participants. Patients with locomotor disorders or postsurgical complications were excluded. Maximal isometric strength of the hip flexors, extensors, and abductors and knee extensors and flexors on the surgical and nonsurgical sides were measured before THA and 3, 6, and 12 months thereafter.</p><p><strong>Results: </strong>Twelve months after THA, hip flexion, extension, and abduction strength on the surgical side were 84.6%, 83.5%, and 76.2%, respectively, of those in individuals who were asymptomatic; at the same time point, those on the nonsurgical side were 94.8%, 83.9%, and 79.4%, respectively. Knee extension strength on the surgical side was 89.3% of that in individuals who were asymptomatic. Compared to individuals who were asymptomatic, nearly all muscles showed significantly lower strength on both sides up to 6 months after THA.</p><p><strong>Conclusion: </strong>At 12 months after THA, hip and knee strength on both the surgical and nonsurgical sides did not recover to the level observed in individuals who were asymptomatic. In particular, hip abductor strength on the surgical and nonsurgical sides were 76% and 79%, respectively, of that in individuals who were asymptomatic.</p><p><strong>Impact: </strong>At 12 months after THA, hip and knee strength on the surgical and nonsurgical sides did not recover to the level observed in individuals who were asymptomatic, suggesting that the nonsurgical side may be inappropriate as a control to assess strength recovery on the surgical side.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767046","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":"Relationships Between Socioecological Factors and Self-Efficacy to Participate in Physical Activity for Adults With Chronic Musculoskeletal Pain: An Integrative Review.","authors":"Mark Vorensky, Stephanie L Orstad, Allison Squires, Susan Parraga, Katherine Byrne, Ericka N Merriwether","doi":"10.1093/ptj/pzae120","DOIUrl":"10.1093/ptj/pzae120","url":null,"abstract":"<p><strong>Objective: </strong>Self-efficacy for leisure-time or health-promoting physical activity (SEPA) is a psychosocial determinant of physical activity. The socioecological model can provide a robust perspective of SEPA. The objective of this study was to synthesize the evidence on multilevel correlates of SEPA among individuals with chronic musculoskeletal pain. The second aim examined the extent to which socioecological disparities are associated with SEPA among individuals with chronic musculoskeletal pain.</p><p><strong>Methods: </strong>An integrative review was conducted. Included studies needed to investigate the relationship between SEPA and socioecological factors at the interpersonal, institutional, community, and/or macrosystem level among adults with chronic musculoskeletal pain (≥3 months). Searches in PubMed, EMBASE, PsycINFO, and CINAHL were performed (December 30, 2020, and October 12, 2022), yielding 4047 records after duplicates were removed. Two independent reviewers completed screening, full-text reviews, and data extraction. After title and abstract screening and full-text reviews, 17 studies were included. The constant comparison method included: data reduction, data display, data comparison, and conclusion drawing/verification. Quality of evidence was assessed using the Joanna Briggs Institute appraisal tools.</p><p><strong>Results: </strong>Five themes emerged with respect to relationships between SEPA and socioecological factors: social relations, social comparisons, patient-provider relationship, organizational resources, and accessibility to physical activity. Relationships between interpersonal factors and SEPA were most prominently studied. One study examined and addressed potential disparities in SEPA at the macrosystem level.</p><p><strong>Conclusion: </strong>A spectrum of relationships from supporting to straining SEPA were found at the interpersonal level. Relationships between institutional, community, and macrosystem factors and SEPA were comparably sparse. Gaps in the literature were identified regarding how health disparities present across the socioecological model with respect to SEPA.</p><p><strong>Impact: </strong>Clinicians can use this review to evaluate how SEPA can be supported or threatened by factors across the socioecological model. This may be a preliminary step towards examining and addressing health disparities in SEPA.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110841","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":"Optimizing Total Knee Arthroplasty Rehabilitation With Telehealth Physical Activity Behavior Change Intervention: A Randomized Clinical Trial.","authors":"Cory L Christiansen, Paul W Kline, Chelsey B Anderson, Edward L Melanson, William J Sullivan, Vanessa L Richardson, Elizabeth Juarez-Colunga, Jennifer E Stevens-Lapsley","doi":"10.1093/ptj/pzae088","DOIUrl":"10.1093/ptj/pzae088","url":null,"abstract":"<p><strong>Objective: </strong>Conventional total knee arthroplasty (TKA) rehabilitation has little impact on sedentary lifestyles that have negative long-term health consequences. The purpose of this trial was to determine the effect of telehealth-based physical activity behavior change intervention on physical activity and functional outcomes following TKA.</p><p><strong>Methods: </strong>This study was a 2-arm, parallel randomized controlled superiority trial at a regional Veterans Affairs medical center. The participants were 92 US military veterans (mean age = 65.7 [SD =7.8] y) undergoing unilateral TKA. The Physical Activity Behavior Change (PABC) intervention included telehealth-based self-management training (10 30-minute sessions) delivered over 12 weeks. The control intervention included telehealth-based health education sessions that matched PABC frequency and duration. Both groups participated in standardized conventional outpatient rehabilitation. Physical activity, measured as average daily step count, was the primary outcome. Secondary outcomes were Life-Space Assessment questionnaire, 30-Second Chair-Stand test, Timed \"Up & Go\" Test, 6-Minute Walk Test, Western Ontario and McMaster Universities Osteoarthritis Index, and Veterans RAND 12-Item Health Survey. The Self Efficacy for Exercise scale and daily time spent in different postures (sitting/lying, standing, stepping) were exploratory variables. Outcomes were measured at baseline (before surgery), mid-intervention (8 weeks after surgery), after the intervention (14 weeks after surgery; primary endpoint), and follow-up (38 weeks after surgery).</p><p><strong>Results: </strong>The PABC group had an estimated 931 (95% CI = 42-1819) more daily steps than the control group from baseline to 14 weeks, though a between-group effect was not sustained at 38 weeks. There were no group differences in secondary outcomes. Participants included only military veterans using Veterans Health Administration services. The intervention targeted self-management and did not include peer support.</p><p><strong>Conclusion: </strong>The PABC intervention improved physical activity for veterans recovering from unilateral TKA at 14 weeks after surgery, though the effect was not sustained at 38 weeks. Physical function improved with rehabilitation but was not different between groups, indicating that physical function was not a primary driver of physical activity behavior.</p><p><strong>Impact: </strong>Conventional TKA rehabilitation has a negligible effect on free-living physical activity, which is relevant to long-term health outcomes. This trial identified telehealth physical activity self-management as effective in addressing activity behaviors, separate from conventional rehabilitation strategies.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604020","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":"Women's Health Across the Lifespan: A Sex- and Gender-Focused Perspective.","authors":"Jessica L McKinney, Susan C Clinton, Laura E Keyser","doi":"10.1093/ptj/pzae121","DOIUrl":"10.1093/ptj/pzae121","url":null,"abstract":"<p><p>Women's health in physical therapy has historically focused on sexual and reproductive health. The biological and social constructs of sex and gender, respectively, are determinants of health, including pathophysiology of disease and therapeutic outcomes, and an expansion of the concept of \"women's health\" is warranted. This Perspective explores the role of sex and gender as key determinants of women's and girls' health and highlights the factors pertinent to physical therapist practice. The Scale for the Assessment for Narrative Review Articles (SANRA), a 6-point assessment to evaluate the quality of narrative reviews, was used a priori and consulted throughout. Across the lifespan, sex- and gender-based health disparities exist. These include sex-based disparities in maternal-fetal outcomes linking female fetal sex to maternal hypertensive disorders of pregnancy, along with a sex-based female advantage in birth outcomes and the emergence of gender differences in motor development. A complex interplay of biological and socially influenced factors contributes to an increased care burden for women throughout adulthood and specific risks for the development of cardiovascular and pelvic floor conditions, decreased function, and increased disability. Sex- and gender-disaggregated data are lacking in outcomes literature. A sex- and gender-informed approach in physical therapy, including analyzing data by sex and gender, may better meet the needs of patients and better prepare physical therapist professionals to contribute to women's health across the lifespan. Success will take coordinated effort involving many stakeholders within and adjacent to the physical therapist community. The influence of sex and gender are lifelong determinants of health, making them critically important to consider in physical therapist practice, education, research, advocacy, and policy. In women's health, focusing on sexual and reproductive health is limiting and insufficient.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110842","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":"Vestibular Rehabilitation: Improving Symptomatic and Functional Outcomes of Persons With Vestibular Schwannoma: A Systematic Review.","authors":"Jayden Yap, Gretta Palmer, Kate Graving, Shona Stone, Elise M Gane","doi":"10.1093/ptj/pzae085","DOIUrl":"10.1093/ptj/pzae085","url":null,"abstract":"<p><strong>Objective: </strong>Persons with vestibular schwannoma suffer from dizziness, imbalance, and decreased function leading to reduced quality of life. Other forms of peripheral vestibular hypofunction show improvements in these signs and symptoms with vestibular rehabilitation; however, the efficacy of this intervention for those with vestibular schwannoma is unknown. Therefore, the aim of this systematic review was to determine the effect of vestibular physical therapy on subjective and objective measures of vestibular symptoms and function in people with vestibular schwannoma.</p><p><strong>Methods: </strong>Four electronic databases were searched: PubMed, CINAHL, EMBASE, and Cochrane. Included studies were experimental or observational in design and featured patients with vestibular schwannoma who had undergone vestibular physical therapy. Screening and quality assessment was completed independently by 2 researchers. Risk of bias was assessed with a tool appropriate for study design (eg, Cochrane Risk of Bias 2.0 tool for randomized trials). The Grading of Recommendations Assessment, Development and Evaluation approach was used to synthesize findings.</p><p><strong>Results: </strong>Twenty-three studies were included. Overall, the effect of vestibular physical therapy for patients with vestibular schwannoma was uncertain. Outcomes of dizziness, static and dynamic balance, and vestibular function all showed very low certainty on the Grading of Recommendations Assessment, Development and Evaluation assessment. Multimodal physical therapist interventions consistent with clinical practice guidelines (eg, gaze stability, habituation, balance training, gait training) demonstrated potential for improvement in dizziness, balance, and vestibular function, respectively. Results were mostly insignificant when a single modality was used.</p><p><strong>Conclusion: </strong>There may be benefit in multimodal vestibular physical therapy for people with vestibular schwannoma to improve symptoms and function. More high-quality studies specific to vestibular schwannoma prehabilitation and rehabilitation are needed to increase the certainty in the evidence.</p><p><strong>Impact: </strong>Physical therapists are encouraged to use multimodal vestibular rehabilitation for vestibular schwannoma in clinical practice in line with clinical guidelines for peripheral vestibular hypofunction.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564102","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":"Upper Limb Function in People With Upper and Lower Limb Loss 8 Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study.","authors":"Fraje C E Watson, Angela E Kedgley, Susie Schofield, Fearghal P Behan, Christopher J Boos, Nicola T Fear, Alexander N Bennett, Anthony M J Bull","doi":"10.1093/ptj/pzae082","DOIUrl":"10.1093/ptj/pzae082","url":null,"abstract":"<p><strong>Objective: </strong>Upper limb (UL) disability in people with UL loss is well reported in the literature, less so for people with lower limb loss. This study aimed to compare UL disability in injured (major trauma) and uninjured UK military personnel, with particular focus on people with upper and lower limb loss.</p><p><strong>Methods: </strong>A volunteer sample of injured (n = 579) and uninjured (n = 566) UK military personnel who served in a combat role in the Afghanistan war were frequency matched on age, sex, service, rank, regiment, role, and deployment period and recruited to the Armed Services Trauma Rehabilitation Outcome (ADVANCE) longitudinal cohort study. Participants completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, scored from 0 (no disability) to 100 (maximum disability) 8 years postinjury. Mann-Whitney U and Kruskal-Wallis tests were used to compared DASH scores between groups. An ordinal model was used to assess the effect of injury and amputation on DASH scores.</p><p><strong>Results: </strong>DASH scores were higher in the Injured group compared to the Uninjured group (3.33 vs 0.00) and higher in people with lower limb loss compared to the Uninjured group (0.83 vs 0.00), although this was not statistically significant. In the adjusted ordinal model, the odds of having a higher DASH score was 1.70 (95% CI = 1.18-2.47) times higher for people with lower limb loss compared to the Uninjured group. DASH score was not significantly different between people with major and partial UL loss (15.42 vs 12.92). The odds of having a higher DASH score was 8.30 (95% CI = 5.07-13.60) times higher for people with UL loss compared to the Uninjured group.</p><p><strong>Conclusion: </strong>People with lower limb loss have increased odds of having more UL disability than the Uninjured population 8 years postinjury. People with major and partial UL loss have similar UL disability. The ADVANCE study will continue to follow this population for the next 20 years.</p><p><strong>Impact: </strong>For the first time, potential for greater long-term UL disability has been shown in people with lower limb loss, likely resulting from daily biomechanical compensations such as weight-bearing, balance, and power generation. This population may benefit from prophylactic upper limb rehabilitation, strength, and technique.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477186","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":"Transgender, Gender-Diverse, and Nonbinary Experiences in Physical Therapy: A Descriptive Qualitative Study.","authors":"Madelaine Aird, Julie L Walters, Alex Ker, Megan H Ross","doi":"10.1093/ptj/pzae086","DOIUrl":"10.1093/ptj/pzae086","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to explore experiences with and identify barriers and facilitators of utilizing physical therapy for people who identify as transgender, gender diverse, and nonbinary (TGNB).</p><p><strong>Methods: </strong>A qualitative descriptive design was employed using semistructured interviews conducted in New Zealand. Eligible participants were individuals who were 12 years old or older, who self-identified as TGNB, and who had accessed physical therapy at a community-based clinic that also provides a gender-affirming service. Participants were recruited via email invitation to the clinic database. Interview data were analyzed using reflexive thematic analysis. Demographics are reported descriptively.</p><p><strong>Results: </strong>Seventeen individuals (15-64 years old and identifying as 11 different genders) participated. All participants reported physical therapy experiences relating to 1 or more of the following 4 themes: challenging cisnormativity at policy, environmental, clinic, and therapist levels; safety and trust throughout the clinical experience, including clinic credibility for being a safe provider, clinic displays of TGNB inclusivity, implementation of safe clinic processes, and respectful therapist interactions; inclusive experiences in a clinic that provided affordable care and took active steps to understand and affirm TGNB identities and with physical therapists who had a high level of knowledge of TGNB-specific health issues and took a biopsychosocial approach to care; and sensitivity to body discomfort or dysphoria triggers. Barriers to and facilitators of care were identified at policy, environmental, clinic, and therapist levels.</p><p><strong>Conclusion: </strong>People who identify as TGNB face challenges to accessing safe and culturally sensitive physical therapy. However, there are achievable areas for improvement at policy, environmental, clinic, and physical therapist levels to gain trust and engagement in care for the TGNB community.</p><p><strong>Impact: </strong>This study provides a detailed exploration of TGNB physical therapy experiences and identifies specific areas of improvement for TGNB physical therapy care to provide clinicians and physical therapy clinics insights into the provision of safe and culturally sensitive physical therapy.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564101","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}