Physical Therapy最新文献

{"title":"Transforming Ableism in Physical Therapist Education One Student at a Time: A Case Report of a Student With Blindness.","authors":"Megan B Flores, Kathryn E Sawyer, Derrick F Campbell, Kathleen J Manella","doi":"10.1093/ptj/pzaf028","DOIUrl":"10.1093/ptj/pzaf028","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of students with disabilities in physical therapist education programs in the United States is <1%. This case report explored the experiences surrounding a specific, unique individual student with blindness or visual impairment (BVI) within the context of an entry-level physical therapist program. The purpose was not merely to describe 1 student's journey but to capture the complex dynamics and shifts in perceptions of students, faculty, staff, and clinicians. This case report retrospectively explored the perceptions of these individuals before, during, and after interactions with the student and examined ableist assumptions expressed by some individuals that vision is essential for Doctor of Physical Therapy (DPT) students and clinical practice.</p><p><strong>Methods: </strong>A recent DPT graduate (pseudonym J.M.) with BVI classified as \"near total blindness,\" is now a licensed, full-time employee at an outpatient orthopedic clinic. We surveyed 36 individuals (20 students, 11 faculty, 2 staff, and 3 clinical instructors) who interacted with J.M. as a student, asking their perceptions about the education, clinical skills, and employment potential of a DPT student with BVI.</p><p><strong>Results: </strong>An increase toward more favorable perceptions of individuals with BVI was exhibited for all of 10 Likert scale questions (X2[2] = 38.00 to 59.42). Qualitative analysis revealed 3 themes: accommodations, personal qualities, and setting with an overarching theme of an approbative shift in perceptions.</p><p><strong>Discussion: </strong>The shift in perceptions about vision as essential for physical therapist practice is important and suggests that physical therapist education program applicant qualifications and essential functions regarding vision should be considered within the context of reasonable accommodations, individual characteristics, and lived experiences.</p><p><strong>Impact: </strong>Redefining physical therapist education program applicant qualifications and essential functions regarding vision may be warranted. For clinical instructors, the benefits may outweigh the challenges of mentoring a student with accommodations for BVI.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616786","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 National Profile of Older Physical Therapy Users in France: Results of the 2015 Capacities, Aids, and Resource Representative Survey.","authors":"Louis Jacob, Romain Pichon, Karim Jamal, Benjamin Landré","doi":"10.1093/ptj/pzaf042","DOIUrl":"10.1093/ptj/pzaf042","url":null,"abstract":"<p><strong>Objective: </strong>Older adults-a highly heterogeneous group with complex health challenges-are often overlooked in the field of physical therapy despite their already important and growing numbers. This study aimed to estimate the use of physical therapy in the older population and compare the characteristics and health profiles of older adults who consult physical therapists with those who do not consult physical therapists.</p><p><strong>Methods: </strong>Data from the French 2015 Capacities, Aids, and Resources survey, a large-scale survey with representative sampling weights, was used. It includes community-dwelling and institutionalized older adults aged 60 to 109 years. The main outcome measures were diseases (16 components), clinical symptoms (10 components), functional limitations (16 components), and geriatric syndromes (5 components).</p><p><strong>Results: </strong>Among the 12,043 older adults included, 26.5% received treatment from a physical therapist, with 23.9% being 80 years or older. They had worse outcomes across all indicators. Rheumatology disorders (55.9%; OR = 2.26; 95% CI, 1.96-2.60), fatigue (48.3%; OR 1.84; 95% CI, 1.61-2.11), lower limb limitations (58.3%; OR = 2.64; 95% CI, 2.28-3.06), difficulty washing (34.1%; OR = 3.03; 95% CI, 2.54-3.61), difficulty with transportation (52.5%; OR = 2.46; 95% CI, 2.09-2.88), and multimorbidity (68.1%; OR = 2.07; 95% CI, 1.78-2.40), were the most common conditions in disease, symptoms, mobility, basic and instrumental activity limitations, and geriatric syndromes in this population. Several clinical situations were also uncommon but highly related to requiring physical therapeutic care such as having bedsores (OR = 2.67; 95% CI, 1.81-3.97) or Parkinson's disease (OR = 3.08; 95% CI, 2.08-4.55). They also accumulate more deficiencies in a 70-item frailty index than their counterparts in every age group and in every disease subgroup, suggesting a more complex health profile than older adults not requiring physical therapists.</p><p><strong>Conclusion: </strong>More than a quarter of older adults consulted a physical therapist. These patients showed complex profiles that simultaneously combine diseases, symptoms, geriatric syndromes, and limitations.</p><p><strong>Impact: </strong>These complex profiles and large-scale demographic changes underway are key challenges in the evolution of a profession that has a significant focus on disability.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743186","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":"Clinical Assessment of Walking Capacity in People With Parkinson Disease: Are 2 Minutes Sufficient?","authors":"Hanna Johansson, Linda Rennie, Wilhelmus J A Grooten, Breiffni Leavy","doi":"10.1093/ptj/pzaf034","DOIUrl":"10.1093/ptj/pzaf034","url":null,"abstract":"<p><strong>Objective: </strong>Walking capacity progressively declines in people with Parkinson disease (PD), and assessment of walking is imperative for monitoring disease progression and evaluating intervention efficacy. The main aim of this study was to explore whether the 2-minute walk test (2MWT) could be substituted for the 6-minute walk test (6MWT) as a measure of walking capacity in people with PD. We also sought to investigate construct and known-groups validity of the 2MWT.</p><p><strong>Methods: </strong>A cross-sectional analysis based on data from the Supported Home Training in Everyday Life for Parkinson Disease trial was conducted in a hospital setting. Sixty-three people with idiopathic, mild to moderate PD (29 women; mean age = 69.2 years) were included. Spatiotemporal gait parameters during the 2MWT and the 6MWT were captured by wearable sensors. Linear regression was used to analyze the association between distances walked, whereas paired-samples t tests and repeated-measures analysis of variance were used to explore mean differences in gait parameters.</p><p><strong>Results: </strong>Distance walked over the 2MWT was very strongly associated with the 6MWT. Gait speed was higher during the shorter test, and several speed-related parameters significantly differed between the tests. There was a trend over the 6MWT, whereby participants performed better during the last 2 minutes of the test. Analyses revealed convergent, discriminant, and known-groups validity of the 2MWT.</p><p><strong>Conclusion: </strong>These findings suggest that the 2MWT adequately captures walking capacity among people with mild to moderate PD and demonstrates robust convergent validity and ability to discriminate between people at different levels of disease severity.</p><p><strong>Impact: </strong>The 2MWT is a sufficient and valid alternative for physical therapists who wish to assess walking capacity in people with mild to moderate PD.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634467","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 \"Training an Anti-Ableist Physical Therapist Workforce: Critical Perspectives of Health Care Education That Contribute to Health Inequities for People With Disabilities\" Whalen Smith CN, Havercamp SM, Tosun L, et al. Phys Ther. 2024;104:pzae092. 10.1093/ptj/pzae092.","authors":"Agnes McConlogue Ferro, Jillian Mercado, Lori Quinn","doi":"10.1093/ptj/pzaf035","DOIUrl":"10.1093/ptj/pzaf035","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639780","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 Therapist Interventions to Prevent Postpartum Urinary Incontinence: A Systematic Review.","authors":"Irene Cabrera-Martos, Cristina Cortés-Alcaraz, Paula Jiménez-López, Laura López-López, Irene Torres-Sánchez, Esther Díaz-Mohedo","doi":"10.1093/ptj/pzaf017","DOIUrl":"10.1093/ptj/pzaf017","url":null,"abstract":"<p><strong>Importance: </strong>Postpartum urinary incontinence has a negative impact on the quality of life of women.</p><p><strong>Objective: </strong>This systematic review aimed to describe and synthesize the scientific evidence on the effects of physical therapy in preventing postpartum urinary incontinence.</p><p><strong>Data sources: </strong>The following databases were searched up to April 2023: PubMed/MEDLINE, Web of Science, ScienceDirect, PEDro, CINAHL, and Scopus.</p><p><strong>Study selection: </strong>Studies were included if they were randomized controlled trials; included women during pregnancy or at postpartum period; conducted a physical therapist intervention; and studied the prevention of postpartum urinary incontinence.</p><p><strong>Data extraction and synthesis: </strong>Two researchers extracted information of the descriptive characteristics of the studies and the interventions, variables, main outcomes, and results.</p><p><strong>Main outcome and measures: </strong>Main outcomes were variables related to postpartum urinary incontinence. Quality appraisal was conducted using the PEDRO and Cochrane Risk of Bias 2.0 tools.</p><p><strong>Results: </strong>Among the 2067 studies initially identified, 9 met the inclusion criteria. The main interventions include pelvic floor muscle exercises, electrical stimulation, and perineal massage. The studies demonstrated a positive impact on postpartum urinary incontinence incidence and related symptoms in most of the studies included. However, the heterogeneity presented in the characteristics of the sample, protocol, and outcome measures limited the conclusions reached. Quality assessment revealed moderate to high methodological quality in 90% of trials using the PEDro scale, while 70% presented a high risk of bias according to the Cochrane tool.</p><p><strong>Conclusions and relevance: </strong>Physical therapist interventions, particularly pelvic floor muscle exercises, may have a positive effect in preventing postpartum urinary incontinence compared to usual care or no intervention. However, the heterogeneity and limited number of studies emphasize the need for more high-quality randomized controlled trials.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670579","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 Continuing Trials of Physical Therapy and Rehabilitation Clinical Trials.","authors":"Steven Z George","doi":"10.1093/ptj/pzaf071","DOIUrl":"10.1093/ptj/pzaf071","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Clinician Perceptions of a \"People-Like-Me\" Tool for Personalized Rehabilitation After Total Knee Arthroplasty: A Qualitative Interview Study.","authors":"Laura Churchill, Jeremy Graber, Meredith Mealer, Charles A Thigpen, Dan D Matlock, Michael J Bade, Jennifer E Stevens-Lapsley","doi":"10.1093/ptj/pzaf058","DOIUrl":"10.1093/ptj/pzaf058","url":null,"abstract":"<p><strong>Objective: </strong>The author team developed a decision support tool to help physical therapists address the varied expectations and recoveries of the total knee arthroplasty (TKA) population. The purpose of this study was to explore patients' and clinicians' perceptions and experiences with the tool during rehabilitation after TKA.</p><p><strong>Methods: </strong>The tool was piloted in 2 outpatient physical therapy clinics. An in-depth semi-structured interview was conducted with patients who underwent TKA and were exposed to the tool during rehabilitation, and with clinicians who used the tool with patients after TKA. Two members of the research team coded the interview data using a descriptive content analysis.</p><p><strong>Results: </strong>Sixteen patients and 10 clinicians were interviewed. Four common themes were identified: (1) expectations: most patients and clinicians felt the tool provided patients with valuable feedback for managing recovery expectations; (2) motivation: patients and clinicians felt the tool motivated patients to participate in rehabilitation by providing positive reinforcement and/or a form of competition; (3) influence on practice: some patients and clinicians indicated that the tool helped guide treatment decisions or provided opportunities for patient education, but most felt it did not influence clinical decision making; and (4) clarity and comprehension: the majority of patients understood the tool's \"take-home\" message, however, some patients and clinicians felt the use of percentiles, line graphs, and medical jargon decreased patients' clarity and comprehension of the tool.</p><p><strong>Conclusions: </strong>Overall, participants reported that the tool helped to shape patients' expectations for postoperative recovery and increase patient motivation to participate in rehabilitation. Participants had mixed perceptions on how the tool influenced clinical care. Finally, participants identified some limitations in patient comprehension of the tool, which will inform future revisions to the tool to accommodate varying levels of health literacy.</p><p><strong>Impact: </strong>A clinical decision support tool that provided individualized projections of TKA recovery was helpful to patients and clinicians during TKA rehabilitation to set expectations and increase patient motivation. Revisions to the tool and how it is implemented may enhance its future utility and potential to impact clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031391","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":"Evaluating the Potential of Large Language Models for Vestibular Rehabilitation Education: A Comparison of ChatGPT, Google Gemini, and Clinicians.","authors":"Yael Arbel, Yoav Gimmon, Liora Shmueli","doi":"10.1093/ptj/pzaf010","DOIUrl":"10.1093/ptj/pzaf010","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the performance of 2 large language models, ChatGPT (Generative Pre-trained Transformer) and Google Gemini, against experienced physical therapists and students in responding to multiple-choice questions related to vestibular rehabilitation. The study further aimed to assess the accuracy of ChatGPT's responses by board-certified otoneurologists.</p><p><strong>Methods: </strong>This study was conducted among 30 physical therapist professionals experienced with vestibular rehabilitation and 30 physical therapist students. They were asked to complete a vestibular knowledge test (VKT) consisting of 20 multiple-choice questions that were divided into 3 categories: (1) Clinical Knowledge, (2) Basic Clinical Practice, and (3) Clinical Reasoning. ChatGPT and Google Gemini were tasked with answering the same 20 VKT questions. Three board-certified otoneurologists independently evaluated the accuracy of each response using a 4-level scale, ranging from comprehensive to completely incorrect.</p><p><strong>Results: </strong>ChatGPT outperformed Google Gemini with a 70% score on the VKT test, while Gemini scored 60%. Both excelled in Clinical Knowledge scoring 100% but struggled in Clinical Reasoning with ChatGPT scoring 50% and Gemini scoring 25%. According to 3 otoneurologic experts, ChatGPT's accuracy was considered \"comprehensive\" in 45% of the 20 questions, while 25% were found to be completely incorrect. ChatGPT provided \"comprehensive\" responses in 50% of Clinical Knowledge and Basic Clinical Practice questions, but only 25% in Clinical Reasoning.</p><p><strong>Conclusion: </strong>Caution is advised when using ChatGPT and Google Gemini due to their limited accuracy in clinical reasoning. While they provide accurate responses concerning Clinical Knowledge, their reliance on web information may lead to inconsistencies. ChatGPT performed better than Gemini. Health care professionals should carefully formulate questions and be aware of the potential influence of the online prevalence of information on ChatGPT's and Google Gemini's responses. Combining clinical expertise and clinical guidelines with ChatGPT and Google Gemini can maximize benefits while mitigating limitations. The results are based on current models of ChatGPT3.5 and Google Gemini. Future iterations of these models are expected to offer improved accuracy as the underlying modeling and algorithms are further refined.</p><p><strong>Impact: </strong>This study highlights the potential utility of large language models like ChatGPT in supplementing clinical knowledge for physical therapists, while underscoring the need for caution in domains requiring complex clinical reasoning. The findings emphasize the importance of integrating technological tools carefully with human expertise to enhance patient care and rehabilitation outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399614","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":"Musculoskeletal Pain as a Risk Factor for Poor Dizziness Outcomes: A Longitudinal Study Among Patients With Persistent Vestibular Dizziness.","authors":"Unni Moen, Roy Miodini Nilsen, Mari Kalland Knapstad, Kjersti Thulin Wilhelmsen, Stein Helge Glad Nordahl, Frederik Kragerud Goplen, Dara Meldrum, Liv Heide Magnussen","doi":"10.1093/ptj/pzaf001","DOIUrl":"10.1093/ptj/pzaf001","url":null,"abstract":"<p><strong>Objective: </strong>Musculoskeletal pain and psychological distress are prevalent comorbidities in patients with persistent dizziness. Little is known about how comorbid pain influences the outcome of persistent dizziness. This study examined the impact of pain on dizziness outcomes and the potential modifying role of psychological distress.</p><p><strong>Methods: </strong>This study was a longitudinal study of 150 patients with persistent dizziness. Vertigo Symptom Scale - short form (VSS-SF), Dizziness Handicap Inventory (DHI), number of pain sites, pain intensity, and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, 6 months and 12 months. Linear mixed effects model for longitudinal data was used to explore the association between musculoskeletal pain and dizziness. Interaction analysis was used to assess whether psychological distress had a modifying effect on the association between pain and dizziness.</p><p><strong>Results: </strong>VSS-SF and DHI decreased during follow-up but not to a clinically relevant level for the patients. Patients reporting comorbid psychological distress reported higher scores on VSS-SF, DHI, more pain sites and higher pain intensity. A positive association was observed between the number of pain sites and VSS-SF and between pain intensity and VSS-SF, and these associations were stronger in patients reporting psychological distress. Similar associations were found for DHI. Patients reporting ≥4 pain sites or pain intensity of ≥4 out of 10 at baseline, still reported severe dizziness and moderate disability 12 months later.</p><p><strong>Conclusion: </strong>Musculoskeletal pain is a risk factor for poor dizziness outcomes, especially when comorbid psychological distress is present. Clinicians should be attentive to musculoskeletal pain when the number of pain sites exceeds 4 or pain intensity exceeds 4 on a numeric rating scale.</p><p><strong>Impact: </strong>A new understanding of the impact of musculoskeletal pain on persistent dizziness could be the key to successful recovery and the prevention of prolonged issues.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"News From the Foundation for Physical Therapy Research, April 2025.","authors":"","doi":"10.1093/ptj/pzaf029","DOIUrl":"https://doi.org/10.1093/ptj/pzaf029","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018268","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}