Physical Therapy最新文献

{"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}

{"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":"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. This study 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. The study 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. Adjusted odds ratios (ORs) were reported.</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":"2025-04-02","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":"Validation of the Revised American Physical Therapy Association Physical Therapist Clinical Performance Instrument 3.0.","authors":"Derrick F Campbell, Mansoor Alameri, Felicity Macahilig-Rice, Sean E Witkin, Nancy G Hellman","doi":"10.1093/ptj/pzaf015","DOIUrl":"10.1093/ptj/pzaf015","url":null,"abstract":"<p><strong>Objective: </strong>Validation of the revised American Physical Therapy Association (APTA) Physical Therapist Clinical Performance Instrument (PT CPI 3.0) is essential to ensure that we are effectively assessing Doctor of Physical Therapy (DPT) students' clinical performance. The purpose was to validate the revised PT CPI 3.0 for use with DPT students as a measure of clinical performance.</p><p><strong>Methods: </strong>A descriptive and exploratory combined cross-sectional retrospective and prospective cohort design was used. University DPT students' clinical education experiences were explored. Participants were selected using a convenience sample of 693 DPT students from 1 US multicampus DPT program(s) during Fall 2023 and Spring 2024 clinical education experiences. DPT students on (1) integrated (ICE) and (2) 2 terminal clinical education experiences (TCE I and TCE II) participated in the study. Clinical instructor PT CPI 3.0 item ratings of DPT students at midterm and final assessments during clinical education experiences were investigated. Descriptive and inferential statistics evaluated differences between clinical instructor PT CPI 3.0 item ratings of DPT students during clinical education experiences.</p><p><strong>Results: </strong>The PT CPI 3.0 demonstrated good internal reliability, and factor analysis with a 1-factor solution explained 81.3% of variance. Construct validity was supported by significant differences in PT CPI item scores between DPT students on ICE and each of TCE I and TCE II. Construct and convergent validity were supported by significant score increases from midterm to final assessments for DPT students on ICE and TCEs and by moderate to large correlations between prior clinical experiences and remaining didactic coursework.</p><p><strong>Conclusion: </strong>Findings support validity of the revised PT CPI 3.0 as a measure of clinical performance. A limitation is that this study did not assess rater reliability.</p><p><strong>Impact: </strong>This study provides preliminary support for validation of the newly revised APTA PT CPI 3.0 as a measure to assess entry-level physical therapist student clinical performance.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414913","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":"Does Inspiratory Threshold Loading and Visual Tasking Affect Visual Attention Accuracy?","authors":"Steven Schan, Yasma Ali-Hassan, Brielle Loebach, Aarushi Bahl, Emily O'Quinn, Manjiri Kulkarni, Marine Van Hollebeke, Peter Rassam, Tamires Mori, Dmitry Rozenberg, W Darlene Reid","doi":"10.1093/ptj/pzaf031","DOIUrl":"10.1093/ptj/pzaf031","url":null,"abstract":"<p><strong>Objective: </strong>Dyspnea is commonly experienced in adults who are young and have different health conditions (asthma, obesity, panic disorders) and may impede not only physical exertion but also cognitive function such as visual attention. To test this, visual attention was evaluated using the Multiple Object Tracking Test (MOT) alone and combined with low or moderate inspiratory threshold loading (ITL).</p><p><strong>Methods: </strong>Using a pretest-posttest design, we evaluated 25 participants who were healthy and 19 to 31 years old. Visual attention accuracy was quantified using the MOT, wherein participants tracked moving disks on a computer monitor. Participants performed 5 single or dual tasks in random order: MOT; low ITL of 20 cm H2O (ITL20); moderate ITL of 40 cm H2O (ITL40); dual task: MOT plus ITL20 (MOT + ITL20); and dual task: MOT plus ITL40 (MOT + ITL40). Dyspnea intensity measured with the Borg Dyspnea Scale and emotional response measured with the Self-Assessment Manikin (SAM) were evaluated at baseline and for single and dual tasks.</p><p><strong>Results: </strong>Compared to single task MOT, dual tasks induced lower MOT scores with moderate loads (MOT + ITL40) resulting in lower scores than dual task low ITL (MOT + ITL20). Exertional dyspnea intensity and SAM affective measures increased during ITL and dual tasks compared to baseline. Moreover, higher dual task MOT scores were related to greater inspiratory muscle strength and to more positive affect evaluated by SAM.</p><p><strong>Conclusions: </strong>Individuals experiencing inspiratory muscle loading and associated dyspnea demonstrated decreased visual attention accuracy, which was accentuated by higher inspiratory loads, lower respiratory muscle strength, and higher emotional response.</p><p><strong>Impact: </strong>Although physical activity is often prescribed according to the musculoskeletal or cardiovascular stress, the cognitive interference of how dyspnea compromises cognitive function should be considered. The inability to attend to visual detail during added respiratory loads with associated dyspnea should be considered during assessment and treatment planning. A physical-cognitive approach to prescription of physical function may ensure more transferability to daily activities.</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/PMC12045938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634470","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":"Health Care Professionals' Views of Barriers and Facilitators for Implementing a Fall Risk Screening Tool in Clinical and Public Health Settings.","authors":"Nathalie Frisendahl, Patrik Karlsson, Christina Sandlund, Stina Ek, Erika Franzén, Anne-Marie Boström, Anna-Karin Welmer","doi":"10.1093/ptj/pzaf018","DOIUrl":"10.1093/ptj/pzaf018","url":null,"abstract":"<p><strong>Objective: </strong>The experiences of health care professionals using new screening tools in clinical and public health settings are crucial to the implementation process. However, further research is needed on their experiences with fall risk screening. This study utilized the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to explore health care professionals' experiences with the First-time Injurious Falls (FIF) screening tool, aiming to identify barriers and facilitators for implementing the FIF tool in primary health care and public health settings.</p><p><strong>Methods: </strong>A qualitative study with 4 focus group interviews and 7 individual interviews was carried out, using a semistructured interview guide. The interviews were recorded, transcribed verbatim, and analyzed with reflexive thematic analysis. The study included 20 participants (13 females and 7 males), with a mean age of 39 years (range 24 to 54). The participants were working in the primary health care setting (8 physical therapists, 3 occupational therapists, 3 managers, 2 registered nurses, and 1 dietician) and in a public health project (1 physical therapist and 2 health educators).</p><p><strong>Results: </strong>The analysis resulted in 3 themes: \"a valuable tool in clinical practice,\" \"how to get everyone onboard when implementing fall risk screening,\" and \"applicable in many areas of health services but not in all\" with 4 related subthemes \"quick and easy to use for all health care professionals,\" \"simplifies assessment and creates a platform for discussion,\" \"need for clear instructions and action list,\" and \"should be incorporated into daily routines.\"</p><p><strong>Conclusion: </strong>The FIF tool was well-received by participants in practice as it was user-friendly and potentially effective in preventing falls. However, there is room for improvement, particularly in clarifying instructions to mitigate possible misinterpretations. The participants emphasized that implementation of a new screening tool requires favorable organizational conditions such as managerial support, that the tool is easily accessible, and the results are easy to document.</p><p><strong>Impact: </strong>The FIF tool seems to be a valuable screening tool for predicting first-time injurious falls in older adults, suitable for use by various health care professionals.</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/PMC12017392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441455","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":"Preventing Falls in Older Adults After Upper Limb Fractures: A Scoping Review.","authors":"Bárbara Santos Lobo, Maynara do Amaral Alfonsi, Camila Astolphi Lima, Sarah Giulia Bandeira Felipe, Morten Tange Kristensen, Lauren A Beaupre, Catherine Sherrington, Andrea M Bruder, Monica Rodrigues Perracini","doi":"10.1093/ptj/pzaf020","DOIUrl":"10.1093/ptj/pzaf020","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to identify and describe fall prevention strategies in upper limb fracture rehabilitation for older people using recent fall prevention guidelines as a standard.</p><p><strong>Methods: </strong>A systematic search was conducted in 9 electronic databases (PubMed/MEDLINE, EBSCOhost, Cochrane Library, Lilacs, SPORTDiscus, CINAHL, Web of Science, AgeLine, and SciELO), gray literature, and in bibliographic and citation searching of selected articles between May and December 2022 and updated between February and March 2024. Two independent reviewers screened citations for inclusion. Data extraction was performed by 1 reviewer and verified by a second reviewer. A frequency of strategies and content analysis syntheses were conducted.</p><p><strong>Results: </strong>A broad search strategy was used, initially identifying 25,945 articles and including 6 randomized clinical trials. The gray literature search identified 18 records. Five studies included forearm fractures, 1 upper limb fracture, and no study exclusively on rehabilitation after humerus fractures. None of the studies provided comprehensive multifactorial fall risk assessments to guide tailored interventions. Assessments mainly focused on gait and balance. Exercise was the most offered intervention alone or in combination with education. Exercise programs were aligned with recommendations to include progressive balance and functional exercises overall. However, the frequency of ≥3 times weekly was less frequently offered. The gray literature showed a lack of fall prevention-specific information after upper limb fractures and mostly called attention to fall prevention after hip fractures.</p><p><strong>Conclusion: </strong>Upper limb fracture rehabilitation in older adults, considered at high risk of falling, did not include comprehensive and tailored multifactorial fall assessment and intervention. Unequivocally, exercise programs were overall aligned with recent recommendations and were the most frequent intervention. There is a crucial gap for humerus fractures. This study can help align the treatment of upper limb fractures with updated fall prevention recommendations and impact future research, guiding and influencing implementation in clinical practice.</p><p><strong>Impact: </strong>There is an urgent need to implement comprehensive and tailored multifactorial fall assessments and interventions in rehabilitation programs for older adults recovering from upper limb fractures. Guidelines should direct this work to enhance clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468817","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}