Physical Therapy最新文献

{"title":"Effectiveness of Photobiomodulation in Reducing Pain and Disability in Patients With Knee Osteoarthritis: A Systematic Review With Meta-Analysis.","authors":"Sofia Oliveira, Renato Andrade, Cristina Valente, João Espregueira-Mendes, Filipe S Silva, Betina B Hinckel, Óscar Carvalho, Ana Leal","doi":"10.1093/ptj/pzae073","DOIUrl":"10.1093/ptj/pzae073","url":null,"abstract":"<p><strong>Objective: </strong>Photobiomodulation (PBM) is not implemented in routine clinical management for knee osteoarthritis. This study aims to systematically investigate the effects of PBM in patients with knee osteoarthritis, comparing with placebo to understand its true clinical effects.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science, and Cochrane databases were searched up to October 2023. Randomized placebo-controlled trials applying PBM versus placebo were included. Study characteristics, intervention parameters, and patient-reported and physical examination outcome measures were collected. The risk of bias was judged using the Cochrane risk-of-bias tool for randomized trials (version 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to interpret the certainty of results.</p><p><strong>Results: </strong>Ten studies were included comprising 542 participants. All studies were judged with unclear to a high risk of bias. Meta-analysis for pain at rest (6 studies) showed that PBM significantly reduced pain at rest as compared to placebo (-0.7 [95% CI = -1.1 to -0.2]), moderate effect, very low certainty of evidence, whereas for the Timed \"Up & Go\" Test (three studies), no significant effect was detected. Statistically significantly within-group (PBM) mean improvement was detected for pain, Lequesne Index, and gait performance outcomes, but not always clinically relevant or significant when compared to placebo.</p><p><strong>Conclusion: </strong>PBM reduces pain intensity in patients with knee osteoarthritis and may improve disability. However, the very low certainty of evidence does not allow to recommend its isolated use but may be used to complement other widely recommended therapies. More rigorous clinical trials and the revision of the recommended dosage guidelines are warranted to increase the strength of evidence.</p><p><strong>Impact: </strong>The findings indicate that photobiomodulation can reduce pain and improve disability in patients with knee osteoarthritis. However, researchers should continue to investigate isolated photobiomodulation intervention versus placebo and extend the dosage guidelines to other types of light emitters.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076394","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: Building the Science of Physical Therapy: Conundrums and a Wicked Problem.","authors":"","doi":"10.1093/ptj/pzae030","DOIUrl":"https://doi.org/10.1093/ptj/pzae030","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009253","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":"Author Response to Hébert and Perron.","authors":"Christopher T Joyce","doi":"10.1093/ptj/pzae105","DOIUrl":"https://doi.org/10.1093/ptj/pzae105","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On \"Concerns on the Science and Practice of a Movement System.\" Joyce CT, Beneciuk JM, George SZ. Phys Ther. 2023;103:pzad087. https://doi.org/10.1093/ptj/pzad087.","authors":"Luc J Hébert, Marc Perron","doi":"10.1093/ptj/pzae104","DOIUrl":"https://doi.org/10.1093/ptj/pzae104","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748786","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":"Implementing the Effective Coach2Move Approach for Community-Dwelling Older Adults with Mobility Limitations in Physical Therapist Practice: A Multi-Methods Process Evaluation.","authors":"Ward Heij, Lieke Sweerts, J Bart Staal, Philip J Wees, Anne Thackeray, Maria W G Nijhuis-van der Sanden, Thomas J Hoogeboom","doi":"10.1093/ptj/pzae093","DOIUrl":"https://doi.org/10.1093/ptj/pzae093","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to evaluate the adoption of and fidelity to the Coach2Move approach; identify differences between physical therapists with a specialization in geriatrics and physical therapists without a specialization; explore if level of adoption and specialization explain variances in effectiveness; and explore group differences in attitudes and experiences with implementation.</p><p><strong>Methods: </strong>A multi-methods process evaluation of Coach2Move implementation through 2 education days, 3 peer-assessment meetings, and an adapted electronic health record was performed alongside a cluster randomized stepped-wedge trial comparing regular care physical therapy with Coach2Move. Participants were 36 physical therapists with a specialization (n = 17) and without a specialization (n = 19) who treated 292 community-dwelling older adults. Level of adoption and fidelity were analyzed by comparing pre-implementation scores with scores 1 year later. Coach2Move adoption was measured by e-assessment scores and fidelity through health record indicators. The impact of specialization and adoption on health outcomes was examined using a mixed-model ANOVA. Therapists' attitudes and experiences were collected through a survey based on semi-structured interviews.</p><p><strong>Results: </strong>Mean total indicator scores on the e-assessment (adoption of a Coach2Move mindset) increased from baseline 17% (SD = 5%) to 47% (SD = 9%) at follow-up. Physical therapists with a specialization in geriatrics scored higher than physical therapists without (54% [SD = 6%] vs 41% [SD = 6%]). Mean indicator scores on health records (fidelity) increased from 35% (SD = 12%) at baseline to 47% (SD = 15%) at follow-up. Mean scores of physical therapists with a specialization in geriatrics were higher. Level of adoption and specialization (yes/no) did not explain the variance in effectiveness. Physical therapists identified important facilitators, including tailored education and peer-assessment meetings, while adequate reimbursement for the extra time investment was considered a necessity. Different workflows in practices were perceived as a barrier.</p><p><strong>Conclusion: </strong>Implementation led to increased adoption and fidelity of the Coach2Move intervention by physical therapists but shows room for improvement. Attitudes towards the approach and its implementation were positive. Future implementation efforts on adoption could be improved by focusing on a fair compensation structure by third party payers and insurance companies and optimizing organizational and financial context within practices.</p><p><strong>Impact: </strong>This study evaluated the implementation of Coach2Move, a clinical reasoning approach designed to increase physical activity and improve self-efficacy in older adults. Overall, the study demonstrates the potential of Coach2Move to be effectively adopted by physical therapists. However, addressing th","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627327","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":"Accreditation Can Advance Excellence in Physical Therapist Education: A Call to Action.","authors":"Terry Nordstrom, Diane U Jette, Susan S Deusinger, Laurita Hack, Gail M Jensen, Zoher Kapasi, Patricia Kluding, Charlotte Royeen","doi":"10.1093/ptj/pzae051","DOIUrl":"10.1093/ptj/pzae051","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326975","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":"Attitudes and Beliefs of Physical Therapists and Physical Therapist Students Toward Working With Older Adults: A Systematic Review.","authors":"Humberto Omaña, Ashvene Sureshkumar, Marja Äijö, Susan W Hunter","doi":"10.1093/ptj/pzae052","DOIUrl":"10.1093/ptj/pzae052","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically review physical therapists' and physical therapist students' attitudes toward working with older adults.</p><p><strong>Methods: </strong>CINAHL, EMBASE, ERIC, MEDLINE, Scopus, PsycINFO, and SocIndex databases were searched in duplicate (from inception to March 2023). Studies that assessed knowledge on aging, intention to work with older adults or attitudes toward older adults for physical therapist students and/or clinicians, and that were written in English, Finnish, Spanish, or Swedish were included. Grey literature, qualitative studies, or articles of people with a specific diagnosis (eg, dementia) were excluded. All articles were reviewed by 2 authors independently, and consensus was required for inclusion. Data extraction was completed using a standardized data extraction sheet.</p><p><strong>Results: </strong>Of 2755 articles screened, 34 met the inclusion criteria. Twenty-five studies recruited only physical therapist students, 6 recruited only physical therapist clinicians, and 3 involved mixed samples of both. Ten intervention studies were included, all of which recruited physical therapist students. Overall, physical therapist students were observed to have predominantly positive attitudes toward older adults, while clinicians had neutral to weak positive attitudes toward older adults. Both physical therapist students and clinicians were observed to have low knowledge on aging and low intentions to work with older adults. Results from intervention studies suggest that education combined with clinical experience with older adults improves attitudes toward older adults.</p><p><strong>Conclusion: </strong>A discrepancy is observed in physical therapists in that although attitudes toward older adults are positive, a lack of knowledge on aging and a disinterest in working with older adults exists. Intervention studies suggest that clinical experience may improve attitudes toward older adults in physical therapist students.</p><p><strong>Impact: </strong>Predominantly positive attitudes toward older adults are reported by physical therapist students, while for clinicians mixed results are observed. Education coupled with clinical experiences appears to be effective interventions to improve attitudes toward older adults, but such research has only been explored in student samples.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336537","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":"News From the Foundation for Physical Therapy Research, July 2024.","authors":"","doi":"10.1093/ptj/pzae078","DOIUrl":"https://doi.org/10.1093/ptj/pzae078","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856186","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":"Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta-Analysis.","authors":"Dario Calafiore, Nicola Marotta, Claudio Curci, Francesco Agostini, Rita Ilaria De Socio, Maria Teresa Inzitari, Francesco Ferraro, Andrea Bernetti, Antonio Ammendolia, Alessandro de Sire","doi":"10.1093/ptj/pzae054","DOIUrl":"10.1093/ptj/pzae054","url":null,"abstract":"<p><strong>Objective: </strong>Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia.</p><p><strong>Methods: </strong>On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale.</p><p><strong>Results: </strong>Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69 to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; I2 = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies.</p><p><strong>Conclusion: </strong>Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future.</p><p><strong>Impact: </strong>This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336539","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: Timing of Evidence-Based Nonsurgical Interventions as Part of Multimodal Treatment Guidelines for the Management of Cervical Radiculopathy: A Delphi Study.","authors":"","doi":"10.1093/ptj/pzae003","DOIUrl":"https://doi.org/10.1093/ptj/pzae003","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734909","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}