Physiotherapy Research International最新文献

{"title":"Effectiveness of Reflex Integration Approach on Asymmetric Tonic Neck Reflex in a Child With Developmental Delay-A Case Study.","authors":"Sneha G, Naveen Kumar I","doi":"10.1002/pri.70086","DOIUrl":"https://doi.org/10.1002/pri.70086","url":null,"abstract":"<p><strong>Background: </strong>Developmental delays in children pose significant challenges, necessitating effective intervention strategies to promote optimal development. Reflex integration therapy, which involves structured movement exercises to encourage reflex maturation, has emerged as a promising approach to address developmental delays, yet its efficacy remains underexplored in clinical settings.</p><p><strong>Aim: </strong>This study aimed to evaluate the effectiveness of reflex integration therapy in a one-year-and-six-month-old female child diagnosed with developmental delay, focusing on integrating the asymmetric tonic neck reflex (ATNR) and enhancing gross motor function.</p><p><strong>Case description: </strong>The subject, Baby Dhanvi, presented with persistent ATNR and failure to achieve age-appropriate milestones despite her age. Treatment interventions included reflex integration therapy, exercises targeting motor skills, vestibular stimulation, and verbal and visual stimulation. The therapy sessions spanned a period of 20 days, with assessments conducted pre- and post-treatment.</p><p><strong>Results: </strong>After 20 days of therapy, significant improvements were observed in ATNR integration, as measured by the Sally Goddard Reflex Rating Scale. Additionally, Baby Dhanvi exhibited moderate enhancement in gross motor function, leading to the attainment of previously unmet milestones, as evidenced by the Trivandrum Development Screening Chart.</p><p><strong>Conclusion: </strong>This case study provides compelling evidence supporting the efficacy of reflex integration therapy in addressing developmental delay, particularly in integrating ATNR and enhancing gross motor function. The findings underscore the potential of reflex integration approaches in clinical settings, emphasizing the importance of further research and application to optimize outcomes for children with developmental delays.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70086"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reliability of Using a Handheld Device to Measure 2D Kinematics: A Systematic Review.","authors":"Lee T Atkins, Mark Wilhelm, Casey Base, Casady Downey, Seth Moore, Rebecca Moreno, Alexander Fogg, Tiffany Sissom, Mindy Brummett","doi":"10.1002/pri.70083","DOIUrl":"10.1002/pri.70083","url":null,"abstract":"<p><strong>Background: </strong>Smartphones and tablets can be used by clinicians to measure 2D joint and segment kinematics, which helps inform important treatment decisions. However, whether 2D kinematic measures obtained with these devices are reliable is unknown.</p><p><strong>Objective: </strong>This study examined the inter- and intrarater reliability of 2D kinematic measures obtained using handheld devices.</p><p><strong>Methods: </strong>CINAHL, Embase, PubMed, and SPORTDiscus database searches were performed using Medical Subject Heading terms, keywords, and text words related to reliability, handheld device, 2-dimensions, video analysis, application, kinematics, and functional movement. The initial search resulted in 407 potentially relevant titles. Following title, abstract, and full-text screening, 8 studies were included in this review. To be included, studies must have examined the inter- or intrarater reliability of 2D joint or segment kinematics measured using digital video on either a smartphone or tablet. Study quality was evaluated using the Quality Appraisal of Reliability Studies (QAREL) tool.</p><p><strong>Results: </strong>Inter- and intrarater reliability intraclass correlation values varied considerably between and within studies. These varied reliability findings can be attributed to differences in testing protocol and equipment, activity examined, the discrete point of interest during an activity (e.g., time of initial contact or peak knee flexion), and joint(s) or segment(s) of interest.</p><p><strong>Conclusion: </strong>Using smartphones and tablets to measure 2D joint and segment kinematics clinically is promising as it can be performed reliably. However, clinicians should be aware of the potential impact of their methodological decisions on the reliability of joint or segment kinematics obtained using these handheld devices.</p><p><strong>Trial registration: </strong>This study was registered with PROSPERO on May 12, 2022 (CRD42022330137).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70083"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Upper Extremity Function in Breast Cancer Survivors.","authors":"Alper Tuğral, Yeşim Bakar, Murat Akyol","doi":"10.1002/pri.70082","DOIUrl":"10.1002/pri.70082","url":null,"abstract":"<p><strong>Background and purpose: </strong>Deteriorated upper extremity function is a leading cause of potential disability and functional decline in breast cancer survivors (BCS) not only during their active treatment but also in their survivorship continuum. Fatigue and decreased muscle strength are the prominent ones that can account for decreased upper extremity function. Therefore, this study aimed to explore the potential contributors to the upper extremity function of BCS.</p><p><strong>Methods: </strong>A total of 100 BCS were included. Handgrip strength (HGS) was assessed with a dynamometer while fatigue and self-reported upper extremity function were assessed with the Fatigue Severity Scale (FSS), Disabilities of Arm, Shoulder, and Hand Questionnaire (DASH), respectively. To control the potential confounding effect of the handedness, the mean value of HGS was used in the regression model.</p><p><strong>Results: </strong>HGS was found to be significantly higher on the right side compared to the left side (22.71 ± 3.51 kg vs. 21.45 ± 3.66 kg, t = 5.328, p < 0.001). The mean scores of DASH and FSS were found 21.97 ± 15.62, and 39.62 ± 12.16, respectively. The multivariate linear regression analysis showed that a total of 26.9% of the cumulative variance in DASH is explained by the mean HGS, FSS, and body mass index (BMI) (F (4,95) = 11.793, p < 0.001, R² = 0.269, Cohen's f²:0.54). There were no significant effects and/or interactions of any clinical features of BCS on DASH. FSS and DASH also significantly correlated with each other (r = 0.49, p < 0.001).</p><p><strong>Discussion: </strong>This study showed that HGS shows itself as a significant outcome measure to predict upper extremity function in BCS. Because BCS can experience fatigue even years after the completion of primary treatment, it is noteworthy to consider it when evaluating the function of BCS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04245657.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70082"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Risk Factors Associated With Aspiration in Patients With Poststroke Dysphagia: A Real-World Study.","authors":"Yun Lu, Jing Teng, Sisi Huang, Manyu Dong, Yilun Qian, Yue Hu, Han Yang, Qiumin Zhou, Dianhuai Meng, Yingying Ji, Huaide Qiu, Ying Shen","doi":"10.1002/pri.70089","DOIUrl":"https://doi.org/10.1002/pri.70089","url":null,"abstract":"<p><strong>Background: </strong>Aspiration is the most severe complication of dysphagia in patients with poststroke dysphagia (PSD). However, the risk factors associated with aspiration remain inadequately understood.</p><p><strong>Objective: </strong>To determine the associated risk factors for aspiration in patients with PSD.</p><p><strong>Methods: </strong>A total of 321 dysphagia patients with first-ever stroke were retrospectively enrolled. We differentiated patients with aspiration from those without aspiration via swallowing function screening, clinical swallowing function examinations, and videofluoroscopic swallowing studies. We conducted a comparative analysis of the basic demographic data, disease-related information, and clinical characteristics between the two groups via multivariate logistic regression.</p><p><strong>Results: </strong>Multivariate logistic regression analysis revealed that age ≥ 65 years (OR = 3.596, 95% CI: 1.251-10.335), history of pneumonia (OR = 3.617, 95% CI: 1.174-11.148), severe dysarthria (OR = 7.331, 95% CI: 1.314-40.889), number of chronic diseases > 2 (OR = 4.814, 95% CI: 1.61-14.397), bilateral brain injury (OR = 6.673, 95% CI: 1.926-23.115), a lesion location in the brainstem (OR = 4.581, 95% CI: 1.05-19.987), and a higher water swallowing test score (OR = 1.806, 95% CI: 1.113-2.93) were risk factors for aspiration. Conversely, a high Montreal Cognitive Assessment (MoCA) score (OR = 0.919, 95% CI: 0.849-0.995) and a high cut-off value of the repetitive saliva swallowing test (RSST) (OR = 0.149, 95% CI: 0.067-0.332) were identified as protective factors.</p><p><strong>Discussion: </strong>Timely diagnosis and intervention for aspiration should prioritise patient populations aged 65 years and older, individuals with a history of pneumonia, those exhibiting severe dysarthria, patients with multiple chronic conditions, individuals with bilateral brain injuries, patients with lesions situated in the brainstem, and those exhibiting higher WST scores.</p><p><strong>Trial registration: </strong>This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2500097142).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70089"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Technology for Exercise Prescription Among Persons With Dizziness: A Mixed-Methods Study.","authors":"Susan L Whitney, Pamela M Dunlap, Pedram Hovareshti, Lisa S Holt, Chad Zalkin, Devendra Tolani, Karen Lambert, Carlos Esquivel, Brooke N Klatt, Chelsea J Manetta","doi":"10.1002/pri.70072","DOIUrl":"10.1002/pri.70072","url":null,"abstract":"<p><strong>Background and purpose: </strong>VestAid is a tablet-based computer application designed to deliver vestibulo-ocular reflex (VOR) exercises to persons with dizziness. It was developed to provide objective data to clinicians to drive clinical decisions. VestAid allows for VOR exercise progression between face-to-face visits via telehealth. The primary aim of this study was to determine the consistency of clinical decision-making among physical therapists (PTs) using an exercise performance report (EPR) from the VestAid app and a video recording of patients performing VOR exercises. The secondary aim was to determine the effect of the clinical experience of a vestibular physical therapist on decision-making agreement about exercise choice. Lastly, an attempt was made to determine if the EPR provided adequate information to make a clinical judgment about exercise progression.</p><p><strong>Methods: </strong>Thirty PTs with varied vestibular experience levels participated. Vestibular experience was clustered into 3 levels [< 5 years of experience (n = 10), 6-15 years of experience (n = 10), and > 15 years of experience (n = 10)]. The PTs viewed 12 videos of individuals with dizziness completing VORx1 exercises that were a priori classified as easy, moderate, or difficult. The PTs were randomly shown 12 EPRs for the same individuals, which included their percentage of gaze fixation, symptom reports, and head speed compliance. Each PT was then asked whether they would progress the exercise program, regress the program, or leave the exercise program unchanged.</p><p><strong>Results: </strong>Physical therapist percent agreement using the video was 60% compared to 71.1% using the EPR. No differences existed in the percentage of agreement between experience levels. One hundred percent of the PTs with less than 5 years of experience reported that the EPR was sufficient for advancing the exercises, compared with 67% of those with greater experience.</p><p><strong>Discussion: </strong>VestAid's EPR yielded comparable clinical decision-making agreement to that of the video. The EPR offers PTs insight into gaze fixation and head speed compliance-information otherwise inaccessible without the use of technology. Currently, there are no established guidelines for exercise progression. While such technology shows potential to improve consistency in clinical decision-making, further research is needed to better understand whether objective VOR exercise outcome metrics facilitate recovery.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70072"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Clinical Trial Comparing the Effectiveness of Aerobic Training and Circuit Training on Balance in Ataxic Patients.","authors":"Hifza Ahmed, Ulvina Riaz, Haleema Sadia, Rimsha Khalil, Zuha Javed, Ishal Ayub","doi":"10.1002/pri.70068","DOIUrl":"10.1002/pri.70068","url":null,"abstract":"<p><strong>Background: </strong>The term ataxia refers to the inability to coordinate movement. It essentially happens when the cerebellum or any of its connections are damaged. A brain tumor, multiple sclerosis, stroke, cerebral palsy, certain drugs, and genetic illnesses are the few examples of the ailments that can result in ataxia. Although aerobic exercise helps ataxic people in decreasing whole disease severity, conventional training does not significantly aid in this regard. On the other hand, circuit training has also proved effective in reducing ataxic symptoms in some literatures.</p><p><strong>Aim and purpose: </strong>This study's primary goal was to ascertain whether aerobic or circuit training provides a better course of treatment for the ataxic patients.</p><p><strong>Methodology: </strong>Eighteen pre-diagnosed ataxic patients participated in a randomized clinical experiment (9 patients in each group) for this objective. Purposive sampling technique was used to collect samples, and patients were allocated into their groups using the lottery method. Group A was aerobic training group and Group B was circuit training group. The time duration for this study was approximately 4 months where data collection took almost 1 month. 30 min sessions consisting of 5 sessions per week were given to the patients for 1 month duration. Data were calculated from Allied hospital. Assessment and examination were carried out using Berg Balance Scale (BBS) and Functional staging for ataxia giving pre- and post-values.</p><p><strong>Statistical analysis: </strong>Data were analyzed statistically through SPSS 24.</p><p><strong>Results: </strong>In terms of indicating balance along with ataxia staging, the statistics showed only a slight difference in the aerobic training group than in the circuit training group. The given differences found between the pre and the post values in mean and standard deviation in Group 1 is -11.75 ± 1.48 and in Group 2 is -9.55 ± 3.67. The first treatment group had a mean rank of 9.50 prior to treatment and 7.50 following treatment. Conversely, the mean rank of the second treatment group was 10.33 at the post-treatment level and 9.50 at the pre-treatment level.</p><p><strong>Discussion: </strong>In essence, these two tactics performed better than some other therapy approaches on a consistent basis. Although there have not been enough studies to compare these two treatments, their respective outcomes are enough to show their effectiveness. Eventually, the aerobic intervention was found only marginally superior to the circuit training, while both were helpful for improving balance in ataxia.</p><p><strong>Trial registration: </strong>This study used a randomized clinical trial research design. It has been registered in IRCT, that is, the Iranian Registry of Clinical Trials under the registration Id IRCT20240323061354N1.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70068"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy in Patients With Acute Stroke Is Associated With Carotid Intima-Media Wall Thickness: A Cross-Sectional Study.","authors":"Ryota Ashizawa, Hiroyasu Sano, Hiroaki Suzuki, Hiroya Honda, Yuto Kameyama, Masafumi Nozoe, Masashi Kanai, Yosuke Kimura, Natsuki Shimizu, Takuaki Tani, Masatoshi Kamada, Yoshinobu Yoshimoto","doi":"10.1002/pri.70087","DOIUrl":"https://doi.org/10.1002/pri.70087","url":null,"abstract":"<p><strong>Background and purpose: </strong>The recurrence rate in patients with stroke is high, and arteriosclerosis is a significant risk factor for recurrent strokes. Health literacy, the ability to access, understand, and use information to promote and maintain health, is associated with various health risks. However, its association with atherosclerosis in patients with stroke remains unclear. Therefore, this study aimed to determine whether carotid intima-media wall thickness (CIMT), a marker of atherosclerosis, is associated with health literacy in patients with acute stroke.</p><p><strong>Methods: </strong>This cross-sectional study included 207 patients (median age: 72 years) after their first stroke, excluding those with subarachnoid hemorrhage, admitted to an acute care hospital. The study variables were CIMT and health literacy. Mean CIMT was measured in the left and right common carotid arteries. Health literacy was assessed using the European Health Literacy Survey Questionnaire (HLS-EU-Q16), a shortened version of the European Health Literacy Survey Questionnaire 47. The correlation between mean CIMT and HLS-EU-Q16 score was analyzed.</p><p><strong>Results: </strong>Mean CIMT was significantly negatively associated with the HLS-EU-Q16 score (r = -0.174, p = 0.012). Multiple regression analysis identified the HLS-EU-Q16 score as a factor associated with mean CIMT (β = -0.171, B = -0.005, 95% confidence interval: -0.009 to -0.001, p = 0.020).</p><p><strong>Discussion: </strong>This study demonstrates that health literacy is associated with mean CIMT in patients with acute stroke, with those having low health literacy exhibiting a higher mean CIMT than their counterparts. Therefore, improving health literacy may be an important management strategy to prevent atherosclerosis and its progression in patients with stroke.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70087"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Water Exercise Improve Motor Function in Parkinson's Disease More Than Land Exercise? A Systematic Review and Meta-Analysis.","authors":"Mohammad Seyedahmadi, Ahmad Ebrahimi Atri, Hadi Akbari, Mansour Sahebozamani","doi":"10.1002/pri.70088","DOIUrl":"10.1002/pri.70088","url":null,"abstract":"<p><strong>Background and purpose: </strong>Research findings on the effects of land-based and water-based exercises on motor performance in people with Parkinson's disease (PD) are conflicting, and despite the known beneficial effects of exercise in these individuals, it is unclear which of these exercise protocols is more beneficial. Therefore, this study aimed to systematically evaluate the effects of exercise on land and water on the performance of people with PD.</p><p><strong>Methods: </strong>Randomized controlled clinical trials related to the motor performance of people with PD were identified by searching the Science Direct, PubMed, Scopus, and Google Scholar databases and analyzed using CMA v4 software. Of 94 studies based on the inclusion and exclusion criteria, eight English articles were included in the comprehensive review.</p><p><strong>Results: </strong>The meta-analysis revealed a significant difference in the motor performance of people with PD between the land- and water-based exercise groups (CI 95%, -0.135 to -0.649; MD = -0.392).</p><p><strong>Discussion: </strong>Water-based exercises may offer greater improvements in motor performance compared to land-based exercises in individuals with PD. Therefore, in addition to conventional exercises, exercising in water could help enhance the motor function of these people, and therapists can incorporate it into their exercise programs.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70088"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Combining Robotic Assisted Therapy for Upper Limb With Other Therapeutic Approaches After Stroke: A Systematic Review and Meta-Analysis of Randomized Control Trials.","authors":"Naoya Anmoto, Shiori Watanabe, Takao Kaneko, Masanori Maeda, Yuho Okita, Takashi Takebayashi","doi":"10.1002/pri.70091","DOIUrl":"10.1002/pri.70091","url":null,"abstract":"<p><strong>Background and purpose: </strong>Robotic-assisted therapy for the upper limb (RAT-UL) is a well-established, evidence-based approach to stroke rehabilitation. However, the effectiveness of combining RAT-UL with other therapeutic approaches remains unclear. This systematic review and meta-analysis, registered in PROSPERO (CRD42023422583), aimed to investigate the effect of combination therapy added to RAT-UL compared with RAT-UL alone on improving the motor function, and capacity of the affected upper limb and activity of daily living.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, CINAHL, Physiotherapy Evidence Database (PEDro), and Web of Science. We included randomized controlled trials (RCTs) published in English before October 2024. Methodological quality was assessed using the Cochrane risk of bias tool for RCTs. Meta-analysis was performed using RevMan 5.4 software. The primary inclusion criteria encompassed adults after stroke who underwent combining RAT-UL with other therapeutic approaches.</p><p><strong>Results: </strong>After reviewing 5669 studies, we included 16 RCTs in this study. The overall effect of combining RAT-UL with other therapeutic approaches on the motor function in Fugl-Meyer Assessment was not significant improvement (MD = 1.40; 95% CI, 0.00-2.81; p = 0.05), whereas the differences on capacity of upper limb in Wolf Motor Function Test-Performance Time (MD = 0.48; 95% CI, 0.01-0.94; p = 0.04) and activities of daily living in the Functional Independence Measure were also observed (MD = 2.21; 95% CI, 0.12-4.31; p = 0.04). However, no significant differences were found in the analysis of activity levels in the ICF domains (SMD = 0.50; 95% CI, -1.33-2.34; p = 0.08). Subgroup analyses showed significant improvements in motor function in the Fugl-Meyer Assessment when partial substitution of RAT-UL with other high-intensity therapeutic approaches (MD = 3.42; 95% CI, 0.61-6.24; p = 0.02).</p><p><strong>Discussion: </strong>Adding a high-intensity therapeutic approach to RAT-UL may lead to improvement in upper limb function and capacity compared with RAT-UL alone. However, the effectiveness of combining RAT-UL with other therapeutic approaches appears to vary depending on the type of adjunctive therapy employed. The effect sizes were small, and the findings across studies were inconsistent.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42023422583).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70091"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severity Classification of Functional Impairment Based on ICF Qualifiers: A New Proposal for Assessing Individuals With Pulmonary Hypertension.","authors":"Jonathan Dalavina, Ivan Peres Costa, Etiene FarahTeixeira de Carvalho, Jonathan Luiz Silva, Soraia Micaela Silva, Luciana Maria Malosá Sampaio","doi":"10.1002/pri.70090","DOIUrl":"https://doi.org/10.1002/pri.70090","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary Hypertension (PH) is a chronic condition that leads to progressive functional limitations, making the assessment of functional capacity essential for clinical management. This study aimed to classify PH patients based on the International Classification of Functioning, Disability, and Health (ICF) qualifiers using the Six-Minute Walk Test (6MWT) and compare this classification with the World Health Organization Functional Classification (WHO-FC).</p><p><strong>Methods: </strong>This observational study included 33 individuals with PH. Demographic data, pulmonary function, and 6MWT results were collected. Participants were classified according to ICF qualifiers (ranging from no impairment to complete impairment) and WHO-FC. The association between classifications was tested using Fisher's exact test, considering the conceptual differences between them.</p><p><strong>Results: </strong>Most participants presented moderate functional impairment, with an average 6MWT distance of 431.5 ± 110 m, equivalent to 68% of the predicted value. Based on ICF qualifiers, 39% of patients had mild impairment, 42% moderate, and 18% severe impairment. However, no significant association was found between ICF qualifiers and WHO-FC, reflecting the distinct conceptual frameworks of these classifications. Unlike WHO-FC, which applies fixed cutoffs, the ICF-based classification provides a more individualized assessment by incorporating the contrast between expected and actual performance in the 6MWT.</p><p><strong>Discussion: </strong>The use of ICF qualifiers enabled a more specific evaluation of functional capacity in PH patients, complementing rather than replacing WHO-FC. This approach allows for a more individualized assessment, supporting targeted rehabilitation strategies and improving clinical decision-making in PH management.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 3","pages":"e70090"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}