Physiotherapy Research International最新文献

{"title":"Greek Translation and Preliminary Test-Retest Reliability of the AQUA CHILD Questionnaire in Children With Developmental Disabilities.","authors":"Stavroula Triantafyllidou, Michaela Christina Tsangala, Eleni Argyroula Tsounia, Chrysoula Moscholouri, Thomas Besios, George Paras, Alfonso Trinidad Morales, Konstantinos Chandolias","doi":"10.1002/pri.70357","DOIUrl":"10.1002/pri.70357","url":null,"abstract":"<p><strong>Background and purpose: </strong>AQUA CHILD is a parent-proxy questionnaire for pre-aquatic assessment. This study describes its Greek translation and examines preliminary test-retest agreement, with explicit verification of response coding and the limits of score interpretation.</p><p><strong>Methods: </strong>In a methodological repeated-measures study, 47 parents completed the questionnaire 7 days apart. The retained electronic paired files contained 99 of the 102 numbered items on the supplied forms. Swimming responses were analysed categorically; 20 non-swimming domain summaries were analysed as exploratory raw-code sums, excluding non-applicable responses and using complete domain pairs (n = 43-47). Intraclass correlation coefficients for absolute agreement, ICC(A, 1), and 95% confidence intervals (CIs), systematic differences, measurement-error estimates, and participant-level Bland-Altman analyses were calculated. No overall score was retained.</p><p><strong>Results: </strong>Swimming-item exact agreement was 91.5%-97.9% (unweighted kappa, 0.899-0.974). Non-swimming ICCs ranged from 0.878 to 0.968, with lower 95% CI limits of 0.786-0.942. Only undertaking a single task retained a mean retest increase after Holm adjustment: 0.22 raw-code points (95% CI, 0.09-0.34; adjusted p = 0.019). Baseline domain alpha coefficients ranged from -0.375 to 0.329. At T2, 41 non-swimming responses from 24 of 47 participants were 'not relevant', all 'not capable' at T1; none were 'not relevant' at T1. Two domain analyses used incomplete item sets. Normal-theory limits of agreement were sensitive to the discrete, zero-heavy differences.</p><p><strong>Discussion: </strong>These estimates describe the retained electronic records. The original paper questionnaires are no longer available, so the accuracy and origin of the 41 transitions could not be independently verified; this unresolved data-quality issue may bias reliability estimates. Unconfirmed clinical stability, incomplete adaptation records, and missing items further limit inference. The findings do not establish validated domain scales, diagnosis-specific reliability, or an overall score. Prospective validation with independent source-data verification remains necessary before individual treatment decisions.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70357"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138689","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":"Effectiveness of Virtual Reality Versus Exercise-Based Interventions in the Management of Chronic Spinal Pain: A Systematic Review and Meta-Analysis.","authors":"Julián Peralta-Álvarez, Francisco Nieto-Escámez, Remedios López-Liria, Juan José González-Geréz, María Jesús Benzo-Iglesias, Patricia Rocamora-Pérez","doi":"10.1002/pri.70354","DOIUrl":"10.1002/pri.70354","url":null,"abstract":"<p><strong>Background/purpose: </strong>This systematic review and meta-analysis assessed the comparative effectiveness of virtual reality (VR) versus exercise-based interventions for pain, disability, fear of movement, and quality of life in patients with chronic spinal pain.</p><p><strong>Methods: </strong>Five databases were searched for randomized control trials (RCTs) in the last 10 years, comparing VR versus exercise-based interventions (with or without passive adjunct modalities) for adults (≥ 18 years) with chronic spinal pain. Risk of bias and certainty of evidence were assessed using the Cochrane RoB 2.0 tool and GRADE framework, followed by random-effect meta-analyses.</p><p><strong>Results: </strong>Fifteen RCTs comprising 659 participants were included, with most presenting a high risk of bias. Based on very low-certainty evidence, VR showed statistically significant superiority over exercise-based interventions for pain (VAS: MD -1.05, 95% CI -1.92 to -0.18; p = 0.02; I² = 94%; NPRS: MD -0.95, 95% CI -1.59 to -0.31; p = 0.003; I² = 14%) and kinesiophobia (MD -3.52, 95% CI -6.08 to -0.96; p = 0.007; I² = 0%). None of these statistically significant reductions met the commonly established thresholds for Minimal Clinically Important Difference (MCID) for chronic spinal pain populations. Very low-certainty evidence found no significant differences for functional disability (MD -1.38, 95% CI -5.43 to 2.67; p = 0.50; I² = 0%), and results on quality of life were heterogeneous and inconclusive.</p><p><strong>Discussion: </strong>Although VR may offer statistical advantages over exercise-based interventions for pain and kinesiophobia, the overall certainty of the evidence remains very low. The non-attainment of the MCID thresholds, coupled with high risk of bias and substantial statistical heterogeneity, underscores the need for strict caution.</p><p><strong>Trial registration: </strong>PROSPERO (CRD420251101584).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70354"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116409","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 Using High-Frequency TENS During an Exercise Therapy Program in Knee Osteoarthritis: A Randomized Sham-Controlled Trial.","authors":"Patrícia Gabrielle Dos Santos, Richard Eloin Liebano, Bruno Ruocco Verengue, Aron Charles Barbosa da Silva, Barbara Greco Miura, Carlos Eduardo Girasol, Almir Vieira Dibai-Filho, Cid André Fidelis-de-Paula-Gomes","doi":"10.1002/pri.70351","DOIUrl":"10.1002/pri.70351","url":null,"abstract":"<p><strong>Background and purpose: </strong>Therapeutic exercise is central to knee osteoarthritis (KOA) management, but movement-evoked pain may limit adherence and outcomes. High-frequency transcutaneous electrical nerve stimulation may reduce pain during movement and enhance exercise-related outcomes. This study evaluated whether high-frequency transcutaneous electrical nerve stimulation applied during an exercise therapy program provides additional benefits over sham stimulation in individuals with KOA.</p><p><strong>Methods: </strong>In this randomized, sham-controlled superiority trial with intended participant blinding and blinded outcome assessment, 96 individuals with KOA were randomized to exercise therapy plus active high-frequency transcutaneous electrical nerve stimulation or exercise therapy plus sham transcutaneous electrical nerve stimulation. The primary outcome was the Knee Injury and Osteoarthritis Outcome Score Pain subscale. Secondary outcomes included the remaining Knee Injury and Osteoarthritis Outcome Score subscales, pain intensity, pain-related self-efficacy, patient-specific function, disability, quadriceps isometric strength, and physical function. Outcomes were assessed at baseline, post-intervention, and 1 month follow-up. Linear mixed models were used for analysis.</p><p><strong>Results: </strong>Active high-frequency transcutaneous electrical nerve stimulation did not provide additional benefit over sham stimulation for the Knee Injury and Osteoarthritis Outcome Score Pain subscale at post-intervention (adjusted mean difference, 1.05 points; 95% CI, -5.19 to 7.29) or at 1 month follow-up (0.40 points; 95% CI, -5.91 to 6.71). These confidence intervals did not reach the predefined 10-point minimal clinically important difference. No statistically significant between-group differences were observed for any secondary outcome. No adverse effects were reported.</p><p><strong>Discussion: </strong>Adding high-frequency transcutaneous electrical nerve stimulation to a structured exercise therapy program did not confer additional benefits over sham stimulation in individuals with KOA. These findings should be interpreted in light of the absence of formal blinding assessment, the short follow-up, and the absence of an exercise-only group.</p><p><strong>Trial registration: </strong>This trial was registered at ClinicalTrials.gov on December 14, 2023, under the identifier NCT06184451.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70351"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026362","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":"Short-Term Effects of a Self-Monitoring-Based Intervention on Prolonged Sedentary Behavior in Older Adults With Cardiovascular Conditions: An Exploratory Secondary Analysis of a Randomized Controlled Trial.","authors":"Masahiro Kitamura, Kazuhiro P Izawa, Takayuki Nagasaki, Takashi Yoshizawa, Koji Fujioka, Wataru Yamaguchi, Hiroaki Matsuda","doi":"10.1002/pri.70356","DOIUrl":"https://doi.org/10.1002/pri.70356","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study was an exploratory secondary analysis of data from a previously conducted randomized controlled trial (RCT) involving older adults receiving long-term care (LTC). The present secondary analysis explored the effects of an accelerometer-guided self-monitoring intervention on prolonged sedentary behavior (≥ 30 min) and physical activity in older adults with cardiovascular conditions.</p><p><strong>Methods: </strong>This exploratory secondary analysis used data from an RCT conducted at a Japanese daycare center (October 2022-January 2023). The parent RCT included 52 participants (26 in the intervention group and 26 in the control group). Of these, 36 participants with cardiovascular conditions were eligible for the present exploratory secondary analysis (intervention, n = 21; control, n = 15). The main outcome was prolonged sedentary behavior accumulated in bouts of ≥ 30 min. Other outcomes included daily step count, sedentary behavior in bouts of ≥ 1 and ≥ 60 min, sedentary bout counts and break counts, physical activity intensity, and EQ-5D-5L utility scores. Outcomes were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>Thirty-three participants with available baseline outcome data were included in the analyses (intervention, n = 19; control, n = 14). Significant group × time interactions were observed for step count, sedentary behavior in bouts of ≥ 1 min and ≥ 30 min, sedentary bout counts, and light physical activity (p < 0.05). Moderate-to-vigorous physical activity and EQ-5D-5L utility scores did not change significantly.</p><p><strong>Discussion: </strong>Accelerometer-guided self-monitoring may influence prolonged sedentary behavior and physical activity in older adults with cardiovascular conditions receiving LTC. These findings provide preliminary, hypothesis-generating evidence that self-monitoring may represent a promising approach to reducing prolonged sedentary behavior in older adults receiving LTC. Confirmation in adequately powered RCTs is warranted.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70356"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116384","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":"Professional Change and Identity in Contemporary Physiotherapy: A Six-Domain Conceptual Framework.","authors":"Dimitrios Stasinopoulos","doi":"10.1002/pri.70367","DOIUrl":"10.1002/pri.70367","url":null,"abstract":"<p><strong>Background and purpose: </strong>Contemporary physiotherapy is often described as evidence-informed, person-centered, and biopsychosocial. These descriptions can imply a break with earlier practice, although some commitments have longer histories. This paper proposes a framework for examining professional change and its implications for professional identity.</p><p><strong>Methods: </strong>This single-author conceptual analysis draws on a purposive reading of historical, sociological, critical, and professional literature. The professional maturation hypothesis is a working proposition: change may strengthen an enduring commitment or alter a foundational assumption. Contrasting examples inform six provisional domains; we did not conduct a systematic review or empirical validation.</p><p><strong>Results: </strong>The domains are understanding of the body and health, knowledge, professional role, therapeutic relationships, therapeutic purpose, and organization of care. Within each domain, the framework distinguishes maturation (better evidence or enactment), consolidation (institutional support), rebranding (new language without demonstrated substantive change), and rupture (a consequential shift in foundational assumptions). These interpretations may coexist.</p><p><strong>Discussion: </strong>The framework helps clinicians, educators, researchers, and professional organizations assess what has changed, where, to what extent, and with what consequences. Its intended use is context-specific reflection and cross-national inquiry, not classification of countries along a universal trajectory. The framework remains provisional and unvalidated.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70367"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197150","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":"Associations of Maximal Inspiratory Pressure With Lung Hyperinflation, Functional Capacity, and Muscle Strength in Patients With Chronic Obstructive Pulmonary Disease.","authors":"Jarinya Kraisalee, Warawut Chaiwong, Teelek Lungta, Nutcha Vimolsutjarit, Mujalin Prasannarong, Athavudh Deesomchok, Sauwaluk Dacha","doi":"10.1002/pri.70353","DOIUrl":"https://doi.org/10.1002/pri.70353","url":null,"abstract":"<p><strong>Background and purpose: </strong>In patients with chronic obstructive pulmonary disease (COPD), the correlations between inspiratory muscle weakness and some physiological factors were inconclusive. Understanding the relationship between these parameters may potentially be a screening tool for inspiratory muscle weakness. The purpose of this study was to evaluate the association between inspiratory muscle strength and functional capacity, dyspnea sensation, airway obstruction, lung hyperinflation, and peripheral muscle strength in patients with COPD.</p><p><strong>Methods: </strong>A cross-sectional analytical study evaluated 40 patients with stable COPD. Patients underwent pulmonary function tests, maximal inspiratory and expiratory pressure (MIP, MEP) tests, handgrip strength measurement, and a six-minute walk test.</p><p><strong>Results: </strong>Forty male patients were included. Fifteen patients (37.5%) had inspiratory muscle weakness when using a cut-off point of 60 cmH₂O. Positive correlations were found between MIP and MEP (Pearson's correlation coefficient [r] = 0.489), six-minute walk distance (r = 0.504), and relative handgrip strength (r = 0.347). There was a negative correlation between MIP and residual volume/total lung capacity (RV/TLC) (r = -0.459). Regression analyses were performed after adjustment for age and forced expiratory volume in the first second (FEV₁) % predicted. Linear regression showed that MIP was associated with MEP (coefficient [β] = 0.37; 95% confidence interval [CI], 0.12-0.62) and peak expiratory flow (PEF) (β = 7.68; 95% CI, 2.50-12.81). Exploratory logistic regression showed an association between PEF and inspiratory muscle weakness (OR = 0.36; 95% CI 0.14-0.93); exploratory ROC analysis yielded an AUC of 0.81 (95% CI, 0.68-0.95).</p><p><strong>Discussion: </strong>A reduction in inspiratory muscle strength is related to lung hyperinflation, functional capacity, and peripheral muscle strength. Higher MIP was independently associated with higher MEP and PEF. After adjustment for age and FEV₁% predicted, PEF was significantly associated with inspiratory muscle weakness.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70353"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116269","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":"Design of an Early Exercise Program for Hospitalized Patients: \"Let's Move\".","authors":"Adriana Marcela Jacome Hortua, Luis Felipe Anaya Duarte, Aura M Cáceres, Zully Rocio Rincon, Cristhian López, Alejandra Mendoza-Monsalve, Edgar Fabián Manrique-Hernández, Alexandra Hurtado-Ortiz, Maricel Licht-Ardila","doi":"10.1002/pri.70358","DOIUrl":"https://doi.org/10.1002/pri.70358","url":null,"abstract":"<p><strong>Background: </strong>Hospital-associated deconditioning (HAD) affects up to 30% of older adults during acute hospitalization, leading to functional and cognitive decline and adverse long-term outcomes.</p><p><strong>Purpose: </strong>To develop and pilot \"Let's Move,\" an implementation-oriented early exercise program designed to support mobility in hospitalized patients.</p><p><strong>Methods: </strong>An action-research study was conducted at a tertiary hospital in two stages: (i) program design based on an electronic health record (EHR) needs assessment and targeted protocol review; and (ii) pilot implementation among clinically stable adults aged ≥ 18 years, hospitalized for ≥ 48 h, without physiotherapy referral. Outcomes included Hopkins Highest Level of Mobility (JH-HLM) functional status, adherence, and safety, complemented by qualitative interviews and a focus group.</p><p><strong>Results: </strong>In Stage 1, 1399 adult inpatients without rehabilitation referral were identified (median age, 65 years [IQR, 46-78]; length of stay, 3 days [IQR, 2-4]) with circulatory diseases predominating (57.18%). Among 26 participants enrolled in the pilot, 17 were evaluable for adherence, with 13 (76.5%) classified as adherent. Walking ≥ 75 m was the most frequent JH-HLM assessment category, no adverse events or in-hospital deaths occurred, and 25/26 participants (96.2%) achieved individualized goals. Qualitative findings supported relevance and feasibility and informed refinements, including sessions every 2 days and standardized educational materials.</p><p><strong>Discussion: </strong>\"Let's Move\" is a structured early-mobilization program developed through action research that integrates brief patient education with low-intensity exercise for routine inpatient care. It provides a practical workflow to support early mobility and warrants broader evaluation to assess its effectiveness and scalability.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70358"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116307","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":"Preference for Resistance Training Volume After Acute Exercise in Women With Fibromyalgia: A Randomized Crossover Clinical Trial.","authors":"Bruno Honório Cavalcanti, André Pontes-Silva, Gleidson Mendes Rebouças, Areolino Pena Matos, Clécio Gabriel de Souza, Mariana Arias Avila, Marcelo Cardoso de Souza","doi":"10.1002/pri.70364","DOIUrl":"10.1002/pri.70364","url":null,"abstract":"<p><strong>Background and purpose: </strong>To evaluate participants' preferences following acute exposure to three resistance training protocols differing solely in the number of sets performed.</p><p><strong>Methods: </strong>Randomized crossover clinical trial. Thirty-eight women aged 18-65 years with fibromyalgia diagnosed according to the 2016 American College of Rheumatology criteria completed the study. All participants were naïve to resistance training during the previous 6 months and completed every intervention protocol and assessment. Participants performed three resistance training sessions in randomized order, consisting of one-, two-, or three-set protocols separated by 7-day washout periods. Exercise selection, intensity, and repetitions were standardized across protocols, with the number of sets representing the only intervention variable. The primary outcome was participant preference for resistance training volume after completion of all three protocols. Secondary outcomes included treatment expectancy, pain intensity assessed before and after exercise and 24 hours later, and exercise execution time.</p><p><strong>Results: </strong>No participant selected the one-set protocol as the preferred training volume, whereas the two- and three-set protocols were equally preferred, each being selected by 50% of participants (p < 0.001; Cohen's w = 0.71). Treatment expectancy did not differ significantly among protocols (p = 0.20). No between-protocol differences in pain intensity were observed at any assessment time point. A significant within-protocol reduction in pain over time was identified only for the two-set protocol (p = 0.015); however, the magnitude of change did not reach the predefined minimal clinically important difference. Exercise execution time did not differ significantly among training volumes, and no serious adverse events occurred during the study.</p><p><strong>Discussion: </strong>Women with fibromyalgia demonstrated equivalent preference for resistance training protocols involving two and three sets, whereas no participant identified the one-set protocol as the preferred option. Treatment expectancy was similar across protocols, and no clinically meaningful differences in pain intensity were observed. These findings support the incorporation of patient preference into individualized resistance training prescriptions and warrant further investigation of whether such preferences translate into improved long-term adherence and clinical outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (Identifier: NCT06424743, 2024-08-21).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 4","pages":"e70364"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197166","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":"Effects of Insomnia, Anxiety and Depression on Clinical Outcomes of Frozen Shoulder After Manipulation Under Anesthesia.","authors":"Fei Lu, Zhenyu Hu, Lingfang Shen, Yejun Hu, Xinji Wang, Xinxin Wang, Dengfeng Ruan, Hengzhi Liu, Honglu Cai, Weiliang Shen","doi":"10.1002/pri.70264","DOIUrl":"10.1002/pri.70264","url":null,"abstract":"<p><strong>Background and purpose: </strong>Frozen shoulder is a common disorder causing pain, stiffness, disability, and sleep disturbance. While often linked to psychological comorbidities, the impact of preoperative mental health and insomnia on recovery outcomes remains unclear. The purpose of this study was to investigate the effects of preoperative anxiety, depression, and insomnia on postoperative recovery in patients undergoing manipulation under anesthesia (MUA) for frozen shoulder.</p><p><strong>Methods: </strong>This study was a secondary analysis of a prospective observational cohort study. A total of 197 patients with primary frozen shoulder were enrolled and treated with MUA. Preoperatively, the Insomnia Severity Index (ISI) and Hospital Anxiety and Depression Scale (HADS) classified patients: 33 with clinical insomnia (ISI ≥ 15) and 45 with psychological distress (PD, including anxiety or depression, HADS anxiety ≥ 8 and depression ≥ 8). Shoulder passive range of motion (ROM), pain (visual analog scale, VAS), and functional scores (Constant-Murley Score [CMS], Oxford Shoulder Score [OSS]) were assessed at 3 and 6 months postoperatively. Outcomes were compared between patients with/without insomnia or PD. To control for multiple comparisons, all p-values were adjusted using the False Discovery Rate (FDR) method.</p><p><strong>Results: </strong>In the insomnia analysis, the insomnia group had a significantly lower proportion of male patients (12.1% vs. 28.7%, p = 0.048) and a lower mean BMI (22.0 ± 2.4 vs. 23.0 ± 2.7, p = 0.033) compared to the group without insomnia. Furthermore, baseline abduction was significantly more restricted in the insomnia group (67.2° ± 21.9 vs. 81.8° ± 24.8, p = 0.001) and OSS was significantly worse (38.5 ± 8.1 vs. 32.6 ± 5.5, p < 0.001). Preoperative PD was more common in right-side cases (60.0% vs. 42.8%, p = 0.042) and was associated with worse baseline external rotation. Following MUA, all patient groups achieved substantial clinical improvement. At 3 and 6 months postoperatively, after FDR adjustment, there were no statistically significant or clinically meaningful differences in ROM, VAS, CMS, or OSS between patients with and without insomnia, nor between patients with and without PD. All observed mean differences between groups were small and fell well below established minimal clinically important difference (MCID) thresholds (e.g., at 6 months, CMS mean difference between PD and no PD was 1.84 [95% CI -0.92 to 4.60]; adjusted p = 0.796).</p><p><strong>Discussion: </strong>Although preoperative clinical insomnia and PD are associated with worse baseline pain and functional presentation, they were not associated with poorer postoperative recovery following MUA in this cohort. At the 3 and 6 months postoperative follow-ups, there were no statistical differences in pain or ROM between patients with and without these preoperative conditions.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70264"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309983","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":"Land-Based Functional Rehabilitation Versus Aquatic Therapy on the Quality of Life of Individuals With Chronic Chikungunya: A Randomized Clinical Trial.","authors":"Oliva Maria da Silva Sousa, Marynara Fabíola Silva Araújo, Geilson Medeiros de Araújo, Hilmaynne Renaly Fonseca Fialho, Renata Newman Leite Dos Santos Lucena, Eleazar Marinho de Freitas Lucena","doi":"10.1002/pri.70239","DOIUrl":"10.1002/pri.70239","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chikungunya may progress to a chronic phase marked by persistent pain and functional impairment, reducing the quality of life. Exercise-based rehabilitation is essential, though comparisons between different modalities remain scarce. Exercises in an aquatic environment can be designed as a task-oriented intervention that utilizes hydrodynamic properties to modulate sensorimotor reweighting and enhance movement confidence. This study aimed to evaluate the effects of two functional rehabilitation programs-one land-based and one aquatic-on the quality of life of individuals in the chronic phase of chikungunya.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted in Santa Cruz, RN, Brazil, with 53 participants of both sexes aged 18-75 years. Data were collected using a sociodemographic and health questionnaire developed for this study and 36-Item Short Form Health Survey (SF-36). Participants were randomly allocated to a land-based Functional Rehabilitation Group (FRG) or an Aquatic Therapy Group (ATG) and underwent functional exercise interventions twice weekly for 6 weeks. Descriptive statistics and linear mixed model analyses were performed, considering Group (FRG vs. ATG) as a between-subjects fixed effect, Time (pre-vs. post-intervention) as a within-subjects fixed effect, and the Group × Time interaction, adopting a compound symmetry covariance structure. The effect size was estimated using partial η².</p><p><strong>Results: </strong>The analysis revealed significant time effects across SF-36 domains, indicating overall improvement between pre- and post-intervention assessments. A significant Group × Time interaction was observed for the social aspects' domain, with greater benefits in the FRG.</p><p><strong>Discussion: </strong>Both rehabilitation programs, land-based and aquatic, significantly improved the quality of life of individuals in the chronic phase of chikungunya, with the land-based program showing superior results in social aspects.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70239"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989570","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}