Physiotherapy Research International最新文献

{"title":"Efficacy of Active Exercises to Improve Range of Motion in Knee Joint After Total Knee Arthroplasty. A Randomized Controlled Trial.","authors":"Lisbeth Mogensen, Torben Rasmussen, Julie Rasmussen, Stig Molsted","doi":"10.1002/pri.70228","DOIUrl":"10.1002/pri.70228","url":null,"abstract":"<p><strong>Background and purpose: </strong>After total knee arthroplasty (TKA), not everybody gains a sufficient joint mobility. The objective of this study was to investigate the effects of high-frequency (HF) versus low-frequency (LF) self-managed knee flexion exercises in individuals with reduced flexion after a TKA.</p><p><strong>Methods: </strong>The study was a randomized controlled trial in adults with a TKA within 6 to 26 weeks and knee flexion ≤ 105° who participated in an 18-day inpatient rehabilitation program. Patients were randomized to additional self-managed HF (eight flexion and extension exercises per day) versus LF (two flexion and extension exercises per day). The primary outcome was knee flexion change. Secondary outcomes were changes of knee extension, Six-Minute Walk Test, 30 Second Chair-Stand Test, pain using Numeric Rating Scale, and Knee Injury and Osteoarthritis Outcome Score.</p><p><strong>Results: </strong>The participants (n = 83) were 65 (SD 8.8) years old and 70% were women. The HF (n = 44) and LF (n = 39) groups performed knee flexions 5.3 (1.4) and 1.7 (0.3) times/day, respectively. The flexion increased 14.2 [11.6; 16.7]° with HF versus 10.1 [8.6; 11.6]° with LF, with 4.1° difference between groups (p = 0.007). Secondary outcomes increased in the two groups without differences between the groups.</p><p><strong>Discussion: </strong>In individuals with reduced joint mobility after TKA, HF self-managed knee flexion exercises were associated with a positive change in flexion compared with LF, though the between-group difference was smaller than expected.</p><p><strong>Trail registration: </strong>The study was registered on ClinicalTrials.gov (NCT06188091).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70228"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934669","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":"Ultrasound-Assessed Rotator Interval Vascularity Is Associated With the Immediate Response to Corticosteroid Injection Combined With Radial Extracorporeal Shock-Wave Therapy in Adhesive Capsulitis: A Single-Group Quasi-Experimental Preliminary Study.","authors":"Koshi Shimizu, Ryo Miyachi, Seiji Nishimura, Mitsugu Yoneda, Takashi Ishikawa, Takashi Kobayashi","doi":"10.1002/pri.70285","DOIUrl":"10.1002/pri.70285","url":null,"abstract":"<p><strong>Background and purpose: </strong>Adhesive capsulitis is characterized by progressive pain and restricted shoulder mobility, with inflammatory changes frequently observed in the rotator interval (RI). This study aimed to evaluate whether ultrasound-assessed RI vascularity is associated with immediate changes in shoulder external rotation range of motion following combined corticosteroid injection and radial extracorporeal shock-wave therapy (r-ESWT) in adhesive capsulitis.</p><p><strong>Methods: </strong>In this single-group quasi-experimental preliminary study, 20 patients with adhesive capsulitis received intra-articular corticosteroid injection followed by five r-ESWT sessions targeting the RI. RI vascularity was assessed using power Doppler ultrasonography (PD-US) and graded using a four-point scale (Grades 0-3). Passive external rotation (ER) was measured before and after each session, and the immediate ER change (ΔER) was calculated. A linear mixed-effects model was employed to identify factors associated with ΔER while accounting for repeated measures.</p><p><strong>Results: </strong>Vascularity grade was significantly associated with ΔER (F = 11.42, p < 0.001). Compared with Grade 3, significantly smaller gains were observed in Grades 0 (estimate = -8.72, p = 0.014) and 1 (estimate = -8.91, p = 0.003), whereas Grade 2 exhibited a smaller improvement that did not reach statistical significance (estimate = -6.23, p = 0.051). No significant associations were observed for other examined covariates.</p><p><strong>Discussion: </strong>Greater RI vascularity assessed using PD-US was associated with larger immediate ΔER following combined corticosteroid injection and r-ESWT in patients with adhesive capsulitis. These exploratory findings suggest that PD-US-based vascular assessment may provide clinically relevant information regarding stage-related biological activity and short-term physiological responsiveness and warrant further investigation in larger controlled studies.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70285"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425339","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":"Asymmetry in Recreational Athletes One Year After Anterior Cruciate Ligament Reconstruction: Comparison of Isokinetic Strength and Hop Test Performance.","authors":"Paulina Cárcamo-Aravena, Joaquín Robledo-Medalla, Nicolás Yañez, Alex Vaisman, Daniel Jerez-Mayorga, Felipe P Carpes, Carlos Cruz-Montecinos","doi":"10.1002/pri.70288","DOIUrl":"10.1002/pri.70288","url":null,"abstract":"<p><strong>Background and purpose: </strong>After anterior cruciate ligament (ACL) reconstruction, strength and performance asymmetries are widely considered relevant indicators for return to sport; however, the definition of acceptable asymmetry thresholds remains controversial. Here we compare the level of asymmetry in isokinetic knee extensor outcomes and vertical and horizontal single-leg hop tests performance one year after ACL reconstruction in recreational athletes.</p><p><strong>Methods: </strong>Cross-sectional study. A total of 32 recreational athletes (females n = 13) one year after ACL reconstruction, with a mean age of 26.21 ± 7.95 years, were included. Peak torque, power, and total work were determined at 60°/s and 180°/s during isokinetic testing. Single-leg hop tests (drop jump and countermovement jump) and vertical hop test (triple hop test) were assessed.</p><p><strong>Results: </strong>Significant differences were observed between limbs in all tests (p < 0.05). No differences in asymmetry were found between the isokinetic and vertical hop tests, with asymmetry values ranging between 13% and 18%. The horizontal hop test showed the lowest asymmetry (4%) and exhibited significant differences compared to all other tests (p < 0.05).</p><p><strong>Discussion: </strong>Our results indicate that, one year after ACL reconstruction, recreational athletes often continue to exhibit inter-limb asymmetries in isokinetic strength and jump performance that exceed the commonly accepted 10% threshold, except for the horizontal single-leg hop.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70288"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473087","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":"Prevalence, Patterns, Treatment Outcomes and Costs of Physiotherapy-Managed Musculoskeletal Disorders in Nigeria.","authors":"Chidozie Mbada, Abeeb Olatunde Ogunsola, Olufemi Oyeleye Oyewole, Tadesse Gebrye, Francis Fatoye","doi":"10.1002/pri.70279","DOIUrl":"https://doi.org/10.1002/pri.70279","url":null,"abstract":"<p><strong>Background and purpose: </strong>Musculoskeletal disorders (MSDs) are a leading cause of global disability, yet data on physiotherapy-managed cases remain limited in Nigeria. This study aimed to assess the prevalence, patterns, treatment effectiveness and cost of physiotherapy for MSDs.</p><p><strong>Methods: </strong>A 10-year retrospective study of all cases of MSDs at a Nigerian University Teaching Hospital was carried out. Data were gleaned on socio-demographics, types of MSDs, treatments given and costs. Real-world evidence for intervention on pain was calculated. Cost of care (direct and indirect) was estimated using the cost-of-illness approach.</p><p><strong>Results: </strong>A total of 1582 patients were assessed, with a mean age of 47.8 ± 25.7 years, predominantly female (52.5%), and from middle (62.8%) and low (25.1%) socioeconomic classes. Over 10 years, 47.35% of physiotherapy-related conditions were MSDs, with low back pain (LBP) being the most common (21.6%) and osteoarthritis the least (6.3%). Strengthening exercises were the primary treatment (73.1%), followed by vertical oscillatory pressure (a manual therapy approach) (21.9%). Both interventions significantly reduced pain (p = 0.001). The total direct and indirect costs for MSDs were ₦9003 ± 7913 and ₦36,011 ± 31,652, equivalent to approximately $23.08 ± 20.29 and $92.34 ± 81.16, respectively, in a high-income country context. Cost analysis revealed that osteoarthritis had the highest direct and indirect costs, adjusted to $29.23 ± 32.75 and $116.91 ± 131.00, respectively, while LBP had the lowest ($14.42 ± 8.55 and $57.69 ± 34.21). Strengthening exercises had the highest treatment costs among interventions, with direct costs of $25.70 ± 22.20 and indirect costs of $102.81 ± 88.60.</p><p><strong>Discussion: </strong>MSDs are highly prevalent among socio-economically disadvantaged groups in Nigeria, with LBP being the most common and least costly condition, and osteoarthritis the costliest; physiotherapy interventions are widely used, with strengthening exercises being the most frequently applied and effective intervention, though they also incur the highest treatment costs. Overall, physiotherapy interventions demonstrated significant pain reduction, with cost variations reflecting the type of condition and the modality used.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70279"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413237","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":"Comparative Effects of Land-Based and Aquatic Physiotherapy on Functional and Neuromuscular Outcomes in the Rigid-Akinetic Subtype of Parkinson's Disease: A Randomized Clinical Trial.","authors":"Jéssica Saccol Borin Aita, Bruno Strey, Bruna Frata, Liziane Mattos Brião, Daniel Barbosa Tresmondi, Suraya Gomes Novais Shimano, Ronei Silveira Pinto, Fernanda Cechetti","doi":"10.1002/pri.70269","DOIUrl":"10.1002/pri.70269","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) leads to motor and neuromuscular impairments, with the rigid-akinetic (RA) subtype progressing more rapidly and affecting daily activities and balance. Beyond medication, strength training can improve disease severity and muscle function. However, research on land-based and aquatic physiotherapy for the RA subtype is limited. The objective of the study was to describe and compare the effects of 12 weeks of land-based physiotherapy (LP) and aquatic physiotherapy (AP) on the motor function of individuals with rigid-akinetic PD.</p><p><strong>Methods: </strong>Thirty individuals with rigid-akinetic PD were allocated to two groups (LP and AP) and participated in a 12-week intervention. Motor function was assessed using the Unified Parkinson's Disease Rating Scale-Part III (UPDRS III) (primary outcome). Secondary outcomes included trunk strength (explosive and maximal), functional capacity, mobility, flexibility, and balance, assessed through the rate of torque development (RTD) and peak torque (PT) using an isokinetic dynamometer, the Sit-to-Stand test (STS), Timed Up and Go (TUG), the Sit-and-Reach test (SR), and the Berg Balance Scale (BBS), respectively.</p><p><strong>Results: </strong>Both LP and AP groups showed no significant changes in UPDRS III, RTD, PT, or TUG, while STS, SR, and BBS showed significant interactions over time (p < 0.05). RTD intervals between 100 and 300 ms, as well as STS and TUG, were significantly linearly associated with UPDRS scores (p < 0.05).</p><p><strong>Discussion: </strong>The results indicate that while motor function and explosive and maximal muscle strength were not significantly affected by the interventions, functional capacity and balance improved, highlighting the importance of continuing physical training as an integral component of rehabilitation.</p><p><strong>Trial registration: </strong>Clinical trial registration data are publicly accessible at ClinicalTrials.gov under the identifier NCT05866120.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70269"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346848","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":"\"I Will Try to Fix You\": A Qualitative Investigation on Italian Women Struggling With Chronic Pelvic Pain.","authors":"Fabio Bernardi, Nadia Laterza, Michele Marelli, Roberta Giovinazzi, Gabriele Giannotta, Giuseppe Girardi, Giuseppe Giovannico, Chiara Leuci, Matteo Cioeta","doi":"10.1002/pri.70273","DOIUrl":"10.1002/pri.70273","url":null,"abstract":"<p><strong>Objectives: </strong>To explore how Italian women with chronic pelvic pain (CPP) describe and interpret clinicians' language, assessment and treatment recommendations, and how these perceived encounters may relate to meaning-making, activity behaviors, and expectations of rehabilitation.</p><p><strong>Design: </strong>Qualitative observational study using semi-structured one-to-one online interviews. Interviews were audio-video recorded, transcribed verbatim, pseudonymized, and analyzed using inductive, semantic, and reflexive thematic analysis.</p><p><strong>Setting: </strong>Online interviews conducted in Italy. Participants described experiences across routine healthcare encounters; no single clinical center was involved.</p><p><strong>Participants: </strong>Adult Italian women reporting a specialist diagnosis of CPP consistent with ICD-11 were eligible. Twenty-one women were recruited and completed the study.</p><p><strong>Interventions: </strong>No experimental intervention was delivered. The study examined participants' experiences of usual care, including prior clinical assessment, treatment, and rehabilitation recommendations.</p><p><strong>Main outcome measures: </strong>The primary outcome was the identification of themes representing how participants interpreted and responded to clinicians' explanations and management approaches. Supporting descriptive measures included the Numeric Pain Rating Scale (NPRS), Örebro short form, and Pain and Psychological Inflexibility in Pain Questionnaire (PPIQ).</p><p><strong>Results: </strong>Twenty-one women (mean age 30.47 years) reported high symptom burden and psychosocial risk (mean NPRS 6.8; mean Örebro 62.23; mean PPIQ 19.85). Four interrelated themes were generated: (1) Trigger points as the root cause of pain; (2) Need to avoid everything; (3) Diagnosis: reassurance or stigma; and (4) Manual Therapy: will it fix me? Divergent accounts indicated that clear explanations and shared decisions were described by some participants as supporting re-engagement in meaningful activities despite persistent symptoms.</p><p><strong>Conclusions: </strong>Women with CPP in this sample often described muscle-centered explanations and restrictive advice as influential in their understanding of pain, activity choices, and expectations of care.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70273"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363105","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":"Validating an Activity Monitor for Acute Care Patients: The Patient/Resident Mobility Tracker (PREEMPT).","authors":"Ann Tuzson, Christopher M Moore, Merrick Furman, Aaron Olowin, Neal Richardson, Christopher Wiles, Brian Clark","doi":"10.1002/pri.70236","DOIUrl":"10.1002/pri.70236","url":null,"abstract":"<p><strong>Background and purpose: </strong>To validate an activity monitor, the Patient Resident Mobility Tracker (PREEMPT), appropriate for use with hospitalized individuals.</p><p><strong>Methods and main outcome measures: </strong>Ten healthy older adults and 46 hospitalized patients wore the PREEMPT activity monitor while performing various physical activities. To determine accuracy and validity, the PREEMPT activity data were compared with video truth data. The five mobility metrics included stride length, number of steps, stepping time (total time spent walking), sedentary time and activity time. In addition to the objective data, participants answered 8 Likert scale usability questions about their experience wearing the PREEMPT device.</p><p><strong>Results: </strong>The measurements taken by the PREEMPT device were statistically equivalent to criterion data for all five metrics with a geometric mean ratio ranging from 0.97 to 0.99. Statistical significance values (p) ranged from 0.043 to < 0.001 depending on the metric. The device received an average total score of 9.4 out of 10 on the Likert scale usability questions, indicating that the prototypical device was comfortable to wear and well received.</p><p><strong>Discussion: </strong>These results demonstrate the initial validity and accuracy for the prototype PREEMPT device in healthy community-dwelling older adults as well as in hospitalized patients. The prototype PREEMPT device accurately measured physical activity in a relatively immobile population residing within a hospital setting.</p><p><strong>Reporting method: </strong>This paper adheres to STROBE guidelines.</p><p><strong>Trial registration: </strong>This research was not a clinical trial and did not require registration.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70236"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340656","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":"Digital Addiction and Body Balance: An Investigation of Postural Stability in Young Adults: A Cross-Sectional Study.","authors":"Yeliz Çırak, Hüsna Güzel, Buse Sert, Elif Sena Düşgün, Büşra Yeşil","doi":"10.1002/pri.70292","DOIUrl":"10.1002/pri.70292","url":null,"abstract":"<p><strong>Background and purpose: </strong>Excessive use of digital devices has become increasingly common among young adults and has been associated with postural changes and impaired balance control. Since postural stability is essential for daily activities and musculoskeletal health, understanding the impact of digital addiction on balance is important for physiotherapy and rehabilitation. This study aimed to compare postural balance performance between young adults with and without smartphone addiction and to examine the effects of attention-demanding tasks on balance control.</p><p><strong>Methods: </strong>This cross-sectional study included a total of 74 volunteer students (mean age = 22.06 ± 6.66 years; 68.9% female, 31.1% male) from the Department of Therapy and Rehabilitation at Fenerbahçe University. Participants were classified into smartphone-addicted and non-addicted groups based on the Smartphone Addiction Scale-Short Version (SAS-SV). Balance performance was assessed using the Becure Balance System under three conditions: eyes open, eyes closed, and texting.</p><p><strong>Results: </strong>Findings revealed that individuals with smartphone addiction (SA) exhibited significantly higher postural sway in the eyes-open condition compared with non-addicted individuals (p < 0.05). No significant differences were observed between groups under the eyes-closed condition (p > 0.05). During the texting task, smartphone-addicted individuals demonstrated lower postural sway values (p < 0.05). No significant differences were found between the groups in overall posture assessment.</p><p><strong>Discussion: </strong>The results indicate an association between smartphone addiction status and postural control during attention-demanding tasks, suggesting that digital dependency may be related to differences in motor control and postural stability mechanisms in young adults. Future studies should include larger and more diverse samples, integrate dynamic balance assessments, and utilize objective postural analysis methods to further clarify the relationship between smartphone addiction and postural stability.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70292"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473432","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":"Reliability of Pressure Pain Threshold Measurements of Upper and Lower Limb Muscles of Young Swimmers: An Observational Study.","authors":"Gabriela Carrion Caldeira Ribeiro, Flávia Alves de Carvalho, Heloísa Paes de Lima, Rafael Moreira de Castro Pereira Perez Espinoza, Isaque Machado da Silva, Ricardo Zacharias de Souza, Carlos Marcelo Pastre","doi":"10.1002/pri.70262","DOIUrl":"10.1002/pri.70262","url":null,"abstract":"<p><strong>Background and purpose: </strong>Objective measures should be combined with subjective assessments to monitor pain and discomfort, particularly in sports with a high prevalence of atraumatic injuries. Therefore, this study aimed to determine the reliability of pressure pain threshold (PPT) measurements in competitive swimmers and to explore the influence of intrinsic and extrinsic factors on PPT.</p><p><strong>Methods: </strong>Forty-seven swimmers were included in the study. PPT was measured bilaterally in 10 muscles of the upper and lower limbs and trunk using a hand-held algometer. Two trained physiotherapists performed four consecutive evaluations on the same day, with a 5-min interval between repeated measures, in randomized order to minimize carryover effects. Intrinsic variables included age, body mass index, shoulder pain, injury history, and years of practice. Extrinsic variables included swimming style, swimming distance, competitive level, training frequency, and training duration. Reliability was assessed using intraclass correlation coefficients, standard error of measurement, minimal detectable change, and coefficient of variation. The influence of intrinsic and extrinsic factors on PPT was explored using multivariate analysis of variance.</p><p><strong>Results: </strong>Reliability varied from good to excellent across all muscles, with ICC values between 0.75 and 0.95. Descriptive data indicated that swimmers competing at the national level had higher PPT values compared with regional/state athletes, and butterfly specialists showed slightly higher PPTs. Across all participants, lower limb muscles consistently exhibited higher PPT values than upper limb muscles (e.g., rectus femoris mean 4.2 kg/cm² vs. biceps brachii mean 2.8 kg/cm²).</p><p><strong>Conclusions: </strong>Reliability was high across all muscles, and PPT differences observed appear to reflect training level, stroke specialization, and muscle group characteristics rather than intrinsic or injury-related factors. Furthermore, applications up to 5 kgf are safe and well tolerated in the lower limb, which differs from the usual threshold of 2.55 kgf commonly used in the upper limb.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70262"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346866","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":"Diaphragm and Skeletal Muscle Changes During Intensive Care: Association With Patient Outcomes (DRASTIC): Observational Study.","authors":"George Ntoumenopoulos, Louise Hansell, Selina M Parry, Zudin Puthucheary","doi":"10.1002/pri.70250","DOIUrl":"10.1002/pri.70250","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit-acquired limb and diaphragm weakness contributes to delays in weaning from mechanical ventilation.</p><p><strong>Purpose: </strong>To determine the associations between measures of diaphragm excursion and thickness and rectus femoris/vastus intermedius thickness during an ICU admission and patient outcomes such as ICU-AW, mechanical ventilation duration and length of stay in ICU.</p><p><strong>Methods: </strong>Single-centre prospective cohort study undertaken in a tertiary referral metropolitan Australian mixed medical-surgical ICU of St Vincent's Hospital Sydney Australia. Inclusion of critically ill adult patients who were expected to remain mechanically ventilated for more than 48 h. Ultrasound measurements of right rectus femoris thickness, vastus intermedius thickness, and right hemidiaphragm thickness/excursion were taken on ICU admission and upon liberation from mechanical ventilation, in addition to Manual muscle strength (MRC-SS), the ICU mobility scale, and the Chelsea Critical Care Physical Assessment score on awakening and ICU discharge.</p><p><strong>Results: </strong>Forty-three participants were enrolled. Study participants were predominantly male (34, 79%) with a median (IQR) age of 55 (40.5-67.5) years, with a mean (SD) APACHE II score of 17.5 ± 6.2. There were reductions (median (IQR)) from ICU admission to liberation from ventilation in the thickness of the R rectus femoris and vastus intermedius by -17% (-37.1% to -4.2%) and -19.7% (-35.1% to -11.2%), respectively. The (R) end-expiratory diaphragm muscle thickness decreased, increased and remained unchanged after ventilator liberation in 19/34 (56%), 8/34 (24%) and 7/34 (20%), respectively. Multiple linear regression demonstrated that ICU discharge MRC-SS and (R) diaphragm excursion on ICU admission were associated with the ICU length of stay. The fitted regression model was ICU length of stay = 24.18 - (4.14 × cm of (R) diaphragm excursion) - (0.19 × ICU DC MRC-SS score).</p><p><strong>Discussion: </strong>Diaphragm excursion and muscle strength during ICU admission may be associated with ICU LOS. Further studies are needed to clarify their prognostic value.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70250"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279134","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}