Physiotherapy Research International最新文献

{"title":"Assistive Ambulatory Devices and Fall Risk in Older Adults: A Biomechanical and Behavioral Perspective.","authors":"Howe Liu","doi":"10.1002/pri.70267","DOIUrl":"10.1002/pri.70267","url":null,"abstract":"","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70267"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346857","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":"Association Between Gait Speed and Upper Limb Movement Time in Healthy Older Adults: Implications for Physiotherapy Practice.","authors":"Naveen Gurung, Ramesh Debur","doi":"10.1002/pri.70276","DOIUrl":"10.1002/pri.70276","url":null,"abstract":"<p><strong>Background and purpose: </strong>Movement time plays a crucial role in performing daily activities, although it is not typically recorded in physiotherapy practice. However, gait speed is regularly used as an overall mobility index in elderly people. As a result, gait speed can be a proxy for assessing motor function in general, not limited to gait alone. Thus, this research aims to investigate the relationship between gait speed and upper limb movement time in healthy older adults.</p><p><strong>Methods: </strong>This is a cross-sectional observational study involving 30 healthy community-dwelling older adults admitted to a tertiary care hospital. Gait speed was recorded using the GAITRite system by having participants walk at a self-selected comfortable pace. Upper limb movement time was evaluated using the Kinovea software while carrying out specific tasks from the Fugl-Meyer Upper Limb Assessment scale. The relationship between gait speed and upper limb movement time was analysed using the Spearman rank correlation coefficient.</p><p><strong>Results: </strong>A moderate inverse relationship was observed between gait speed and upper limb movement time (ρ = -0.44, p = 0.003; 95% CI: -0.66 to -0.15).</p><p><strong>Discussion: </strong>Gait speed is moderately associated with upper limb movement time in healthy older adults (ρ = -0.44), representing a moderate effect size; a substantial proportion of variance in upper limb performance remains independent of walking speed. These findings are associative in nature and suggest that upper limb movement time may complement gait speed in physiotherapy assessment; however, validation in larger, more diverse samples is needed before clinical translation.</p><p><strong>Trial registration: </strong>This study was registered with the Clinical Trials Registry-India (CTRI) (Registration Number: CTRI/2023/11/059756; Registration date: 13 November 2023).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70276"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363030","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":"AI-Based Exergaming as a Digital Assessment Tool for Post-Stroke Upper-Limb Function: Protocol for a Feasibility Study.","authors":"Júlia Tannús de Souza, Caroline Valentini de Queiroz, Daniel Hilário da Silva, Danilo Santos Rocha, Eduardo Lázaro Martins Naves","doi":"10.1002/pri.70237","DOIUrl":"10.1002/pri.70237","url":null,"abstract":"<p><strong>Background and purpose: </strong>Accurate assessment of upper limb motor function is critical for guiding effective rehabilitation strategies in stroke survivors. The Fugl-Meyer Assessment for Upper Extremity (FMA-UE) is a widely used clinical tool, yet it is time-consuming and subject to inter-patient variability. A low-cost, computer vision-based exergame was developed to provide a remote rehabilitation alternative that also enables motor assessment. This approach represents a promising alternative for scalable and objective assessment, but requires validation. This study aims to evaluate the feasibility and preliminary validity of a computer vision-based exergame system for assessing upper limb motor function in individual post-stroke. Specifically, it investigates correlations between kinematic features derived from gameplay and FMA-UE scores. It is expected that gameplay-derived metrics, such as range of motion, jitter index, and average hand angle, will show moderate to strong correlations with the FMA-UE, supporting the exergame's potential as a remote assessment tool.</p><p><strong>Methods: </strong>This is a cross-sectional feasibility and preliminary concurrent validity pilot study with 15-30 individuals with chronic stroke. Participants will perform a markerless camera-based exergame producing pseudo-3D hand coordinates using MediaPipe-based hand tracking. Kinematic features, including range of motion, average hand angle, and jitter index, will be extracted from gameplay. Each participant will also be evaluated using the FMA-UE by a certified therapist. Correlation and regression analyses will assess the relationship between exergame metrics and clinical scores. Usability will be assessed using the System Usability Scale (SUS).</p><p><strong>Results: </strong>We expect moderate to strong correlations between selected gameplay metrics and FMA-UE scores, particularly for range of motion, average hand angle, total traveled distance, jitter index, and score. The system is also expected to demonstrate high usability, indicating its feasibility for broader use in rehabilitation settings.</p><p><strong>Discussion: </strong>If validated, the proposed exergame may serve as an accessible and scalable digital tool to support future development of objective assessment tools in stroke rehabilitation, potentially reducing clinical workload and enabling remote evaluations. A future large-scale study will evaluate test-retest reliability, longitudinal responsiveness, and home-based implementation.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70237"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036379","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":"'It Felt Safe'. Experiences With an Early Cognitive Behavioural Approach After Lumbar Spinal Surgery: A Qualitative Study of Participants' Perspectives.","authors":"Heidi Tegner, Ida Wentzel Winther, Nanna Rolving, Dorte Barfred Stisen, Mette Errebo, Bente Appel Esbensen","doi":"10.1002/pri.70282","DOIUrl":"10.1002/pri.70282","url":null,"abstract":"<p><strong>Background and purpose: </strong>In patients undergoing lumbar spinal fusion, a randomised controlled trial examined the effect of an early cognitive behavioural rehabilitation intervention designed to reduce sedentary behaviour. The intervention consisted of graded activity and pain education (GAPE). The objective of this qualitative study was to explore participants' experiences with GAPE following the three-month intervention period.</p><p><strong>Methods: </strong>This study employed an interpretive qualitative design. Participants were purposefully recruited 3 months post-surgery. Semi-structured individual interviews were conducted, and data were analysed using a Template Analysis approach by a research group adopting an intermediate epistemological stance.</p><p><strong>Results: </strong>A total of 11 participants were included. Based on the data, a final template was developed comprising four themes and associated subthemes: (1) An angel in the house post-surgery, (2) Embodied experiences and regaining control, (3) Master in my own house, and (4) Bridging personalised rehabilitation across settings. The study showed that GAPE provided meaningful support during the early post-surgical period after lumbar spinal fusion. Important factors included individually formulated goals, a strong therapeutic alliance, appropriate timing, and graded activity. These components helped participants understand their bodies and pain, thereby enhancing their safety and bodily confidence. Trusting relationships with physiotherapists and home-based sessions made rehabilitation both manageable and personally meaningful.</p><p><strong>Discussion: </strong>Overall, GAPE supported participants' early recovery after lumbar spinal fusion by combining personalised goals, trusting therapeutic relationships, and home-based, graded activity, thereby enhancing bodily confidence and making rehabilitation manageable and meaningful. Strengths of the study include participant diversity and a reflexive, multidisciplinary research team, which strengthened data richness and transparency. However, the overrepresentation of highly educated participants and researcher involvement in intervention development may limit generalisability and introduce potential bias.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70282"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438383","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":"Linking the Pre-Assessment Information Form (PIF) to the ICF: Enhancing Standardized Functional Assessment in Parkinson's Disease.","authors":"Fernanda Botta Tarallo Rogatto, Érica Tardelli Neves Guelfi, Vívian Elaine Vargas Alflen, Leandro Bruno Barbosa Silva, Gabriela Santos Pereira, Soraia Micaela Silva","doi":"10.1002/pri.70247","DOIUrl":"10.1002/pri.70247","url":null,"abstract":"<p><strong>Background and purpose: </strong>Systematic documentation of functioning in people with Parkinson's disease (pwPD) requires a standardized language to enable comparability across services and countries. The International Classification of Functioning, Disability and Health (ICF) provides this framework; however, instruments recommended by the European Physiotherapy Guideline for Parkinson's disease have not previously been linked to its categories. This study aimed to link items from the Pre-Assessment Information Form (PIF) to ICF categories using the refined linking rules.</p><p><strong>Methods: </strong>Methodological study. Two independent evaluators with extensive knowledge of the ICF taxonomic framework applied 10 refined linking rules to 26 PIF items, working independently and blindly. Disagreements were resolved by a third evaluator with prior ICF experience. Inter-rater agreement was assessed using the Kappa coefficient (95% confidence interval).</p><p><strong>Results: </strong>Initial inter-rater agreement was moderate across all ICF taxonomy levels (k = 0.42-0.54; p < 0.001), decreasing as category specificity increased. Following a final consensus, 26 PIF items were linked to 25 unique ICF categories and 34 linked concepts across two components: Activities and Participation (21 categories; 84.0%) and Body Functions (4 categories; 16.0%). Within Activities and Participation, categories were predominantly distributed in the d4 Mobility domain (14 categories; 66.7%), followed by d5 Self-care (4; 19.0%), d6 Domestic Life (2; 9.5%), and d2 General Tasks and Demands (1; 4.8%). Secondary concepts were identified for seven items.</p><p><strong>Discussion: </strong>The resulting set of 25 ICF categories provides a structured description of the mobility and body function domains represented in the instrument. The application of ICF qualifiers to grade the severity of patient-reported limitations represents a potential next step, subject to implementation and validation in applied clinical settings.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70247"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253919","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":"Recovery After Primary Knee Surgery Rehabilitation: Patients' Perspectives on Physical Activity and Quality of Life.","authors":"José Moreira, Rogério Ferreira, Elisabete Alves, José Flamínio, António Lista, Rui Raimundo, Armando Raimundo, Manuel Almeida, Paulo Boto","doi":"10.1002/pri.70298","DOIUrl":"10.1002/pri.70298","url":null,"abstract":"<p><strong>Background: </strong>Recovery after primary knee surgery is a complex process that may affect physical activity, confidence, and quality of life. Understanding patients' experiences after rehabilitation is important for person-centred follow-up and post-discharge care.</p><p><strong>Aim: </strong>To explore how patients perceived recovery, motivation to engage in physical activity, and quality of life after a rehabilitation programme following primary knee surgery.</p><p><strong>Methods: </strong>Between April and September 2024, adults who had completed a rehabilitation program following primary knee surgery were interviewed six months after completing the intervention. Semi-structured face-to-face interviews were audio-recorded, transcribed verbatim, and returned to participants for checking. Data were analysed using qualitative content analysis.</p><p><strong>Results: </strong>Of 12 patients screened for eligibility, 11 met the inclusion criteria, all 10 (consented) completed the interview and none refused participation or dropped out. Three interrelated categories were identified: changing dependency across the recovery trajectory, quality of life after the rehabilitation programme, and motivation for physical activity. Participants described recovery as shaped by both physical and psychological factors, including symptom burden, fear of re-injury, confidence, professional guidance, access to resources, and support for self-management.</p><p><strong>Conclusions: </strong>Recovery after primary knee surgery was described not only as a functional process but also as one shaped by confidence, self-management, and motivation to engage in physical activity. Follow-up after knee surgery rehabilitation should address self-care, confidence, tailored guidance for physical activity, and access to supportive resources to improve long-term recovery and quality of life.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70298"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498113","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":"Reproducibility of the 6-Minute Step Test in Individuals on Hemodialysis.","authors":"Heverson Felipe Pranches Carneiro, Thamiê Cristina Stella, Ivan Peres Costa, Luciana Maria Malosá Sampaio","doi":"10.1002/pri.70291","DOIUrl":"10.1002/pri.70291","url":null,"abstract":"<p><strong>Background: </strong>Functional impairments are common in individuals with end-stage renal disease (ESRD) undergoing hemodialysis (HD); however, the clinical assessment of physical function remains challenging due to the limited availability of simple and reliable functional tests validated for this population.</p><p><strong>Purpose: </strong>To evaluate the test-retest reproducibility of the 6-minute step test (6MST) in individuals undergoing HD, including the interpretation of measurement error.</p><p><strong>Methods: </strong>This was a cross-sectional, test retest- reliability study conducted in patients receiving maintenance HD. All assessments were performed immediately before the HD session. Participants completed the Kidney Disease Quality of Life 36-Item Short Form questionnaire (KDQOL SF-36) and performed two 6MSTs under standardized conditions. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Absolute reliability was evaluated through the standard error of measurement (SEM) and minimal detectable change (MDC). Agreement between tests was examined using Bland-Altman analysis.</p><p><strong>Results: </strong>Fifty patients completed both test sessions. The 6MST demonstrated good test-retest reliability for total steps (ICC = 0.80), with most differences between tests remaining below the MDC95, indicating the absence of a clinically meaningful learning effect. Bland-Altman analysis showed minimal bias and acceptable limits of agreement for both total steps and heart rate measured at the sixth minute of the test. Physiological responses, including oxygen saturation, blood pressure, and perceived exertion, remained stable between sessions.</p><p><strong>Discussion: </strong>The 6 minute step test is a reliable and clinically applicable tool for assessing functional capacity in individuals undergoing hemodialysis. The absence of a relevant learning effect and the stability of physiological responses support its use for functional assessment and follow-up, even when performed before the hemodialysis session. Further studies should investigate inter-rater reproducibility and responsiveness to interventions.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70291"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550787","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":"Effect of Feldenkrais Method in Enhancing Postural Control for Patients With Diabetic Polyneuropathy.","authors":"Ahmed M Elshinnawy, Zeezy S Eraky, Mohamed Nabil Fiaad, Ahmed Mohamed Ahmed Mostafa, Islam H Fayed","doi":"10.1002/pri.70233","DOIUrl":"10.1002/pri.70233","url":null,"abstract":"<p><strong>Background: </strong>Diabetic polyneuropathy (DPN) contributes to impaired postural control and increases the risk of falls due to sensory and motor deficits. The Feldenkrais Method (FM), a sensorimotor approach that enhances body awareness and coordination, may offer therapeutic benefits in addressing these challenges.</p><p><strong>Objective: </strong>To evaluate the effectiveness of the Feldenkrais Method in improving dynamic balance, postural control, fear of falling, and quality of life in adults with DPN.</p><p><strong>Methods: </strong>Twenty-six participants aged 45-60 years with DPN were randomized into a study group receiving FM-based training or a control group receiving conventional balance training. Both interventions were administered twice weekly for 24 weeks. Primary outcomes included Timed Up and Go (TUG), limits of stability (LoS), Falls Efficacy Scale (FES), and Diabetes-39 Questionnaire for quality of life (QoL). Data were analyzed using repeated-measures ANOVA and post hoc Bonferroni tests.</p><p><strong>Results: </strong>Significant post-intervention improvements were observed in the FM group across all outcomes: TUG (p = 0.0001), LoS (p = 0.0001), FES (p = 0.0001), and QoL (p = 0.0001). Furthermore, the FM group demonstrated statistically significant superiority over the control group in all primary and secondary measures (p < 0.05). The control group showed no statistically significant changes.</p><p><strong>Conclusion: </strong>The Feldenkrais Method appears effective in enhancing balance, postural control, and quality of life in individuals with DPN. These results support its integration into neurorehabilitation programs.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70233"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007040","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 Efficacy of Dynamic Taping and Tissue Flossing Combined With Resistance Band Training on Dynamic Balance, Jump Performance, Agility, Sprint Velocity, and Lower Limb Strength in Young Football Players: A Randomized Controlled Trial Protocol.","authors":"Mohd Asif, Mohammad Sidiq, Jyoti Sharma","doi":"10.1002/pri.70241","DOIUrl":"10.1002/pri.70241","url":null,"abstract":"<p><strong>Background: </strong>Football is a physiologically demanding sport that places large biomechanical loads on the lower limbs, predisposing adolescent players to knee and ankle injuries. Agility, dynamic balance and lower-extremity strength are therefore central to both performance and injury prevention. Emerging adjuncts such as dynamic taping and tissue flossing, combined with neuromuscular resistance-band training, have shown promise for enhancing performance metrics and lowering injury risk.</p><p><strong>Methods: </strong>This will be a three-arm, parallel-group, randomized controlled trial adhering to CONSORT 2025 and SPIRIT 2013 guidelines. Eighty-one male footballers aged 14-18 years (BMI 18.5-24.9 kg m^-2, ≥ 1-year competitive experience, no lower-limb injury in the preceding 6 months) will be recruited from Delhi-NCR academies. Participants will be block-randomized (block size 7) in a 1:1:1 ratio to (A) dynamic taping plus resistance-band training, (B) tissue flossing plus resistance-band training, or (C) resistance-band training only. The 4-week intervention will be delivered three times per week (≈35 min session^-1) by certified sports physiotherapists.</p><p><strong>Primary outcome: </strong>change in the Y-Balance Test composite score at 4 weeks.</p><p><strong>Secondary outcomes: </strong>counter-movement jump height, T-test agility, 40-m sprint time, and 1-RM squat and dead-lift. Sample size was computed with G*Power 3.1.9.7 for repeated-measures ANOVA (effect size 0.25, α 0.05, power 0.80, 3 groups, 4 measurements, 20% attrition), yielding 81 participants.</p><p><strong>Discussion: </strong>Results will clarify the relative benefits of adding dynamic taping or tissue flossing to standard resistance-band training in youth football. Findings will inform evidence-based non-invasive conditioning and rehabilitation strategies for physiotherapists and coaches.</p><p><strong>Conclusions: </strong>This will be the first three-arm, parallel-group RCT to quantify the isolated and additive effects of dynamic taping and tissue flossing when super-imposed on a standardized, youth-specific resistance-band program. The trial is powered to detect a 6-point between-group difference in the Y-Balance composite score (MCID = 5.5) and is prospectively registered with an openly available SAP. In case either adjunct is better, clinicians can immediately have an inexpensive tool to boost balance, sprint capacity and lower-limb strength in adolescent footballers, hence decreasing injury burden. To confirm long-term stability, involve female participants, and incorporate mechanistic functions (e.g., EMG, motion-capture) to elucidate neuro-muscular pathways, longer-term multi-center trials are needed.</p><p><strong>Trial registration: </strong>Clinical Trial Registry of India CTRI/2025/02/079841 (registered 09 September 2024).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70241"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018081","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 Impact of Gender on the Landing Error Scoring System: A Systematic Review and Meta-Analysis.","authors":"Mohammad Seyedahmadi, Ahmad Ebrahimi Atri, Behnaz Shahtahmassebi, Hadi Akbari","doi":"10.1002/pri.70230","DOIUrl":"10.1002/pri.70230","url":null,"abstract":"<p><strong>Background: </strong>Women are more likely than men to experience injuries to the anterior cruciate ligament (ACL). Biomechanical differences, assessed using tools such as the Landing Error Scoring System (LESS), may contribute to this risk. The LESS does not directly influence ACL injury risk but helps identify individuals who might be at higher risk. However, conflicting findings in the literature prevent clear conclusions about sex-based differences in LESS scores. This study systematically reviews and meta-analyzes research examining the influence of sex on LESS scores.</p><p><strong>Methods: </strong>Four databases (ScienceDirect, PubMed, Web of Science, and Scopus) were searched from 2009 (when LESS was introduced) to May 21, 2024. Only studies evaluating the impact of sex on LESS scores were included. Studies were screened for bias risk and critically appraised. A meta-analysis was performed utilizing a random-effects model, where sex served as the independent variable and LESS scores represented the dependent variable. The quality of evidence was assessed with the GRADE criteria. This study was registered with PROSPERO.</p><p><strong>Results: </strong>Sixteen studies met the inclusion criteria. Females showed significantly higher LESS scores than males (p < 0.0001), with a mean difference of 0.62 errors. However, substantial heterogeneity was observed across studies, and the overall quality of evidence was rated as very low according to GRADE.</p><p><strong>Conclusions: </strong>Although a statistically significant difference between sexes was identified, the mean difference of 0.62 errors is not clinically meaningful. The findings should be interpreted with caution due to their high heterogeneity and very low-quality evidence. Furthermore, sex differences in LESS scores may be context-dependent and influenced by population characteristics and study conditions.</p><p><strong>Trial registration: </strong>PROSPERO (CRD 42023470540, October 19, 2023).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70230"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965099","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}