Physiotherapy Research International最新文献

{"title":"Comparative Efficacy of Abdominal Exercises and Abdominal Binding on Diastasis Recti Abdominis Reduction in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Abdullah, Khawaja Abdul Rehman, Bilal Ahmad, Muhammad Khubaib Arshad, Humza Saeed, Mahnoor Asghar Keen, Amna Anwar, Noor Ul Ain Saleem, Umm E Salma Shabbar Banatwala, Zara Bilal, Maryam Shahzad, Pakeeza Shakoor, Muhammad Ahsen Niazi","doi":"10.1002/pri.70038","DOIUrl":"10.1002/pri.70038","url":null,"abstract":"<p><strong>Background and purpose: </strong>Diastasis Recti Abdominis (DRA) is a separation of the rectus abdominis muscles which often results from pregnancy. This meta-analysis aims to identify the most effective non-surgical treatment to reduce post-partum DRA.</p><p><strong>Methods: </strong>A comprehensive search was performed on electronic databases including PubMed, Cochrane, and Embase databases for RCTs involving abdominal or pelvic muscle exercises, and abdominal binding for DRA Reduction. Primary outcomes included inter-recti distance (IRD) Resolution, Oswestry Disability Index (ODI) score, and Pelvic Floor Disability Index (PFDI) score. ROB 2.0 tool was used for the risk of bias assessment of RCTs. Meta-analysis was performed using Review Manager version 5.4. Sensitivity analysis was conducted to determine the influence of studies on the overall results. Meta regression was performed using R version 4.4 to identify the sources of heterogeneity.</p><p><strong>Results: </strong>Thirteen RCTs were included in the analysis. Abdominal exercise significantly reduced IRD below the umbilicus compared with abdominal binding (Mean difference [MD] = -0.31, 95% CI: -0.53 to -0.10, p = 0.004) but was ineffective for IRD resolution ≥ 2 cm above the umbilicus (MD = 0.22, 95% CI: -1.43 to 1.88, p = 0.79). Compared with no intervention, abdominal exercise significantly reduced IRD below the umbilicus (MD = -0.31, 95% CI: -0.53 to -0.10, p = 0.004) but was ineffective in IRD resolution ≥ 2 cm above the umbilicus (MD = 0.11, 95% CI: -0.38 to 0.59, p = 0.67). No significant reduction was found in the ODI score (MD = -5.57, 95% CI: -19.31 to 8.17, p = 0.43) and PFDI score (MD = -12.99, 95% CI: -43.49 to 17.51, p = 0.04).</p><p><strong>Discussion: </strong>Abdominal exercises reduce IRD below the umbilicus more effectively than binding and no intervention, but their effectiveness above the umbilicus is unclear. ODI and PFDI showed no significant improvement. Further research with standardized criteria and diverse population is needed to clarify the efficacy of these treatments for diastasis recti.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70038"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524842","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":"Physiotherapists' Practices on Assessing Hospitalised Older Patients: What Are the Current Gaps?","authors":"Elisângela Cristina Ramos Hernandes, Geovanna Maria de Moura, Adriana Lunardi, Luciana Chiavegato, Monica Rodrigues Perracini","doi":"10.1002/pri.70051","DOIUrl":"10.1002/pri.70051","url":null,"abstract":"<p><strong>Background and purpose: </strong>Incorporating Person-centred Care (PCC) and Comprehensive Geriatric Assessment (CGA) practices for hospitalised patients result in positive health outcomes. We aimed to identify the frequency of incorporating PCC and CGA practices among physiotherapists (PTs) working in hospitals and its association with PTs' gender, years of experience, and duration of physiotherapy sessions and to identify the barriers to assessing older patients in the hospital.</p><p><strong>Methods: </strong>Cross-sectional survey with physiotherapists working in hospitals using a questionnaire including PTs characteristics, barriers and the frequency of incorporation of PCC and CGA practices, using a Likert scale. An ordinal regression analysis was conducted.</p><p><strong>Results: </strong>Male PTs, compared to females, were less likely to consider the patient's and family's feelings (OR = 0.35; p = < 0.001), use appropriate language (OR = 0.42; p = 0.04), embrace the patient's feelings (OR = 0.28; p = < 0.001), adapts their communication (OR = 0.33; p = 0.006) and used encouragement and negotiation strategies (OR = 0.52; p = 0.02). Less experienced PTs (< 2 years) tended not to value older patients' choices (OR = 0.08; p = 0.03), share assessments with families (OR = 0.39; p < 0.001), define a care plan (OR = 0.61; p = 0.02), and embrace the patient's feelings, compared to more experienced ones. PTs conducting quick assessments (< 10 min) were less likely to provide feedback (OR = 0.26; p = 0.006), share assessments with families (OR = 0.09; p < 0.001), define a care plan (OR = 0.22; p < 0.001), assess social conditions (OR = 0.34; p = 0.009), falls (OR = 0.06; p = 0.007), sarcopenia (OR = 0.18; p = 0.002), frailty (OR = 0.27; p = 0.006), provide prognosis (OR = 0.29; p = 0.002), consider older patients' goals (OR = 0.21; p = 0.04) and plan discharge (OR = 0.23; p < 0.001). The main barriers were related to patients' health conditions and the limitations of time and resources.</p><p><strong>Discussion: </strong>Incorporating PCC and CGA practices by PTs in the hospital seems to be linked to the characteristics of PTs and their availability of time. Educational and organizational interventions to foster PCC and CGA are needed.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70051"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744237","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":"Immediate Impact of Assisted Autogenic Drainage on Diaphragmatic Function: A Case Report.","authors":"Sara Rúbia de Souza Franco, Bárbara Bernardo Figueirêdo, Naiara Kássia Macêdo da Silva Bezerra, Paulo André Freire Magalhães","doi":"10.1002/pri.70039","DOIUrl":"10.1002/pri.70039","url":null,"abstract":"<p><strong>Background and purpose: </strong>Assisted Autogenic Drainage (AAD) is suggested as a promising technique for effective secretion removal, especially in non-cooperative patients, including infants. However, there is a scarcity regarding the effects of AAD on diaphragmatic function. This study aimed to evaluate the immediate effect of the AAD technique on diaphragmatic function in a healthy infant.</p><p><strong>Methods: </strong>Case Presentation-This exploratory case study involved a healthy 1-year-and-2-month-old female infant. CARE case reporting guidelines were followed. After collecting demographic data, the AAD technique was applied for 5 min using an abdominal belt. Diaphragmatic function, including excursion (DE) and contraction velocity (CV), was assessed via ultrasonography before and after the intervention.</p><p><strong>Results: </strong>Post-intervention, significant increases in inspiratory DE (12.08-18.57 mm), expiratory DE (9.28-16.33 mm), and CV (17.14 to 27.65 mm/s) were noted, indicating that AAD positively impacts diaphragmatic function. These results reflect a notable improvement in diaphragmatic mobility.</p><p><strong>Discussion: </strong>With regard to the potential mechanism, the increased diaphragmatic excursion observed may be attributed to a temporary enhancement of thoracoabdominal synchrony. The abdominal belt utilized during the intervention likely provided stability to the abdominal muscles and the zone of apposition of the diaphragm. Further studies are needed to investigate how long these effects persist.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70039"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450557","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":"Non-Invasive Ventilatory Support as a Tool to Improve Exercise Tolerance in Patients With Heart Failure: A Systematic Review With Meta-Analysis.","authors":"Jessiane Bianca Pinheiro da Silva, Maria Carolina Rosário Santana, Bruno Prata Martinez, Helder Brito Duarte","doi":"10.1002/pri.70037","DOIUrl":"10.1002/pri.70037","url":null,"abstract":"<p><strong>Background and purpose: </strong>Heart failure (HF) is a complex syndrome that impacts persons' daily activities and adherence to exercise programs. Non-Invasive ventilation (NIV) reduces respiratory load and improves cardiac function, potentially serving as an important adjunct in its treatment. These effects can be enhanced with a cardiac rehabilitation program, improving dyspnea and functionality. This study aimed to evaluate the effects of NIV during exercise on functional performance outcomes, dyspnea, QL, hemodynamics, and respiratory function.</p><p><strong>Methods: </strong>A systematic review followed by meta-analysis was conducted. Searches were performed in PubMed, CENTRAL, Embase, LILACS, SciELO, and CINAHL.</p><p><strong>Eligibility criteria: </strong>Randomized clinical trials of patients over 18 years of age with HF, compared to a control group, were included with the objective of improving exercise tolerance. The studies were categorized as short-term effects of NIV and those implementing an exercise program.</p><p><strong>Results: </strong>Seven studies were included in the qualitative review and five in the meta-analysis. Only two studies presented a low risk of bias. The analyzed outcomes were the 6-min walk test (6MWT), dyspnea, SpO2, heart rate (HR), systolic, and diastolic arterial pressure (SAP and DAP, respectively), maximal inspiratory and expiratory muscle strength (MIP and MEP, respectively), forced expiratory volume in one second (FEV1), and quality of life (QL).</p><p><strong>Discussion: </strong>There was a significant difference in favor of the NIV group compared to the control group in both modalities in relation to the 6MWT, with a mean difference (MD) 41.72 (CI 95% 2.15, 81.29) meters in the exercise program and MD 68.61 (CI 95% 5.69, 131.54) meters in short-term effect studies. There were also favorable results in the outcomes of dyspnea and FEV1 in the NIV group (p < 0.01). There were no statistically significant differences in the outcomes peripheral oxygen saturation (p = 0.11), systolic (p = 0.76) and diastolic blood pressure (p = 0.93), heart rate (p = 0.19), MIP (p = 0.49), MEP (p = 0.22) and QL (p = 0.13).</p><p><strong>Trail registration: </strong>PROSPERO CRD42022367746.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70037"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442327","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":"High-Intensity Functional Activities Specific Training (FAST) in Post-Stroke Rehabilitation: A Randomized Trial on Motor Recovery and Quality of Life Improvements.","authors":"Ayesha Afridi, Arshad Nawaz Malik, Farooq Azam Rathore","doi":"10.1002/pri.70064","DOIUrl":"https://doi.org/10.1002/pri.70064","url":null,"abstract":"<p><strong>Background: </strong>Stroke often leads to long-term disability, impacting motor function, mobility, and quality of life. However, the effectiveness of different intensities of functional training in improving these outcomes in stroke rehabilitation is not well established.</p><p><strong>Purpose: </strong>This study aimed to determine the effects of different intensities of functional activities specific training on upper extremity function, mobility, fall risk, and quality of life in stroke patients.</p><p><strong>Methods: </strong>This randomized controlled trial was conducted in a rehabilitation setting (PRH Islamabad) with age 40-60 years and 3 months post-stroke. Participants (N = 99) were randomly (simple) assigned to conventional therapy, moderate-intensity, or high-intensity training with 33 in each group. Eligibility criteria included a Montreal Cognitive Assessment score of 18-25, Fugl-Meyer Assessment score of 50-70 and a Modified Rankin Scale score of 3 and 4, suggesting moderate motor impairment and moderate to severe disability, respectively. Participants with severe spasticity, inability to follow two-step commands, concurrent stroke treatments, other neurological conditions, and a history of falls were excluded. The 12-week training program utilized the FAST-Table, and outcomes including Fugl-Meyer Assessment for upper extremity, Berg Balance Scale, and Stroke-Specific Quality of Life Urdu scale-were assessed at baseline, 4, 8, and 12 weeks.</p><p><strong>Results: </strong>The mean age of participants were 65.4 ± 7.2 years, gender (52% male, 48% female, ischemic 70%, and hemorrhagic 30%). The high-intensity group showed significant improvements in Fugl-Meyer Assessment-Upper Extremity scores at weeks 8 and 12 (p < 0.05), Timed Up and Go test (p < 0.05), Berg Balance Scale scores (p < 0.05), and Stroke-Specific Quality of Life Urdu scale (p < 0.05). Moderate-intensity and conventional groups also showed improvements individually.</p><p><strong>Discussion: </strong>High-intensity functional training leads to greater improvements in physical performance and quality of life in stroke survivors compared with moderate-intensity functional training and conventional therapies.</p><p><strong>Trial registration: </strong>https://clinicaltrials.gov/ (NCT05158543).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70064"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050186","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":"Combined Activity-Based Therapy and Cervical Spinal Cord Stimulation: Active Ingredients, Targets and Mechanisms of Actions to Optimize Neurorestoration of Upper Limb Function After Cervical Spinal Cord Injury.","authors":"Urvashy Gopaul, Mark Theodore Bayley, Sukhvinder Kalsi-Ryan","doi":"10.1002/pri.70036","DOIUrl":"10.1002/pri.70036","url":null,"abstract":"<p><strong>Background: </strong>Improving hand and arm function is an important goal for individuals with cervical spinal cord injury (cSCI). Activity Based Therapy (ABT) is a neurorestorative approach that incorporates a high intensity, long duration and effortful engagement to garner sensory-motor improvements. Spinal cord stimulation is a neuromodulation modality that can restore sensory-motor function. Spinal cord stimulation can elevate the excitability of the spinal neural network and potentially enhance the neurorestorative benefits of ABT. However, there is scarce evidence on the combined effects of ABT and spinal cord stimulation on UL recovery after cSCI.</p><p><strong>Objective: </strong>This report aims to describe how theory informed the design and development of a Phase 1 study on a new UL intervention combining ABT and transcutaneous cervical spinal cord stimulation (tCSCS) (short form:ABT-tCSCS) delivered simultaneously for individuals with cSCI.</p><p><strong>Method: </strong>The design of the ABT-tCSCS was guided by theory-based frameworks such as the Rehabilitation treatment specification system and the Template for Intervention Description and Replication guide. The ABT-TCSCS aimed to improve somatosensory-motor deficits and function in the UL after cSCI. The ABT-tCSCS intervention was developed through the following stages: (a) Description of the active ingredients, mechanism of action, and targets of the ABT-tCSCS; (b) Tailoring of ABT-tCSCS; and (c) Development of treatment regimen guidelines for the delivery of the ABT-tCSCS.</p><p><strong>Results: </strong>ABT constitutes 4 types of exercises, including cardio-fitness, resistance, postural/weightbearing, and functional exercises, for activation of the neuromuscular system below the level of lesion to target somatosensory-motor impairments. In tCSCS, electrical stimulation is delivered at a frequency of 30-50 Hz at 500-1000 μs between C3-C7. The spinal neural networks of the cervical region are stimulated to neuromodulate the descending motor commands which control the muscles. ABT-tCSCS will be delivered simultaneously over 28 sessions (1 h/session, 3x/week over 9-10 weeks).</p><p><strong>Conclusions: </strong>Combined ABT-tCSCS is a new intervention for neurorestoration of the upper limbs after cSCI.</p><p><strong>Trail registration: </strong>ClinicalTrials.gov ID: NCT06472986.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70036"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383585","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":"Sexual Function and Quality of Life in Individuals Post Stroke.","authors":"Danielle Schneider, Nicolette Comley-White","doi":"10.1002/pri.70004","DOIUrl":"10.1002/pri.70004","url":null,"abstract":"<p><strong>Background: </strong>Sexual function is commonly affected post stroke and impacts an individual's quality of life. This study aimed to determine the factors associated with sexual function in an individual post stroke and the association with quality of life.</p><p><strong>Method: </strong>This cross-sectional study included 56 participants who had a stroke between three and 24 months prior. The participants were assessed for: level of disability with the Modified Rankin Scale (MRS); quality of life with the Stroke Specific Quality of Life scale (SSQOL); and sexual function with the Changes in Sexual Functioning Questionnaire (CSFQ-14), and an open-ended questionnaire was administered.</p><p><strong>Results: </strong>The average age of the participants was 51.32 (SD = ±13.24) years, with 32 (57.1%) males and 24 (42.9%) females. According to the CSFQ-14, the majority of the study participants (n = 35, 62.5%) had sexual dysfunction after their stroke. The factors associated with sexual dysfunction post stroke included age, disability, comorbidities, psychosocial factors such as self-esteem, role changes, and depression. Those with sexual dysfunction were found to have a lower mean SSQOL score (139.94 ± 33.89) than those without sexual dysfunction (149.76 ± 33.77), however, there was no significant difference (p = 0.298) between the groups. Majority of the participants (n = 37; 66.1%) did not know that healthcare professionals can assist with sexual dysfunction.</p><p><strong>Conclusion: </strong>The majority of participants experienced sexual dysfunction after their stroke. Factors such as pain, difficulty with positioning, self-esteem issues, lack of motivation, and change in desire, are important considerations for the multidisciplinary team in the rehabilitation of a patient's sexual function post stroke.</p><p><strong>Trial registration: </strong>This cross-sectional study did not require study registration.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 1","pages":"e70004"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630302","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":"Anticipatory and Compensatory Postural Adjustments in Sitting and Standing Positions During Functional Activities in Children With Cerebral Palsy.","authors":"Priyal Vasani, Amitesh Narayan, Akshatha Nayak, Mohammed Alsulaimani, Abdul Rahman Alzahrani","doi":"10.1002/pri.70028","DOIUrl":"10.1002/pri.70028","url":null,"abstract":"<p><strong>Background and purpose: </strong>Anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA) have played a vital role in postural control since early childhood, which is critical to accomplishing activities in daily life. However, literature indicated dissimilarities and inconsistencies in APA and CPA analysis in sitting and standing positions in children with Cerebral Palsy (CP). Thus, this study analyzed the changes in postural control (APA and CPA) through the postural muscles [rectus abdominis (RA) and erector spinae (ES)] in both standing and sitting positions during functional activities (grasping a ball) in children with CP.</p><p><strong>Methods: </strong>Children with CP [N = 21] aged 5-13 years having GMFCS levels I (n = 12) and II (n = 9) participated. Surface electromyography (EMG) was performed for postural muscles (ES and RA) to measure the APA and CPA with two types of loads (heavy and light) in both sitting and standing positions.</p><p><strong>Results: </strong>Children with CP showed increased EMG amplitude for APA and CPA with a heavier load than light load in sitting and standing positions. The EMG amplitude of CPA in sitting and standing for both load conditions was significantly higher than that of APA.</p><p><strong>Discussion: </strong>The findings suggest rehabilitation programs should enhance APA and CPA through targeted exercises and load management strategies. These insights have the potential to inform clinical practices, improve postural stability, and ultimately strengthen the ability of children with CP to perform daily activities with greater ease and confidence, thereby significantly impacting the quality of life.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 1","pages":"e70028"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972609","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":"The Effectiveness of Telemedicine in Hypertension Management of Adults in Rural Communities: A Systematic Review and Meta-Analysis.","authors":"Valentin Dones, Abigail Anne G Velasquez, Maureen G Dacuya, Kirsten Ermengild T Ignacio, Ella Teresa M Cavite, Ronan S Ibuna, Christian Rey D Rimando","doi":"10.1002/pri.70014","DOIUrl":"10.1002/pri.70014","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has emerged as an effective approach for managing hypertension, particularly in rural areas where healthcare access is limited. This review evaluates telemedicine's role in providing essential remote healthcare services for hypertension management.</p><p><strong>Objective: </strong>We determined the effectiveness of telemedicine versus the usual care in hypertension management among adults living in rural settings.</p><p><strong>Methods: </strong>We conducted a systematic review of randomized controlled trials (RCTs) focusing on adults aged 18 and older with hypertension (blood pressure ≥ 140/90 mmHg) using telehealth services in rural or community-based settings. We searched nine databases, including PubMed, ScienceDirect, and ProQuest, up to April 2024, without restrictions on language or publication year, focusing only on human subjects. Five pairs of reviewers independently screened and selected studies using predefined eligibility criteria. Methodological quality was assessed using the Revised Cochrane Collaboration Risk of Bias tool, and data synthesis was performed using a random-effects model due to study heterogeneity. Evidence quality was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Nine randomized trials were included. Pooled data showed no clinically significant differences between telehealth and control groups in improving systolic blood pressure (SBP), diastolic blood pressure (DBP), and their changes over time. The mean difference (MD) of SBP in five trials was 0.78 mmHg lower (95% CI: 2.49 lower to 0.94 higher), and the SBP change showed a mean reduction of 2.29 mmHg (95% CI: 4.76 lower to 0.19 higher). DBP in five trials had a mean increase of 0.46 mmHg (95% CI: 0.73 lower to 1.64 higher), and DBP change in six trials showed a mean decrease of 0.83 mmHg (95% CI: 2.34 lower to 0.68 higher). Additionally, telehealth showed varying impacts on BMI and HbA1c levels, with one study reporting a higher BMI increase in the intervention group, while two other studies indicated that mobile health improved HbA1c levels and controlled blood pressure as effectively as standard care.</p><p><strong>Limitations: </strong>Study heterogeneity, selection, and performance biases, as well as varying healthcare contexts, limited the generalizability of findings.</p><p><strong>Conclusion: </strong>Telemedicine is as effective as usual care in managing hypertension among adults in rural settings, providing a viable solution for improving healthcare access in these areas. Future research should address biases and explore long-term impacts to optimize telemedicine's effectiveness in diverse populations.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 1","pages":"e70014"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787341","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":"Facilitators and Barriers for Physiotherapists to Engage in Goal-Setting With Patients During Their Hospital Stay-An Explanatory Sequential Mixed-Methods Study.","authors":"Linda Baumbach, Wiebke Feddern, Friederike Grube, Hans-Helmut König, André Hajek, Susanne G R Klotz","doi":"10.1002/pri.70024","DOIUrl":"10.1002/pri.70024","url":null,"abstract":"<p><strong>Background and purpose: </strong>Goal setting is a key aspect of patient-centered physiotherapy, helping to motivate patients, align healthcare efforts, prevent oversight, and stop ineffective interventions. This study aims to identify facilitators and barriers for physiotherapists in hospitals to set and document patient treatment goals.</p><p><strong>Methods: </strong>An explanatory sequential mixed-methods approach was used. The survey, informed by systematic reviews of factors influencing shared decision-making and the theoretical domains framework (TDF), included 25 statements to be rated. Two focus groups (n = 8) discussed (1) factors from the survey, (2) the goal-setting processes, and (3) brainstormed facilitators and barriers for documenting physiotherapy goals.</p><p><strong>Results: </strong>Survey findings showed mixed opinions but agreement on two factors, which indicate that the goal influences the therapeutic interventions and motivates the therapists. The focus group identified four themes: \"Goal,\" \"Physiotherapeutic Self-Conception,\" \"Interprofessionality\", and \"Hospital Setting.\" Issues included limited space and poor placement in documentation systems, mental rather than written goal conceptualization, and a perceived lack of interest from interprofessional team members, leading to deprioritization by physiotherapists. Finally, joint goal setting was deemed impractical for certain patients.</p><p><strong>Discussion: </strong>Hospital physiotherapists set treatment goals with their patients. The process is influenced by various factors, including interprofessional dynamics and the hospital setting. The identified themes align with existing literature. Effective documentation of patient-centered physiotherapy goals in hospitals requires well-designed tools and interprofessional collaboration. Further, it is crucial to understand professional self-conception and acknowledge situations where physiotherapists need to set goals independently.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 1","pages":"e70024"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956188","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}