Physiotherapy Research International最新文献

{"title":"Optimal Reactive Balance Training Characteristics Poststroke: Secondary Analysis of a Clinical Trial.","authors":"Júlia O Faria, Cynthia J Danells, Elizabeth L Inness, Avril Mansfield","doi":"10.1002/pri.70231","DOIUrl":"10.1002/pri.70231","url":null,"abstract":"<p><strong>Background and purpose: </strong>Reactive balance training (RBT) has shown promise for enhancing reactive balance control and reducing falls poststroke. However, the optimal training parameters (e.g., intensity, duration) are unknown. This secondary analysis examined dose-response relationships between specific reactive balance training characteristics and improvements in reactive balance control and fall rates poststroke.</p><p><strong>Methods: </strong>30 people with chronic stroke (mean age: 66.6 ± 8.8 years; time after stroke: 3.3 ± 2.3 years) completed up to 12 one-hour reactive balance training sessions, twice per week. Training included experiencing losses of balance due to internal or external perturbations while performing voluntary tasks. The tasks were of four types: stable, quasi-mobile, mobile, and unpredictable, each with choice of three difficulty levels (normal, increased, or reduced). Multiple linear regression (reactive balance outcome) and negative binomial regression (fall rates) were used to model associations between training characteristics (total number of perturbations, task difficulty, perceived challenge, and success rate) and post-training fall rates and changes in the reactive balance control sub-score of the mini-Balance Evaluation Systems Test (mini-BESTest).</p><p><strong>Results: </strong>A higher number of perturbations were significantly associated with better post-intervention reactive balance scores on the mini-BEST (p = 0.010). There were no significant associations with any other training characteristics and post-intervention mini-BEST Scores. For fall incidence rates, there were no significant associations with any training characteristic (all p > 0.05).</p><p><strong>Discussion: </strong>Greater exposure to RBT was associated with improvements in reactive balance control among individuals with chronic stroke. Participants who completed a higher number of perturbations within the standardized 12-session protocol showed greater improvements in reactive balance control, consistent with a dose-response association. These results indicate that training volume-reflected in the number of perturbations experienced-may be an important factor to consider when refining RBT protocols.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70231"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934630","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":"Efficacy and Modulating Factors of Repetitive Transcranial Magnetic Stimulation on Motor Function in Parkinson's Disease: A Meta-Analysis.","authors":"Jiaying Lu, Songbin Chen, Yujie Chen, Jin Zhang, Yuan Peng, Shunxi Zhang","doi":"10.1002/pri.70256","DOIUrl":"10.1002/pri.70256","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aimed to evaluate the short-term and long-term therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on motor function in patients with Parkinson's disease (PD) and to investigate the potential factors affecting rTMS treatment outcome, including stimulation site, coil type, stimulation frequency, treatment regimen frequency and stimulation pulse number.</p><p><strong>Methods: </strong>A comprehensive literature search was performed systematically across PubMed, EMBASE, MEDLINE, the Cochrane Library, and Web of Science. Only English-language studies comparing rTMS with sham stimulation were included. Standardized mean difference (SMD) was applied as effect sizes. The Minimum Clinically Important Difference (MCID) was applied to interpret the clinical relevance of findings.</p><p><strong>Results: </strong>Twelve studies comprising 457 patients were included. Using a random-effects model, active rTMS reduced Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) scores compared with sham stimulation (SMD = -0.40, 95% CI: -0.59 to -0.21, p < 0.0001). Long-term benefits were also observed, with a modest improvement in UPDRS-III scores at 1-month follow-up compared with baseline (SMD = -0.43, 95% CI: -0.67 to -0.19, p = 0.0004). Subgroup analyses suggested moderate-to-large effects for daily stimulation protocols (SMD = -0.67, 95% CI: -1.12 to -0.22, p = 0.003). According to the GRADE criteria, the overall quality of evidence was rated as moderate.</p><p><strong>Discussion: </strong>The pooled evidence supports the short-term and long-term efficacy of rTMS in improving motor performance among Parkinson's patients. Based on current evidence, an rTMS protocol involving daily consecutive stimulation may yield therapeutic benefits.</p><p><strong>Trial registration: </strong>Our meta-analysis is registered with PROSPERO (registration number: CRD420250655158).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70256"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370221","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":"Utilizing the International Classification of Functioning, Disability and Health to Describe Quality-of-Life Assessment in Older Adults in a Middle-Income Country.","authors":"Maik Berber Freitas, Gustavo Pietracatelli Janizello, Wallace Pereira Silva, Léia Cordeiro de Oliveira, Vívian Elaine Alflen Soares, Ariadne Cardoso da Silva, Bibiana Caldeira Monteiro, Cid André Fidelis de Paula Gomes, Soraia Micaela Silva","doi":"10.1002/pri.70271","DOIUrl":"10.1002/pri.70271","url":null,"abstract":"<p><strong>Background and purpose: </strong>The global aging population is rapidly increasing, prompting the United Nations to declare the \"Decade of Healthy Aging\" (2021-2030) to improve the quality of life for older adults. Health-related quality of life (HRQoL) is crucial in this context, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for its evaluation. This study aimed to apply a previously proposed method for converting SF-36 domain scores into ICF qualifiers in community-dwelling older adults attending primary care services in a middle-income country, describing the resulting classification of functioning domains using standardized ICF qualifiers.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with older adults aged 60 and above who accessed primary healthcare services and had no cognitive impairment. Participants underwent HRQoL assessment using the SF-36, and ICF codes previously linked to SF-36 domains were classified using ICF qualifiers. A simple calculation method was developed to convert SF-36 scores into ICF qualifiers.</p><p><strong>Results: </strong>The study included 52 participants, with a mean age of 71.6 ± 7.0 years, 92.3% of whom were women. The ICF framework qualified 27 codes from SF-36 domains. Moderate impairments were observed in \"Bodily Pain,\" \"General Health,\" and \"Vitality\" domains, while \"Physical Functioning,\" \"Social Functioning,\" and \"Mental Health\" domains showed mild impairments. No impairments were noted in the \"Role Physical\" and \"Role Emotional\" domains.</p><p><strong>Discussion: </strong>The application of ICF qualifiers to SF-36 domain scores yielded standardized classifications of HRQoL domains across the ICF framework, allowing HRQoL outcomes to be described according to the severity levels defined by the ICF qualifier scale.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70271"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354132","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":"Preoperative Respiratory Training Before Cardiac Surgery: Feasibility and Longitudinal Pulmonary Function Changes in Elderly Patients.","authors":"Andranik Petrosyan, Emilie Besson, Nathalie Grand, Julien Lanoiselee, Khalil Raissouni, Kasra Azarnoush","doi":"10.1002/pri.70286","DOIUrl":"10.1002/pri.70286","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the feasibility and short-term spirometric changes observed during a 3-week physiotherapist-supervised incentive-spirometry program in elderly patients awaiting elective cardiac surgery.</p><p><strong>Methods: </strong>This prospective, single-center observational study included patients aged ≥ 65 years scheduled for elective cardiac surgery. Patients completed a 3-week home-based respiratory training program using an incentive spirometer (TriFlo 2), comprising six daily sessions and supervised twice weekly by physiotherapists. Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and the Tiffeneau index, was evaluated at the baseline, after the training program, and 30 days after surgery.</p><p><strong>Results: </strong>A total of 27 patients completed the preoperative training phase with high adherence, and 21 patients had complete three-phase longitudinal spirometric data. No adverse events related to respiratory training were reported. FVC increased significantly after the training program (4.22 ± 1.16 L to 5.09 ± 1.96 L; p = 0.036), whereas FEV1 did not change significantly. At 30 days after surgery, marked reductions in FVC and FEV1 persisted compared with the baseline (p < 0.001 for both), whereas the Tiffeneau index did not differ significantly from the baseline. No postoperative pulmonary complications were recorded in this cohort; however, postoperative outcomes were descriptive and cannot be attributed to the intervention because no comparator group was included.</p><p><strong>Conclusion: </strong>In elderly patients awaiting elective cardiac surgery, a 3-week physiotherapist-supervised respiratory training protocol was feasible and was associated with improved preoperative FVC. Because of the small sample size, absence of randomization, and lack of a control group, these findings should be interpreted as exploratory and hypothesis-generating. Larger controlled studies are required to determine whether preoperative respiratory training improves postoperative pulmonary or functional recovery.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 3","pages":"e70286"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473389","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 Telerehabilitation-Based Music Therapy and Motor Imagery on Pain, Autonomic Function, and Psychosocial Outcomes in People With Multiple Sclerosis: A Randomized Controlled Trial Protocol.","authors":"Hilal Karakas, Ozge Ertekin, Ipek Yavas, Rabia Gokcen Gozubatik-Celik, Hasan Kazdagli, Barbara Seebacher, Turhan Kahraman","doi":"10.1002/pri.70186","DOIUrl":"10.1002/pri.70186","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chronic pain affects approximately 63% of people with multiple sclerosis (pwMS), contributing to fatigue, depression, anxiety, poor sleep, reduced quality of life, and cognitive decline. Within the biopsychosocial model, music therapy has emerged as a promising intervention to address these complex symptoms. This study aims to examine the effects of heart rate-synchronized music therapy combined with motor imagery practice on pain, autonomic and cognitive functions, and psychosocial outcomes in patients with pwMS. We hypothesize that the combined intervention will lead to greater improvements than music therapy alone or routine care.</p><p><strong>Methods: </strong>A double-blind, randomized, and three-arm parallel trial will be conducted with 45 patients with pwMS experiencing chronic pain. Participants will be randomly assigned to one of three groups: (1) heart rate-synchronized music therapy combined with motor imagery, (2) heart rate-synchronized music therapy alone, or (3) a control group receiving routine care. Interventions will be delivered twice weekly for 8 weeks, with each session lasting 20-30 min. The experimental groups will receive music therapy via videoconferencing. Assessments will be conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome is pain intensity. Secondary outcomes include neuropathic pain, central sensitization, heart rate variability, anxiety, depression, fatigue, sleep quality, quality of life, and cognitive function. Sample size was calculated using G*Power; HRV data will be analyzed with Kubios software. Statistical analyses will be performed using SPSS and GraphPad Prism 10.</p><p><strong>Results: </strong>Following randomization, baseline data will be collected. Blinded assessors will evaluate all outcomes at follow-up points. An independent researcher will perform statistical analyses to assess changes across time and between groups.</p><p><strong>Discussion: </strong>This study may provide evidence supporting a novel, non-pharmacological, and telehealth-compatible intervention for chronic pain in pwMS.</p><p><strong>Trial registration: </strong>NCT06800144, 24th January 2025.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70186"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370436","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":"Physiotherapist's Management of Suspected Cauda Equina Syndrome in the United Kingdom: A National Survey.","authors":"Rob Tyer, Nick Livadas, Robert Hogg","doi":"10.1002/pri.70182","DOIUrl":"10.1002/pri.70182","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cauda Equina Syndrome (CES) is a rare but serious spinal condition requiring urgent diagnosis and management. Physiotherapists in UK musculoskeletal (MSK) services increasingly encounter suspected CES cases, but little is known about their clinical decision-making and referral practices. This study aimed to examine the clinical decision-making processes of UK physiotherapists when presented with three clinical vignettes of suspected CES and to identify themes in referral handover methods when emergency care is deemed necessary.</p><p><strong>Methods: </strong>An online survey featuring three clinical case vignettes was distributed to UK physiotherapists. Respondents were asked about their referral decisions, clinical reasoning, and preferred methods of handover to Accident & Emergency (A&E) services. Thematic analysis was used to identify common clinical reasoning patterns and referral practices.</p><p><strong>Results: </strong>The presence of altered bladder function was the strongest predictor of referral to A&E, consistent with previous literature. Sexual dysfunction was also a significant referral factor when present. Themes for not referring included recent A&E attendance, plans for in-clinic assessment, specialist consultation, and requesting urgent MRI scanning. A range of handover methods were reported, with written letters and direct phone calls being the most common. Variation in clinical decision-making was evident, particularly regarding timing and urgency of investigations, reflecting some uncertainty around guideline interpretation.</p><p><strong>Discussion: </strong>Findings demonstrate variability in UK physiotherapists' approaches to suspected CES management, with some respondents opting for community assessment or delayed imaging despite CES's urgent nature. Findings emphasise the need for clearer, unified guidelines on referral pathways and handover methods to reduce delays and improve patient outcomes. Future research should explore the impact of recent guideline updates and include perspectives from other healthcare professionals involved in CES care.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70182"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469609","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":"Acute Effect of Transcutaneous Auricular Vagus Nerve Stimulation in Two Different Locations on Blood Pressure and Cardiac Autonomic Modulation in Healthy and Hypertensive Individuals: Pilot Study of a Randomized Crossover Clinical Trial.","authors":"Paulo Henrique Leite Souza, João Carlos Ferrari Corrêa, Bruno Paulino Venâncio, Liége Sanches Buzá, Gustavo Oliveira da Silva, Felipe Fregni, Fernanda Marciano Consolim-Colombo, Raphael Mendes Ritti Dias, Fernanda Ishida Corrêa","doi":"10.1002/pri.70209","DOIUrl":"10.1002/pri.70209","url":null,"abstract":"<p><strong>Background: </strong>and PurposeTranscutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising noninvasive strategy to modulate autonomic function and reduce blood pressure (BP). However, whether the stimulation site influences acute cardiovascular responses remains unclear.</p><p><strong>Objective: </strong>To compare the acute effects of taVNS applied to the tragus and cymba conchae on BP and cardiac autonomic modulation in hypertensive and healthy individuals.</p><p><strong>Methods: </strong>This pilot randomized crossover clinical trial included 14 hypertensive and 14 healthy participants who underwent two taVNS sessions (tragus and cymba conchae) in randomized order, one week apart. Sessions lasted 30 min and delivered a sinusoidal current (30 Hz, 500 ms pulse width), with intensity adjusted to the individual sensory threshold. Systolic BP (SBP), diastolic BP (DBP), and heart rate variability (HRV) parameters were assessed at baseline, during stimulation, and post-stimulation. Generalized estimating equations were used for analysis.</p><p><strong>Results: </strong>A significant group × time × stimulation site interaction was observed for SBP (χ² = 19.0, p = 0.001) and DBP (χ² = 10.0, p = 0.038). Cymba conche stimulation reduced BP in healthy individuals, whereas no meaningful BP changes were observed in hypertensive participants. Tragus stimulation reduced diastolic BP only in the hypertensive group. Significant interactions were also detected for normalized spectral HRV components and sample entropy (p < 0.05), though autonomic responses were modest and not consistently indicative of enhanced parasympathetic modulation.</p><p><strong>Discussion: </strong>Acute taVNS induces site- and group-dependent cardiovascular responses, with limited clinical impact after a single session. These findings suggest that short-term stimulation may be insufficient to overcome impaired autonomic regulation in hypertension and highlight the need for repeated or longer stimulation protocols in future clinical trials.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70209"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628919","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":"Inertial Motion Capture of Sagittal Kinematics Reveals Compensatory Strategies for Forward Loss of Balance in Individuals With Visual Impairment.","authors":"Juncong Yang, Kun Wang, Yongxin Zhu, Lianhui Fu, Xinwei Huang, Qi Qi","doi":"10.1002/pri.70168","DOIUrl":"10.1002/pri.70168","url":null,"abstract":"<p><strong>Background and purpose: </strong>Improving the ability of visually impaired (VI) people to react quickly to daily falls is crucial. However, it is not clear whether long-term vision impairment leads to unique reactive balance strategies compared with those with visually healthy (VH). To examine whether the lower-limb compensatory strategies identified through wearable sensor-based biomechanical analysis in the sagittal plane are distinctive and measurable in VI individuals responding to postural perturbations.</p><p><strong>Methods: </strong>This study was conducted from August 2023 to October 2024. A total of 13 VI individuals and 13 age-matched VH controls were recruited. High-precision IWS inertial sensors were used to collect kinematic data from the pelvis, hip, knee, and ankle joints during balance perturbations. The joint motion responses were divided into the perturbation phase and the response phase. Key parameters analyzed included peak angles, angular displacement, time to peak angle, response time, response velocity, and inter-joint coordination (e.g., pelvis/hip, pelvis/ankle, and hip/ankle angular displacement ratios) during both phases. Between-group comparisons were performed using independent samples t-tests, with the significance level set at α = 0.05.</p><p><strong>Results: </strong>While the lower limb joint movement trajectories of VI and VH showed overall similarity, significant intergroup differences emerged in key kinematic parameters. During the perturbation phase, the VI demonstrated significantly shorter peak ankle plantar flexion and pelvic anteversion durations, indicating more abrupt initial compensatory strategies. In the reaction phase, they exhibited markedly greater joint mobility at the pelvis, knee, and ankle joints, accompanied by significantly prolonged response times for the pelvic and ankle joints. Additionally, their hip, knee, and ankle joint response rates were notably slower, with significant differences in the response angle displacement ratios between the pelvic/hip and pelvic/ankle joints. These findings collectively reflect the lower efficiency of VI in restoring overall stability following balance perturbations.</p><p><strong>Discussion: </strong>This study demonstrates that individuals with visual impairment employ kinematically distinct and measurable compensatory strategies in the lower limbs when responding to sagittal plane postural perturbations. These results substantiate the use of wearable sensor-based biomechanics for objectively evaluating balance recovery strategies in visually impaired populations, providing a foundation for future interventions aimed at fall prevention.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70168"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097608","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":"Functional Electrical Stimulation Cycling for Gait Rehabilitation in Stroke Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Anas R Alashram","doi":"10.1002/pri.70188","DOIUrl":"10.1002/pri.70188","url":null,"abstract":"<p><strong>Background and purpose: </strong>People with stroke often experience gait impairments. Functional electrical stimulation (FES) cycling allows patients with little or no voluntary lower limb movement to pedal a stationary bicycle. This review examines the effects of FES cycling on gait ability post-stroke.</p><p><strong>Methods: </strong>\"PubMed, SCOPUS, EMBASE, REHABDATA, CINAHL, MEDLINE, PEDro, and Web of Science\" were reviewed until July 10, 2024. Randomized controlled trials that included ischemic or hemorrhagic stroke patients who received lower limb FES cycling, compared with passive or active interventions, and assessed gait parameters (i.e., kinematic, kinetic, spatial, temporal) were included in this review. The risk of bias was assessed using the PEDro scale. The results were analyzed using Comprehensive Meta-Analysis Version 4.</p><p><strong>Results: </strong>Ten studies met our criteria. In total, 311 patients with stroke (mean age 63.44 years; 58% male) were included in this review. Gait speed, walking endurance, and spatiotemporal gait variables were assessed as outcomes. The included studies ranged from 6 to 9 on the PEDro scale, with a median of 8. The meta-analysis showed a small, non-significant effect of FES cycling on gait in stroke patients, including the 10-m Walk Test (SMD = -0.160, 95% CI: -0.631 to 0.311, p = 0.505, I² = 60%), the 50-m Walk Test (SMD = -0.071, 95% CI: -0.841 to 0.700, p = 0.857, I² = 66%), and the 6-Minute Walk Test (SMD = -0.083, 95% CI: -0.739 to 0.574, p = 0.806, I² = 55%). Some descriptive outcomes showed improvements in gait parameters, but the overall evidence remains inconclusive.</p><p><strong>Discussion: </strong>The evidence for the effects of FES cycling on gait ability in patients with stroke is limited. The optimal treatment parameters are not yet firmly established. Additional high-quality studies are recommended.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70188"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349576","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 Added Value and the Efficacy of Preoperative Physiotherapy on Degenerative Diseases of the Lumbar Spine: A Systematic Review.","authors":"Manna Jacopo, Fanigliulo Ciro, Giardulli Benedetto, Testa Marco, Andreoletti Federico","doi":"10.1002/pri.70214","DOIUrl":"10.1002/pri.70214","url":null,"abstract":"<p><strong>Background and purpose: </strong>Degenerative Diseases of the Lumbar Spine (DDLS) are typically managed with conservative treatments, while surgery is reserved for cases with severe motor and/or sensory deficits. Preoperative physiotherapy has been shown to improve postoperative outcomes in shoulder, hip, and knee surgeries. However, its effects on the lumbar spine have been poorly investigated. This systematic review aimed to evaluate the efficacy of preoperative physiotherapy on pain, disability, and hospitalisation in individuals with DDLS.</p><p><strong>Methods: </strong>A literature search was conducted in MEDLINE, Cochrane CENTRAL, Scopus, PEDro and EMBASE. Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias. We included randomised controlled trials (RCTs) in which preoperative interventions were delivered by physiotherapists and compared to usual care or other interventions. We conducted meta-analyses on primary outcomes.</p><p><strong>Results: </strong>We screened 9.803 studies and included 6 with 5 different study populations. All studies were RCTs that evaluated the efficacy of preoperative physiotherapy compared with usual care in pain and disability. The preoperative interventions were heterogeneous, varying between therapeutic exercise, cognitive-behavioural therapies, and multimodal interventions. The meta-analyses showed no difference between interventions. All studies had a high risk of bias.</p><p><strong>Conclusion: </strong>The effects of preoperative physiotherapy, compared with usual care, on pain, disability, and hospitalisation among patients with DDLS, are minimal. However, the risk of bias of the included studies and the certainty of evidence, based on the GRADE approach, were very low. Future high-quality, low-bias trials are needed to clarify its effectiveness and identify patient subgroups that may benefit the most.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"31 2","pages":"e70214"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700275","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}