Sara Monleón Guinot, Constanza San Martín Valenzuela, Vivina Aranda Asensi, Manuel Villanueva Navarro, José M Tomás
{"title":"Interference of functional dual-tasks on static posturography in people with Parkinson's disease.","authors":"Sara Monleón Guinot, Constanza San Martín Valenzuela, Vivina Aranda Asensi, Manuel Villanueva Navarro, José M Tomás","doi":"10.1080/09593985.2025.2574388","DOIUrl":"https://doi.org/10.1080/09593985.2025.2574388","url":null,"abstract":"<p><strong>Background: </strong>Balance impairments lead to daily-life complications in people with Parkinson's disease (PwPD). However, the way the environment interferes with balance is still unknown.</p><p><strong>Objective: </strong>To analyze the interference of dual-tasks (DTs) on balance in PwPD and compare it with healthy participants.</p><p><strong>Methods: </strong>Sixty-seven people were evaluated, 42 comprised the Parkinson's disease group (PDG) and 25 were part of the Control group (CG). All followed the balanced HOME assessment trial, performing static posturography under 5 conditions: single-task, visual DT (DT<sub>visual</sub>), verbal DT (DT<sub>verbal</sub>), and two manual tasks, one above 90º of shoulder flexion (DT<sub>upper</sub>) and the other below (DT<sub>lower</sub>). Swept area, velocity, displacement, dispersion, and force of the Center of Pressure (CoP) were recorded.</p><p><strong>Results: </strong>DT interfered with the balance of the PDG in all conditions, while the CG was affected mainly in manual tasks. In the PDG, the swept area had the highest interference, reaching 218.84 mm<sup>2</sup> in the DT<sub>upper</sub> condition, meaning 255.34% more swept area than in the single-task condition. However, CoP velocity was the most sensitive parameter to secondary tasks, being perturbed in all dual conditions tested, and the only outcome that increased (19.49%) during the DT<sub>visual</sub> (<i>p</i> < .05). In DT<sub>verbal</sub> condition the groups maintained similar balance, except for the CoP mediolateral displacement and dispersion (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Compared to healthy participants, untrained PwPD showed poorer postural control under DTs conditions. This impairment increased with task complexity, ranging from visual distraction to overhead manipulation. Mediolateral CoP movements may serve as an early indicator of balance deterioration in challenging environments.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole Sleddens, Elizabeth Beam, Kyle Meyer, Lynnette Leeseberg Stamler, Louise LaFramboise, Harlan Sayles, Steven Wengel
{"title":"Examining the frequency, severity and associated factors of burnout in Nebraska physical therapists.","authors":"Nicole Sleddens, Elizabeth Beam, Kyle Meyer, Lynnette Leeseberg Stamler, Louise LaFramboise, Harlan Sayles, Steven Wengel","doi":"10.1080/09593985.2025.2571795","DOIUrl":"https://doi.org/10.1080/09593985.2025.2571795","url":null,"abstract":"<p><strong>Background: </strong>Recognizing the adverse effects of burnout on clinician well-being and patient care, there has been a surge in national interest in this subject. However, within the physical therapy profession, the extent of burnout has not been as deeply examined.</p><p><strong>Objective: </strong>This study aimed to 1) describe the frequency and severity of burnout of Nebraska physical therapists using the Maslach Burnout Inventory and 2) explore potential associations of burnout with sociodemographic and work environment characteristics.</p><p><strong>Methods: </strong>Using a cross-sectional design, 2057 licensed physical therapists in Nebraska were invited to complete a survey that included the Maslach Burnout Inventory, demographic information, work environment factors, and stressors. Burnout profiles were generated based on Maslach Burnout Inventory subscale scores and scores were compared to previously established cutoffs. Associations between burnout and sociodemographic and work environment factors were analyzed, and key stressors for each burnout profile were identified.</p><p><strong>Results: </strong>The overall response rate was 23.5%. Approximately half of respondents exhibited engagement, while the remainder experienced at least one dimension of burnout, with 9.9% displaying a full burnout profile. Work environment factors, such as workload, autonomy, flexibility, time off, ethics, supervisor and coworker support, and professional judgment, contributed more significantly (<i>p</i> < .001) to burnout than sociodemographic characteristics (<i>p</i> < .05). The top stressors among participants with burnout were workload/productivity standards, hours worked per week, and student loan debt.</p><p><strong>Conclusion: </strong>These findings suggest that burnout, driven by emotional exhaustion, is a concern for Nebraska physical therapists. Addressing modifiable work environment factors could help reduce burnout and enhance workforce well-being.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-17"},"PeriodicalIF":1.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolina Lise Laras, Tamiris Beppler Martins, Jaqueline de Souza, Taís Beppler Martins, Rodrigo Okubo
{"title":"Musculoskeletal injury incidence, associated factors, and players' beliefs in beach tennis: a cross-sectional study.","authors":"Carolina Lise Laras, Tamiris Beppler Martins, Jaqueline de Souza, Taís Beppler Martins, Rodrigo Okubo","doi":"10.1080/09593985.2025.2573021","DOIUrl":"https://doi.org/10.1080/09593985.2025.2573021","url":null,"abstract":"<p><strong>Introduction: </strong>Beach tennis is increasingly demanding, raising injury risk linked to overload, poor recovery, and limited prevention. Identifying related factors may help reduce musculoskeletal injuries.</p><p><strong>Objectives: </strong>To estimate the incidence of musculoskeletal injuries in beach tennis players, investigate practice habits and beliefs about injury causes in beach tennis players, and investigate factors associated with injury occurrence between injured and non-injured players.</p><p><strong>Methods: </strong>Retrospective, cross-sectional, descriptive epidemiological study with 235 beach tennis players (186 amateur, 6 professional, and 43 recreational) across Brazil. Data were collected via digital questionnaire between April and September 2024, covering demographics, training habits, sleep, nutrition, pain, and injury history. Injury incidence was calculated per 1000 hours of exposure. Associations were explored using unadjusted chi-square and t-tests; given convenience sampling, comparisons between competitive levels were interpreted descriptively.</p><p><strong>Results: </strong>Injury incidence was 1.11 per 1000 hours of exposure. Injury prevalence differed by competitive level (professionals 83.3%, recreational 30.2%; unadjusted/descriptive). Older age (<i>p</i> < .001), longer practice duration (<i>p</i> < .001), and inadequate sleep (<i>p</i> < .001) were associated with injury in unadjusted analyses. Over half of respondents attributed injuries to lack of muscle strengthening and repetitive movements. Preventive routines such as warming up, mobility drills, and muscle activation were more common among injured athletes, potentially reflecting higher physical demand.</p><p><strong>Conclusion: </strong>Musculoskeletal injuries in beach tennis are significantly associated with age, prolonged exposure, and poor sleep quality. Professional players presented higher injury prevalence than recreational athletes. Comparisons across competitive levels should be interpreted with caution due to potential selection bias and age-related differences.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gender-specific impact of falls on ankle function and its relationship with balance in older adults.","authors":"Melda Başer Seçer, Melahat Aktaş Öztürk, Sinem Çiçek Güvendik, Ozge Çeliker Tosun, Erhan Seçer, Mehmet Emin Limoncu","doi":"10.1080/09593985.2025.2570369","DOIUrl":"https://doi.org/10.1080/09593985.2025.2570369","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated changes in ankle function in older adults with a history of falls and the influence of gender. It also explored the relationship between balance and ankle function in fallers.</p><p><strong>Methods: </strong>A cross-sectional study of 78 nursing home residents [54 women (mean age: 75.54 ± 4.88), 24 men (mean age: 78.87 ± 5.50)] aged ≥65 years was conducted. Ankle dorsi-plantar flexion range of motion (ROM), tibialis anterior (TA) and gastrocnemius (GC) electromyography (EMG) activity during contraction/relaxation, and isometric TA/GC strength were measured. Fear of falling (FoF) and balance were assessed using the Falls Efficacy Scale (FES) and Berg Balance Scale (BBS), respectively.</p><p><strong>Results: </strong>Rates of fallers (women %32, men %33) were similar between genders. Men with a history of falls showed higher GC EMG activity (<i>p</i> = .016) and greater FoF (<i>p</i> = .016) than women with fall history. Fallers versus non-fallers in men also exhibited higher GC EMG activity (<i>p</i> = .039) and FoF (<i>p</i> = .011). In men, fall number positively correlated with GC work average and FES. A strong negative correlation existed between BBS and FES in male fallers (<i>r</i> = -0.985, <i>p</i> = .015).</p><p><strong>Conclusion: </strong>Ankle ROM and muscle function may be unaffected in women post-fall. However, men experiencing falls might have reduced ankle strength, potentially compensated by increased EMG activity. Men appear more significantly impacted by falls psychologically and functionally.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nahid Pirayeh, Fateme Abrishami, Mohammad Mehravar, Neda Mostafaee, Zahra Najarzadeh
{"title":"Impact of motor fatigue on spatiotemporal parameters of gait under single-and dual-task conditions in individuals with chronic ankle instability and copers.","authors":"Nahid Pirayeh, Fateme Abrishami, Mohammad Mehravar, Neda Mostafaee, Zahra Najarzadeh","doi":"10.1080/09593985.2025.2568111","DOIUrl":"https://doi.org/10.1080/09593985.2025.2568111","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic ankle instability (CAI) is associated with altered gait mechanics and cognitive-motor deficits, while some individuals with a history of ankle sprain recover successfully as copers. Dual-tasking and fatigue represent common real-world challenges, but their combined effects on gait in CAI compared with copers remain unclear.</p><p><strong>Purpose: </strong>To investigate the effects of motor fatigue on spatiotemporal gait parameters under single- and dual-task conditions in individuals with CAI compared with copers.</p><p><strong>Methods: </strong>Thirty individuals with CAI (mean age 26.7 ± 7.2 years) and 30 age- and sex-matched copers, (mean age 24.48 ± 6.2 years) completed gait trials under single- and cognitive dual-task conditions, both before and after a fatiguing exercise protocol. Spatiotemporal gait parameters were recorded, and repeated-measures ANOVA with Bonferroni correction was used to examine main effects and interactions.</p><p><strong>Results: </strong>Dual-tasking significantly altered gait in both groups, with increased step length (<i>p</i> = .005) and step time (<i>p</i> < .001) and reduced step width (<i>p</i> = .018) and step length variability compared with single-task walking (<i>p</i> = .036). Fatigue further modified spatiotemporal parameters. The individuals with CAI showed increased variability in step length, while copers demonstrated decreased variability in step time (<i>p</i> = .021). Cognitive performance remained stable across conditions.</p><p><strong>Conclusion: </strong>Dual-tasking and fatigue interact to shape gait differently in CAI and coper groups. Rather than uniformly impairing gait, dual-tasking sometimes promoted more consistent walking, while fatigue destabilized gait, particularly in individuals with CAI. These findings highlight the importance of incorporating both cognitive and fatigue-related challenges into rehabilitation to better prepare individuals with CAI for real-world demands.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shear-wave elastography of the upper trapezius in office workers with chronic neck pain: Associations with pain-related neck disability, fear-avoidance beliefs, and work ability.","authors":"Hio Teng Leong, Chung Yee Cecilia Ho","doi":"10.1080/09593985.2025.2570368","DOIUrl":"https://doi.org/10.1080/09593985.2025.2570368","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared upper trapezius (UT) muscle stiffness between office workers with and without chronic neck pain using shear-wave elastography (SWE), and investigated the relationship between UT muscle stiffness, pain-related neck disability, fear-avoidance beliefs, and work ability.</p><p><strong>Methods: </strong>Eighty-eight office workers (66 individuals with chronic neck pain and 22 healthy controls, mean age = 32.7 ± 8.3 years) participated in this study. UT muscle stiffness was measured using SWE. The Neck Disability Index (NDI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Work Ability Index (WAI) were also assessed.</p><p><strong>Results: </strong>Office workers with chronic neck pain exhibited significantly higher UT shear modulus compared to healthy controls (<i>p</i> < .001). UT shear modulus was positively correlated with NDI (r<sub>s</sub> = 0.472, <i>p</i> < .001) and FABQ score (r<sub>s</sub> = 0.350, <i>p</i> = .001), and negatively correlated with WAI (r<sub>s</sub> = -0.330, <i>p</i> = .002).</p><p><strong>Conclusion: </strong>Increased UT muscle stiffness is associated with greater neck disability, higher fear-avoidance beliefs, and reduced work ability. These findings highlight the importance of addressing both the mechanical properties of the UT muscle and psychosocial factors in the management of chronic neck pain, and this warrants further research and investigation. and warrant further research.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sue Peters, Laura K Fitzgibbon-Collins, Siying Luan, Sarthak Kohli, Nathan Durand, Robert Teasell, Ricardo Viana, Shannon L MacDonald, Jaspreet Bhangu, Jamie L Fleet
{"title":"Functional and brain activation changes in females with subcortical subacute stroke captured through functional near infrared spectroscopy: a case series.","authors":"Sue Peters, Laura K Fitzgibbon-Collins, Siying Luan, Sarthak Kohli, Nathan Durand, Robert Teasell, Ricardo Viana, Shannon L MacDonald, Jaspreet Bhangu, Jamie L Fleet","doi":"10.1080/09593985.2025.2568708","DOIUrl":"https://doi.org/10.1080/09593985.2025.2568708","url":null,"abstract":"<p><strong>Background: </strong>Females have worse functional outcomes than males after a stroke including worse standing balance, slower gait speed, and higher fatigue levels. The current understanding of stroke recovery mechanisms has not yet been able to explain why females have worse outcomes compared to males. Functional Near Infrared Spectroscopy (fNIRS) amplitude offers information on the level of cognitive effort required to perform a task, as well as the impact of rehabilitation on brain function.</p><p><strong>Objectives: </strong>The aim of this case series was to use fNIRS to provide detailed prefrontal cortex activation data on several functional lower extremity sensorimotor tasks in females admitted to a stroke inpatient rehabilitation unit.</p><p><strong>Methods: </strong>Four female participants completed impairment, balance, gait, and fatigue measures as well as fNIRS assessments at admission and discharge from the inpatient stroke rehabilitation unit. fNIRS assessments included quiet and semi-tandem standing, and supine ankle sensorimotor tasks.</p><p><strong>Results: </strong>All participants had a subcortical ischemic stroke with improvements in sensorimotor impairment (average 9-point increase on the Fugl-Meyer), balance (average 29-point increase on the Berg Balance Scale), and gait (average 0.25 m/s increase in gait speed, average 30 m increased distance on the 2-minute walk test) at discharge. Larger fNIRS amplitudes were observed at baseline which were reduced at discharge for the three supine tasks, and these changes were less evident for the two standing tasks. Two females had decreased fatigue at discharge with the other two females experiencing small increases (average 0.5-point decrease on the Fatigue Severity Scale).</p><p><strong>Conclusions: </strong>For females admitted to an inpatient stroke unit, relationships may be present with improvements on clinical scores and decreased fNIRS amplitude during supine tasks, with standing tasks generating more diverse fNIRS responses. These findings suggest that fNIRS can provide prefrontal cortex activation data in females on an inpatient stroke unit and that a standard inpatient rehabilitation program appears to have an effect on fNIRS amplitudes.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalia Hernández-Segura, Arrate Pinto-Carral, Diane D Allen, Alba Marcos-Delgado, Tania Fernández Villa, Antonio J Molina
{"title":"Validity and reliability of the Spanish movement ability measure: an item response theory approach.","authors":"Natalia Hernández-Segura, Arrate Pinto-Carral, Diane D Allen, Alba Marcos-Delgado, Tania Fernández Villa, Antonio J Molina","doi":"10.1080/09593985.2025.2566155","DOIUrl":"https://doi.org/10.1080/09593985.2025.2566155","url":null,"abstract":"<p><strong>Background: </strong>Assessment of movement capacity is fundamental in the field of physiotherapy to understand patient progress and the effectiveness of therapeutic interventions. The Movement Ability Measure (MAM) instrument is a self-reported questionnaire designed to assess self-perceived movement capacity.</p><p><strong>Objective: </strong>To validate a Spanish version of the MAM instrument.</p><p><strong>Methods: </strong>A two-part study was designed, based on guidelines for the cultural adaptation of patient-reported outcome measures: a phase for adaptation, involving 15 participants, and a phase for psychometric property analysis using Item Response Theory. The second phase included 205 subjects (49.9 ± 16.2 years, and 60.5% women). Structural validity was examined through the partial credit model. Reliability was estimated using the coefficient of reliability separation, test information function, and test-retest reliability (intraclass correlation coefficient) at one week. The association with the Physical Functioning Subscale was assessed using Spearman correlation coefficients. Movement capacity across different groups was compared using Wilcoxon - Mann - Whitney and Kruskal - Wallis tests.</p><p><strong>Results: </strong>The Spanish version of the MAM instrument showed good fit indices, especially in the multidimensional model. The correlation with the Physical Functioning Subscale was 0.79 (<i>p</i> < .001), and the coefficient of reliability separation was 0.98. The intraclass correlation coefficient was 0.94 (95% CI 0.89-0.97). When analyzing differences between groups based on age, reported mobility issues, presence of chronic illness, and origin group, statistically significant differences were found according to prior hypotheses (<i>p</i> < .001).</p><p><strong>Conclusion: </strong>The Spanish version of the MAM instrument is both reliable and valid for evaluating movement ability.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigating the effects of mechanical traction and high intensity laser therapy on pain, muscle activity, and functional balance in knee osteoarthritis.","authors":"Pardis Norouzi, Roya Ravanbod, Giti Torkaman","doi":"10.1080/09593985.2025.2566935","DOIUrl":"https://doi.org/10.1080/09593985.2025.2566935","url":null,"abstract":"<p><strong>Background: </strong>Mechanical traction (MT) is a noninvasive approach to unload the joint in knee osteoarthritis (KOA), however,its effects on co-contraction index (CCI) and balance remain unclear.</p><p><strong>Purpose: </strong>To investigate whether combining MT with high intensity laser therapy (HILT) yields greater improvements in subjective and objective outcomes among patients with KOA compared to HILT alone.</p><p><strong>Methods: </strong>Thirty-eight patients with KOA were randomly assigned to MT+HILT (<i>n</i> = 19) or HILT (<i>n</i> = 19) groups and received 10 treatment sessions over 2 weeks. Outcomes included pain (VAS), function (WOMAC), active knee flexion range of motion (AROM), CCI, and balance during curve tracking (CT) and sit-to-stand (STS) tasks. A two-way mixed-model ANOVA was used to assess the effects of treatment and time (pre - post).</p><p><strong>Results: </strong>The MT+HILT showed significantly greater improvements than HILT in VAS (<i>p</i> < .001, η<sub>p</sub><sup>2</sup> = 0.27), WOMAC (<i>p</i> < .001, η<sub>p</sub><sup>2</sup> = 0.37), and AROM (<i>p</i> < .001, η<sub>p</sub><sup>2</sup> = 0.12). During CT, MT+HILT significantly reduced anteroposterior and mediolateral mean absolute errors (<i>p</i> = .00 and 0.03, η<sub>p</sub><sup>2</sup> = 0.10 and 0.15), and standard deviations of absolute errors (<i>p</i> = .02 and 0.04, η<sub>p</sub><sup>2</sup> = 0.82 and 0.15). Center of pressure area also decreased significantly in anteroposterior and mediolateral directions (<i>p</i> = .03 and 0.01; η<sub>p</sub><sup>2</sup> = 0.66 and 0.23).</p><p><strong>Conclusion: </strong>These findings suggest that the combined application of MT+HILT may serve as an effective conservative strategy to improve pain management, functional capacity, AROM, and balance, potentially contributing to a reduced risk of falls in individuals with KOA.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail Grover Snook, Ingvi S Waage, Solveig A Arnadottir, Sigrun V Bjornsdottir, Giacomo Rossettini, Marco Testa
{"title":"Icelandic physiotherapists' perceptions of contextual factors as triggers of nocebo effects: a mixed methods survey.","authors":"Abigail Grover Snook, Ingvi S Waage, Solveig A Arnadottir, Sigrun V Bjornsdottir, Giacomo Rossettini, Marco Testa","doi":"10.1080/09593985.2025.2490047","DOIUrl":"10.1080/09593985.2025.2490047","url":null,"abstract":"<p><strong>Introduction: </strong>Contextual factors surrounding physiotherapy treatment can trigger nocebo effects, resulting in negative outcomes despite evidence-based treatment.</p><p><strong>Purpose: </strong>This study explored Icelandic physiotherapists' awareness, perception, and prevention of contextual factors that may trigger nocebo effects.</p><p><strong>Methods: </strong>This was a cross-sectional, convergent mixed-methods study utilizing an online survey. Quantitative data was collected by translating and adapting a previously developed survey and analyzed using descriptive and non-parametric statistics. Qualitative data from open-ended questions were transformed and analyzed using a contextual factor framework.</p><p><strong>Results: </strong>For the quantitative analysis, 206 responses were included. Seventy percent of Icelandic physiotherapists reported \"seldom\" or \"rarely\" encountering nocebo effects. The highest-rated perceived causes, based on the percent answering \"very much\" or \"much,\" were inappropriate touch (89%), lack of trust between physiotherapist and patient (85%), use of negative language by the physiotherapist (83%), patient's prior negative experiences (80%), physiotherapist's negative attitude (78%), patient's negative expectations (77%), and negative non-verbal communication (74%). The most endorsed strategy for preventing nocebo effects was to teach and train patients in coping skills. Eighty-eight percent agreed that nocebo effects should be part of the physiotherapy curriculum. Qualitative descriptions of nocebo effects by 81 physiotherapists showed little self-reflection, with a tendency to attribute nocebo effects primarily to the patient's mind-set.</p><p><strong>Conclusion: </strong>Comparisons to other surveys showed similarities that may be universal among physiotherapists alongside notable differences. Physiotherapists frequently attributed nocebo effects to the patient's mind-set but may need to consider a broader range of contextual factors to reduce nocebo effects more effectively.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"2030-2042"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}