Physiotherapy Theory and Practice最新文献

{"title":"Effects of adding sustained natural apophyseal glides on neuropathic pain-related symptoms and clinical outcomes in patients with lateral elbow tendinopathy: A randomized controlled trial.","authors":"Ahmed M El Melhat, Saher Lotfy Elgayar, Ahmed F Elhalawaty, Ghada M Koura, Mohammad Takkoush, Ali Mohamed Ali Ismail, Ayman A Mohamed","doi":"10.1080/09593985.2026.2749509","DOIUrl":"https://doi.org/10.1080/09593985.2026.2749509","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine dysfunction and neural mechano-sensitivity may contribute to persistent symptoms in lateral elbow tendinopathy (LET), suggesting a potential role for cervical intervention such as sustained natural apophyseal glides (SNAGS) as an adjunct to rehabilitation.</p><p><strong>Purpose: </strong>To investigate whether adding cervical SNAGS to a conventional rehabilitation program (CRP) improves neuropathic pain-related symptoms and signs, pain intensity, handgrip strength, pinch strength, and disability in individuals with LET.</p><p><strong>Methods: </strong>Arandomized controlled trial was conducted on52 participantswith unilateral LET, randomlyassigned toa study grouporcontrol group. The control group received aCRP, whereas the study group received the same program plus cervical SNAGS.Both groups were treated twice weekly for 4 weeks. Outcomes includedLeeds Assessment of Neuropathic Symptoms and Signs(LANSS), handgrip strength (HGS),lateral pinch strength, fingertip pinch strength, Numeric Pain Rating Scale (NPRS) at rest and during activity, and Patient-Rated Tennis Elbow Evaluation (PRTEE). Outcomes were assessed before and after treatment.</p><p><strong>Results: </strong>Both groups demonstrated significant pre-to-post improvements across all outcomes (<i>p</i> < .001). Between-group analysis of change scores favored the study group for LANSS (<i>p</i> = .049, r_rb = 0.314), HGS (<i>p</i> < .001, r_rb = 1.000), lateral pinch strength (<i>p</i> < .001, r_rb = 1.000), and PRTEE (<i>p</i> = .001, r_rb = 0.521). No significant between-group differences were found for fingertip pinch strength (<i>p</i> = .343, r_rb = 0.152), NPRS at rest (<i>p</i> = .089, r_rb = 0.277), or NPRS during activity (<i>p</i> = .067, r_rb = 0.283). Baseline-adjusted analysis favored the study group for LANSS (<i>p</i> = .008), HGS (<i>p</i> < .001), lateral pinch strength (<i>p</i> < .001), fingertip pinch strength (<i>p</i> = .001), NPRS during activity (<i>p</i> = .034), and PRTEE (<i>p</i> = .001), whereas NPRS at rest did not differ significantly between groups (<i>p</i> = .105).</p><p><strong>Conclusion: </strong>Adding cervical SNAGS to a CRP resulted in greater short-term improvement in several clinically relevant outcomes in individuals with LET.These findings support cervical SNAGS as a useful adjunct within a multimodal rehabilitation approach for LET.<b>Clinical Trial Registry number:</b> Prospectively registered at ClinicalTrials.gov (NCT06271915).</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225227","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":"Extending beyond the spine: Upper extremity exercise capacity and disability in non-specific chronic low back pain - A cross-sectional study.","authors":"Merve Firat, Fatih Ozyurt, Abdulhamit Tayfur, Figen Tuncay","doi":"10.1080/09593985.2026.2749507","DOIUrl":"https://doi.org/10.1080/09593985.2026.2749507","url":null,"abstract":"<p><strong>Background: </strong>Non-specific chronic low back pain (NSCLBP) is associated with functional limitations that may affect areas beyond the lumbar region. While lower extremity functional performance has been extensively studied, upper extremity functional performance has received limited attention in this population.</p><p><strong>Purpose: </strong>The primary aim of this study was to investigate the relationship between 6-minute pegboard and ring test (6PBRT) performance and disability in individuals with NSCLBP. Secondary aims were to examine its relationships with respiratory muscle strength, thoracoabdominal mobility, peripheral muscle strength, and kinesiophobia.</p><p><strong>Methods: </strong>This cross-sectional study involved 44 individuals with NSCLBP (mean age: 52.23 ± 8.48 years). Upper extremity exercise capacity was assessed using the 6PBRT. Respiratory muscle strength (maximal inspiratory and expiratory pressure), thoracoabdominal mobility, peripheral muscle strength (shoulder abductor and hand grip strength), disability level (Oswestry Disability Index, ODI) and kinesiophobia (Tampa Scale of Kinesiophobia) were evaluated.</p><p><strong>Results: </strong>A moderate negative correlation was found between 6PBRT performance and ODI score (<i>r</i> = -0.432, <i>p</i> = .003; Holm-adjusted <i>p</i> = .027). After adjustment for age, sex, body mass index, and activity-related pain intensity, ODI score remained significantly associated with 6PBRT performance (β = -0.546, <i>p</i> < .001). No significant correlations were found between 6PBRT performance and the secondary outcomes (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>In this sample, poorer 6PBRT performance was associated with greater disability in individuals with NSCLBP. No significant relationships were found between 6PBRT performance and respiratory muscle strength, thoracoabdominal mobility, peripheral muscle strength, or kinesiophobia. The 6PBRT may provide additional information about upper extremity functional performance alongside commonly used lower extremity-based assessments in this population.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217162","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":"Assessing functional capacity in patients with chronic low back pain: validity and reliability of the Glittre-ADL test.","authors":"Merve Firat, Basak Kavalci-Kol, Figen Tuncay","doi":"10.1080/09593985.2026.2745708","DOIUrl":"https://doi.org/10.1080/09593985.2026.2745708","url":null,"abstract":"<p><strong>Background: </strong>While chronic low back pain (CLBP) impairs individuals' capacity to perform activities of daily living (ADL), objective, performance-based assessments of functional capacity in this patient population remain limited.</p><p><strong>Purpose: </strong>This study aimed to investigate the test-retest reliability and construct validity of the Glittre-ADL test as an assessment tool for ADL and functional capacity in individuals with CLBP.</p><p><strong>Methods: </strong>This cross-sectional study involved 42 participants (28 female, 14 male), with a median age of 42.50 years (Q1-Q3: 24.50-54.25). The Glittre-ADL test was used to evaluate ADL performance. Construct validity was examined by correlating Glittre-ADL performance with comparator measures assessing related domains, including functional exercise capacity using the 6-minute walk test (6MWT), lower extremity endurance using the 1-minute sit-to-stand test (1STS), functional mobility using the timed up and go (TUG) test, and self-reported disability using the Oswestry Disability Index (ODI). Test-retest reliability was evaluated by repeating the Glittre-ADL test after a one-week interval. The intraclass correlation coefficient [ICC(A,1)], standard error of measurement (SEM), and minimal detectable change at the 95% confidence level (MDC95) were subsequently calculated.</p><p><strong>Results: </strong>The ICC(A,1) for repeated Glittre-ADL measurements was 0.776 (95% CI: 0.389-0.903), with an SEM of 0.40 min and an MDC95 of 1.12 min. Strong correlations were observed between the first Glittre-ADL test result and 6MWT distance (<i>r</i> =  -0.789, <i>p</i> < .001) and TUG time (<i>r</i> = 0.797, <i>p</i> < .001). Moderate correlations were observed with 1STS repetitions (<i>r</i> =  -0.531, <i>p</i> < .001) and ODI score (<i>r</i> = 0.542, <i>p</i> < .001), supporting its construct validity.</p><p><strong>Conclusion: </strong>As an objective, performance-based measure, the Glittre-ADL test demonstrated evidence of test-retest reliability and construct validity for assessing ADL-related functional limitations in individuals with CLBP. However, completion time was systematically shorter at the second assessment, suggesting a possible learning or familiarization effect; therefore, changes observed across repeated Glittre-ADL assessments should be interpreted cautiously.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197426","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":"Therapeutic alliance development in physical therapy for people with serious mental illness: a qualitative study.","authors":"Meredith Cimmino, Michelle Zechner, Gerard Fluet, Pamela Rothpletz-Puglia, Saren Nonoyama","doi":"10.1080/09593985.2026.2749514","DOIUrl":"https://doi.org/10.1080/09593985.2026.2749514","url":null,"abstract":"<p><strong>Purpose: </strong>Physical therapy (PT) has been demonstrated to be beneficial for people with serious mental illness (SMI). Literature in this field is emerging and growing rapidly. However, little is known about how therapeutic relationships are formed in PT for people with SMI. Expanding our knowledge of how people with serious mental illness perceive and experience their relationships with physical therapists, and how these perceptions impact the development of therapeutic alliance (TA), may inform the development of strategies to enhance TA. The purpose of this study was to explore how people with SMI perceive the development of TA with their therapists during PT.</p><p><strong>Methods: </strong>This study employed an interpretive descriptive qualitative approach, utilizing interviews with study participants. This qualitative study analyzed interview transcripts from 30 adults with SMI who had received skilled PT. Interview transcripts were analyzed using inductive and deductive applied thematic analysis, informed by Peplau's Interpersonal Relations Theory and core principles of psychiatric rehabilitation.</p><p><strong>Results: </strong>Six themes were generated: 1) orient to care, 2) develop a strong relationship, 3) provide person-centered care, 4) importance of life history, 5) it takes time, and 6) empower to get better.</p><p><strong>Conclusions: </strong>The findings of this study provide preliminary evidence supporting factors that drive the development of a therapeutic alliance for individuals with SMI in PT. Our findings suggest that PTs treating people with SMI should consider: 1) offering a pre-examination orientation using Peplau's Interpersonal Relations Theory as a guide; 2) allow for extra time for relationship building; 3) engage clients as active partners throughout the rehabilitation process; and 4) demonstrate respect for a patient with SMI's personal boundaries during all stages of care. These recommendations are supported by the core psychiatric rehabilitation principles of empowerment, person-centered care, and collaborative partnership. Adding them to PT practice may enhance engagement in rehabilitation for people with SMI, making PT more inclusive and recovery-oriented.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197419","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":"Body mass index is associated with muscle strength, functional capacity, balance, and quality of life in patients with type 2 diabetes: A cross-sectional study.","authors":"Sule Topcu Sahin, Semiramis Ozyilmaz, Muhammed Tunc","doi":"10.1080/09593985.2026.2745704","DOIUrl":"https://doi.org/10.1080/09593985.2026.2745704","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is accompanied by obesity and elevated body mass index (BMI), which may be associated with poorer physical function and quality of life (QOL). However, associations of BMI with muscle strength, functional capacity, balance, and QOL have not been comprehensively evaluated together in T2DM.</p><p><strong>Purpose: </strong>To evaluate associations of BMI with muscle strength, functional capacity, balance, and QOL in patients with T2DM.</p><p><strong>Methods: </strong>Patient characteristics were recorded. Body composition, muscle strength, functional capacity, balance, and QOL were assessed using validated measures. Bivariate Pearson correlations were supplemented by partial correlations controlling for age, sex, height, diabetes duration, glycated hemoglobin A1c (HbA1c), and insulin use.</p><p><strong>Results: </strong>Fifty patients with T2DM were included (age: 52.90 ± 9.27 years; BMI: 33.76 ± 7.18 kg/m²). In unadjusted analyses, higher BMI was associated with greater adiposity, lower skeletal muscle mass percentage and handgrip strength, shorter 6-minute walk test (6MWT) distance, lower Berg Balance Scale scores, and poorer QOL, but not with quadriceps strength, resting metabolic rate, Biodex balance parameters, or several QOL subdomains. After adjustment, BMI remained associated with body fat percentage (partial <i>r</i> = 0.854, <i>p</i> < .001), skeletal muscle mass percentage (partial <i>r</i> = -0.665, <i>p</i> < .001), 6MWT distance (partial <i>r</i> = -0.545, <i>p</i> < .001), and Nottingham Health Profile (NHP) pain (partial <i>r</i> = 0.426, <i>p</i> = .004), mobility (partial <i>r</i> = 0.440, <i>p</i> = .003), and total score (partial <i>r</i> = 0.351, <i>p</i> = .019). Associations with handgrip strength (<i>p</i> = .728) and Berg Balance test score were no longer significant (<i>p</i> = .069).</p><p><strong>Conclusion: </strong>After adjustment for confounders, higher BMI remained associated with higher body fat percentage, lower skeletal muscle mass percentage, shorter 6MWT distance, and poorer QOL, whereas associations with handgrip strength and functional balance were attenuated. BMI-related functional findings should be interpreted cautiously in light of potential confounding.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208085","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":"Trends in Australia's physiotherapy workforce: changes and future implications.","authors":"Stephanie Burke, Asmita Mudholkar, Kehinde Obamiro","doi":"10.1080/09593985.2026.2745705","DOIUrl":"https://doi.org/10.1080/09593985.2026.2745705","url":null,"abstract":"<p><strong>Introduction: </strong>Physiotherapists play a vital role in managing and rehabilitating patients across the lifespan who suffer from musculoskeletal diseases and broader health conditions. Yet, there are current and anticipated shortages of physiotherapists being reported in several areas of healthcare where specialized skills are required.</p><p><strong>Objective: </strong>The objective of this study was to examine Australia's physiotherapy workforce, describing the demographic profile and trend of the workforce between 2013 and 2023, workforce distribution by state and rurality, workforce comparison between 2013 and 2023, and predictors of practicing in regional, rural, and remote locations in 2023.</p><p><strong>Methods: </strong>The National Health Workforce Dataset (NHWDS) was analyzed over an 11-year period. Descriptive statistics were used to describe demographic characteristics. Multinomial regression analysis was used to assess associations between demographic characteristics and rural and remote practice.</p><p><strong>Results: </strong>Nationally, the number of physiotherapists increased from 21,046 in 2013 to 35,889 in 2023, a 70.5% increase, with a less‑than‑1% change in the distribution of the workforce to rural and remote areas. In 2023, 22,290 (62.1%) of physiotherapists were female, and 3,652 (10.7%) obtained their primary qualification overseas. In 2023, males were 15% less likely to practice in regional centers (vs metropolitan) compared to females [0.85 (0.78-0.92), <i>p</i> < .001]; also, males were less likely to practice in large, medium, and small rural towns as well as remote and very remote areas [0.73 (0.58-0.93), <i>p</i> = .009] compared to females. Physiotherapists aged 45-99 years were more likely to practice in large rural towns; however, they were less likely to practice in remote and very remote areas than those aged 20-34 years. Indigenous physiotherapists were 85% more likely to practice in regional centers [1.85 (1.31-2.61), <i>p</i> < .001] and across large, medium, and small rural towns as well as in remote and very remote areas compared to metropolitan regions, respectively.</p><p><strong>Conclusion: </strong>Analysis of the NHWDS over an 11-year period suggests an ongoing maldistribution of the physiotherapy workforce, with 81.0% practicing in a metropolitan area in 2023. Males were significantly less likely to practice outside metropolitan areas across all locations, whereas Indigenous physiotherapists were significantly more likely to practice outside metropolitan areas across all locations. Strategies focusing on education practices, incentives, and support that would make rural and remote practice more attractive for the workforce are required.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197483","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":"Exploring patient experiences of same-day discharge after hip and knee arthroplasty: a qualitative study.","authors":"Martin van Heerden, Monique M Keller, Sandy Lord","doi":"10.1080/09593985.2026.2746477","DOIUrl":"https://doi.org/10.1080/09593985.2026.2746477","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored and compared patient experiences of same-day discharge (SDD) following total hip (THA) and knee arthroplasty (TKA) in South Africa's private healthcare sector, aiming to understand perceptions, recovery processes, and implications for rehabilitation.</p><p><strong>Methods: </strong>A qualitative design using semi-structured interviews was undertaken with participants following SDD THA and TKA. Interviews were conducted 6 weeks postoperatively. Data from each procedure group were analyzed independently using inductive thematic analysis before comparative analysis. Trustworthiness was enhanced through triangulation, peer debriefing, and member checks.</p><p><strong>Results: </strong>Twenty-four participants (THA: <i>n</i> = 14; TKA: <i>n</i> = 10) were interviewed. Participants reported high satisfaction with SDD, with structured care, interdisciplinary (IDT) support, and preoperative education facilitating recovery. However, procedure-specific differences were identified. THA participants emphasized emotional reassurance, relational support, and intrinsic motivation, whereas TKA participants described greater physical challenges, particularly pain, mobility limitations, and sleep disturbance. Effective pain management, caregiver support, and coordinated interdisciplinary care were important across both groups.</p><p><strong>Conclusions: </strong>SDD was positively experienced within this South African private healthcare setting, but recovery experiences differed meaningfully between THA and TKA. These findings support procedure-specific rehabilitation pathways, incorporating common elements of preparation and interdisciplinary care while addressing the differing physical, functional, and emotional priorities associated with THA and TKA recovery.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185328","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":"Bothersome and activity-limiting pain in community-dwelling older adults with versus without stroke: a cross-sectional analysis of the National Health and Aging Trends study (2011-2024).","authors":"Shivananda Venkata Reddy, Aby Mathew, Thomas Dombrowsky, Arunachalam Ramachandran, S Hariharan, K Chandrakumar","doi":"10.1080/09593985.2026.2745706","DOIUrl":"https://doi.org/10.1080/09593985.2026.2745706","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke and pain are common health challenges among older adults. However, limited research has examined the burden of pain among community-dwelling older adults with a history of stroke in the United States of America (USA). This study aimed to estimate the prevalence of bothersome and activity-limiting pain and examine the association between stroke history and pain outcomes among older adults in the USA.</p><p><strong>Materials and methods: </strong>This cross-sectional secondary analysis used publicly available data from Rounds 1-14 of the National Health and Aging Trends Study (NHATS), conducted from 2011 to 2024. The study included adults aged ≥ 65 years and compared participants with and without a self-reported physician-diagnosed history of stroke. Pain outcomes were derived from standardized NHATS interview data and included bothersome pain and activity-limiting pain. Demographic, clinical, psychological, physical, and sleep-related variables were obtained from the NHATS dataset. Survey-weighted multivariable logistic regression was used to examine the associations between stroke history and pain outcomes after adjustment for relevant covariates.</p><p><strong>Results: </strong>Among 12,797 participants, 2,235 (15.71%) had a history of stroke, and 10,562 (84.29%) did not. The prevalence of bothersome pain was higher among participants with stroke than among those without stroke (60.77% vs. 54.66%; <i>p</i> = .003). Similarly, activity-limiting pain was more prevalent among participants with stroke (62.83% vs. 52.00%; <i>p</i> < .001). After adjustment for demographic, clinical, psychological, physical, and sleep-related factors, stroke remained independently associated with bothersome pain (OR 1.30, 95% CI 1.02-1.66; <i>p</i> = .034) and activity-limiting pain (OR 1.20, 95% CI 1.04-1.38; <i>p</i> = .013).</p><p><strong>Conclusions: </strong>Pain represents a substantial burden among U.S. older adults with a history of stroke. Stroke was independently associated with both bothersome and activity-limiting pain, highlighting the importance of comprehensive pain assessment and management within geriatric stroke rehabilitation.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166384","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":"Night-time sling use improves sleep, pain, and anxiety early after arthroscopic rotator cuff repair: a retrospective study.","authors":"Fenghua Zhang, Jie Xu, Qian Zhang","doi":"10.1080/09593985.2026.2744783","DOIUrl":"https://doi.org/10.1080/09593985.2026.2744783","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sleep disturbance is common after arthroscopic rotator cuff repair (ARCR). Although abduction braces are routinely used to protect the repair, they may impair sleep and comfort. This study evaluated whether replacing the brace with a simple sling at night was associated with improved early postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective comparative study included 92 patients undergoing ARCR. Patients were classified according to routine postoperative immobilization: continuous abduction-brace use (brace group, <i>n</i> = 46) or daytime brace use with a simple sling during habitual overnight sleep (sling group, <i>n</i> = 46). Sleep quality was assessed using a visual analog scale (VAS) and the Medical Outcomes Study Sleep Scale (MOS-SS), pain using a numerical rating scale (NRS), anxiety using the Hamilton Anxiety Rating Scale (HAMA), and shoulder function using the Constant-Murley Score (CMS). Patient satisfaction was also evaluated.</p><p><strong>Results: </strong>The sling group had better sleep VAS scores at postoperative night 3, week 1, and week 6 (all <i>p</i> < .001). At week 6, the sling group had longer sleep duration (7.02 vs. 6.61 hours, <i>p</i> = .023), lower MOS-SS 10-item composite scores (31.98 vs. 35.20, <i>p</i> < .001), lower pain NRS scores (1.46 vs. 2.22, <i>p</i> < .001), and lower HAMA scores (4.89 vs. 6.20, <i>p</i> < .001). CMS values were comparable between groups throughout follow-up, while satisfaction was higher in the sling group (100% vs. 78.26%, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>Nighttime sling use after ARCR was associated with better early sleep, less pain and anxiety, and greater satisfaction without an observed difference in functional recovery. Because treatment allocation was nonrandom and structural healing was not assessed, these findings should be interpreted cautiously.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171303","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":"Early clinical outcomes following reverse shoulder arthroplasty or InSpace balloon implantation for irreparable massive rotator cuff tears: An exploratory retrospective cohort study.","authors":"Mingdi Zheng, Linyan Cong, Longji Zhao, Zhilin Cao, Junjie Jiang, Tao Sun, Shiwei Ju, Gong Cheng","doi":"10.1080/09593985.2026.2744784","DOIUrl":"https://doi.org/10.1080/09593985.2026.2744784","url":null,"abstract":"<p><strong>Purpose: </strong>To compare early pain, functional, and perioperative outcomes following reverse total shoulder arthroplasty (RTSA) or InSpace balloon implantation for irreparable massive rotator cuff tears (IRCTs), interpreting differences as exploratory, non-causal associations.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 29 patients treated between June 2023 and June 2025 (RTSA, <i>n</i> = 15; InSpace, <i>n</i> = 14). Treatment was non-randomized. Operative measures and visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Constant-Murley scores were compared at 6 weeks and 3 months using exploratory time-point analyses with Holm adjustment for the six postoperative score comparisons.</p><p><strong>Results: </strong>The InSpace group had shorter median operative time (72.5 versus 130.0 min; <i>p</i> = .013) and lower median blood loss (20.0 versus 200.0 mL; <i>p</i> < .001). Median VAS, ASES, and Constant-Murley scores were more favorable in the InSpace group at both postoperative assessments (all <i>p</i> ≤ .021); the 95% CIs for all six postoperative between-group comparisons excluded zero, and all six comparisons remained statistically significant after Holm adjustment. These were unadjusted time-point associations; the analysis did not estimate between-group differences in recovery trajectory.</p><p><strong>Conclusions: </strong>In this small, non-randomized cohort, the observed early between-group differences may reflect differences in clinical indication, rehabilitation exposure, and other residual confounding. They do not establish causal treatment effects, clinical superiority, comparable safety, or durability. The findings are hypothesis-generating and require confirmation in adequately powered prospective randomized studies with longitudinal analysis and long-term follow-up. For physiotherapists, these findings support a 4-6-week protection phase before active motion after reverse total shoulder arthroplasty versus earlier tolerated motion after InSpace implantation, with strengthening introduced at approximately 6 weeks when pain control and movement quality permit; they do not establish the superiority of either rehabilitation pathway.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171075","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}