Physiotherapy Theory and Practice最新文献

{"title":"The Australian physiotherapy attrition and retention collaboration project: practitioner perspectives.","authors":"Sunita Bayyavarapu Bapuji, Jade Tan, Lee Barclay, Rechu Divakar, Eva Saar, Bronwyn Darmanin, Paula Harding, Sheila Lennon, Gillian McDermott, Jackie Robertson, Lowana Williams, Sarah Anderson, Kim Gibson","doi":"10.1080/09593985.2026.2667374","DOIUrl":"https://doi.org/10.1080/09593985.2026.2667374","url":null,"abstract":"<p><strong>Background: </strong>Australia's healthcare system, a crucial economic pillar, faces significant workforce shortages, impacting its ability to meet increasing demand. These shortages, particularly acute for physiotherapists, are exacerbated by an aging population, rising chronic disease incidence, and the COVID-19 pandemic. The Australian Government's 2024 Skills Priority List confirms this national shortage, highlighting the urgent need for strategies to improve workforce planning, expand roles, and enhance retention. Therefore, it is vital to gain a deeper understanding of why Australian physiotherapists leave clinical practice and what would encourage them to remain.</p><p><strong>Objective: </strong>This study aimed to explore physiotherapists' perspectives on factors associated with the retention and attrition of physiotherapists in Australia and to identify potential strategies to encourage physiotherapists to stay in practice.</p><p><strong>Methods: </strong>This study used a mixed-data collection approach, qualitatively analyzing open-ended cross-sectional survey responses from Australian registered physiotherapists and 21 semi-structured interviews with physiotherapists who volunteered to provide further insights.</p><p><strong>Results: </strong>Study analysis identified four themes: (1) Anchors of physiotherapists retention, (2) Barriers to workforce entry: Navigating identity and system constraints, 3) Drivers of physiotherapists' attrition and (4) Retention strategies: Addressing systemic constraints and individual needs to sustain clinical engagement. These themes demonstrate the complex, bidirectional relationships between factors influencing physiotherapist workforce retention, highlighting a profession sustained by purpose but challenged by systemic issues.</p><p><strong>Conclusion: </strong>Overall, a collegial work environment, the ability to work close to family and being embedded in the local community, and career advancement motivate physiotherapists to stay in the profession. Conversely, poor financial sustainability, limited career progression pathways, and poor workplace conditions and burnout contribute to attrition. Strategies to support retention include improved remuneration, more opportunities for career progression and a focus on preventing burnout.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-20"},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857495","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":"The relationship between trapezius muscle oxygenation, respiratory and peripheral muscle strength, and functional performance in patients with chronic neck pain.","authors":"Başak Kavalcı Kol, Merve Fırat, Figen Tuncay","doi":"10.1080/09593985.2026.2665405","DOIUrl":"https://doi.org/10.1080/09593985.2026.2665405","url":null,"abstract":"<p><strong>Background: </strong>Chronic neck pain is a common musculoskeletal disorder associated with functional limitations and reduced activities of daily living. The upper trapezius muscle plays an important role in posture, scapular stabilization, and accessory respiration, and may be affected metabolically in chronic neck pain. This study aimed to investigate the relationship between trapezius muscle oxygenation and respiratory and peripheral muscle strength and functional performance in patients with chronic neck pain.</p><p><strong>Methods: </strong>Fifty-one patients with chronic neck pain (age: 53.4 ± 12.3 years) were included in the study. Muscle oxygenation (Moxy® monitor), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (mouth pressure device), peripheral muscle strength (hand-held dynamometer), upper extremity functional exercise capacity (six-minute pegboard and ring test [6-PBRT]), and activities of daily living (ADL) (Glittre ADL test) were evaluated.</p><p><strong>Results: </strong>The minimum trapezius muscle oxygen saturation (SmO₂) value had a moderate, significant positive correlation with MIP (<i>r</i> = 0.511), MEP (<i>r</i> = 0.522), the 6-PBRT score (<i>r</i> = 0.634), and trapezius muscle strength (<i>r</i> = 0.542), and a moderate, significant negative correlation with Glittre ADL test time (<i>r</i> =  -0.581). It showed weak correlations with shoulder abductor and flexor strength, elbow flexor strength, and handgrip strength (<i>r</i> = 0.30-0.49). The maximum SmO₂ value demonstrated moderate correlations with MIP (<i>r</i> = 0.637), MEP (<i>r</i> = 0.606), and trapezius muscle strength (<i>r</i> = 0.590); strong correlations with the 6-PBRT score (<i>r</i> = 0.718) and Glittre ADL (<i>r</i> =  -0.711) test time; and weak correlations with shoulder abductor and flexor strength, elbow flexor strength, and handgrip strength (<i>r</i> = 0.30-0.49). Changes in SmO₂ during exercise were significantly associated with MIP (β = 0.400, R² = 0.160, <i>p</i> = .004), MEP (β = 0.327, R² = 0.107, <i>p</i> = .019), 6-PBRT score (β = 0.510, R² = 0.260, <i>p</i> < .001), and Glittre ADL test time (β = -0.354, R² = 0.125, <i>p</i> = .011).</p><p><strong>Conclusion: </strong>Trapezius muscle oxygenation was associated with respiratory muscle strength, upper extremity exercise capacity, and activities of daily living. These findings suggest that trapezius muscle oxygenation may provide insight into underlying physiological mechanisms related to respiratory and functional impairment.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844830","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":"An examination of patient adherence and feasibility of different home-based exercise programs: a multicenter randomized controlled study.","authors":"Neslihan Altuntaş Yılmaz, Mustafa Karademir, Yavuz Özkan, Abdulkadir Dağbaşı","doi":"10.1080/09593985.2025.2596176","DOIUrl":"10.1080/09593985.2025.2596176","url":null,"abstract":"<p><strong>Background: </strong>Home-based exercise programs (HEPs) are critical for maintaining patient functionality after hospital discharge, yet a consensus on the most effective instruction method is lacking.</p><p><strong>Purpose: </strong>This study aims to examine the feasibility and patient adherence to different HEPs in adult and pediatric patients.</p><p><strong>Methods: </strong>This multicenter, randomized controlled study included 237 adult and 60 pediatric patients. The adult group was given HEPs primarily consisting of strengthening exercises, while the pediatric group focused on stretching. Patients were randomized into one of three groups: verbal instruction only, verbal instruction together with a brochure, and verbal instruction together with a video. Participants and caregivers were evaluated using standardized tools such as the Functional Independence Measure (FIM) or Functional Independence Measure for Children (WeeFIM), the Fatigue Severity Scale (FSS), the State-Trait Anxiety Inventory (STAI), the Visual Analog Scale (VAS), and the Gross Motor Function Classification System (GMFCS). Exercise adherence was measured by the level of confidence in performing the exercises, and exercise feasibility was measured by the number of days exercised and exercise completion percentage.</p><p><strong>Results: </strong>The mean age was 41.50 ± 16.84 years for adults and 12.87 ± 3.92 years for children. No significant difference was observed among the exercise learning types in the adult group (exercise confidence level: <i>p</i> = .936, η² = 0.001; number of days exercised: <i>p</i> = .987, η² = 0.001; exercise completion: <i>p</i> = .942, Cramer's V = 0.108). Similarly, no significant difference was found in the pediatric group (exercise confidence level: <i>p</i> = .536, η² = 0.200; number of days exercised: <i>p</i> = .266, η² = 0.045; exercise completion: <i>p</i> = .342, Cramer's V = 0.194). Furthermore, no significant difference in adherence was found between the age groups.</p><p><strong>Conclusion: </strong>This study suggests that the method of providing HEPs does not significantly impact adherence in either adult or pediatric patient populations. This finding indicates that video-based instruction is not superior to traditional methods like verbal instruction or brochures in improving exercise adherence.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"679-688"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656045","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":"Effects of left and bilateral transcutaneous auricular vagus nerve stimulation on pain, mood, and autonomic nervous system in female patients with fibromyalgia: a randomized controlled trial.","authors":"Mustafa Ferit Akkurt, Ali Veysel Özden, Halil Ekrem Akkurt, Burcu Akkurt, Celaleddin Bildik","doi":"10.1080/09593985.2025.2594572","DOIUrl":"10.1080/09593985.2025.2594572","url":null,"abstract":"<p><strong>Introduction: </strong>Fibromyalgia Syndrome (FMS) is a complex disease characterized by widespread pain, fatigue, emotional disturbances, and autonomic dysfunction. Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) has emerged as a potential noninvasive approach to modulate FMS-related symptoms.</p><p><strong>Purpose: </strong>To compare the effects of left and bilateral taVNS on pain, mood, functionality, and autonomic nervous system (ANS) activity in individuals with FMS.</p><p><strong>Methods: </strong>Forty female individuals with FMS were assigned to either a left (<i>n</i> = 20) or a bilateral (<i>n</i> = 20) taVNS group. Both received 11 sessions of taVNS targeting the tragus and concha regions (30 minutes each, 25 Hz, 300 µs) over nonconsecutive days, excluding weekends and menstrual periods. Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ) were assessed. ANS activity was evaluated via heart rate variability (HRV). After 11 sessions of taVNS, a 2-week follow-up was performed.</p><p><strong>Results: </strong>No significant differences were observed between groups except for FIQ and BAI on day 28 (<i>p</i> = .002-0.008). Both groups showed significant within-group improvements in VAS (<i>r</i> = 0.87-0.94; <i>p</i> < .001), BDI (<i>r</i> = 0.46-0.71; <i>p</i> < .001), FIQ (<i>r</i> = 0.95-0.99; <i>p</i> < .001), and BAI (<i>r</i> = 0.69-0.94; <i>p</i> < .001) scores. Parasympathetic Nervous System (PNS) (<i>p</i> = .365-0.776) and Sympathetic Nervous System (SNS) (<i>p</i> = .598-0.880) indices, which are the subparameters of HRV, showed no significant between-group differences, with small effect sizes (<i>r</i> < 0.15).</p><p><strong>Conclusion: </strong>Both stimulation protocols effectively reduced pain and improved mood and functionality in fibromyalgia, indicating a safe, noninvasive adjunctive treatment option.</p><p><strong>Clinicaltrials.gov: </strong>(Identifier: NCT06871306).</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"657-667"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661964","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":"Headache, not neck pain, primarily influences the extent of pain in the neck region in symptomatic office workers. Cross-sectional and longitudinal evaluations.","authors":"Mariya Marchenko, Lúcia Domingues, Marco Barbero, Corrado Cescon, Deborah Falla, Markus J Ernst","doi":"10.1080/09593985.2025.2596179","DOIUrl":"10.1080/09593985.2025.2596179","url":null,"abstract":"<p><strong>Background: </strong>Neck pain and headache are common among office workers and lead to a significant personal, societal and economic burden. Whether the area of pain or pain extent (PE) obtained from pain drawings by the office workers themselves can be explained and predicted by clinical outcomes such as pain intensity, frequency or disability is the aim of the current study.</p><p><strong>Objectives: </strong>To examine whether clinical outcomes related to neck pain and headache can explain the PE in the head and neck region at baseline (cross-sectional analysis), and predict the PE at follow-up (longitudinal analysis) in office workers with neck pain and/or headache.</p><p><strong>Methods: </strong>Secondary analysis of a cluster randomized controlled trial with 112 participants. The focus of this analysis was on the associations between neck pain variables (occurrence, average and maximal pain intensity ratings, and disability) and headache variables (occurrence, headache intensity, frequency and impact) with PE of the two regions. Data was analyzed using general linear models for both cross-sectional and longitudinal data.</p><p><strong>Results: </strong>Headache occurrence and frequency explained 26% of the PE variance for the neck region at baseline. Further, baseline headache frequency, maximum neck pain intensity (<i>p</i> = .07). and age, could explain 21% of the variability in neck PE at follow-up: For the head region statistical assumptions for modeling data were not met.</p><p><strong>Conclusion: </strong>Frequent headaches are closely related with PE in the neck region in symptomatic office workers. There is a strong need to additionally screen and assess for headache features in office workers with neck pain.</p><p><strong>Clinical trial number: </strong>NCT04169646. Registered November 15, 2019.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"689-699"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745248","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":"Physiotherapists' knowledge and attitudes toward pediatric pain in Maharashtra state of India: A survey.","authors":"Medha A Shrivastava, Rinkle J Malani, Pallavi R Palaskar","doi":"10.1080/09593985.2025.2596180","DOIUrl":"10.1080/09593985.2025.2596180","url":null,"abstract":"<p><strong>Background: </strong>Pediatric pain is complex due to physiological, psychological, and social factors. Evidence suggests that untreated childhood pain might have long-term physical and mental effects. While physiotherapists are key in pediatric care, research from India remains scarce. In the Indian context, children's pain is frequently underestimated due to cultural norms, limited pain education in physiotherapy curricula, and inconsistent access to resources. Maharashtra, as a diverse and populous state, presents specific challenges where physiotherapists' knowledge and attitudes directly influence pediatric care.</p><p><strong>Objective: </strong>Examining the knowledge and attitudes of physiotherapists in Maharashtra with relation to the management of pediatric pain was the primary goal of this research.</p><p><strong>Methods: </strong>Using the Pediatric Healthcare Provider's Knowledge and Attitudes Survey Regarding Pain, 152 physiotherapists completed a descriptive, online cross-sectional survey. A convenience sample was used to recruit participants from a range of clinical settings in Maharashtra. Using SPSS version 25.0, we examined the data and found significant relationships between variables using chi-square tests.</p><p><strong>Results: </strong>A total of 124 therapists responded (81.6%) from which most participants (59.7%) demonstrated average knowledge, while 39.5% had good knowledge. Educational qualification (<i>p</i> = .002) and clinical experience (<i>p</i> = .023) were significantly associated with higher knowledge levels. Gender and age showed no significant impact. Gaps were observed in pharmacological knowledge, infant pain perception, and cultural sensitivity. Although a majority supported proactive pain management, inconsistencies were noted in opioid use and pain assessment.</p><p><strong>Conclusion: </strong>Physiotherapists in Maharashtra show a foundational understanding of pediatric pain, yet notable gaps remain. Continued education, standardized protocols, and culturally competent training are essential for improving care.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"749-757"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835038","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":"Perceived challenges and solutions to providing rural physical therapy services: A qualitative inquiry of provider experience.","authors":"Kelly Atkins, Maegan Powell, Morgan Boyd, Lillian Cook, Sarah Ross, C Scott Bickel","doi":"10.1080/09593985.2025.2594571","DOIUrl":"10.1080/09593985.2025.2594571","url":null,"abstract":"<p><strong>Background: </strong>Persons living in rural areas face increased rates of multiple chronic health conditions and all-cause mortality. Physical therapy can positively impact disease prevention and wellness; however, a lack of rural providers limits access to physical therapy services and subsequent benefits in rural areas. This study aims to gain insights on physical therapists' experiences providing rural physical therapy services.</p><p><strong>Methods: </strong>This qualitative study employed a phenomenological approach to capture the perspectives of physical therapists practicing in rural Alabama on providing healthcare services. Participants were recruited using convenience and snowball methods, and each participant completed a semi-structured telephone or Zoom interview. Interview data were coded independently by two separate members of the research team with subsequent group verification. Recruitment continued until saturation was achieved.</p><p><strong>Results: </strong>Three themes emerged from 15 participants: 1) System-wide challenges in rural healthcare; 2) Personal considerations in providing rural healthcare; and 3) Proposed solutions to identified challenges.</p><p><strong>Conclusion: </strong>Participants identified inadequate staffing, reduced access to specialty services, and financial concerns as system-wide challenges. Personal considerations included professional isolation, expansive caseloads, and aversion to rural living as challenges, while community pride and responsibility were identified as personal benefits to providing rural healthcare. Proposed solutions included financial incentives for providers, physical therapy student exposure to rural settings, and use of telehealth services. Interactions between themes and subthemes emerged, highlighting potential factors contributing to difficulty adequately staffing rural physical therapists.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"710-724"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641550","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":"Comparison of scapular muscle activity during Y-raise exercise with isometric adduction in subjects with and without rounded shoulder posture.","authors":"Byeong-Hun Hwang, In-Cheol Jeon","doi":"10.1080/09593985.2025.2594569","DOIUrl":"10.1080/09593985.2025.2594569","url":null,"abstract":"<p><strong>Background: </strong>Rounded shoulder posture (RSP) is a commonly observed abnormal alignment of the scapula. RSP is typically associated with shortening of the pectoralis muscle and weakness of the lower trapezius (LT). Changed muscle length of these muscles may result in different movement patterns compared to healthy subjects when performing exercises.</p><p><strong>Purpose: </strong>We investigated to compare the muscle activity of the upper trapezius (UT), LT, and serratus anterior (SA) between healthy and RSP groups during Y-raise exercises with and without isometric adduction (IAD) using an elastic band.</p><p><strong>Methods: </strong>A cross-sectional study with a single data collection session, participants were classified according to the criteria for RSP and assigned to either the healthy group (25.06 ± 1.24, <i>n</i> = 16) or the RSP group (24.88 ± 2.09, <i>n</i> = 16). Surface electromyography was used to measure muscle activity of the UT, LT, and SA during the exercises.</p><p><strong>Results: </strong>UT and SA muscle activity significantly decreased during the Y-raise with IAD compared to the Y-raise without IAD in both groups (<i>p</i> < .025). Conversely, LT muscle activity significantly increased during the Y-raise with IAD compared to the Y-raise without IAD in the healthy group (<i>p</i> < .025), while LT activity significantly decreased in the RSP group (<i>p</i> < .025).</p><p><strong>Conclusion: </strong>Applying IAD during the Y-raise exercise is effective for selectively increasing LT activity while decreasing UT and SA activity in the healthy group. However, structural improvement of scapular alignment may be required for subjects with RSP to perform the Y-raise with IAD effectively.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"649-656"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655974","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":"Experiences of video-based and in-person initial consultations in individuals presenting with knee-related symptoms: A qualitative comparison.","authors":"Matilda Nyqvist, Emma Lithner, Joakim Hall, Thea Ekman, Elvira Lange","doi":"10.1080/09593985.2025.2597387","DOIUrl":"10.1080/09593985.2025.2597387","url":null,"abstract":"<p><strong>Introduction: </strong>Video-based physiotherapy consultations are increasingly implemented within primary care, yet insight about patients' subjective experiences remains limited. Prior research has primarily examined the reliability and validity of video-based physical assessments. However, a qualitative approach is useful while studying patients' experiences of physiotherapy.</p><p><strong>Objective: </strong>To explore and contrast patients' experiences of initial physiotherapy consultations for individuals presenting with knee-related symptoms delivered via video or in-person in a primary care context.</p><p><strong>Methods: </strong>A comparative qualitative study was conducted using individual, semi-structured interviews with 15 participants (8 in-person, 7 video-based). Data were analyzed using inductive qualitative content analysis. Separate analyses were conducted for each group, followed by a comparative thematic synthesis to identify converging and diverging experiences across consultation formats.</p><p><strong>Results: </strong>Participants with various knee-conditions were recruited from primary health care in both rural and urban areas. The analysis resulted in 5 categories and 19 subcategories. The categories were: <i>Practical circumstances regarding the consultation, The need for communication and clear instructions, Video-based physiotherapy places new demands on the patient, Building a partnership</i>, and <i>Establishing confidence in the physiotherapy consultation.</i></p><p><strong>Conclusion: </strong>In both in-person and digital settings, it is essential that physiotherapy is delivered in a way that fosters trust. Limited nonverbal communication in video-based consultations may hinder the development of trust and therapeutic alliance, shifting its foundation from interpersonal connection to perceived professional competence. Both consultation formats revealed a shared desire for more thorough examination, despite existing evidence supporting the adequacy of physiotherapy assessments. These findings suggest that video-based consultations are still perceived as a novel and evolving format, requiring time, experience, and clear communication to achieve broader acceptance.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"738-748"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702628","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 goals, roles, and scopes of advanced practice physiotherapy in French primary and secondary specialized care settings: a qualitative multi-step study.","authors":"Anthony Demont, Olivier Daudier, Yvan Tourjansky","doi":"10.1080/09593985.2025.2594577","DOIUrl":"10.1080/09593985.2025.2594577","url":null,"abstract":"<p><strong>Background: </strong>The increasing burden of chronic diseases and limited physician availability in France have prompted interest in new care models. Advanced practice physiotherapy (APP), involving greater autonomy and the delegation of certain medical tasks, has been successfully implemented in several countries but remains unexplored in the French healthcare system.</p><p><strong>Objective: </strong>To explore perceptions of healthcare facility managers, physicians, and physiotherapists regarding the integration of APPs into primary and secondary specialized care settings in France, and to co-develop context-specific care models defining their roles, tasks, and target patient populations.</p><p><strong>Methods: </strong>A multi-step qualitative study was conducted, beginning with a scoping review of international APP models. Focus groups were then organized with stakeholders from diverse care settings in the Ile-de-France region. Discussions focused on unmet care needs, the relevance of APP roles, and appropriate tasks. Data were thematically analyzed and used to construct tailored care frameworks.</p><p><strong>Results: </strong>Across five focus groups, including a total of 30 participants, key objectives for implementing APPs were identified: improving access to care, reducing physician workload, optimizing physiotherapy skills, and enhancing care coordination. Suitable patient groups included individuals with musculoskeletal disorders (acute or post-surgical), stabilized neurological diseases, and chronic respiratory conditions. Stakeholders agreed on core APP competencies: clinical assessment, diagnostic test prescription and interpretation (e.g. imaging, pulmonary function tests), therapeutic management (e.g. rehabilitation, analgesics, ventilatory settings), and coordination within multidisciplinary teams.</p><p><strong>Conclusions: </strong>APPs are perceived as a promising solution to current challenges in care access and coordination. The co-constructed frameworks demonstrate broad stakeholder support and broad stakeholder support, suggesting perceived feasibility, in both primary and secondary specialized care settings.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"725-737"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606768","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}