Physiotherapy Theory and Practice最新文献

{"title":"Post-discharge kinesiophobia trajectories and rehabilitation outcomes in post-stroke hemiplegia.","authors":"Hongjin Ge, Xinyu Zhang, Wei Chen, Jiayi Zhang, Xiaoyang He, Haiyue Li, Yafei Wang, Peng Chen, Xinying Zheng, Rufu Jia","doi":"10.1080/09593985.2026.2708226","DOIUrl":"https://doi.org/10.1080/09593985.2026.2708226","url":null,"abstract":"<p><strong>Background: </strong>Kinesiophobia may reduce participation in post-stroke rehabilitation and impede functional recovery, but its course after discharge and its clinical significance remain unclear. This study identified 6-month trajectories of kinesiophobia in patients with post-stroke hemiplegia and examined their associations with motor recovery and rehabilitation exercise adherence.</p><p><strong>Methods: </strong>In this single-center prospective longitudinal study, 296 patients with post-stroke hemiplegia were assessed at discharge and at 1, 3, and 6 months after discharge. Baseline discharge assessment occurred a mean of 18.7 ± 5.8 days after stroke onset, so the follow-up window captured both early subacute and later community recovery phases. Kinesiophobia was measured with the validated Chinese Tampa Scale for Kinesiophobia (TSK-17), motor recovery with the Fugl-Meyer Assessment (FMA), and rehabilitation exercise adherence with the validated Chinese Engagement in Exercise Rehabilitation Scale for Patients with Stroke (EERS), assessed from month 1 onward. Self-report measures could be completed by standardized face-to-face or telephone interview when outpatient attendance was not possible, whereas FMA was assessed only by trained raters during outpatient or home-based in-person visits. Kinesiophobia trajectories were identified using latent class growth analysis. Associations with repeated FMA and EERS outcomes were analyzed using adjusted linear mixed-effects models, and baseline predictors of trajectory membership were examined with a bias-adjusted three-step multinomial logistic model.</p><p><strong>Results: </strong>A three-class solution showed the best fit: persistent-low (138/296, 46.6%), decreasing-moderate (112/296, 37.8%), and persistent-high (46/296, 15.5%). Trajectory membership was significantly associated with both motor recovery and rehabilitation exercise adherence over time (time-by-class interaction, both <i>p</i> <.001). At 6 months, adjusted mean FMA scores were 74.2, 65.9, and 50.6 across the three classes, and corresponding EERS scores were 70.5, 66.8, and 55.8. Compared with the persistent-low class, the persistent-high class had markedly poorer motor recovery (mean difference, 23.6 points; 95% CI, 19.2-28.0) and lower exercise adherence (mean difference, 14.7 points; 95% CI, 10.8-18.6), while the decreasing-moderate class showed intermediate deficits. Older age, history of falls, higher anxiety and depression, and lower exercise self-efficacy independently predicted unfavorable trajectories.</p><p><strong>Conclusions: </strong>Post-discharge kinesiophobia follows heterogeneous trajectories in patients with post-stroke hemiplegia. Persistently high kinesiophobia identifies a vulnerable subgroup with poorer motor recovery and lower rehabilitation exercise adherence. Early screening and targeted support may improve post-discharge rehabilitation outcomes.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609070","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":"Determinants of daily activity value in a cross section of adults feeling pain.","authors":"Erin A Dannecker, Lori Popejoy, Gregory F Petroski","doi":"10.1080/09593985.2026.2709827","DOIUrl":"https://doi.org/10.1080/09593985.2026.2709827","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare providers (HCPs) and patients value daily activities differently. So, HCPs routinely assess patients' preferences. To clarify the value of daily activities for people feeling pain, this study examined the influence of daily activity source (questionnaire or participant), daily activity performance, and daily activity-related difficulty and pain. The study also explored participants' perceptions of communicating daily activity-related difficulty and pain to HCPs.</p><p><strong>Methods: </strong>A cross-section of adults (<i>N</i> = 457; Mean age 39.17 years (SD = 16.33)) feeling pain reported the importance, performance, difficulty, and painfulness of daily activities. The sources of the daily activities were questionnaires and participants.</p><p><strong>Results: </strong>The odds of higher daily activity importance were 10.85 times larger for the participant-generated daily activity than the questionnaire and 11.00 times larger for performed daily activities than the not performed. Higher daily activity importance was also associated with daily activity-related pain (odds ratio; OR:2.29) and age (OR:1.07), but not daily activity-related difficulty (OR:0.98). Participants' certainty about daily activity-related difficulty and pain was positively associated with daily activity source (ORs:1.35 and 1.75, respectively) and performance (ORs:1.76 and 1.80, respectively). In addition, the importance of HCPs knowing participants' daily activity-related difficulty and pain was associated with daily activity source (OR:1.94 and OR:1.63, respectively), performance (OR:1.56 and OR: 1.55, respectively), age (OR:1.06 and OR: 1.05, respectively), and daily activity-related difficulty (OR:1.49 and OR: 1.33, respectively) and pain (OR:2.92 and OR:2.92, respectively).</p><p><strong>Conclusions: </strong>These results clarify the daily activities that participants with pain value and want to discuss with their HCPs. This information facilitates the provision of patient-centered care. The results also suggest that the positive relationship between daily activity value and daily activity-related pain is stronger than daily activity-related difficulty. Expectancy value models of health behaviors would benefit from future research comparing the influence of daily activity-related difficulty on daily activity value and the expectation of performing daily activity.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594322","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 reliability and validity of the timed up and go test in individuals following lumbar spinal surgery.","authors":"Mustafa Yalçın, Fatih Özden, Miray Başer, İsmail Uysal, Mehmet Özkeskin, Duygu Baykal, Zübeyir Sarı","doi":"10.1080/09593985.2026.2707231","DOIUrl":"https://doi.org/10.1080/09593985.2026.2707231","url":null,"abstract":"<p><strong>Background: </strong>Although the Timed Up and Go (TUG) test is frequently used in lumbar pathologies, its test - retest reliability, convergent validity, and measurement error have not yet been established in the postoperative period.</p><p><strong>Objective: </strong>The purpose of this study was to comprehensively evaluate the test - retest reliability, convergent validity, andmeasure menterr or of the TUG test in individuals after lumbar spinal surgery.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 100 individuals (mean age 55.0 ± 8.9 years; 48 women, 52 men) at least 6 weeks after lumbar spinal surgery. Participants performed the TUG, Five-Repetition Sit-to-Stand Test (5xSTS), and 10-Meter Walk Test (10MWT). The TUG was repeated after a 1-hour rest period. Test - retest reliability was evaluated using the intraclasss correlation coefficient (ICC_2,1). Measurement error was evaluated using the standard error of measurement (SEM), the minimal detectable change at the 95% confidence level (MDC₉₅), and the Bland - Altman limits of agreement (LoA). Convergent validity was assessed using the Pearson correlation coefficient with the 5xSTS and 10MWT.</p><p><strong>Results: </strong>Excellent test - retest reliability was demonstrated (ICC_2,1 = 0.99; 95% CI: 0.98-0.99). The SEM and MDC₉₅were 0.26 seconds (s) and 0.72 s, respectively. The mean difference (bias) was -0.00 s (95% CI: -0.80 to 0.70), with lower and upper limits of agreement of -0.74 s (95% CI: -0.87 to -0.61) and 0.73 s (95% CI: 0.60 to 0.86), respectively. The TUG showed strong positive correlations with the 5xSTS (<i>r</i> = 0.95, <i>p</i> < .001) and the 10MWT (<i>r</i> = 0.92, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>The TUG is a reliable and valid tool for measuring functional mobility in individuals after lumbar spinal surgery, providing objective data to complement subjective assessments.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580771","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":"Pain neuroscience education versus spinal physiology and ergonomics education in multidisciplinary rehabilitation for chronic low back pain: 12-month follow-up of a randomized controlled trial.","authors":"Nicolas Adenis, Valérie Wieczorek, Sophie Corbinau, Léa Mortain, Vincent Tiffreau, André Thevenon","doi":"10.1080/09593985.2026.2706161","DOIUrl":"https://doi.org/10.1080/09593985.2026.2706161","url":null,"abstract":"<p><strong>Background: </strong>Pain neuroscience education (PNE) combined with active rehabilitation has been shown to improve outcomes in chronic low back pain; however, its comparative effectiveness with other educational approaches within multidisciplinary rehabilitation programs remains unclear, particularly over longer follow-up periods.</p><p><strong>Objective: </strong>To evaluate the effectiveness of pain neuroscience education compared with spinal physiology and ergonomics education(SPEE) within a one-week multidisciplinary rehabilitation program for patients with chronic low back pain at 12-month follow-up.</p><p><strong>Methods: </strong>This study reports the 12-month follow-up of a previously published randomized controlled trial. Eighty-eight patients were randomized to the PNE group (<i>n</i> = 44) or the SPEE group (<i>n</i> = 44). Outcomes included disability (Roland-Morris Disability Questionnaire), pain intensity, fear-avoidance beliefs, kinesiophobia (17-item Tampa Scale of Kinesiophobia [TSK-17]), pain catastrophizing, and anxiety-depression, assessed at baseline, post-intervention, 3 months, and 12 months.</p><p><strong>Results: </strong>All analyses were done among all randomized patients who had not withdrawn before the start of the rehabilitation program (D0) according to the allocated group to which they were assigned at randomization (<i>n</i> = 74). The between-group difference in disability between baseline and 12 months was not statistically significant (mean difference, -1.04; 95 CI%, -3.14 to 1.06; <i>p</i> = .33). The between-group difference in TSK-17 score significantly favored the PNE group at 12 months(-3.97;95%CI, -7.36 to -0.58; <i>p</i> = .022). No significant between-group differences were observed for pain, pain catastrophizing, anxiety, depression or patient satisfaction.</p><p><strong>Conclusion: </strong>At 12 months, PNE improves kinesiophobia scores more than SPEE within a short multidisciplinary rehabilitation program, but does not confer benefits for pain catastrophizing or disability in patients with chronic low back pain.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04179708.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551150","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 the associations of early physical and occupational therapy on outcomes in patients admitted for hematopoietic stem cell transplant via cohort study.","authors":"Sasha E Knowlton, Alexis C Wardell, Sascha Tuchman, Christopher Jensen, William A Wood, Farrell Wiggins, Michelle Leblanc, Alexis Petteway, Paul Armistead","doi":"10.1080/09593985.2026.2701931","DOIUrl":"10.1080/09593985.2026.2701931","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing hematopoietic stem cell transplant (HSCT) for hematologic cancers experience deconditioning postprocedure. Prehabilitation for patients admitted for HSCT improves fitness and has the potential to improve other outcomes as well.</p><p><strong>Objective: </strong>To investigate the associations of early physical and occupational therapy with outcomes for patients admitted for HSCT.</p><p><strong>Methods: </strong>Patients admitted for HSCT at the University of North Carolina between 2021 and 2023 were eligible for inclusion in this study. This chart-review study analyzed a quality improvement initiative started in 2022 to proactively consult physical and occupational therapy (PT/OT) at the time of admission for HSCT with the intent to improve patient outcomes, including reduced 30- and 90-day admissions, length of stay, complications, and improved survival and discharge disposition.</p><p><strong>Results: </strong>There were 206 patients in the proactive cohort and 206 patients in the no‑consult cohort included for analysis. Early physical and occupational therapy consultation at the time of admission for HSCT did not reduce 30- or 90-day readmissions, length of stay, 90-day survival, and no differences in discharge disposition compared to the no‑consult group. Patients who underwent autoHSCT in the proactive group had a higher 30-day admission rate (13% vs 5%, <i>p</i> = .02) and a higher total number of complications (6 vs 5, <i>p</i> = .004) than the no‑consult group.</p><p><strong>Conclusion: </strong>The broader literature regarding prehabilitation of patients awaiting HSCT suggests that prehabilitation is important, and future study is needed to examine the ideal timing for therapy prior to admission for transplant to determine its influence on outcomes beyond functional status.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438523","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":"How do pain-related cognitions relate to lifting techniques in people with lifting-related chronic low back pain? A replicated single-case design study.","authors":"Ivan Pui Hung Au, Nic Saraceni, Anne Smith, Peter O'Sullivan, Leo Ng, Amity Campbell","doi":"10.1080/09593985.2026.2691146","DOIUrl":"https://doi.org/10.1080/09593985.2026.2691146","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain (CLBP) frequently involves lifting as a pain-provoking activity. Pain-related cognitions, such as pain-related fear, pain catastrophizing, and pain self-efficacy, are suggested to influence lifting behavior. However, the longitudinal relationship between changes in lifting kinematics and pain-related cognitions within individuals remains unexplored.</p><p><strong>Objective: </strong>To investigate longitudinal within-person relationships between changes in lifting kinematics and changes in pain-related cognitions in people with lifting-related CLBP.</p><p><strong>Methods: </strong>Five adults (2 females, aged 26-47 years) with lifting-related CLBP participated in a single-case design study. Weekly assessments were conducted during a 4-6-week baseline period, a 12-week Cognitive Functional Therapy intervention (up to 10 sessions), and a 3-month follow-up. Sagittal plane lifting kinematics of the spine and lower extremities were measured using wearable sensors, and pain-related cognitions (pain-related fear, pain catastrophizing, pain self-efficacy) were assessed via online questionnaires. Cross-correlation analyses examined within-person relationships between changes in lifting kinematics and changes in pain-related cognitions.</p><p><strong>Results: </strong>Relationships between changes in lifting kinematics and pain-related cognitions were individual-specific. Changes in lifting techniques were frequently associated with reduced pain-related fear (15/25 relationships, 60%) and pain catastrophizing (16/25 relationships, 64%), and occasionally with improved pain self-efficacy (12/25 relationships, 48%). Where relationships were observed, reduced pain-related fear and pain catastrophizing, along with improved pain self-efficacy, were usually (39/43 relationships, 91%) associated with increased trunk flexion and velocity, decreased knee flexion and velocity, and faster lifting speed.</p><p><strong>Conclusions: </strong>For individuals with lifting-related CLBP, reduced pain-related fear and pain catastrophizing, along with improved pain self-efficacy, often occurred alongside a transition from squat-like to more semi-squat or stoop-like lifting techniques, accompanied by faster movement speed.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450036","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":"Empathy levels among physical therapists working with injured servicemembers.","authors":"Gabrielle Fine, Michal Elboim-Gabyzon, Einat Shuper Engelhard","doi":"10.1080/09593985.2026.2698061","DOIUrl":"https://doi.org/10.1080/09593985.2026.2698061","url":null,"abstract":"<p><strong>Introduction: </strong>Empathy is a cognitive and affective construct that involves understanding and feeling someone else's pain and suffering. Empathy is fundamental to effective physical therapy practice, a basis for therapeutic relationships that enhances patient concordance to recovery. Physical therapists working with populations experiencing heightened psychological distress, such as injured servicemembers, may face greater empathetic requirements.</p><p><strong>Objective: </strong>Limited research has examined how physical therapists' empathy levels vary across different patient populations. Therefore, this study aimed to map empathy levels among physical therapists treating injured servicemembers and identify personal and professional characteristics associated with those levels.</p><p><strong>Methods: </strong>This study employed a cross-sectional, anonymous online survey of 85 physical therapists who were actively treating injured servicemembers. Participants were identified through physical therapy social media forums and dedicated groups, and at a professional conference. Empathy levels were assessed using the Interpersonal Reactivity Index (IRI), a multidimensional tool measuring four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Personal and professional characteristics were assessed using a sociodemographic questionnaire. Associations between empathy subscales and personal and professional characteristics were analyzed.</p><p><strong>Results: </strong>Physical therapists demonstrated mean Perspective Taking levels of 25.46 ± 1.01, Fantasy levels of 21 ± 1.32, Empathic Concern levels of 26.93 ± 1.02, and Personal Distresslevels of 19.16 ± 1.24. Age approached significance for Empathic Concern (<i>p</i> = .074). Longer clinical experience was significantly associated with higher Empathic Concern (<i>p</i> = .023), and participation in post-degree courses on psychological aspects of physical therapy treatment was significantly associated with lower Personal Distress (<i>p</i> = .003).</p><p><strong>Conclusion: </strong>This study establishes initial empathy benchmarks for physical therapists treating injured servicemembers. Findings indicate the need for enhanced support for younger physical therapists, aged 20-40, and less experienced physical therapists, with 0-5 years of experience, and emphasize the importance of encouraging participation in courses on psychological aspects of physical therapy treatment to mitigate Personal Distress.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438565","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' experiences of persistent pain rehabilitation practice: a qualitative systematic review and meta-synthesis.","authors":"Aleksi Sarkkinen, Riikka Holopainen, Pirjo Vuoskoski","doi":"10.1080/09593985.2026.2699339","DOIUrl":"https://doi.org/10.1080/09593985.2026.2699339","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent pain is a global health concern, and physiotherapists play a central role in its rehabilitation. Understanding their perspective is essential, as it informs care quality.</p><p><strong>Objective: </strong>This systematic review and meta-synthesis identified, critically appraised, and synthesized the available evidence on physiotherapists' experiences of persistent pain rehabilitation practice.</p><p><strong>Methods: </strong>A systematic literature search was conducted, following Joanna Briggs Institute guidelines, across the PubMed, CINAHL, Medic, and Cochrane databases. This review considered studies employing qualitative methods in both data collection and analysis, focused on physiotherapists working in persistent pain rehabilitation, written in English, and with full text available before June 25, 2025. Two independent reviewers screened studies for inclusion and extracted data using a standardized tool. Data synthesis followed a meta-aggregative approach, categorizing findings and synthesizing them into evidence-based conclusions.</p><p><strong>Results: </strong>Three synthesized findings were derived from 252 individual findings across 20 qualitative studies: (i) Persistent pain rehabilitation was perceived as a complex process, shaped by structural constraints, emotional demands, and patient resistance to biopsychosocial approaches. (ii) Physiotherapists described navigating a paradigm shift away from a biomedical model toward a more holistic approach, often feeling unprepared and inadequately trained for this evolving role. (iii) Physiotherapists conveyed that professional meaning was found in person-centered care, emphasizing therapeutic relationships and patient empowerment through active self-management. The confidence in the three synthesized findings was rated as low according to the ConQual approach.</p><p><strong>Conclusions: </strong>These synthesized findings suggest physiotherapists experience a demanding transition toward holistic pain rehabilitation. While they value therapeutic relationships and patient empowerment, limited training and systemic constraints leave them feeling ill-equipped. This tension between evolving care models and lived clinical realities highlights the need for improved education and structural support to enable physiotherapists to embrace their changing role.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-18"},"PeriodicalIF":1.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431267","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":"Gait speed and future ambulatory status in amyotrophic lateral sclerosis: a retrospective observational study with implications for power wheelchair referral.","authors":"Chelsea E Macpherson, Julie Muccini, Miguel E Blacutt, Meghan Bjalme-Evans, Mary E Lough, Lori Quinn","doi":"10.1080/09593985.2026.2700400","DOIUrl":"https://doi.org/10.1080/09593985.2026.2700400","url":null,"abstract":"<p><strong>Background or introduction: </strong>Amyotrophic lateral sclerosis (ALS) causes rapid and progressive loss of ambulation resulting in immobility. A power wheelchair (PWC) increases safety, independence, and quality of life, however, the PWC referral process is lengthy and complex. When the PWC is delayed, immobility complications can occur. One barrier is the lack of a universal predictive \"gait speed threshold\" to help clinicians determine when to initiate the PWC referral process.</p><p><strong>Objective or purpose: </strong>Identify a clinically relevant gait speed threshold associated with future loss of ambulation in people with ALS.</p><p><strong>Methods: </strong>This was a retrospective chart review of a single multidisciplinary ALS Center of Excellence from July 1, 2016 - July 1, 2019 (36-months). Participants were included in this study if they were adults (age >18 years) with clinically definite ALS who were ambulatory at baseline. The primary outcome was gait speed on the 10-meter walk test. Secondary outcomes included the ALS Functional Rating Scale-Revised, forced vital capacity, falls, and ambulation status.</p><p><strong>Results: </strong>Of <i>N</i> = 180 people with ALS identified during the study period, <i>n</i> = 72 met inclusion for analysis with a mean age 66.1 ± 11.9 years, 64% male, 76% with an ALS phenotype of spinal onset, and 24% bulbar onset. A gait speed threshold of 0.79 m/s maximized the combined sensitivity and specificity for classifying ambulatory status at the subsequent 6-month visit. Faster gait speeds (>1.2-1.4 m/s) were associated with greater odds of remaining ambulatory at 6-months based on Bayesian logistic regression.</p><p><strong>Conclusion: </strong>A gait speed threshold of 0.79 m/s was associated with increased likelihood of subsequent loss of ambulation, though modest predictive accuracy limits its use as a stand-alone indicator. Gait speed may serve as one component of clinical decision-making regarding PWC planning and referral in people with ALS. Larger multicenter studies are needed to confirm and generalize results across ALS phenotypes.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425687","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":"Psychometric properties of the STEP (step-tibia-events-phases) test: an instrument for assessing gait performance in individuals with stroke.","authors":"Youngkeun Woo, Hyesun Hwang, Sanghyun Moon, Sujin Hwang","doi":"10.1080/09593985.2026.2700406","DOIUrl":"https://doi.org/10.1080/09593985.2026.2700406","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the reliability and validity of the step-tibia-events-phases (STEP) test, a newly developed instrument for assessing gait performance in individuals with stroke, and to determine optimal cutoff scores for clinical applications.</p><p><strong>Methods: </strong>A total of 103 individuals with stroke participated in the study. Participants completed the STEP test to assess gait performance, followed by five clinical measures: the 10-Meter Walk Test (10MWT), Timed Up and Go (TUG) test, Five Times Sit-to-Stand test, One-Leg Stand test, and Mini-Mental State Examination. Reliability was examined using Cronbach's α and intraclass correlation coefficient (ICC_2,1), and construct validity was also analyzed. Receiver operating characteristic curve analyses were conducted to determine the optimal cutoff scores.</p><p><strong>Results: </strong>The STEP test demonstrated good internal consistency and excellent interrater reliability for the total score. It showed strong correlations with the 10MWT and TUG. Statistical cutoff scores distinguishing household ambulation (<0.4 m/s) and community ambulation (<0.8 m/s) with lower fall-risk potential were identified as 14.50 and 21.50 points, respectively.</p><p><strong>Conclusions: </strong>The STEP test is a reliable and valid tool for evaluating gait and balance in individuals with stroke. A score of ≥ 15 may indicate the capacity for indoor ambulation, whereas a score of ≥ 22 may indicate the potential for independent community ambulation and correspond to a lower fall-risk classification based on TUG performance.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413417","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}