Physiotherapy Theory and Practice最新文献

{"title":"High-intensity interval training versus moderate-intensity continuous training for COPD: a systematics review and meta-analysis.","authors":"Irem Suzen, Aynur Demirel","doi":"10.1080/09593985.2026.2654806","DOIUrl":"https://doi.org/10.1080/09593985.2026.2654806","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease(COPD) leads to reduced exercise capacity, lung function, and muscle dysfunction, highlighting the need for effective rehabilitation. Exercise is a key component of COPD management.</p><p><strong>Purpose: </strong>This study aims to compare the effectiveness of high-intensity interval training (HIIT) and Moderate-Intensity Continuous Training (MICT) on functional capacity, pulmonary function, and muscle performance in individuals with COPD.</p><p><strong>Methods: </strong>Eight electronic databases were systematically searched from inception to August 2025. Data extraction and quality assessment were independently performed by two reviewers. Methodological quality was assessed using the PEDro scale and the JBI Critical Appraisal Checklist. The risk of bias was evaluated using the Cochrane Collaboration's Tool and the ROBINS-I tool.</p><p><strong>Results: </strong>Twelve studies with 401 participants were included. Seven of the included studies involved patients with GOLD stage III (severe COPD), and five involved patients with GOLD stage II (moderate COPD). HIIT did not demonstrate a statistically significant superiority over MICT in improving lung function parameters (<i>p</i> > .05). The combined mean difference for FEV₁ was 6.84 (95% CI: -1.59 to 15.28; <i>p</i> = .11) and the mean difference for FEV₁/FVC was 1.15 (95% CI: -8.98 to 11.28; <i>p</i> = .82). In terms of functional capacity, MICT showed superiority for VO₂peak (MD =  -41.79 mL/min, 95% CI [-74.77, -8.81], <i>p</i> = .01; I² = 39%, <i>p</i> = .12), while HIIT significantly improved 6MWT performance (MD = 14.63 m, 95% CI [1.00, 28.25], <i>p</i> = .04; I² = 33%, <i>p</i> = .22); no significant difference was observed for 12MWT (MD =  -55.00 m, 95% CI [-147.40, 37.40], <i>p</i> = .24). In terms of muscle function, HIIT provided greater benefits than MICT, including improvements in respiratory pressure, quadriceps endurance, handgrip strength, and muscle fiber composition.</p><p><strong>Conclusion: </strong>HIIT is superior to MICT in improving selected functional capacity outcomes and muscle function in COPD patients, and shows comparable effects to MICT in other functional measures. HIIT is a viable alternative training method; further research is needed to determine optimal protocols to maximize its benefits.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-18"},"PeriodicalIF":1.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700175","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":"Delayed active standing and mobility decline in adult survivors of critical illness: a single-center retrospective cohort study.","authors":"Alessandro Domingues Heubel, Stephanie Nogueira Linares, Tathyana Emília Neves de Figueiredo, Fabiano Matos de Souza, Naiara Molina Garcia, Gerhard da Paz Lauterbach, Adriana Sanches Garcia de Araújo, Valéria Amorim Pires Di Lorenzo, Renata Gonçalves Mendes","doi":"10.1080/09593985.2026.2658130","DOIUrl":"10.1080/09593985.2026.2658130","url":null,"abstract":"<p><strong>Background: </strong>Patients with critical illness frequently experience mobility decline, which has been associated with adverse clinical outcomes. However, the factors associated with this decline are not fully understood, and available evidence remains limited and inconsistent.</p><p><strong>Objective: </strong>To investigate factors associated with mobility decline in adults who survived an intensive care unit (ICU) stay.</p><p><strong>Methods: </strong>This retrospective study included adults who survived an ICU stay in a public hospital in Brazil. The ICU Mobility Scale (IMS) was used to assess mobility prior to hospitalization and at ICU discharge. The primary outcome was mobility decline, defined as a clinically important decrease of at least 1 point in the IMS (IMS at ICU discharge - IMS pre-hospitalization). Secondary outcomes were ICU readmission and hospital length of stay.</p><p><strong>Results: </strong>Among the 178 patients included, 49% experienced mobility decline. After multivariate analysis, mobility decline was associated with older age (OR 1.49 per 10-year increase; 95% CI, 1.15-1.95) and delayed active standing (OR 4.95; 95% CI, 2.06-11.88). Compared with patients who preserved mobility, those who experienced mobility decline had a lower probability of hospital discharge within 7 days after ICU liberation (HR 0.65; 95% CI, 0.44-0.97), with no differences in ICU readmission rates.</p><p><strong>Conclusion: </strong>Older age and delayed active standing were independently associated with mobility decline in adults who survived critical illness. Early mobilization and rehabilitation strategies focusing on postural progression may improve mobility outcomes and reduce hospital length of stay.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677922","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":"Is trait mindfulness associated with pain interference in patients undergoing total knee arthroplasty? A prospective cohort study.","authors":"William Egan, Patricia Crane, John Morris, Jodi L Young, Daniel I Rhon","doi":"10.1080/09593985.2026.2656341","DOIUrl":"https://doi.org/10.1080/09593985.2026.2656341","url":null,"abstract":"<p><strong>Introduction: </strong>About 20% of individuals undergoing total knee arthroplasty (TKA) report ongoing pain and poor function. Trait mindfulness - a person's inherent ability to be attentive to the present - has been linked to reduced pain in other conditions but not yet studied in TKA.</p><p><strong>Objective: </strong>This study examined whether higher trait mindfulness was associated with less pain interference at baseline and 12 weeks post-TKA. Secondary aims included associations with physical function and opioid use at 12 weeks.</p><p><strong>Methods: </strong>This prospective cohort study included 248 patients (59% female, mean age 66.4 years) undergoing TKA in the Bellin Health System during 2022. Trait mindfulness was measured preoperatively using the Mindfulness Attention Awareness Scale (MAAS). Researchers analyzed associations between baseline MAAS scores and outcomes at 12 weeks.</p><p><strong>Results: </strong>Higher baseline MAAS scores were significantly associated with lower pain interference (β = -1.24, <i>p</i> = .004) and better physical function (β = 0.92, <i>p</i> = .03) at baseline, but not with opioid use. However, MAAS scores did not significantly predict pain, function, or opioid use at 12 weeks postoperatively.</p><p><strong>Conclusion: </strong>This is the first study exploring trait mindfulness in relation to pain outcomes after TKA. Findings suggest trait mindfulness is related to pain and function at the time of assessment but may not predict longer-term recovery. Additional research into this topic is warranted to determine the value and impact of assessing trait mindfulness in individuals undergoing TKA.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677886","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":"Effect of hip-focused exercises on medial longitudinal arch height in individuals with pes planus: A systematic review.","authors":"Ali Mutlu, Gözde Yağcı","doi":"10.1080/09593985.2026.2656335","DOIUrl":"https://doi.org/10.1080/09593985.2026.2656335","url":null,"abstract":"<p><strong>Background: </strong>Traditional exercise approaches focusing on the foot and ankle are generally preferred for pes planus treatment. However, given that the lower extremity functions as a kinetic chain with its segmental connections, the relationship of this deformity beyond local musculature to more proximal segments is becoming increasingly important. This study aimed to evaluate the effects of hip-focused exercise approaches on medial longitudinal arch (MLA) height in individuals with pes planus.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in International Prospective Register of Systematic Reviews (PROSPERO). PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from inception to November 2025. Randomized controlled trials (RCTs) involving individuals with pes planus that included hip-focused exercises and reported MLA height outcomes were included. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2 (RoB2) tool.</p><p><strong>Results: </strong>Eleven RCTs with a total of 478 participants were included. All studies reported significant improvements in MLA height following interventions that incorporated hip-focused exercises. In most studies, hip exercises were combined with traditional foot-focused protocols, resulting in superior improvements compared to control groups. Several studies also reported improvements in balance and foot posture.</p><p><strong>Conclusion: </strong>Hip-focused exercise approaches may significantly enhance MLA height in individuals with pes planus, especially when integrated into comprehensive lower extremity exercise protocols. These results suggest that targeting the proximal kinetic chain particularly the hip musculature may provide additional benefits beyond local foot and ankle interventions.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655140","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 relationships between proprioceptive awareness, balance, and spasticity in patients post-stroke with varying levels of trunk impairment.","authors":"Güler Ada, Mehmet Duray","doi":"10.1080/09593985.2026.2656807","DOIUrl":"https://doi.org/10.1080/09593985.2026.2656807","url":null,"abstract":"<p><strong>Background: </strong>Cervical and trunk proprioceptive deficits resulting from impaired sensorimotor integration post-stroke may contribute to deficiencies in balance reactions and tone regulation.<b>Purpose:</b> To examine relationships between cervical and trunk proprioceptive awareness, balance, and lower extremity spasticity in patients post-stroke with varying levels of trunk control.</p><p><strong>Methods: </strong>This single-center cross-sectional observational study included patients post-stroke aged 35-65 years, stratified into low trunk control (LTC) and high trunk control (HTC) groups. Cervical proprioception was assessed using the Cervical Joint Position Error Test (CJPET), trunk proprioception using the Trunk Proprioception Test (TPT), balance performance using the Tecnobody ProKin 252 system, and lower extremity spasticity using the Modified Tardieu Scale (MTS).</p><p><strong>Results: </strong>Ninety-eight patients post-stroke participated in the study (<i>n</i> = 49 per group). The LTC group demonstrated significantly higher CJPET, TPT, and MTS scores and lower balance performance compared with the HTC group (<i>p</i> = .003-0.001). In the LTC group, CJPET scores showed limited associations with static balance and spasticity measures. Conversely, in the HTC group, higher CJPET scores, except left rotation, were significantly associated with both higher MTS X scores and greater spasticity angles in proximal lower extremity muscles (ρ = 0.318-0.394, <i>p</i> = .026-0.005). Weak-to-moderate but significant correlations were observed between cervical lateral flexion and rotation errors and ankle plantar flexor spasticity (ρ = 0.288-0.303, <i>p</i> = .045-0.034). TPT scores were significantly associated with dynamic balance in LTC group (ρ = 0.282-0.412, <i>p</i> = .050-0.003) and with static balance in HTC group (ρ = 0.328-0.706, <i>p</i> = .021-0.001). TPT scores were not correlated with spasticity in either group.</p><p><strong>Conclusion: </strong>Trunk control modulates the role of cervical and trunk proprioception in balance and spasticity post-stroke. Cervical proprioception primarily influences static balance and spasticity, whereas trunk proprioception supports dynamic balance when trunk stability is reduced.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663377","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 physiotherapists personalize airway clearance in children with primary ciliary dyskinesia.","authors":"Lynne Schofield, Sally J Singh, Susanne Shanks, Jim M Wild, Daniel Hind","doi":"10.1080/09593985.2026.2654032","DOIUrl":"https://doi.org/10.1080/09593985.2026.2654032","url":null,"abstract":"<p><strong>Introduction: </strong>Current literature recommends the personalization of airway clearance technique (ACT) regimens for people with chronic suppurative lung diseases, such as primary ciliary dyskinesia (PCD). However, how physiotherapists navigate cues including the individual's physical and psychosocial presentation, the properties of the ACT regimen and their response to the ACT regimen, remains unknown.</p><p><strong>Objective: </strong>This study aimed to understand how physiotherapists make decisions in relation to personalizing airway clearance regimens for children and young people with PCD.</p><p><strong>Methods: </strong>Critical decision method (CDM) interviews were used to explore expert physiotherapists' decision-making during an ACT personalization incident. Six physiotherapists with ≥5 years PCD experience, from four specialist centers were interviewed; one-to-one virtual interviews were conducted (duration 55-100 min). Data were analyzed using the CDM derived recognition-primed decision model and an ACT personalization model.</p><p><strong>Results: </strong>Our interviews (<i>n</i> = 6) showed all physiotherapists initially found the situation to be familiar, but in most cases the initial expectancies of the physiotherapist were violated. Participants described uncertainty in personalization of ACT regimens. An iterative process was used to manage the uncertainty and make any modifications to ensure the regimen would likely work prior to implementation. This suggests a need for objective tools to support clinical decision-making. Physical characteristics (age, disease severity, pulmonary and non-pulmonary factors, medications), psychosocial factors (lifestyle, adherence, ability to engage) and treatment-related factors (regimen burden, patient's preference) were commonly considered during personalization. The ACT type, procedures and dosage were personalized for each individual. All physiotherapists undertook mental or physical simulations of their proposed actions and in most cases, this led to regimen modifications.</p><p><strong>Conclusion: </strong>ACT personalization is a complex, iterative process in which uncertainty can arise. With limited tools to assess the effects of ACT regimens, it remains unknown if uncertainty would be reduced, or personalization changed with the provision of more sensitive outcome data.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655166","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":"Student attributes and behavioral examples used by physiotherapy clinical educators in Hong Kong: a qualitative data analysis.","authors":"Doris Y K Chong, Catherine M Capio, Alice Y M Jones, Percy P S Tse, Sammi H Y Chau, Kathlynne F Eguia","doi":"10.1080/09593985.2026.2656345","DOIUrl":"https://doi.org/10.1080/09593985.2026.2656345","url":null,"abstract":"<p><strong>Background: </strong>Clinical placements are a vital element of physiotherapy education, where students must demonstrate competence across a range of professional attributes. Although core competencies such as clinical knowledge, ethical conduct, and communication are universally valued, clinical educators (CEs) from different cultural contexts may emphasize these attributes in different ways. Gaining insight into how Hong Kong CEs evaluate students is important for aligning academic expectations with clinical practice.</p><p><strong>Objective: </strong>This study identifies the key student attributes prioritized by Hong Kong CEs and summarizes the behavioral examples they use to distinguish performance levels on the Assessment of Physiotherapy Practice (APP) Global Rating Scale.</p><p><strong>Methods: </strong>A secondary qualitative analysis was conducted on 456 qualitative feedback comments from APP forms completed by 45 CEs assessing physiotherapy students across two cohorts. The data were analyzed using AI-assisted thematic analysis combined with human expert interpretation, followed by deductive validation across performance levels (Excellent, Good, Adequate, Not Adequate).</p><p><strong>Results: </strong>Six core attributes emerged from the analysis: (1) communication and interpersonal skills, (2) clinical reasoning and decision‑making, (3) practical knowledge and technical competence, (4) learning attitudes and reflective practice, (5) professionalism and work ethics, and (6) safety and risk management and patient‑centered care. Behavioral examples were mapped across performance levels, revealing clear distinctions between competent and underperforming behaviors. Among these attributes, <i>learning attitudes and reflective practice</i> were consistently emphasized.</p><p><strong>Conclusion: </strong>Hong Kong CEs prioritize not only technical and cognitive competence, but also reflective and affective attributes rooted in professional training and local cultural values. The identified attributes and behavioral descriptors may guide curriculum design, educator development, and student preparation, supporting coherent and culturally attuned assessment practices in local contexts while also providing a foundation for greater international alignment among programs that use or adapt the APP instrument.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646993","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":"Impact of disability on quality of life and activities of daily living in peripheral facial paralysis.","authors":"Miray Baser, Fatih Özden, Yalçın Gölcük, Özgür Nadiye Doğrukök, Zübeyir Sarı","doi":"10.1080/09593985.2026.2656806","DOIUrl":"https://doi.org/10.1080/09593985.2026.2656806","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationships between patient-reported physical and social facial disability, health-related quality of life (HRQoL), and instrumental activities of daily living (IADLs) in individuals with peripheral facial paralysis (PFP) compared with healthy controls.</p><p><strong>Methods: </strong>This cross-sectional study included 100 PFP patients and 116 age- and sex-matched controls. Facial disability, IADLs, and HRQoL were assessed using the Facial Disability Index (FDI), Nottingham Extended Activities of Daily Living Index (NEADL), and EuroQol-5 Dimensions (EQ-5D). Between-group comparisons and partial correlations controlling for demographics were performed.</p><p><strong>Results: </strong>Patients with PFP had significantly lower physical and social scores on the FDI than controls (<i>p</i> < .001). Scores for HRQoL were significantly reduced across all dimensions (<i>p</i> ≤ .002). Total and subdomain scores of the NEADL Index were also significantly lower in the PFP group. Partial correlation analyses showed that the social subscale of the FDI was significantly associated with multiple NEADL items and EQ-5D dimensions (<i>r</i> = 0.197-0.410, <i>p</i> < .050), whereas physical scores had limited correlations. Mediation analysis confirmed that psychological distress (EQ-5D Anxiety/Depression) fully mediated the relationship between social disability and IADL performance (Path c' <i>p</i> = .108). Paralysis duration showed limited association with functional outcomes.</p><p><strong>Conclusion: </strong>Patients with PFP exhibited significant impairments in social facial function, HRQoL, and NEADL performance. Social facial disability, rather than physical impairment, is the primary driver of limitations in daily activities, a relationship that is fully mediated by psychological distress. These findings underscore the need for psychosocial interventions alongside motor rehabilitation to optimize functional independence in PFP patients.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647066","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":"Immediate effects of conventional and burst tens combined with cryotherapy in chronic non-specific low back pain: a randomized controlled trial.","authors":"Rafael Limeira Cavalcanti, Liane Brito Macedo, Vinicius Dantas da Silva, Karinna Sonálya Aires da Costa, Lidiane Cristina Correia Bulhões, Sâmara Raquel Alves Gomes, Jamilson Simões Brasileiro","doi":"10.1080/09593985.2026.2652415","DOIUrl":"https://doi.org/10.1080/09593985.2026.2652415","url":null,"abstract":"<p><strong>Background: </strong>Chronic nonspecific low back pain (CNLBP) is a recurrent problem. The association between Transcutaneous Electrical Nerve Stimulation (TENS) and cryotherapy appears as an option in the treatment of painful symptoms caused by this dysfunction. Objective: To investigate the immediate effects of TENS, alone or combined with cryotherapy, on pain in individuals with CNLBP.</p><p><strong>Methods: </strong>120 individuals with CNLBP were randomized into six groups: placebo TENS (PT), burst TENS (BT: 100 Hz modulated at 4 Hz, 200 μs), conventional TENS (CT: 100 Hz, 100 μs), cryotherapy alone (Cryo), cryotherapy plus conventional TENS (CryoCT), and cryotherapy plus burst TENS (CryoBT). Participants received a single 25-minute intervention followed by 25 minutes of rest. Pain intensity was measured using the Numerical Pain Rating Scale (NPRS), and pressure pain threshold (PPT) was assessed by algometry over the lumbar paravertebral muscles. Assessments were performed at baseline, immediately post-intervention, and after 25 minutes.</p><p><strong>Results: </strong>Both CryoCT and CryoBT significantly reduced pain intensity immediately post-intervention compared to the other groups (<i>p</i> = .009 to <i>p</i> = .047 and d = 0.61 to d = 1.05). However, only CryoBT maintained lower pain intensity after 25 minutes (<i>p</i> = .005 to <i>p</i> = .049 and d = 0.74 to d = 1.33). This group also demonstrated greater increases in PPT immediately and 25 minutes after the intervention compared to most other groups (<i>p</i> < .001 to <i>p</i> = .049 and d = 0.54 to d = 0.87).</p><p><strong>Conclusion: </strong>A single session of burst TENS combined with cryotherapy produced greater immediate and short-term improvements in pain intensity than isolated techniques or conventional TENS combinations. Although statistical PPT improvements were observed, they lacked clinical meaningfulness. These findings suggest that, by integrating both modalities within a single protocol, CryoBT remains a promising, time-optimizing, and practical analgesic strategy for individuals with CNLBP.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634013","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":"Effectiveness of physical activity counseling and PILATES exercises in women with prediabetes and type 2 diabetes: a randomized controlled trial.","authors":"Merve Şuay Uçgul, Ela Tarakcı, Gamze Kus, Nimet Bilge Shalaby","doi":"10.1080/09593985.2026.2654807","DOIUrl":"https://doi.org/10.1080/09593985.2026.2654807","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) has a protective effect on impaired glucose and pilates effectively supports patients with high plasma glucose levels.</p><p><strong>Objective: </strong>This study aimed to evaluate the effects of ACSM (American College of Sports Medicine) person-centered PA counseling using the 5A model (Assess, Advise, Agree, Assist, And Arrange), combined with Pilates exercises, on metabolic control variables in patients with prediabetes (PD) and type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Ninety women with T2D and PD were randomly assigned to three groups: Group 1 (Pilates + PA counseling), Group 2 (PA counseling), and Group 3 (standard treatment). Both intervention groups also received standard treatment. Primary outcomes were metabolic measures (blood glucose and lipid parameters). Secondary outcomes included body composition (body fat %, visceral fat, muscle mass) and physical performance (functional capacity, PA level, balance). Measurements were taken at baseline and after 12 weeks.</p><p><strong>Results: </strong>No significant between-group differences were found in metabolic or body composition outcomes. However, Group 1 showed higher PA levels (<i>p</i> = .002, η2 = 0.13) and step counts (<i>p</i> = .003, η2 = 0.12) compared with the control group. Both intervention groups improved functional capacity (<i>p</i> = .001, η2 = 0.15) and balance (<i>p</i> < .001, η2 = 0.26). In T2D participants, functional capacity improved in Group 1 and 2 (both <i>p</i> < .001, η2 = 0.25). In PD participants, steps counts increased in Group 1 (<i>p</i> = .003, η2 = 0.24) compared with Group 3, while PA levels and balance scores (<i>p</i> < .001, both, η2 = 0.31, η2 = 0.43, respectively) improved in Groups 1 and 2. The remaining parameters showed no differences (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>Physical activity counseling using the 5A model plus Pilates exercises may improve functional capacity, PA level, number of steps, and balance. In Type 2 diabetes, PA counseling alone may prevent declines in functional capacity. In PD, PA counseling improves PA levels and balance, and adding Pilates may further boost daily steps.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":1.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635068","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}