Physiotherapy Theory and Practice最新文献

{"title":"Relationship of kinesiophobia with pain, disability, and lumbar multifidus muscle morphology in chronic mechanical low back pain: an ultrasonographic cross-sectional study.","authors":"İlhan Celil Özbek, Gonul Ertunc Gulcelik, Zeliha Ünlü, Canan Tıkız, Erkan Özduran","doi":"10.1080/09593985.2026.2733863","DOIUrl":"https://doi.org/10.1080/09593985.2026.2733863","url":null,"abstract":"<p><strong>Background: </strong>Chronic mechanical low back pain (CMLBP) cannot be explained by biomechanical factors alone; psychosocial factors such as kinesiophobia may also relate to structural changes in trunk-stabilizing muscles. Ultrasonography enables objective assessment of lumbar multifidus morphology (anteroposterior [AP] thickness and cross-sectional area [CSA]).</p><p><strong>Aims: </strong>To investigate the relationship between kinesiophobia and lumbar multifidus morphology among those with CMLBP, and to determine whether this relationship is independent of pain intensity, disability, and demographic/anthropometric factors.</p><p><strong>Methods: </strong>In this cross-sectional study, 100 patients with CMLBP (≥3 months) were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Tampa Scale of Kinesiophobia (TSK; low <37, high ≥37). Bilateral multifidus AP thickness and CSA were measured ultrasonographically at L4-L5. Group comparisons, correlation, partial correlation, and regression analyses were performed.</p><p><strong>Results: </strong>Mean age was 49.8 ± 12.6 years (68% female); 65% had high kinesiophobia, more frequent among women (76.9% vs. 51.4%, <i>p</i> = .017). The high-TSK group showed higher VAS (6.68 ± 1.98 vs. 5.03 ± 1.71, d = 0.87) and ODI (35.12 ± 15.23 vs. 24.46 ± 11.47, d = 0.76), and smaller multifidus AP thickness and CSA (d = 0.48-0.62). Kinesiophobia scores correlated positively with VAS (<i>r</i> = 0.53) and ODI (<i>r</i> = 0.64), and negatively with multifidus thickness/CSA (<i>r</i> =  -0.24 to -0.41). After adjusting for VAS and ODI, the TSK-CSA correlation was markedly attenuated and lost significance (partial <i>r</i> = -0.13 to -0.18, <i>p</i> > .05); after adjusting for age, sex, and BMI, it remained significant (partial <i>r</i> = -0.36 to -0.40, <i>p</i> < .001). Regression confirmed VAS and ODI, but not CSA, as independent predictors of TSK.</p><p><strong>Conclusions: </strong>High kinesiophobia is associated with greater pain, disability, and reduced multifidus morphology among those with CMLBP. However, this morphological association appears largely mediated by pain and disability rather than being independent of them, while remaining unrelated to demographic/anthropometric confounding. These cross-sectional findings support a biopsychosocial framework and warrant longitudinal confirmation.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983945","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":"Australian Occupational Health Physiotherapy from 1970-1990: a qualitative study.","authors":"Lee Curtis, Rose Boucaut, Caroline Adams, Steve Milanese","doi":"10.1080/09593985.2026.2722215","DOIUrl":"https://doi.org/10.1080/09593985.2026.2722215","url":null,"abstract":"<p><strong>Background: </strong>Occupational Health Physiotherapy plays an important role in maintaining a healthy Australian workforce and reducing the associated economic burden of work-related musculoskeletal disorders. However, there is limited literature surrounding the Australian context in which this field developed.</p><p><strong>Objective: </strong>To explore the development of Australian Occupational Health Physiotherapy during its formative years from 1970 to 1990.</p><p><strong>Methods: </strong>A qualitative descriptive study design was employed. Physiotherapists participated in semi-structured interviews via videoconference. Interview questions were informed by the seven Australian Physiotherapy Association Professional Practice Standards in Occupational Health and Safety Physiotherapy. Interview transcripts were inductively analyzed to derive themes and sub-themes.</p><p><strong>Results: </strong>Four main themes emerged from the data. First, the significance of the Repetitive Strain Injury epidemic. Second, the ineffective medical response to repetitive strain injury. Third, the barriers of conventional physiotherapy education and practice, and legislation. Finally, the opportunity for an alternative approach created by physiotherapists' willingness and ability to engage, and legislative reforms.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first primary study to identify the contextual factors that influenced the development of Australian Occupational Health Physiotherapy in the early years. The results suggest that the future of physiotherapy is dependent on the adaptability of the profession to meet the needs of dynamically evolving societies, their industries, and the unprecedented health challenges they present.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971924","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 effects of instrument-assisted soft tissue mobilization on respiratory function, posterior chain mobility, and functional capacity in individuals with chronic obstructive pulmonary disease: a randomized controlled trial.","authors":"Gülben Erciyas, Emine Atici, Gamze Aydin","doi":"10.1080/09593985.2026.2731239","DOIUrl":"https://doi.org/10.1080/09593985.2026.2731239","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the effects of instrument-assisted soft tissue mobilization (IASTM) applied to the lower extremities on respiratory function, chest mobility, posterior chain mobility, and functional capacity in individuals with chronic obstructive pulmonary disease (COPD) and hamstring shortness.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included 44 patients with COPD (mean age: 55.09 ± 8.42 years; 43.1% female). The participants were randomly assigned to the IASTM group, and the control group (CG). The IASTM group received IASTM applied to the lower extremity in addition to respiratory exercises, while the CG received respiratory exercises alone. Both groups performed respiratory exercises 5 days per week for 4 weeks. In addition to the respiratory exercises, participants in the IASTM group received one session of IASTM (40 min) per week for 4 weeks. The participants were evaluated for respiratory function (spirometry), thoracic mobility (chest circumference measurement), hamstring mobility (popliteal angle test), posterior chain mobility (fingertip-to-floor test), and functional capacity (6-min walk test (6MWT)).</p><p><strong>Results: </strong>Between-group comparisons revealed significantly greater improvement in chest mobility at the axillary, and xiphoid levels (η² = 0.234 (95% CI 0.031-0.407); η² = 0.225, (95% CI 0.027; 0.398); popliteal angle test (right-left) (η² = 0.529 (95% CI 0.291; 0.654); η² = 0.640 (95% CI 0.432; 0.738); fingertip-to-floor test (η² = 0.500 (95% CI 0.257; 0.632) in the IASTM group compared to the CG (<i>p</i> < .05). In addition, there were significant increases in FEV₁ (η² = 0.110 (95% CI 0.001; 0.274), FEF_25-75 (η² = 0.176 (95% CI 0.005; 0.349)), FEV₁/FVC (η² = 0.158 (95% CI 0.001; 0.330)) in the IASTM group compared to the CG (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>IASTM applied to the lower extremities, when added to breathing exercises, is beneficial in enhancing respiratory function, chest mobility, posterior chain mobility in individuals with COPD and hamstring shortness. Although statistically significant, the between-group difference in respiratory function was small, and its clinical relevance remains unclear.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957046","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":"Building trauma-informed physical therapists: a mixed-methods evaluation of a multimodal training module in hybrid DPT education.","authors":"Rebecca E Parr, Michael V Richardson, Kristen Anderson","doi":"10.1080/09593985.2026.2730589","DOIUrl":"10.1080/09593985.2026.2730589","url":null,"abstract":"<p><strong>Background: </strong>Trauma-informed care (TIC) remains inadequately integrated into health professions education despite its clinical relevance, limiting opportunities for graduates to develop the skills necessary to support individuals with trauma histories.</p><p><strong>Objective: </strong>This gap is particularly pronounced in Doctor of Physical Therapy (DPT) education, where hands-on clinical practice creates unique conditions that could evoke trauma-related responses or retraumatization. This study evaluated a multimodal TIC training module embedded in a hybrid DPT curriculum.</p><p><strong>Methods: </strong>Using a convergent mixed-methods design, this study evaluated a multimodal TIC training module embedded in the third semester of the first year of a hybrid DPT curriculum across two consecutive cohorts (<i>N</i> = 142). Quantitative pre-post surveys measured changes in self-reported TIC-related knowledge, attitudes, and confidence; qualitative data were drawn from post-intervention open-ended survey responses and student self-reflection essays.</p><p><strong>Results: </strong>Significant improvements were observed across all three domains, with large effect sizes replicated across both cohorts (Hedges' <i>g</i> = 1.39 for knowledge familiarity; <i>g</i> = 1.31 for confidence). Qualitative analysis yielded four themes: developing a trauma-informed professional identity, intentional relationship-building as core clinical practice, applying TIC principles in clinical decision-making, and recognizing the role of the clinician's inner experience. Integration of quantitative and qualitative data revealed strong convergence and complementarity across strands, and identified a confidence-complexity paradox; large measured gains in physical examination confidence alongside persistent qualitative uncertainty about managing trauma responses during hands-on care.</p><p><strong>Conclusion: </strong>These findings support embedding TIC training in DPT education, with implications for professional identity formation and mitigation of physical therapist burnout.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-16"},"PeriodicalIF":1.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907880","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 role of catastrophizing and kinesiophobia in pain intensity and interference among older adults with musculoskeletal pain.","authors":"David Oliveira, Júlia Costa, Maria H Marques, Anabela G Silva","doi":"10.1080/09593985.2026.2727927","DOIUrl":"https://doi.org/10.1080/09593985.2026.2727927","url":null,"abstract":"<p><strong>Introduction: </strong>Pain catastrophizing and kinesiophobia have been associated with pain severity and pain interference in adults. Older adults have specific beliefs and fears about pain and attentional resources that can affect how pain catastrophizing and kinesiophobia relate to pain severity and interference. However, studies in older adults are scarce and have a transversal design.</p><p><strong>Objectives: </strong>This longitudinal study aimed to investigate the association between pain catastrophizing and kinesiophobia and pain intensity and interference at the initial assessment and 3-month follow-up in older adults with musculoskeletal pain.</p><p><strong>Methods: </strong>Sixty-seven older adults with chronic musculoskeletal pain were assessed in person for age, sex, years of schooling, body mass index, comorbidities, falls, self-reported physical activity, and pain-related variables (duration, frequency, number of painful body sites, pain phenotype, pain catastrophizing, kinesiophobia, pain severity, and interference). Pain severity and interference were also assessed (in person) at the 3-month follow-up. Multivariate linear regression analysis with pain interference and pain severity as dependent variables was conducted.</p><p><strong>Results: </strong>Catastrophizing was associated with pain severity (β = 0.50, <i>p</i> < .001; Adjusted R² = 0.46), and catastrophizing (β = 0.40, <i>p</i> < .001), kinesiophobia (β = 0.28, <i>p</i> = .019), and number of school years (β = -0.20, <i>p</i> = .018) were associated with pain interference at the initial assessment (Adjusted R² = 0.59). Pain severity at the initial assessment (β = 0.47, <i>p</i> < .001) and number of school years (β = -0.23, <i>p</i> = .028) predicted pain severity at 3-month follow-up (Adjusted R² = 0.46). Pain interference at the initial assessment (β = 0.63, <i>p</i> < .001) and physical activity (β = -0.17, <i>p</i> = .049) predicted pain interference at 3-month follow-up (Adjusted R² = 0.58).</p><p><strong>Conclusions: </strong>Pain catastrophizing and kinesiophobia are associated with pain severity and interference at the initial assessment and may be considered as part of the clinical assessment for rehabilitation interventions. Pain severity and interference predicted severity and interference, respectively, and should be considered as a prognostic factor.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907838","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 chronic kidney disease on respiratory muscle strength, lung capacity, peripheral muscle strength, and functional capacity in dialysis patients: a systematic review.","authors":"Tiago Moraes, Mônica Soares de Oliveira, Beatriz Luiza Marinho Cunha, Juliana Rodrigues da Silva, Patrícia Érika de Melo Marinho","doi":"10.1080/09593985.2026.2624514","DOIUrl":"10.1080/09593985.2026.2624514","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is associated with muscular and respiratory complications, negatively affecting respiratory muscle strength, pulmonary capacity, peripheral muscle strength, and functional capacity in patients undergoing hemodialysis (HD). Understanding the extent of these impairments is essential to guide therapeutic strategies.</p><p><strong>Objective: </strong>To evaluate the impact of CKD on respiratory muscle strength, pulmonary capacity, peripheral muscle strength, and functional capacity in patients undergoing dialysis.</p><p><strong>Methods: </strong>This systematic review was conducted using PubMed/MEDLINE, LILACS, Embase, SciELO, and the Cochrane Library, with searches performed from July to August 2025. Cross-sectional observational studies evaluating respiratory muscle strength, pulmonary function, peripheral muscle strength, and functional capacity, compared with predicted values for sex and age, were included. Methodological quality was assessed using the Newcastle - Ottawa Scale. Results: A total of 1266 articles were identified, of which 22 met the inclusion criteria. Most studies presented satisfactory methodological quality (scores ≥6). Patients with CKD undergoing hemodialysis exhibited reduced respiratory muscle strength, with mean maximal inspiratory pressure of 53.7 ± 19.5% and maximal expiratory pressure of 49.5 ± 15.8% of predicted values. A moderate to strong correlation between maximal inspiratory pressure and functional capacity was observed (<i>r</i> = 0.38-0.79). Handgrip strength was also reduced compared with healthy individuals, with values approximately 40% below normal (28.18 ± 9.36 kgf; 114.00 ± 39.51% of predicted). Functional capacity was impaired, as indicated by a six-minute walk test distance corresponding to 66.33 ± 20.53% of predicted values. Pulmonary function findings were heterogeneous, with restrictive ventilatory pattern being the most frequently reported abnormality (66.7%). Conclusion: Patients with CKD undergoing hemodialysis present reduced respiratory and peripheral muscle strength, pulmonary capacity, and functional capacity.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1247-1256"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094616","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":"Integrating physiotherapy into the emergency department for acute low back spasm: a retrospective comparative study.","authors":"Veysel Uludağ, Rabia Tuğba Tekin, Mustafa Bogan, Erdinç Şengüldür, Mehmet Cihat Demir","doi":"10.1080/09593985.2026.2624519","DOIUrl":"10.1080/09593985.2026.2624519","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the short-term clinical and economic outcomes of physiotherapy, pharmacological therapy, and combined management in patients presenting to the emergency department (ED) with acute mechanical low back spasm.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 150 adults aged 18 to 65 years who presented to the ED between January 2024 and January 2025. Patients were retrospectively stratified according to the treatment received during routine emergency care into physiotherapy, pharmacological therapy, or combined therapy groups (<i>n</i> = 50 each). Pain intensity and functional activity were assessed at baseline (pre-treatment) and post-treatment at ED discharge, and direct, short-term costs related to ED care were calculated.</p><p><strong>Results: </strong>All treatment groups demonstrated significant reductions in pain intensity after intervention (within-group <i>p</i> < .001). The combined therapy group showed the greatest pain reduction (ΔVAS -5.80 ± 1.42), compared with physiotherapy (-3.80 ± 1.70) and pharmacological therapy (-3.30 ± 1.84) (between-group <i>p</i> < .001), with a large effect size (ε² = 0.31). Functional activity improved significantly in all groups (<i>p</i> < .001), with no significant difference between treatment modalities (<i>p</i> = .843). Patient-reported satisfaction scores differed significantly among groups and were highest in the combined therapy group (<i>p</i> < .001). Total treatment cost varied significantly between groups (<i>p</i> < .001), with pharmacological therapy being the least costly option.</p><p><strong>Conclusion: </strong>Combined physiotherapy and pharmacological treatment was associated with superior short-term pain relief and higher patient-reported satisfaction compared with either approach alone in patients presenting to the ED with acute low back spasm. Despite higher immediate costs, these findings support the integration of physiotherapy into emergency care to improve short-term, patient-centered outcomes. Further prospective and cost-effectiveness studies are warranted.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov Identifier: NCT06987656.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1193-1202"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087782","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":"Operationalizing wellness in physiotherapy: development and validation of a 0-100 wellness physical therapy index from a national population survey.","authors":"Shinyu Kise","doi":"10.1080/09593985.2026.2621961","DOIUrl":"https://doi.org/10.1080/09593985.2026.2621961","url":null,"abstract":"<p><strong>Background: </strong>Physiotherapists are increasingly expected to promote physical activity and reduce sedentary time, but there is no simple, field-specific metric that summarizes these behaviors for everyday practice.</p><p><strong>Objective: </strong>To develop a 0-100 Wellness Physical Therapy Index (WPTI) combining domain-specific physical activity and sedentary time, and to examine its validity and potential clinical utility in a national sample of adults.</p><p><strong>Methods: </strong>A cross-sectional secondary analysis of the Sasakawa Sports Foundation \"Sports Life Survey 2024 (Adults)\" was conducted. Leisure and transport physical activity (min/week) and sedentary time (min/day; reverse-coded) were winsorized and transformed into standardized scores. Principal component analysis generated data-driven weights used to construct the Wellness Physical Therapy Index (WPTI) and rescale it from 0 to 100. Analytic survey weights were constructed using raking with trimming. Distributional properties, internal consistency, convergent validity with total metabolic equivalent (MET) minutes/week, and criterion validity for achieving the World Health Organization (WHO) guideline (≥600 MET-minutes/week) were evaluated using weighted regression, receiver operating characteristic analyses, and restricted cubic splines.</p><p><strong>Results: </strong>Among 2966 adults with complete data, the mean weighted WPTI score was 20.9 (standard deviation (SD) 11.3). The index showed acceptable internal consistency and moderate correlations with total MET-minutes/week. Higher WPTI scores were strongly associated with meeting the World Health Organization guideline (odds ratio per 10-point increase 19.9, 95% confidence interval 15.7-25.2). Discrimination was excellent (area under the curve 0.865) with good calibration and robust results across sensitivity analyses.</p><p><strong>Conclusions: </strong>The WPTI provides a practice-ready, physiotherapy-specific index that integrates domain-specific activity and sedentary time into a single 0-100 score. It may support rapid screening, communication about movement and sitting, and the translation of population surveillance data into routine physiotherapy practice.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":"42 9","pages":"1171-1180"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866374","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 impact of social vulnerability on rehabilitation success: A retrospective study of outpatient orthopedic physical therapy.","authors":"Allison Butcher, Wayne Brewer, Rupal Patel, Kelli Jo Brizzolara, Gregory Marchetti","doi":"10.1080/09593985.2026.2635036","DOIUrl":"10.1080/09593985.2026.2635036","url":null,"abstract":"<p><strong>Background: </strong>Physical therapy is a cornerstone of musculoskeletal rehabilitation, yet limited research has explored how community-level factors influence outcomes in outpatient orthopedic settings. Understanding these factors is essential for addressing disparities in care and optimizing treatment effectiveness.</p><p><strong>Objective: </strong>To investigate the relationship between social vulnerability and patient outcomes in outpatient physical therapy within an urban, government-funded hospital system.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using data from 748 patients who received outpatient physical therapy between November 2018 and May 2021 in Houston, Texas. Social vulnerability scores were assigned using residential zip codes. Outcomes were assessed using the Focus on Therapeutic Outcomes (FOTO) measure. Binary logistic regression models evaluated the predictive value of the Social Vulnerability Index (SVI) on therapy success or failure, with secondary analyses examining attendance as an additional predictor.</p><p><strong>Results: </strong>Social vulnerability was a significant predictor of therapy outcomes among patients with shoulder diagnoses (OR = .182, <i>p</i> = .039). SVI did not significantly predict outcomes in patients with lower quarter (<i>p</i> = .799) or lumbar diagnoses (<i>p</i> = .404), or when stratified by evaluation date (Pre-COVID, <i>p</i> = .400; Post-COVID, <i>p</i> = .362). SVI was also not a significant predictor of outcomes across the overall sample (<i>p</i> = .525). However, higher social vulnerability was negatively correlated with the number of attended therapy visits (r_s = -0.114, <i>p</i> = .002). Visit frequency was a strong predictor of success, with each additional visit associated with an 9% increase in the odds of therapy success (OR = 1.09, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>Social vulnerability was not associated with outpatient physical therapy outcomes in the overall sample, although an exploratory association was identified among patients with shoulder diagnoses. The inverse relationship between SVI and attendance suggests that social vulnerability may indirectly influence rehabilitation outcomes through its impact on treatment engagement. Although these findings are preliminary and limited by study design, they underscore the importance of considering social determinants of health when planning outpatient physical therapy care.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1234-1246"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277330","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":"Spatiotemporal gait alterations in lower limb amputees during the pre-prosthetic phase: performance indicators and age-related differences.","authors":"Thais Andréia Schepa Weber, Ana Carolina Viecili, Guilherme Auler Brodt, Anderson Rech, Pedro Lopez, Leandro Viçosa Bonetti, Raquel Saccani","doi":"10.1080/09593985.2026.2620450","DOIUrl":"10.1080/09593985.2026.2620450","url":null,"abstract":"<p><strong>Background: </strong>Ambulation ability is among the most significantly compromised functions following lower-limb amputation, considerably impacting autonomy and quality of life.</p><p><strong>Objective: </strong>To compare the spatiotemporal gait alterations between adults and older adults with lower-limb amputation in the pre-prosthetic phase and to identify the indicators of gait performance.</p><p><strong>Methods: </strong>This observational, analytical, cross-sectional study enrolled 24 participants (13 adults aged 20-50 years and 11 older adults aged ≥60 years). Data collection included a demographic and clinical questionnaire, the Amputee Mobility Predictor without prosthesis (AMPnoPRO), the Functional Independence Measure (FIM), the Timed Up and Go (TUG) test, and gait analysis using an Inertial Measurement Unit with an accelerometer and gyroscope. Descriptive statistics were performed. Group comparisons were conducted using the Mann-Whitney U test. The Spearman correlation coefficient (<i>p</i> ≤ .05) was used to examine associations between gait parameters, age, anthropometric variables, and functional outcomes.</p><p><strong>Results: </strong>Age, duration of physical therapy, and functional test performance (FIM, AMPnoPRO, TUG) were significantly associated with spatiotemporal gait parameters. Older adults demonstrated significantly lower cadence (-23.2 steps/min; <i>p</i> = .013) and longer step duration (+0.68 s; <i>p</i> = .022) compared to younger adults (20-59 years).</p><p><strong>Conclusion: </strong>Age, duration of physical therapy, and performance on functional tests may serve as reliable indicators of gait performance, contributing to individualized rehabilitation strategies.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1131-1140"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067940","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}