Physiotherapy Theory and Practice最新文献

{"title":"Measurement properties of a 300-m community-based walking test incorporating environmental walking demands in individuals with subacute stroke.","authors":"Jun Min Lee, Eun Joo Kim, Sung Phil Yang, Byung Ju Shin, Su Ji Choi, Seung Heun An","doi":"10.1080/09593985.2026.2722213","DOIUrl":"https://doi.org/10.1080/09593985.2026.2722213","url":null,"abstract":"<p><strong>Background: </strong>Performance-based assessments reflecting environmental walking demands remain limited in subacute stroke rehabilitation.</p><p><strong>Objective: </strong>To evaluate the measurement properties of a 300-m Community-Based Walking Test (CBWT) designed to reflect environmental walking demands in individuals with subacute stroke.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively collected clinical data from 26 ambulatory individuals with subacute stroke (13 men and 13 women; mean age, 56.8 years [range, 26-81 years]) who completed the CBWT in both forward and reverse directions during rehabilitation. Assessments were performed at baseline and weeks 1, 2, and 4. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC_2,1), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman analysis. Responsiveness was assessed using standardized response mean (SRM) and effect size (ES), and convergent and longitudinal validity using Spearman correlations with gait, balance, and mobility measures.</p><p><strong>Results: </strong>CBWT completion time demonstrated excellent test-retest reliability in both directions (ICC = 0.92-0.93; 95% CI = 0.83-0.96). SEM ranged from 30 to 31 s and MDC from 83 to 86 s. Four-week responsiveness was moderate to high (SRM = 0.91-1.01; ES = 0.53-0.55). CBWT completion time showed moderate to high correlations with gait speed (<i>r</i> =  -0.70 to -0.84), walking endurance (<i>r</i> =  -0.76 to -0.81), and mobility (<i>r</i> = 0.78-0.83). Variability was observed even among independently ambulatory participants.</p><p><strong>Conclusion: </strong>The present findings provide preliminary evidence supporting the measurement properties of the CBWT in individuals with subacute stroke. The CBWT may provide complementary clinical information regarding walking performance under structured environmental demands beyond conventional indoor gait assessments, which may support the evaluation of environmental walking adaptation and inform clinical judgment regarding community mobility during rehabilitation and discharge planning.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799994","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":"Associations of motor recovery and perceived social support with participation-related outcomes in chronic stroke.","authors":"Mine Pekesen-Kurtca, Seda Nur Kemer, Yusra Baran, Kamil Yilmaz","doi":"10.1080/09593985.2026.2719835","DOIUrl":"https://doi.org/10.1080/09593985.2026.2719835","url":null,"abstract":"<p><strong>Background: </strong>Participation after stroke is shaped by motor recovery and contextual factors within the ICF framework. Although social support is considered an important environmental factor, its association with participation-related health outcomes in chronic stroke remains insufficiently understood.</p><p><strong>Aims: </strong>To examine the associations of motor recovery and perceived social support with participation-related outcomes in individuals with chronic stroke and to provide descriptive comparisons with healthy controls.</p><p><strong>Methods: </strong>Forty community-dwelling individuals with chronic stroke (≥3 months post-stroke) and 41 age-matched healthy controls completed a single-session assessment. Perceived social support, life satisfaction, and participation-related health-related quality of life were assessed using validated instruments. Forced-entry multivariable linear regression analyses were performed in the stroke group, with age, Multidimensional Scale of Perceived Social Support total score, and Brunnstrom lower extremity stage entered simultaneously into each model.</p><p><strong>Results: </strong>Compared with healthy controls, individuals with chronic stroke demonstrated poorer physical functioning (<i>p</i> < .01), role physical(<i>p</i> < .01), general health (<i>p</i> = .002), vitality (<i>p</i> = .003), and social functioning (<i>p</i> = .001), whereas total perceived social support (<i>p</i> = .835) and life satisfaction(<i>p</i> = .736)did not differ. In the stroke group, the regression models for social functioning (R²adj = 0.245) and vitality (R²adj = 0.270) were statistically significant. Higher Brunnstrom lower extremity stage was associated with better social functioning (β = 0.399, <i>p</i> = .007) and vitality (β = 0.438, <i>p</i> = .003), while higher perceived social support was associated only with better vitality (β = 0.288, <i>p</i> = .045).</p><p><strong>Conclusion: </strong>Motor recovery and perceived social support showed domain-specific associations with participation-related outcomes in chronic stroke. These findings support a multidimensional interpretation of participation-related health outcomes rather than assuming a uniform role for either functional recovery or social support.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800013","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":"Academic belonging and department satisfaction among undergraduate physiotherapy students: a cross-sectional study.","authors":"Hayriye Kul Karaali, Nazlı Demir, Özlem Özcan","doi":"10.1080/09593985.2026.2718788","DOIUrl":"https://doi.org/10.1080/09593985.2026.2718788","url":null,"abstract":"<p><strong>Introduction: </strong>Academic belonging is an important component of students' educational experience and may be particularly relevant in physiotherapy education, where learning requires theoretical knowledge, practical skills, clinical reasoning, and close interaction with peers and faculty.</p><p><strong>Objective: </strong>This study examined academic belonging among undergraduate physiotherapy and rehabilitation students and evaluated its associations with sociodemographic and educational variables.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among undergraduate students in the Department of Physiotherapy and Rehabilitation. Data were collected using an online questionnaire including sociodemographic and academic variables, satisfaction with the department and faculty, and the Academic Belonging Scale. Descriptive statistics, group comparisons, Spearman correlation analyses, and hierarchical linear regression analysis were performed.</p><p><strong>Results: </strong>A total of 469 students participated. The mean Academic Belonging Scale total score was 79.26 ± 17.59. Grade point average (GPA) (rho = 0.164, <i>p</i> < .001), satisfaction with the department (rho = 0.284, <i>p</i> < .001), and satisfaction with the faculty (rho = 0.141, <i>p</i> = .002) were positively correlated with the Academic Belonging Scale total score. In the final hierarchical regression model, only satisfaction with the department remained independently associated with academic belonging (B = 2.20, 95% CI: 1.02 to 3.37, <i>p</i> < .001). The final model explained 10.9% of the variance.</p><p><strong>Conclusion: </strong>Department satisfaction was the only variable independently associated with academic belonging among undergraduate physiotherapy students after accounting for sociodemographic and academic characteristics, GPA, department choice status, and faculty satisfaction. These findings suggest that students' perceptions of the department-level educational climate may be an important consideration for supporting academic belonging in physiotherapy education.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800031","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":"Beyond treatment: how care process factors shape physical therapist management of low back pain.","authors":"Chad Cook, Cassie Young, Daniel Harvey, Giacomo Rossettini","doi":"10.1080/09593985.2026.2716786","DOIUrl":"10.1080/09593985.2026.2716786","url":null,"abstract":"<p><strong>Background: </strong>Clinical outcomes are shaped not only by patient characteristics and treatment interventions but also by the <i>process</i> through which care is delivered. These care process factors, the events, interactions, and structures that occur during the continuum of receiving care, remain under-recognized contributors to patient recovery.</p><p><strong>Purpose: </strong>This commentary examines key domains of care process factors and synthesizes emerging evidence on how these elements influence outcomes independent of the specific treatment provided.</p><p><strong>Discussion and recommendations: </strong>We outline several major categories of care process factors: 1)timing/timeliness of care (early vs. delayed access); 2) point of entry (initial provider type); 3) care pathway design (triage models, referral structures); 4)insurance and payment models; and 5) continuity of care (consistent vs. fragmented clinician contact). Across these domains, research suggests that the process of care delivery can meaningfully shape patient expectations, engagement, and clinical trajectories, often with effects that are similar to well-designed, targeted treatments.</p><p><strong>Conclusion: </strong>Care process factors represent a critical but underappreciated layer of clinical practice and research. Understanding and optimizing these elements may enhance outcomes regardless of the treatment modality used. Future research should prioritize systematic evaluation of care processes to better integrate them into clinical decision-making and health system re-design.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799942","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":"Musculoskeletal impairments associated with migraine in young adults: a case-control study.","authors":"Akshitha Rajasekhar, Vijayakumar Palaniswamy, H S Deepti, Jackson Shaji, Femina Ibrahim, Havas Muhammed, Shikha Mehra","doi":"10.1080/09593985.2026.2719837","DOIUrl":"https://doi.org/10.1080/09593985.2026.2719837","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Migraine is common among university students and is frequently associated with neck pain, postural alterations, and musculoskeletal dysfunction. Cervical musculoskeletal impairments may be clinically relevant because nociceptive input from the upper cervical region can converge with trigeminal pathways within the trigeminocervical complex, potentially contributing to pain sensitization in some individuals with migraine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the association of core muscle endurance, cervical muscle endurance, and craniovertebral angle with migraine in university studentsand to determine whether these musculoskeletal variables remained associated with migraine status after accounting for age, sex, and body mass index.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this case-control study, 140 university students aged 18-28 years were recruited, including 70 with neurologist-confirmed migraine based on the International Classification of Headache Disorders, 3rd edition (beta version), and 70 headache-free controls. Core muscle endurance was assessed using the McGill endurance tests. Cervical flexor and extensor muscle endurance, as well as craniovertebral angle, were also measuredusing standardized procedures. Baseline characteristics were compared between groups. Between-group comparisons were performed using independent-samples t tests, and adjusted analyses were performed with age, sex, and body mass index entered as covariates. Predictors of migraine status were explored using logistic regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with controls, the migraine group demonstrated significantly lower core muscle endurance across all McGill tests (all &lt;i&gt;p&lt;/i&gt; &lt; .001), lower cervical muscle endurance (cervical flexors: 22.46 ± 15.54 vs 48.37 ± 16.82 seconds; cervical extensors: 49.80 ± 28.86 vs 72.23 ± 36.41 seconds; both &lt;i&gt;p&lt;/i&gt; &lt; .001), and a smaller craniovertebral angle (45.37 ± 3.07° vs 51.57 ± 2.06°, &lt;i&gt;p&lt;/i&gt; &lt; .001). In multivariable analysis, cervical flexor endurance and craniovertebral angle remained independently associated with migraine status. In the demographic-adjusted sensitivity model, cervical flexor endurance (odds ratio = 0.855, &lt;i&gt;p&lt;/i&gt; = .012) and craniovertebral angle (odds ratio = 0.201, &lt;i&gt;p&lt;/i&gt; = .001) remained significant predictors of migraine status. The model showed excellent apparent discrimination, with an area under the receiver operating characteristic curve of 0.99.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;University students with migraine exhibited reduced core and cervical muscle endurance, along with greater forward head posture, compared with headache-free controls. These findings suggest that migraine in young adults is associated with measurable musculoskeletal impairments, supporting the inclusion of postural alignment and muscle endurance assessment in physiotherapy evaluation and providing direction for future research on targeted rehabilitation strategies. Howe","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799974","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":"Biopsychosocial profile in individuals with chronic low back pain and high central sensitization symptoms: a cross-sectional comparative study.","authors":"Sevinc Akdeniz, Saliha Akyuz, Zafer Ucurum, Derya Ozer Kaya","doi":"10.1080/09593985.2026.2719836","DOIUrl":"https://doi.org/10.1080/09593985.2026.2719836","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain (CLBP) is a heterogeneous condition, and some individuals may exhibit high levels of central sensitization (CS) symptoms.</p><p><strong>Purpose: </strong>This study aimed to compare pain, physical and cognitive functions, circadian rhythm characteristics, and psychosocial factors in individuals with CLBP with high and low CS symptoms, and asymptomatic controls.</p><p><strong>Methods: </strong>This study included 45 participants. Individuals with CLBP were classified based on the Central Sensitization Inventory (CSI) scores: high-CSI and low-CSI.The high-CSI [age:45(37-54) years], low-CSI [age:50(39-59) years], and asymptomatic control group [age:44(28-52) years] each consisted of 15 individuals. Visual Analog Scale for pain intensity; an algometer for pressure pain threshold (PPT); an algometer and an ischemic cuff for conditioned pain modulation (CPM); Oswestry Disability Index for disability; Montreal Cognitive Assessment for cognitive function; Morningness-Eveningness Questionnaire for chronotype; Pittsburgh Sleep Quality Index for sleep quality; Epworth Sleepiness Scale for daytime sleepiness; Hospital Anxiety and Depression Scale for anxiety and depression; and Pain Self-Efficacy Questionnaire for pain self-efficacy were used. Independent samplest-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, and Fisher exact test were used for statistical analyses.</p><p><strong>Results: </strong>Compared with the low-CSI group, the high-CSI group had higher rest, activity, and night pain intensity (<i>p</i> = .025, <i>p</i> = .004, and <i>p</i> = .012, respectively), lower PPTs at the thumbnail and low back (<i>p</i> = .043 and <i>p</i> = .012, respectively), lower CPM at the thumbnail (<i>p</i> = .035), higher physical disability (<i>p</i> = .032), and greater sleep disturbance (<i>p</i> = .001). Compared with the asymptomatic control group, the high-CSI group had shorter sleep duration (<i>p</i> = .007), greater sleep disturbance (<i>p</i> = .001), and poorer sleep quality (<i>p</i> = .009).</p><p><strong>Conclusion: </strong>Individuals with CLBP and high CS symptoms exhibit higher pain intensity, lower PPTs, reduced CPM, greater physical disability, and poorer sleep. By emphasizing the heterogeneity of CLBP and the clinical relevance of central sensitization symptoms, this study supports individualized and mechanism-informed rehabilitation planning.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800029","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":"Development and psychometric validation of the shoulder problems assessment scale.","authors":"Hüsamettin Koçak, Ertuğrul Demirdel","doi":"10.1080/09593985.2026.2718441","DOIUrl":"https://doi.org/10.1080/09593985.2026.2718441","url":null,"abstract":"<p><strong>Background: </strong>Many shoulder patient-reported outcome measures (PROMs) rely on response categories that may be difficult to interpret in routine care.</p><p><strong>Objective: </strong>To develop and validate the 12-item Shoulder Problems Assessment Scale (SPAS), an activity-based PROM that uses a hierarchical stepwise yes/no format to identify the first threshold of difficulty during daily activities.</p><p><strong>Methods: </strong>The study used a multicenter design combining qualitative item development with psychometric testing. Items were generated from patient interviews, literature review, and clinician input, then refined through expert review. Pilot testing (<i>n</i> = 52) supported item refinement. Field testing (<i>n</i> = 415) was conducted at 12 outpatient physical therapy centers. The final SPAS includes 12 activity-based items, each with four ordered difficulty statements scored 4-0. For structural validation, exploratory factor analysis (EFA) and confirmatory factor analysis were performed in separate subsamples (<i>n</i> = 207 and <i>n</i> = 208), respectively. Internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficient (ICC(3,1))), convergent validity (Shoulder Pain and Disability Index (SPADI) correlations), and discriminative ability were evaluated using receiver operating characteristic analysis. Analyses followed COSMIN recommendations.</p><p><strong>Results: </strong>The results of EFA indicated a three-factor structure (Joint Mobility, Functionality, Pain), accounting for 56.16% of the variance. The proposed three-factor structure demonstrated excellent model fit (χ²/df = 1.07, CFI = 0.999, TLI = 0.998, RMSEA = 0.021, SRMR = 0.056). Total-scale internal consistency was α = 0.834; test-retest reliability was excellent (ICC_(3,1) = 0.913). The SPAS correlated strongly with SPADI (<i>r</i> = 0.790; <i>p</i> < .001). Discriminative ability was acceptable (area under the curve = 0.862).</p><p><strong>Conclusion: </strong>The SPAS is a 12-item, culturally relevant, activity-based shoulder PROM that uses a hierarchical yes/no response format to identify the activity level at which difficulty first occurs. It may support goal setting and follow-up in routine outpatient physiotherapy by assessing shoulder-related functional limitation.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799947","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":"Relationships between oxygen consumption, heart rate, perceived exertion, and walking speed during ecological walking tasks in stroke survivors and healthy controls: a secondary cross-sectional analysis.","authors":"Amine Guediri, Maxence Compagnat, Alix Poyet, Jean-Christophe Daviet, Stéphane Mandigout","doi":"10.1080/09593985.2026.2719838","DOIUrl":"https://doi.org/10.1080/09593985.2026.2719838","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although direct measurement of task-specific oxygen consumption (&lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt;) using portable metabolic gas analysis is the gold standard for exercise intensity assessment, it is impractical for home-based monitoring. Heart rate (HR), rating of perceived exertion (RPE), and walking speed (WS) are more accessible, but their associations with &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; during real-life walking tasks remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the relationship between &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; and HR, RPE, and WS during ecologically walking tasks in stroke survivors and healthy controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This secondary cross-sectional analysis included 30 stroke survivors and 30 healthy controls. Participants completed six walking tasks: overground walking, stair ascent and descent, irregular terrain walking, level-to-uphill and downhill-to-level walking. &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; was measured using a portable gas analyzer, HR with a Polar H10 monitor, RPE using the Borg 6-20 RPE scale, and WS from task distance and duration. Linear mixed-effects models were used to investigate the associations between &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; and each predictor (HR, RPE, and WS), adjusting for task and testing predictor-by-task interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In stroke survivors, RPE showed an inverse association with &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; during stair ascent, whereas no significant association was observed in healthy controls. HR showed a significant positive task-independent association with &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; in both groups (stroke: β = 0.031; healthy controls: β = 0.104 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; per bpm; both &lt;i&gt;p&lt;/i&gt; &lt; .001). The relationship between WS and &lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;O&lt;/mi&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt; was task-dependent in both groups, with the strongest associations observed during stair ascent (stroke: β = 2.172 and healthy controls: β = 2.344 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt; per 0.1 m·s&lt;sup&gt;-1&lt;/sup&gt; increase in WS; both &lt;i&gt;p&lt;/i&gt; &lt; .001) and level-to-uphill walking (stroke: β = 0.687 and healthy controls: β = 1.135 mL","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800009","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":"Arm exercise training in chronic obstructive pulmonary disease: an umbrella review of systematic reviews and meta-analyses.","authors":"Hidaye Yamikan, Aynur Demirel","doi":"10.1080/09593985.2026.2717391","DOIUrl":"https://doi.org/10.1080/09593985.2026.2717391","url":null,"abstract":"<p><strong>Background: </strong>Due to systemic inflammation, long-term oxygen therapy, corticosteroids, and symptoms, skeletal muscle dysfunctions or myopathies are observed in patients with chronic obstructive pulmonary disease (COPD). To manage the extrapulmonary features of COPD, arm exercise training has gained increasing attention as a component of pulmonary rehabilitation. However, there is no consensus regarding the level of evidence for arm exercises.</p><p><strong>Purpose: </strong>This umbrella review is aimed at synthesizing the findings about arm exercise training in patients with COPD.</p><p><strong>Methods: </strong>This umbrella review was registered at PROSPERO (CRD420251230948). Six databases were screened from inception to May 2026 and results were imported into Rayyan AI tool for detailed screening. Systematic reviews and meta-analysis that investigated arm exercise were included. The AMSTAR-2 tool was used for methodological quality. The GRADE framework was used to determine the certainty of evidence for the findings.The overlap among primary studies was assessed using the corrected covered area.Results:A total of 1,835 patients with COPD were included in eight studies (5 meta-analyses and 3 systematic reviews). The methodological quality of the reviews was rated as high in one review, moderate in two reviews, low in three reviews, and critically low in two reviews.Arm exercises improved dyspnea with moderate certainty evidence and arm exercise capacity and muscle strength with low-certainty evidence. Moreover, the effects of arm exercise training on fatigue were inconsistent with low certainty, and quality of life and activities of daily living were inconsistent with very low certainty.</p><p><strong>Conclusions: </strong>Arm exercise training may improve dyspnea and may enhance arm exercise capacity and muscle strength. However, confidence in these findings is limited by methodological weaknesses of the included reviews, overlap among primary studies, and heterogeneity in exercise interventions and outcome measures.It may be considered as an adjunct to pulmonary rehabilitation to improve these outcomes.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799959","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 exercise in rotator cuff-related shoulder pain: a systematic review with meta-analysis.","authors":"Alba Tena-Portilla, Rodrigo Martín-San Agustín, Mariano Gacto-Sánchez, Adrian Escriche-Escuder","doi":"10.1080/09593985.2026.2717392","DOIUrl":"https://doi.org/10.1080/09593985.2026.2717392","url":null,"abstract":"<p><strong>Objective: </strong>To study the effectiveness of exercise in rotator cuff-related shoulder pain by analyzing the changes produced in performance, disability, pain, and adherence.</p><p><strong>Methods: </strong>A systematic review of the bibliography collected in the databases MEDLINE, EMBASE, SPORTDiscus, PEDro, and Web of Science was carried out, collecting the data available until November 4, 2025. Risk of bias was measured using the Version 2 of the Cochrane Risk-of-Bias tool. A review and meta-analysis of randomized controlled clinical trials interventional studies on the effects of exercise interventions on performance, disability, pain, and adherence in people with rotator cuff-related shoulder pain was carried out following the Preferred Items for Reporting in Systematic Review and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Thirty-four articles encompassing 2019 subjects were included. Exercise produced significant improvements in disability in 15 studies, showing a significant reduction in DASH-measured disability compared with no intervention (MD = -8.50), with no differences versus other interventions. SPADI analyses showed no significant differences between exercise and either no intervention or non-exercise interventions. For pain, 11 studies reported significant improvements in favor of exercise, with reduced pain during activity or movement compared with non-exercise controls (SMD = -1.61), and greater effects versus no intervention (SMD = -1.87), while no significant effects were observed for pain at rest except for a borderline trend versus no intervention (SMD = -0.72). Mean adherence across studies was 83.6%. Most trials showed a high risk of bias, and the overall certainty of evidence was low.</p><p><strong>Conclusion: </strong>Exercise interventions appear to improve pain, disability, performance, and adherence in rotator cuff-related shoulder pain. However, due to substantial heterogeneity in exercise type and low certainty of evidence, exercise was not consistently superior to other rehabilitation modalities, and no specific exercise approach can be recommended as clearly most effective.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-30"},"PeriodicalIF":1.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799949","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}