Physiotherapy Theory and Practice最新文献

{"title":"Patient perspectives of a physiotherapy-led musculoskeletal community event: A mixed methods survey.","authors":"Peter Alan Brookes, Daniel Thomas Jackson, Kirstie Smith, Jennifer Plagerson, Fiona Blackman","doi":"10.1080/09593985.2025.2576622","DOIUrl":"10.1080/09593985.2025.2576622","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal (MSK) disorders represent a growing burden on healthcare systems. The musculoskeletal community event (MSK-CE) is an emerging, integrated model of community-based care that incorporates multi-professional and organizational collaboration to deliver holistic support. However, patient perspectives on this model remain largely unexplored.</p><p><strong>Aim: </strong>To measure patient perceptions of an MSK-CE related to satisfaction, confidence, and comparison to usual care, to describe and explore these perceptions, and to merge these findings with intent to obtain a deeper understanding.</p><p><strong>Methods: </strong>Patients on an NHS physiotherapy waiting list were invited to attend an MSK-CE and complete an anonymous post-event survey comprising multiple-choice, Likert-scale, and free-text questions. A pragmatic, cross-sectional, mixed-method \"questionnaire variant\" design was employed, integrating frequency-based descriptive statistics with qualitative review of free-text responses. These responses were grouped into key categories - satisfaction, confidence, and comparison to usual care, and coded as positive or negative.</p><p><strong>Results: </strong>There were 71 respondents. Satisfaction was positive, with 80% rating 7-10 on the Likert scale and subcategories \"advice and guidance\" and \"care provision\" emerging from free-text responses. Confidence to self-manage improved for 64% (rated 7-10), with subcategories \"promotion of self-management\" and \"reassurance\" also identified. Compared to routine physiotherapy, 35% rated the MSK-CE better, 27% the same, and 32% were unsure. Feedback on \"format\" and \"organisation\" was mixed.</p><p><strong>Conclusions: </strong>The MSK-CE shows promise as a holistic, community-based MSK care model aligned with trends in accessibility, integration, prevention, and value-based care. Further research is recommended to explore scalability and evaluate key performance indicators to optimize implementation.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"471-482"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309546","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":"Interference of functional dual-tasks on static posturography in people with Parkinson's disease.","authors":"Sara Monleón Guinot, Constanza San Martín Valenzuela, Vivina Aranda Asensi, Manuel Villanueva Navarro, José M Tomás","doi":"10.1080/09593985.2025.2574388","DOIUrl":"10.1080/09593985.2025.2574388","url":null,"abstract":"<p><strong>Background: </strong>Balance impairments lead to daily-life complications in people with Parkinson's disease (PwPD). However, the way the environment interferes with balance is still unknown.</p><p><strong>Objective: </strong>To analyze the interference of dual-tasks (DTs) on balance in PwPD and compare it with healthy participants.</p><p><strong>Methods: </strong>Sixty-seven people were evaluated, 42 comprised the Parkinson's disease group (PDG) and 25 were part of the Control group (CG). All followed the balanced HOME assessment trial, performing static posturography under 5 conditions: single-task, visual DT (DT_visual), verbal DT (DT_verbal), and two manual tasks, one above 90º of shoulder flexion (DT_upper) and the other below (DT_lower). Swept area, velocity, displacement, dispersion, and force of the Center of Pressure (CoP) were recorded.</p><p><strong>Results: </strong>DT interfered with the balance of the PDG in all conditions, while the CG was affected mainly in manual tasks. In the PDG, the swept area had the highest interference, reaching 218.84 mm² in the DT_upper condition, meaning 255.34% more swept area than in the single-task condition. However, CoP velocity was the most sensitive parameter to secondary tasks, being perturbed in all dual conditions tested, and the only outcome that increased (19.49%) during the DT_visual (<i>p</i> < .05). In DT_verbal condition the groups maintained similar balance, except for the CoP mediolateral displacement and dispersion (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Compared to healthy participants, untrained PwPD showed poorer postural control under DTs conditions. This impairment increased with task complexity, ranging from visual distraction to overhead manipulation. Mediolateral CoP movements may serve as an early indicator of balance deterioration in challenging environments.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"386-398"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303994","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 injury incidence, associated factors, and players' beliefs in beach tennis: a cross-sectional study.","authors":"Carolina Lise Laras, Tamiris Beppler Martins, Jaqueline de Souza, Taís Beppler Martins, Rodrigo Okubo","doi":"10.1080/09593985.2025.2573021","DOIUrl":"10.1080/09593985.2025.2573021","url":null,"abstract":"<p><strong>Introduction: </strong>Beach tennis is increasingly demanding, raising injury risk linked to overload, poor recovery, and limited prevention. Identifying related factors may help reduce musculoskeletal injuries.</p><p><strong>Objectives: </strong>To estimate the incidence of musculoskeletal injuries in beach tennis players, investigate practice habits and beliefs about injury causes in beach tennis players, and investigate factors associated with injury occurrence between injured and non-injured players.</p><p><strong>Methods: </strong>Retrospective, cross-sectional, descriptive epidemiological study with 235 beach tennis players (186 amateur, 6 professional, and 43 recreational) across Brazil. Data were collected via digital questionnaire between April and September 2024, covering demographics, training habits, sleep, nutrition, pain, and injury history. Injury incidence was calculated per 1000 hours of exposure. Associations were explored using unadjusted chi-square and t-tests; given convenience sampling, comparisons between competitive levels were interpreted descriptively.</p><p><strong>Results: </strong>Injury incidence was 1.11 per 1000 hours of exposure. Injury prevalence differed by competitive level (professionals 83.3%, recreational 30.2%; unadjusted/descriptive). Older age (<i>p</i> < .001), longer practice duration (<i>p</i> < .001), and inadequate sleep (<i>p</i> < .001) were associated with injury in unadjusted analyses. Over half of respondents attributed injuries to lack of muscle strengthening and repetitive movements. Preventive routines such as warming up, mobility drills, and muscle activation were more common among injured athletes, potentially reflecting higher physical demand.</p><p><strong>Conclusion: </strong>Musculoskeletal injuries in beach tennis are significantly associated with age, prolonged exposure, and poor sleep quality. Professional players presented higher injury prevalence than recreational athletes. Comparisons across competitive levels should be interpreted with caution due to potential selection bias and age-related differences.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"378-385"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an adapted dance exercise program on trunk control, balance and functional mobility in children and adolescents with cerebral palsy: randomized controlled study.","authors":"Asena Yekdaneh, Nilay Arman","doi":"10.1080/09593985.2025.2575072","DOIUrl":"10.1080/09593985.2025.2575072","url":null,"abstract":"<p><strong>Aims: </strong>The study aimed to investigate whether an 8-week adapted dance exercise program (ADEP), delivered in addition to conventional physiotherapy, would improve trunk control, balance, functional mobility, and quality of life (QoL) in children and adolescents with cerebral palsy (CP) compared with conventional physiotherapy alone.</p><p><strong>Methods: </strong>Thirty participants with CP (Gross Motor Function Classification System Level I - II) were randomly assigned to the ADEP group (<i>n</i> = 15) or the control group (<i>n</i> = 15). Both groups received conventional physiotherapy, while the ADEP group additionally performed physiotherapist-choreographed dance exercises accompanied by music, twice a week for 8 weeks. Outcomes included the Trunk Control Measurement Scale (TCMS) for trunk control, the Pediatric Balance Scale (PBS) for balance, the Timed Up and Go (TUG) for functional mobility, and the Pediatric Outcomes Data Collection Instrument (PODCI) for QoL.</p><p><strong>Results: </strong>The ADEP group showed significantly greater improvements than the control group in TCMS-Total (Δ = 10.53 vs 3.50, <i>p</i> < .001), TCMS-selective motor control (Δ = 6.00 vs 1.42, <i>p</i> < .001), TCMS-dynamic sitting balance (Δ = 7.53 vs 2.28, <i>p</i> < .001), and PODCI-Global scores (Δ = 4.61 vs -1.71, <i>p</i> < .001). Both groups improved in PBS and TUG, but between-group differences were not significant. Effect sizes indicated large improvements in trunk control in favor of the ADEP group.</p><p><strong>Conclusions: </strong>An 8-week ADEP program, when combined with conventional physiotherapy, produced clinically meaningful gains in trunk control and QoL in children and adolescents with CP. These findings support the use of dance-based rehabilitation as a feasible and engaging adjunct to physiotherapy.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"399-408"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337883","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":"Examination of functional characteristics related to physical function improvement in older adults with heart failure and low physical function.","authors":"Shuntaro Tamura, Masami Inokuma, Masaya Hattori, Yuta Tani, Yuki Ito, Shin Okazaki, Tatsuya Igarashi, Kazuhiro Miyata","doi":"10.1080/09593985.2025.2581133","DOIUrl":"10.1080/09593985.2025.2581133","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to clarify the physical characteristics of older adults with heart failure and low physical function based on the functional improvement following cardiac rehabilitation.</p><p><strong>Methods: </strong>This retrospective observational study included 257 older adults (≥60 years) with heart failure and low physical function (Short Physical Performance Battery [SPPB] ≤ 6) who underwent cardiac rehabilitation while in hospital. Modified Poisson regression analysis was conducted to examine the associations between functional improvement (defined as SPPB ≥9 at discharge) and baseline SPPB subitem scores (balance, walking speed, and five times sit-to-stand), along with other clinical variables.</p><p><strong>Results: </strong>The mean age of the participants was 85.2 (SD = 7.5) years, and the mean SPPB score at admission was 3.7 (SD = 1.9). A total of 76 (29.6%) participants showed functional improvement. Regression analysis revealed that higher SPPB subitem scores of balance (relative risk [RR]: 1.34 [95% CI: 1.15-1.57], <i>p</i> < .01) and five-times sit-to-stand (RR: 1.47 [95% CI 1.24-1.73], <i>p</i> < .01) at admission were significantly associated with functional improvement.</p><p><strong>Conclusions: </strong>Preserved balance and lower-limb strength at admission were associated with greater functional improvement following inpatient cardiac rehabilitation. Among older adults with heart failure and low SPPB scores, preserved baseline balance and lower-limb strength are associated with greater functional recovery. These findings underscore the importance of initiating early rehabilitation focused on balance and strength training in older adults with heart failure.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"463-470"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402476","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":"Examining the frequency, severity and associated factors of burnout in Nebraska physical therapists.","authors":"Nicole Sleddens, Elizabeth Beam, Kyle Meyer, Lynnette Leeseberg Stamler, Louise LaFramboise, Harlan Sayles, Steven Wengel","doi":"10.1080/09593985.2025.2571795","DOIUrl":"10.1080/09593985.2025.2571795","url":null,"abstract":"<p><strong>Background: </strong>Recognizing the adverse effects of burnout on clinician well-being and patient care, there has been a surge in national interest in this subject. However, within the physical therapy profession, the extent of burnout has not been as deeply examined.</p><p><strong>Objective: </strong>This study aimed to 1) describe the frequency and severity of burnout of Nebraska physical therapists using the Maslach Burnout Inventory and 2) explore potential associations of burnout with sociodemographic and work environment characteristics.</p><p><strong>Methods: </strong>Using a cross-sectional design, 2057 licensed physical therapists in Nebraska were invited to complete a survey that included the Maslach Burnout Inventory, demographic information, work environment factors, and stressors. Burnout profiles were generated based on Maslach Burnout Inventory subscale scores and scores were compared to previously established cutoffs. Associations between burnout and sociodemographic and work environment factors were analyzed, and key stressors for each burnout profile were identified.</p><p><strong>Results: </strong>The overall response rate was 23.5%. Approximately half of respondents exhibited engagement, while the remainder experienced at least one dimension of burnout, with 9.9% displaying a full burnout profile. Work environment factors, such as workload, autonomy, flexibility, time off, ethics, supervisor and coworker support, and professional judgment, contributed more significantly (<i>p</i> < .001) to burnout than sociodemographic characteristics (<i>p</i> < .05). The top stressors among participants with burnout were workload/productivity standards, hours worked per week, and student loan debt.</p><p><strong>Conclusion: </strong>These findings suggest that burnout, driven by emotional exhaustion, is a concern for Nebraska physical therapists. Addressing modifiable work environment factors could help reduce burnout and enhance workforce well-being.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"361-377"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294170","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":"Does exercise adherence influence outcome in knee osteoarthritis? - a secondary analysis of a superiority randomized controlled trial.","authors":"Georg Mørtvedt Rugelbak, Tom Arild Torstensen, Fredrik Paulsberg, Wilhelmus Johannes Andreas Grooten, Håvard Østerås","doi":"10.1080/09593985.2025.2579576","DOIUrl":"10.1080/09593985.2025.2579576","url":null,"abstract":"<p><strong>Background: </strong>The benefits of exercise in patients with knee osteoarthritis are well documented, but there is a knowledge gap regarding how exercise adherence influences outcome. This is a secondary analysis of a multicenter randomized controlled trial (<i>n</i> = 189).</p><p><strong>Objective: </strong>To examine associations between exercise adherence (number of treatments, exercises, repetitions, and exercise duration) and short-term clinical outcomes.</p><p><strong>Methods: </strong>Adherence was measured by number of treatments, exercises, repetitions, and cycling duration expressed as a percentage of the prescribed dose. Pearson's correlations were calculated between adherence and outcomes: knee function (Knee Injury and Osteoarthritis Outcome Score - KOOS), eight pain visual analogue scales (VAS), and quality of life (EuroQol-5 Dimension - EQ5D). Student's t-tests assessed whether adherence was associated with achieving minimal clinically important difference (MCID).</p><p><strong>Results: </strong>Treatment attendance was 98% in both groups. The high-dose group showed significantly lower adherence for exercises (81% vs 95%; <i>p</i> = .003), repetitions (79% vs 96%; <i>p</i> < .001), and cycling (78% vs 97%; <i>p</i> < .001), resulting in lower total exercise adherence (78% vs 97%; <i>p</i> < .001). Adherence was very weakly to weakly correlated with outcomes (<i>r</i> = -.209 to .117). No significant differences in adherence were found between those reaching or not reaching MCID in function, pain, or quality of life, except for pain when unloading in the final week in the high-dose group (-24.8 vs -9.5; <i>p</i> = .022).</p><p><strong>Conclusion: </strong>Despite lower adherence in the high-dose group, adherence showed little association with clinical outcomes. These results suggest that high adherence to high-dose exercise may not be necessary for short-term benefit, highlighting the need for further research on optimal dosage and identifying meaningful adherence components.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02024126. First version 2013-12-26.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"435-449"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423387","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":"https://doi.org/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":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-02-23","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":"An assessor-blinded randomized controlled trial comparing a tele-rehabilitation program with wearable technology to conventional face-to-face physiotherapy in patients with knee osteoarthritis.","authors":"Congcong Cai, Poh Gek Tiang, Amanda Ng, Faye Ng Xian Fei, Wei Ling Koh","doi":"10.1080/09593985.2026.2635044","DOIUrl":"https://doi.org/10.1080/09593985.2026.2635044","url":null,"abstract":"<p><strong>Introduction: </strong>Access to face-to-face physiotherapy for knee osteoarthritis (OA) is often limited by logistical barriers. This study compared a tele-rehabilitation program integrating video-conferencing and wearable motion sensors with conventional physiotherapy.</p><p><strong>Methods: </strong>Thirty-five participants with radiographic knee OA (Kellgren - Lawrence grades II - III) were randomized to a tele-rehabilitation group used a wearable sensor (<i>n</i> = 16) or conventional group (<i>n</i> = 19) attended face-to-face sessions. Both groups underwent a 12-week exercise program.</p><p><strong>Results: </strong>Both groups improved significantly over time in Numeric Pain Rating Scale score (end-intervention: B = -1.05, <i>p</i> = .003, 3-month follow-up: B = -1.15, <i>p</i> = .001, and 6-month follow-up: B = -0.97, <i>p</i> = .015), Patient-Specific Functional Scale score (end-intervention: B = 1.37, <i>p</i> < .001, 3-month follow-up: B = 1.83, <i>p</i> < .001, and 6-month follow-up: B = 2.06, <i>p</i> < .001), 30-second Chair Stand Test (end-intervention: B = 2.08, <i>p</i> = .001) and most of Knee Injury and Osteoarthritis Outcome Score (symptoms) (B = -1.03 to -0.50, <i>p</i> < .042) with no significant time × group interactions (<i>p</i> > .192).</p><p><strong>Conclusion: </strong>Tele-rehabilitation supported by wearable technology achieved outcomes comparable to conventional physiotherapy and may represent a viable alternative for delivering knee OA rehabilitation.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776731","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":"Prevalence and factors associated with difficult discharges in outpatient physical therapy: A cross-sectional survey.","authors":"Benton Lindaman, Michael Clarke, John Mischke, James Smoliga","doi":"10.1080/09593985.2026.2635038","DOIUrl":"https://doi.org/10.1080/09593985.2026.2635038","url":null,"abstract":"<p><strong>Background: </strong>Outpatient physical therapy often marks the final stage of formal rehabilitation and is punctuated by discharge to community-based wellness or home exercise program. Despite its critical role in care continuity, the outpatient discharge process remains underexplored, specifically those discharges that are more difficult or challenging.</p><p><strong>Objective: </strong>This exploratory study examined the prevalence, contributing factors, and clinician-perceived impact of difficult discharges in outpatient physical therapy to inform early conceptual and operational definition development.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using an Qualtrics survey that incorporated both quantitative and qualitative components. Three hundred and twenty four licensed physical therapists (PTs) practicing in United States (US) outpatient settings who primarily treated adults completed the survey. Quantitative data were analyzed descriptively and with regression modeling to examine clinician and practice characteristics associated with self-reported discharge difficulty, while qualitative responses to four open-ended questions were analyzed thematically to identify recurrent concepts and contextual factors influencing difficult discharges.</p><p><strong>Results: </strong>The median self-reported prevalence of difficult discharges was 20% (interquartile range [IQR] 10-31%). Physical therapist age was inversely associated with reported discharge difficulty, with younger clinicians (<34-years-old) and those treating neurological populations reporting higher rates and emotional burden. Thematic analysis helped generate a preliminary working definition of the difficult discharge. Six qualitative themes were identified: early communication and education, knowledge gaps, chronic condition complexity, behavioral compliance, financial barriers, and interdisciplinary collaboration. These themes illustrated the multifactorial nature of difficult discharges and their impact on care transitions and clinician well-being.</p><p><strong>Conclusions: </strong>Difficult discharges are common in outpatient physical therapy and arise from interconnected patient, provider, and system factors. Younger clinicians and those working in neurological practice may experience greater emotional strain. Early, consistent discharge planning and improved support systems may be associated with smoother care transitions and help sustain clinician well-being.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-16"},"PeriodicalIF":1.5,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259667","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}