Physiotherapy Theory and Practice最新文献

{"title":"Influence of pain, sequential movement or short-term rest performance on the evaluation results of neck muscle mechanical properties: a case-control study.","authors":"Lourdes García-Luque, Sandra Alcaraz-Clariana, Daiana Priscila Rodrigues-de-Souza, Cristina Carmona-Pérez, Juan Luis Garrido-Castro, Francisco Alburquerque-Sendín","doi":"10.1080/09593985.2025.2451200","DOIUrl":"https://doi.org/10.1080/09593985.2025.2451200","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with neck pain (NP) often experience altered muscle mechanical properties (MMPs), such as increased tone and stiffness. Myotonometry has become a reliable, noninvasive tool for measuring MMPs. However, the effect of movement and rest on MMPs in acute neck pain (ANP) individuals remains insufficiently explored.</p><p><strong>Objective: </strong>This study aimed to evaluate how sequential movement and short-term rest influence the MMPs of neck muscles in subjects with ANP.</p><p><strong>Methods: </strong>A case-control study was conducted with 37 subjects with APN and 37 matched healthy controls. Muscle mechanical properties were assessed by myotonometry at baseline, post-movement (after a motion assessment sequence), and post-rest. The outcome measures of MMPs were frequency or tone, stiffness, decrement, which is the inverse of elasticity, relaxation, and creep.</p><p><strong>Results: </strong>Subjects with ANP showed higher muscle tone, stiffness and decrement, and lower relaxation than controls, all with <i>p</i> < .05. In the ANP group, decrement was the only property that showed a significant change after movement and rest, both with <i>p</i> < .05. Reduced means values (m) with its standard deviation (SD) were observed post-movement (<i>m</i> = 1.35 Ø, SD = 0.03) and post-rest (<i>m</i> = 1.33 Ø, SD = 0.03) compared to baseline values (<i>m</i> = 1.43 Ø, SD = 0.04). The other MMPs remained stable across evaluation times (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>The evaluation of MMPs should be conducted prior to any mobility protocol to ensure that the results reflect the basal tissue characteristics in individuals with ANP, highlighting decrement as a sensitive marker of these changes.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025400","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":"High-intensity interval training to improve cardiorespiratory fitness in a patient with frailty and multimorbidity: A case report.","authors":"Anna Liu, James C Baldi, John C Woodfield, Kari A Clifford","doi":"10.1080/09593985.2025.2450609","DOIUrl":"https://doi.org/10.1080/09593985.2025.2450609","url":null,"abstract":"<p><strong>Background: </strong>Low cardiorespiratory fitness predicts worse postoperative outcomes, exacerbated by age and frailty. Preoperative High-Intensity Interval Training (HIIT) improves cardiorespiratory fitness and postoperative outcomes but is challenging to implement in frailty due to perceived risks.</p><p><strong>Purpose: </strong>The aim of this case report was to demonstrate feasibility of HIIT in a patient with frailty and multimorbidity.</p><p><strong>Case presentation: </strong>An 83-year-old frail male with atrial fibrillation and limited mobility presenting with locally advanced rectal cancer was assessed as unfit for major surgery unless his cardiorespiratory fitness improved. Initial cardiopulmonary exercise testing demonstrated low cardiorespiratory fitness (peak oxygen consumption (<math><mover><mi>V</mi><mo>˙</mo></mover></math>O_2peak) of 11.45 mL·min^-1·kg^-1). He subsequently underwent 15 supervised HIIT sessions targeting a Rating of Perceived Exertion ≥ 15.</p><p><strong>Outcomes: </strong>The patient demonstrated initial substantial improvements in his physical condition, increasing maximal work rate from 27.5 W to 55 W. However, there was no additional progress following session eight. At his post-exercise CPET he rapidly fatigued, resulting in a <math><mover><mi>V</mi><mo>˙</mo></mover></math>O_2peak of 7.4 mL·min^-1kg^-1. Clinical investigations revealed a worsening anemia with a hemoglobin of 92 g/L caused by an undiagnosed synchronous cecal tumor which was corrected preoperatively. Postoperatively, the patient recovered without complications and was successfully discharged home.</p><p><strong>Conclusion: </strong>Personalized HIIT improved exercise duration and work rate and was associated with positive postoperative outcomes in this patient with frailty and multimorbidity. A unique feature of this case was the unexpected loss of training progress and <math><mover><mi>V</mi><mo>˙</mo></mover></math>O_2peak deterioration post-HIIT, which prompted further clinical investigations. These identified a worsening anemia and resulted in important changes in both the preoperative and intraoperative treatment.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025398","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 multifaceted role of physiotherapy - a qualitative study exploring the experiences of physiotherapists working with adolescents with persistent pain.","authors":"Arne Kandal, Berit Østerås, Sylvia Söderström","doi":"10.1080/09593985.2024.2447915","DOIUrl":"https://doi.org/10.1080/09593985.2024.2447915","url":null,"abstract":"<p><strong>Background: </strong>Persistent pain is increasingly recognized as a growing issue among adolescents worldwide, with an estimated prevalence of 10-30%. Physical therapy is a recommended treatment modality for managing this kind of pain. Yet, there is still limited knowledge regarding how physiotherapists experience, manage, and follow up this patient population.</p><p><strong>Purpose: </strong>This qualitative study aimed to explore the experiences of physiotherapists in Norwegian primary healthcare working with adolescents experiencing persistent pain. The study examined the resources the therapists make use of, and the challenges they encounter.</p><p><strong>Method: </strong>Four focus group interviews were conducted with a total of 13 Norwegian physiotherapists experienced in treating adolescents with persistent pain. The interviews explored the physiotherapists' experiences of working with adolescents with persistent pain. A reflexive thematic analysis was conducted to analyze the data.</p><p><strong>Results: </strong>Three main themes were identified from the data analysis: (1) Relationship building as the foundation of the intervention. (2) Accompanying the adolescents into their everyday life. (3) Challenging cases that are also rewarding to work with.</p><p><strong>Conclusion: </strong>This study sheds light on the importance of sufficient and multifaceted clinical competence among physiotherapists to enable them to work effectively with adolescents experiencing persistent pain, and their families. The experiences of physiotherapists show the importance of a strong therapeutic alliance and individualized treatment approaches, based on shared decision-making and age-appropriate communication and interventions. The therapists in our study emphasized the need to integrate interventions into the adolescents' everyday lives, tailoring treatments to the unique life of each individual. Physiotherapists must navigate the complexities of meeting individual patient needs and adapting to challenges beyond traditional practice. To support this patient group effectively, ongoing professional development is recommended, either through continued education or colleague guidance from other experienced physiotherapists.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014047","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":"Using metabolic parameters to inform emergency care referral in a patient with a hyperglycemic induced acute kidney injury: a case report.","authors":"Juan P Gonzalez, Francesco Vendrame, Sabine Gempel, Kathryn E Roach, Neva Kirk-Sanchez, Marlon Wong","doi":"10.1080/09593985.2024.2449222","DOIUrl":"https://doi.org/10.1080/09593985.2024.2449222","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical reasoning and use of the American Diabetes Association (ADA) blood glucose and exercise guidelines in the face of an emerging acute glycemic crisis for a patient with type 2 diabetes mellitus receiving physical therapy for chronic ankle instability and fibromyalgia.</p><p><strong>Case description: </strong>Assessment of the patient's baseline blood glucose and ketone urinalysis revealed hyperglycemia and ketonuria, respectively. Shortly after testing, the patient became nauseous and vomited. This prompted assessment of her end-tidal carbon dioxide via nasal capnography to screen for diabetic keto-acidosis. Evidence of Kussmaul breathing, tachypnea, and hypocapnia in conjunction with hyperglycemia and ketonuria, as well as symptoms of nausea and signs of vomiting prompted a referral to the emergency department.</p><p><strong>Outcomes: </strong>The patient was admitted to the hospital for five days with a diagnosis of acute kidney injury. It was determined that the acute kidney injury was caused by hyperglycemia in combination with impaired kidney function and an exacerbation of her congestive heart failure, all of which are known risk factors for acute kidney injuries in patients with diabetes mellitus.</p><p><strong>Conclusions: </strong>Compliance with the ADA blood glucose exercise guidelines allowed for early recognition of metabolic dysfunction prior to the onset of symptoms. Failure to have complied with the ADA blood glucose exercise guidelines may have resulted in the physical therapist administering therapeutic exercise that likely would have contributed to a worse prognosis.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate changes in standing and walking when placing a hanger around the head of a patient with body lateropulsion: a case report.","authors":"Mayumi Matsumura, Hideaki Matsuo, Hirohito Sasaki, Masafumi Kubota","doi":"10.1080/09593985.2025.2452902","DOIUrl":"https://doi.org/10.1080/09593985.2025.2452902","url":null,"abstract":"<p><strong>Introduction: </strong>Body lateropulsion is a postural disorder characterized by involuntary leaning to one side and is a major symptom in individuals with Wallenberg syndrome. Although the hanger reflex has potential applications as a simple stimulus to control posture, there are no reports of its use in body lateropulsion cases. The case report aims to document the immediate effects of a wire hanger worn around the head on the center of foot pressure and gait pattern parameters.</p><p><strong>Case description: </strong>The patient, a man in his 50s, exhibited no motor paralysis of the upper and lower extremities following the onset of stroke but demonstrated left lateropulsion. Assessments of center of pressure (COP) during standing, as well as evaluating spatiotemporal and kinematic factors through three-dimensional gait analysis, both with and without a hanger worn around the head.</p><p><strong>Outcomes: </strong>The application of the hanger to the patient's head resulted in immediate improvements in postural control and walking ability. When the hanger was placed around the head, compared with the non-hanger condition, the deviation of the COP toward the lateropulsion side during the standing trial improved immediately. Additionally, placement of a hanger around the head increased hip adduction range of motion during the stance phase, decreased step width, and increased gait speed.</p><p><strong>Discussion: </strong>This case report suggests the need for further research regarding the effect and efficacy of a hanger worn around the head as a tool for understanding the pathophysiology of body lateropulsion and for providing enhancements in both standing posture and walking ability.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014624","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":"Implementation and sustainment of a clinical practice guideline in a physical therapy student-run pro bono clinic: a case report.","authors":"Amy Yorke, Suzanne Trojanowski, Sean Hurlburt, Jessika Gehrke","doi":"10.1080/09593985.2025.2450612","DOIUrl":"https://doi.org/10.1080/09593985.2025.2450612","url":null,"abstract":"<p><strong>Background: </strong>The development of evidence-based practitioners is an expectation of entry-level physical therapist education. Knowledge translation is a process to enhance the uptake of evidence into clinical practice. Student run pro bono clinics provide an authentic learning environment in which knowledge translation activities can be used to implement clinical practice guidelines (CPGs).</p><p><strong>Purpose: </strong>The purpose of this case report was to describe the implementation, evaluation, and sustainment process of incorporating a physical therapy neurologic outcome measure CPG in a physical therapy student run pro bono clinic.</p><p><strong>Methods: </strong>A mixed methods study, using the Knowledge to Action framework, was completed to standardize the outcome measures completed on patients with neurologic conditions who received services at a physical therapy student run pro bono clinic. The project was titled iKNOW (integrating KNOWledge translation) Super Six.</p><p><strong>Results: </strong>Chart audits, surveys, and focus groups revealed success in implementing a CPG promoting standardization of practice in a student run pro bono clinic. Students reported that environmental modifications and the availability of resources were strong facilitators of completing the measures. Differences existed between cohorts in perceived usefulness of peer support. To sustain use of the neurologic outcome measures as recommended by the CPG, efforts to enhance awareness, leverage peer support, maximize environmental facilitators, along with audit and feedback will continue.</p><p><strong>Conclusion: </strong>Student run pro bono clinics provide the environment for the implementation of CPGs. Students engaging in knowledge translation may develop the skills needed as an evidence-based practitioner.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013638","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":"Reliability, validity, responsiveness and minimal important changes of common clinical standing balance tests in individuals with knee osteoarthritis.","authors":"Neda Mostafaee, Nahid Pirayeh, Seyed Shahnam Moosavi","doi":"10.1080/09593985.2024.2445143","DOIUrl":"https://doi.org/10.1080/09593985.2024.2445143","url":null,"abstract":"<p><strong>Introduction: </strong>Standing balance is essential for physical functioning. Therefore, improving balance control is a key priority in the management of knee osteoarthritis (OA), underscoring the importance of accurately assessing standing balance.</p><p><strong>Purpose: </strong>To assess reliability, construct validity and responsiveness of common clinical balance tests, including Step Test, Single-Leg Stance Test, and Functional Reach Test, in patients with knee OA.</p><p><strong>Methods: </strong>In the initial session, 100 participants underwent balance tests and completed Persian-version of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Timed Up and Go Test (TUG) as comparators for evaluating the construct validity of balance tests. For test-retest reliability, a subset of 70 participants repeated balance tests 1 week after initial assessment. To examine responsiveness, a subset of 90 participants underwent tests and completed WOMAC and TUG at baseline and after completing intervention. At post-intervention assessment, participants also completed global rating of change scale.</p><p><strong>Results: </strong>Three balance tests showed excellent test-retest reliability (intra-class correlation coefficient >0.75). All balance tests were considered valid and responsive because they confirmed 100% of priori hypotheses. Minimal detectable change (MDC) values were 2.71 steps for Step Test, 7.15 seconds for Single-Leg Stance Test, and 4.90 centimeters for Functional Reach Test. Minimal important change (MIC) values were 4.5 steps for Step Test, 13.10 seconds for Single-Leg Stance Test, and 5.5 centimeters for Functional Reach Test.</p><p><strong>Conclusion: </strong>Three tests are reliable, valid and responsive for measuring balance in patients with knee OA. The MIC values aid clinicians and researchers in assessing the clinical relevance of changes in balance for these patients.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013965","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":"Clinimetric analysis of the numeric pain rating scale, patient-rated tennis elbow evaluation, and tennis elbow function scale in patients with lateral elbow tendinopathy.","authors":"Ian Young, James Dunning, Firas Mourad, James Escaloni, Paul Bliton, César Fernández-de-Las-Peñas","doi":"10.1080/09593985.2025.2450090","DOIUrl":"https://doi.org/10.1080/09593985.2025.2450090","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is conflicting clinimetric data on the patient-rated tennis elbow evaluation (PRTEE) and a paucity of evidence regarding the reliability, validity, and responsiveness of the numeric pain rating scale (NPRS), and tennis elbow function scale (TEFS) in patients with lateral elbow tendinopathy.</p><p><strong>Objective: </strong>Perform a comprehensive clinimetric analysis of the NPRS, PRTEE, and TEFS in a sample of patients (<i>n</i> = 143) with lateral elbow tendinopathy.</p><p><strong>Methods: </strong>Establish the reliability, construct validity, responsiveness, meaningful clinically important difference (MCID), and minimal detectable change (MDC₉₀) values for the NPRS, PRTEE, and TEFS at the 3-month follow-up.</p><p><strong>Results: </strong>The NPRS [intraclass correlation coefficient (ICC_2,1): 0.54, 95% confidence interval (CI): 0.17-0.78], PRTEE (ICC_2,1: 0.62, 95% CI: 0.21-0.86), and the TEFS (ICC_2,1: 0.71, 95% CI: 0.14-0.90) exhibited moderate reliability. All three outcomes exhibited excellent responsiveness [NPRS: area under the curve (AUC): 0.94, 95% CI: 0.89-0.98]; PRTEE: (AUC: 0.96, 95% CI 0.93-0.99); TEFS: (AUC: 0.95, 95% CI: 0.91-0.98). The MCID and MDC₉₀ were 2.3 and 1.4 for the NPRS, 14.8 and 9.7 for the PRTEE, and 7.5 and 5.7 for the TEFS, respectively. All three patients reported outcome measures also demonstrated strong construct validity (Pearson's r from 0.71 to 0.83, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>The NPRS, PRTEE, and TEFS are clinimetrically sound patient reported outcome measures for patients with lateral elbow tendinopathy at a 3-month follow-up.</p><p><strong>Registration at clinicaltrials.gov: </strong>NCT03167710.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967013","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":"Between the lines: a discursive analysis of the non-specific low back pain literature.","authors":"Clair Hebron, Morten Ekornsaeter, Karime Mescouto","doi":"10.1080/09593985.2024.2446530","DOIUrl":"https://doi.org/10.1080/09593985.2024.2446530","url":null,"abstract":"<p><strong>Background: </strong>The term nonspecific low back pain (NSLBP) is often ambiguously defined and inconsistently used in scientific literature. Yet, there is limited discussion and reflection on the meaning of the term and how different meanings influence research and clinical practice.</p><p><strong>Aim: </strong>The aim of this study was to critically analyze the meaning of NSLBP in scientific literature and its consequent influence on research and clinical practice.</p><p><strong>Methodology and methods: </strong>Conducting a Foucauldian discourse analysis, we analyzed 24 articles that explicitly discussed the term's meaning. Relevant articles were retrieved through a systematic literature search of six databases, supplemented by snowballing and expert recommendations.</p><p><strong>Findings: </strong>Our analysis identified five distinct discourses analyzing NSLBP: \"Biomedical,\" \"Neurocentric,\" \"Rational-Multifactorial,\" \"Complex-Multifactorial,\" and \"NSLBP Otherwise.\"</p><p><strong>Conclusion: </strong>Each identified discourse was underpinned by unique assumptions that both enable and constrain certain ways of thinking about, researching, and managing NSLBP. Most discourses were individual-centric, guiding a search for causes and solutions within the individual. An exception was the \"NSLBP Otherwise Discourse,\" which enables a more society-centric perspective and encourages alternative views on NSLBP. Given the significant impact of NSLBP and the paucity of substantial breakthroughs in understanding and management, critical reflection on current discourses and their influence on clinical and research practices seem timely. Moreover, considering the present uncertainty surrounding NSLBP, embracing multiplicity could pave the way for a more expansive research agenda.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-16"},"PeriodicalIF":1.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957275","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":"Exploring the influence of hospital context on acute care physical therapy fall prevention practice: A qualitative study.","authors":"James P Crick, Gideon Hewitt, Lisa Juckett, Marka Salsberry, Carmen E Quatman, Catherine C Quatman-Yates","doi":"10.1080/09593985.2024.2447923","DOIUrl":"10.1080/09593985.2024.2447923","url":null,"abstract":"<p><strong>Background: </strong>Falls are a significant concern for hospitals and patients. The risk of falls is particularly heightened around the period of hospitalization. Physical therapy (PT) is commonly consulted for hospitalized patients at-risk for falls, yet it is unknown how the hospital context influences fall prevention practice among physical therapists.</p><p><strong>Purpose: </strong>To explore the perspectives of acute care physical therapists on fall prevention practices within hospital settings and examine how specific contextual factors influence their practice patterns and the effectiveness ofPT interventions.</p><p><strong>Methods: </strong>A prospective qualitative study using collaborative qualitative data analysis was conducted through semi-structured interviews with acute care physical therapists nationwide. Interviews focused on therapists' perceptions of fall prevention practices, PT intervention effectiveness, and the influence of hospital context.</p><p><strong>Results: </strong>We derived three primary themes and ten subthemes. First, mobility promotion was identified as central to fall prevention, requiring a system-wide culture involving multidisciplinary teams, particularly nursing staff. Second, systemic factors, such as time constraints, institutional priorities, high patient volumes, staff availability, equipment availability, and the physical environment, were found to limit optimal PT practice for fall prevention. Third, the effectiveness of PT interventions was context-dependent, with therapists adapting their practices to maximize impact within systemic constraints. Notably, clinical experience seemed to mitigate some practice limitations.</p><p><strong>Conclusions: </strong>Despite the acknowledged benefits of PT, systemic factors often prevent therapists from implementing effective fall prevention interventions. Addressing these contextual barriers and developing standards of practice may enhance patient safety and the overall success of fall prevention efforts in hospitals.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957277","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}