Brazilian Journal of Physical Therapy最新文献

{"title":"Shoulder pain phenotyping: A guide for clinicians to determine predominant nociceptive, neuropathic, or nociplastic shoulder pain","authors":"Liesbet De Baets ,&nbsp;Kevin Kuppens ,&nbsp;Céline Labie ,&nbsp;Melina Nevoeiro Haik ,&nbsp;Eleni Kapreli ,&nbsp;Paraskevi Bilika ,&nbsp;Filip Struyf ,&nbsp;Dorien Borms ,&nbsp;César Fernández-de-Las-Peñas ,&nbsp;Eva Kosek ,&nbsp;Enrique Lluch ,&nbsp;Marco Testa ,&nbsp;Jeremy Lewis ,&nbsp;Zosia Goossens ,&nbsp;Marc Schilz ,&nbsp;Inge Bonneux ,&nbsp;Jo Nijs","doi":"10.1016/j.bjpt.2025.101240","DOIUrl":"10.1016/j.bjpt.2025.101240","url":null,"abstract":"<div><h3>Background</h3><div>Persistent shoulder pain is common, and it is associated with substantial morbidity and healthcare costs. Approximately 21 to 50 % of people with shoulder pain treated in primary healthcare recover within six months. It is not known why at least half do not recover. One possibility is the manner underlying mechanisms related to persistent shoulder pain are managed. Being able to determine the predominant pain phenotype in people with persistent shoulder pain (i.e., nociceptive, neuropathic, or nociplastic pain) together with their underlying mechanism and tailoring management accordingly may improve outcomes for people seeking care for persistent shoulder pain. The International Association for the Study of Pain (IASP) recently developed clinical criteria and a grading system for the identification of nociplastic pain.</div></div><div><h3>Objective</h3><div>In this paper, we aim to provide suggestions to clinicians to assist in the evaluation of pain phenotypes, underlying mechanisms, and their causal relationships.</div></div><div><h3>Discussion</h3><div>Based on the IASP clinical criteria and grading system for nociplastic pain, we outline pain phenotype evaluation and provide a clinical reasoning framework. To facilitate this, three case studies involving people living with persistent shoulder pain are presented.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101240"},"PeriodicalIF":3.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOBRAFIR clinical practice guidelines in cardiovascular physical therapy: Exercise-based interventions in outpatient rehabilitation programs for heart failure","authors":"Marlus Karsten ,&nbsp;Giulliano Gardenghi ,&nbsp;Alessandra Choqueta Toledo Arruda ,&nbsp;Aparecida Maria Catai ,&nbsp;Ariany Marques Vieira ,&nbsp;Cinara Stein ,&nbsp;Cintia Laura Pereira de Araujo ,&nbsp;Danielle Aparecida Gomes Pereira ,&nbsp;Darlan Laurício Matte ,&nbsp;Fabiola Maria Ferreira da Silva ,&nbsp;Fernando Silva Guimarães ,&nbsp;Gabriela Lima de Melo Ghisi ,&nbsp;Gaspar Rogério Silva Chiappa ,&nbsp;Graciele Sbruzzi ,&nbsp;Graziella França Bernardelli Cipriano ,&nbsp;Gustavo dos Santos Ribeiro ,&nbsp;Juliana Goulart Prata Oliveira Milani ,&nbsp;Laura Maria Tomazi Neves ,&nbsp;Leonardo Calegari ,&nbsp;Letícia de Araújo Morais ,&nbsp;Gerson Cipriano Jr.","doi":"10.1016/j.bjpt.2025.101260","DOIUrl":"10.1016/j.bjpt.2025.101260","url":null,"abstract":"<div><h3>Background</h3><div>Exercise training is a core component of cardiovascular rehabilitation programs for patients with heart failure (HF). In Brazil, physical therapists frequently deliver rehabilitation interventions. Given heart failure clinical management advancements and varied rehabilitation approaches, standardizing exercise training within cardiovascular rehabilitation programs is essential.</div></div><div><h3>Objective</h3><div>To provide evidence-based recommendations for structuring exercise training (ET) in outpatient cardiovascular rehabilitation with HF, whether with preserved or reduced left ventricular ejection fraction.</div></div><div><h3>Methods</h3><div>The Guideline Panel followed the principles of the Guidelines International Network (GIN) and the Appraisal of Guidelines for Research &amp; Evaluation (AGREE-II) to ensure methodological rigor. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of evidence (CoE) and to formulate recommendations for key questions regarding supervised ET in clinically stable outpatients with HF. Treatment effects were assessed through meta-analyses of randomized clinical trials published since 2009.</div></div><div><h3>Results</h3><div>The Guideline Panel suggests: 1. High-intensity interval training and moderate-intensity continuous training are equivalent (conditional recommendation [CoR], low CoE); 2. Moderate-intensity resistance training is more effective than low-intensity resistance training (CoR, very low CoE); 3. High-intensity inspiratory muscle training (IMT) is more effective than low-intensity IMT (CoR, very low CoE); 4a. Neuromuscular electrical stimulation (NMES) is more effective than NMES placebo or usual activities (CoR, low CoE). 4b. NMES, in addition to aerobic training, is not more effective than aerobic training alone (CoR, low CoE).</div></div><div><h3>Conclusion</h3><div>These recommendations provide valuable guidance for delivering exercise-based interventions to outpatient cardiovascular rehabilitation programs in heart failure patients.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101260"},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of injuries and illnesses in Para Athletes: A one-year prospective study of 102 para athletes across four sports","authors":"Fernanda Oliveira Madaleno ,&nbsp;Andressa Silva ,&nbsp;Evert Verhagen ,&nbsp;Larissa Santos Pinto Pinheiro ,&nbsp;Erik Witvrouw ,&nbsp;Evi Wezenbeek ,&nbsp;Thiago Fernando Lourenço ,&nbsp;Marco Tulio de Mello ,&nbsp;Juliana Melo Ocarino ,&nbsp;Renan Alves Resende","doi":"10.1016/j.bjpt.2025.101253","DOIUrl":"10.1016/j.bjpt.2025.101253","url":null,"abstract":"<div><h3>Background</h3><div>Para athletes experience high prevalence, incidence, and burden of health problems related to sport.</div></div><div><h3>Objectives</h3><div>To assess the prevalence, incidence, severity, and burden of injuries and illnesses in Para athletes throughout one year and to compare the prevalence of these health conditions across four sports.</div></div><div><h3>Methods</h3><div>Data were collected from January to December 2022 at two Brazilian Paralympic Reference Centers. Para athletes from swimming, athletics, powerlifting, and taekwondo were included. The OSTRC<img>H2 Questionnaire was used to record injuries and illnesses weekly for one year. Injury and illness prevalence, incidence, severity scores, and burden were calculated. A one-way ANOVA compared the prevalence of health problems among the four sports.</div></div><div><h3>Results</h3><div>In total, 102 Para athletes participated in this study (77 males, 25 females). Six hundred and twelve health problems (453 injuries and 159 illnesses) were reported. The prevalence of injuries was 31.8 % (95 % CI: 28.2, 35.3), and the prevalence of illnesses was 7.9 % (95 % CI: 7.0, 8.9). Taekwondo had the highest prevalence of injuries (44.9 %). The mean incidence rate of sudden-onset injuries was 9.9 per 1000 athlete hours, with taekwondo also exhibiting the highest rates. Injuries to the shoulder complex, followed by the ankle and knee, had the greatest burdens. Powerlifting exhibited the highest burden of injuries.</div></div><div><h3>Conclusion</h3><div>During the one year season, Para athletes experienced high injury rates and burdens, with severe impacts observed especially in taekwondo and powerlifting. Para athletics had a high prevalence of illnesses. These findings emphasize the need to develop injury prevention strategies tailored to the specific characteristics of each sport.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101253"},"PeriodicalIF":3.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are physical therapists doing to prevent falls in older adults in Brazil? - Findings from a nationwide survey","authors":"Renato Barbosa dos Santos ,&nbsp;Marcos Paulo Miranda de Aquino ,&nbsp;Tatiane da Silva ,&nbsp;Camila Astolphi Lima ,&nbsp;Nancy M Salbach ,&nbsp;Keith D Hill ,&nbsp;Catherine Sherrington ,&nbsp;Monica R Perracini","doi":"10.1016/j.bjpt.2025.101252","DOIUrl":"10.1016/j.bjpt.2025.101252","url":null,"abstract":"<div><h3>Background</h3><div>Understanding how physical therapists (PTs) approach fall prevention in older adults and factors that may influence their clinical practices is essential for designing knowledge translation strategies.</div></div><div><h3>Objectives</h3><div>To describe PTs’ clinical practices and barriers to implementing fall prevention best practices in older adults and to identify professional characteristics associated with implementation of fall prevention best practices.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted. Registered PTs providing care to older adults were recruited through social media platforms. A pre-tested questionnaire assessed clinical practice patterns, sociodemographic and professional characteristics, and behavioral factors influencing the implementation of fall prevention best practices. Data were analyzed descriptively, and multinomial regression identified associations between PTs’ characteristics and practice frequency. The Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behaviour model guided questionnaire design and interpretation of findings.</div></div><div><h3>Results</h3><div>Among 454 PTs surveyed, over 65 % reported frequently (often or always) asking patients about falls, identifying and documenting fall risk factors, and implementing fall prevention interventions. Recommended practices such as balance and strength training were commonly implemented. Barriers to fall prevention best practices included patient denial of risk, reluctance to report falls, and adherence challenges. PTs not practicing in geriatrics or those lacking up-to-date fall prevention knowledge were less likely to report consistent use of best practices.</div></div><div><h3>Conclusion</h3><div>Brazilian PTs frequently integrate fall prevention into older adult care but face patient-related barriers. Addressing the identified barriers through behavior change strategies could enhance the implementation of fall prevention best practices.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101252"},"PeriodicalIF":3.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical flexion posture during smartphone use was not a risk factor for neck pain, but low sleep quality and insufficient levels of physical activity were. A longitudinal investigation","authors":"Igor Macedo Tavares Correia ,&nbsp;Arthur de Sá Ferreira ,&nbsp;Jessica Fernandez Mosqueira Gomes ,&nbsp;Felipe José Jandre Reis ,&nbsp;Leandro Alberto Calazans Nogueira ,&nbsp;Ney Meziat-Filho","doi":"10.1016/j.bjpt.2025.101258","DOIUrl":"10.1016/j.bjpt.2025.101258","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of longitudinal studies investigating the association between cervical flexion posture during smartphone use (commonly referred to as text neck [TN]) and neck pain (NP).</div></div><div><h3>Objective</h3><div>To investigate whether TN is a risk factor for NP, considering the influence of lifestyle and psychosocial factors.</div></div><div><h3>Methods</h3><div>A 12-month longitudinal study. The sample consisted of 457 volunteers of both sexes, aged between 18 and 65 years, without NP. Sociodemographic, anthropometric, lifestyle, psychosocial, and smartphone-use data were collected through a self-reported questionnaire. TN was assessed objectively at baseline by measuring the cervical flexion angle using the cervical range of motion device (CROM) with participants standing and sitting while texting on their smartphones. One year after the initial assessment, participants were assessed regarding the point prevalence and frequency of NP.</div></div><div><h3>Results</h3><div>Of the total, 396 (87 %) participants completed the one-year follow-up. NP was reported by 40 (10 %) participants. Multiple logistic regression analysis showed that TN did not increase the chance of NP (standing OR [95 % confidence interval] = 1.0 [0.97, 1.04]; sitting OR = 1.01 [0.98, 1.04]) or frequency of NP (standing OR = 1.01 [0.99, 1.03]; sitting OR = 1.00 [0.99, 1.02]) after baseline. However, low sleep quality (OR = 1.76 [1.17, 2.63]) and insufficient level of physical activity (OR = 2.41 [1.03, 5.65]) increased the chance of NP.</div></div><div><h3>Conclusion</h3><div>Cervical flexion posture during smartphone use was not a risk factor for NP or frequency of NP, but low sleep quality and insufficient levels of physical activity were.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101258"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scapular kinematics variability in individuals with and without rotator cuff-related shoulder pain: A systematic review with multilevel meta-regression","authors":"Rubén Fernández-Matías ,&nbsp;Jorge Ballesteros-Frutos ,&nbsp;Pablo Gallardo-Zamora ,&nbsp;Néstor Requejo-Salinas ,&nbsp;Iván Caballero-Pozo ,&nbsp;Paula Ludewig ,&nbsp;Enrique Lluch-Girbés","doi":"10.1016/j.bjpt.2025.101261","DOIUrl":"10.1016/j.bjpt.2025.101261","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, great importance has been placed on abnormal scapula kinematics in the approach to treatment of patients with rotator cuff related shoulder pain (RCRSP).</div></div><div><h3>Objective</h3><div>To review the literature regarding the variability of scapular position and movement in individuals with and without RCRSP.</div></div><div><h3>Methods</h3><div>A systematic search was performed on 18^th April 2024 on nine databases. Studies evaluating scapular kinematics during arm elevation in healthy individuals and those with RCRSP were included, with a focus on 3D non-surface tracking systems.</div></div><div><h3>Results</h3><div>Twenty studies were included. In asymptomatic individuals, the estimated scapular position at rest was 1.00° to 11.58° of upward rotation (UR), 4.82° to 11.24° of anterior tilt, and 26.84° to 39.05° of internal rotation. During arm elevation, the scapula moves from the very beginning (no setting phase) towards UR (final position, 47.88° to 61.00° at 150° of elevation) and posterior tilt (final position, 10.78° to 11.96° at 150° of elevation), and there is a trend towards external rotation. The estimated scapulohumeral rhythm for humerothoracic elevation and scapular UR ranged from 2.86:1 to 3.13:1. There was very low certainty of evidence for differences in individuals with RCRSP in scapula resting position for UR (mean difference, -6.11°; 95 % CI: -7.36°, -4.86°), and internal rotation (mean difference, 4.21°; 95 % CI: 0.68°, 7.74°), that were below the width of the 95 % prediction intervals.</div></div><div><h3>Conclusion</h3><div>This meta-analysis has debunked the myth of the setting phase and the constant 3:1 scapulohumeral rhythm. There is great variability in scapular kinematics, making it difficult to detect abnormal patterns.</div></div><div><h3>Prospero registration number</h3><div>CRD42021259479</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101261"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing mortality risk in older adults by replacing sedentary behavior with leisure-time physical activity: insights from a prospective cohort study","authors":"Lucas Lima Galvão ,&nbsp;Douglas de Assis Teles Santos ,&nbsp;Claudio André Barbosa de Lira ,&nbsp;Jair Sindra Virtuoso Júnior ,&nbsp;Sheilla Tribess ,&nbsp;Anne Sulivan Lopes da Silva Reis ,&nbsp;Marilia Santos Andrade ,&nbsp;Beat Knechtle ,&nbsp;Rodrigo Luiz Vancini","doi":"10.1016/j.bjpt.2025.101256","DOIUrl":"10.1016/j.bjpt.2025.101256","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity (PA) has many health benefits. However, more research is needed to understand its effects on mortality risk in older adults.</div></div><div><h3>Objective</h3><div>To verify the hypothetical effects of replacing sedentary behavior (SB) and PA domains on the risk of mortality in the older adults.</div></div><div><h3>Methods</h3><div>A population-based prospective cohort study was conducted using exploratory survey methods, involving 332 participants of both sexes aged ≥ 60 years monitored over five years. PA and SB were assessed using the International Physical Activity Questionnaire, with the domains assessed including leisure, occupational, transport, and domestic. Isotemporal replacement modeling was applied to examine the hypothesized effects of replacing the PA and SB domains on mortality risk, using Cox proportional hazards regression with Hazard Ratio estimates and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>At all time points tested in the model, replacing SB exposure time with leisure-time PA proved to be protective against mortality risk, while the opposite substitution of leisure-time PA with SB was associated with higher mortality risk among participants.</div></div><div><h3>Conclusion</h3><div>This study suggests implementing strategies, highlighting the importance of promoting leisure activities among the older adult population.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101256"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What factors are associated with physical therapists’ use of patient-reported outcome measures in managing patients with low back pain in primary health care in Sweden?","authors":"Christine Melbye,&nbsp;Sara Östhols,&nbsp;Philip von Rosen,&nbsp;Eva Rasmussen-Barr","doi":"10.1016/j.bjpt.2025.101250","DOIUrl":"10.1016/j.bjpt.2025.101250","url":null,"abstract":"<div><h3>Background</h3><div>Physical therapists' use of patient-reported outcome measures (PROMs) in managing patients with low back pain (LBP) is reportedly low, especially for health-related and psychosocial factors.</div></div><div><h3>Objective</h3><div>To investigate factors associated with using specific PROMs among physical therapists working in primary care.</div></div><div><h3>Methods</h3><div>We analyzed data collected from physical therapists (<em>n</em> = 1237). Logistic regression analyses (Odd Ratios (OR), 95 % Confidence Intervals) were conducted to investigate how using PROMs for pain, disability, health-related, and psychosocial factors is associated with the physical therapists' demographic characteristics, including educational levels.</div></div><div><h3>Results</h3><div>Most physical therapists used PROMs for pain (83 %), while PROMs for disability (28 %), health-related (14 %), and psychosocial factors (13 %) were used less frequently. Being female (OR 2.57, 95 % CI: 1.84, 3.59) and working in private clinics (OR 1.83, 95 % CI: 1.27, 2.67) were associated with using PROMs for pain. Holding a master’s degree or PhD was linked to using PROMs for disability (OR 1.85, 95 % CI: 1.28, 2.66) and psychosocial factors (OR 2.11, 95 % CI: 1.19, 3.65). Being female (OR 1.51, 95 % CI 1.01, 2.29) and being an advanced clinical specialist (OR 2.09, 95 % CI: 1.29, 3.33) were associated with using PROMs for health-related factors.</div></div><div><h3>Conclusions</h3><div>While physical therapists commonly use PROMs for pain, few use them to assess health-related and psychosocial factors. Those with higher educational levels or advanced clinical specialists are more likely to incorporate such PROMs in managing patients with LBP. Future studies should explore educational interventions to improve understanding of PROMs and their role in clinical reasoning within a biopsychosocial framework.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101250"},"PeriodicalIF":3.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental factors contribute to the success of extubation in newborns: A multicenter cross-sectional study","authors":"Taís Beppler Martins ,&nbsp;Emanuella Cristina Cordeiro ,&nbsp;Giane Amorim Ribeiro-Samora ,&nbsp;Luciana Sayuri Sanada ,&nbsp;Gentil Gomes da Fonseca Filho ,&nbsp;Silvana Alves Pereira ,&nbsp;Dayane Montemezzo","doi":"10.1016/j.bjpt.2025.101255","DOIUrl":"10.1016/j.bjpt.2025.101255","url":null,"abstract":"<div><h3>Introduction</h3><div>Newborns (NB) undergoing invasive mechanical ventilation (IMV) should be extubated as early as possible. Predictive factors for successful extubation are often considered in isolation, focusing on personal factors and the functions and structures of the NB's body, according to the International Classification of Functioning, Disability and Health (ICF).</div></div><div><h3>Objectives</h3><div>To assess the contribution of ICF components to the successful extubation of NB.</div></div><div><h3>Method</h3><div>A multicenter, observational and retrospective study was conducted using medical records of NB from five macroregions of Brazil. NB who underwent IMV of &gt;24 h were included. Clinical and sociodemographic variables were organized according to ICF components, and factors associated with successful extubation were analyzed using a generalized linear model.</div></div><div><h3>Results</h3><div>A total of 498 NB were included, with an extubation success rate of 82.3 %. The body functions and structures component included pH (<em>p</em> = 0.006), the environmental factors component included the number of prenatal consultations (<em>p</em> = 0.002) and mode of ventilation (<em>p</em> = 0.004), and the personal factors component included gestational age (<em>p</em> &lt; 0.001), birth weight (<em>p</em> &lt; 0.001), gestational age at extubation (<em>p</em> &lt; 0.001), and weight at extubation (<em>p</em> &lt; 0.001). Environmental factors increased the probability of successful extubation by 1.72 times (95 % CI: 1.26, 2.35).</div></div><div><h3>Conclusion</h3><div>The environmental factors component of the ICF significantly influenced extubation outcomes in NB, increasing the probability of success. These findings highlight the importance of developing extubation protocols that integrate predictive variables from all ICF components, considering both functional and structural alterations along with contextual factors.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101255"},"PeriodicalIF":3.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and beliefs of physical therapists regarding the mechanisms of manual therapy","authors":"Gabriela F. Carvalho ,&nbsp;Wacław M. Adamczyk ,&nbsp;Carine S. Ludes ,&nbsp;Rachel Scharbach ,&nbsp;Andres Jung ,&nbsp;Sven Karstens ,&nbsp;Kerstin Luedtke ,&nbsp;Tibor M. Szikszay","doi":"10.1016/j.bjpt.2025.101231","DOIUrl":"10.1016/j.bjpt.2025.101231","url":null,"abstract":"<div><h3>Background</h3><div>Manual therapy (MT) is a widely utilized approach for managing musculoskeletal pain and functional disorders, particularly through joint mobilizations. Traditionally explained by immediate biomechanical processes, a paradigm shift has occurred in the last few decades, recognizing neurophysiological mechanisms as crucial contributors.</div></div><div><h3>Objectives</h3><div>To evaluate whether this shift is also reflected by clinicians, this study explores the beliefs and perceptions of physical therapists regarding the mechanisms underlying MT through an online survey design. The focus was if dominantly peripheral biomechanical model or a neurophysiological explanatory model prevails.</div></div><div><h3>Methods</h3><div>The study involved a national cross-sectional survey of 569 physical therapists, average age 36.5y (9.7), and 58 % female. Based on a fictitious case scenario, participants rated on a scale from 0 % to 100 %, the involvement of anatomical structures and physiological mechanisms and provided additional suggestions.</div></div><div><h3>Results</h3><div>The majority of responders attributed significant involvement to the brain (75 %), myofascial structures (71 %), peripheral nervous system (68 %), and cervical joints (60 %). Mechanisms such as endogenous pain modulation (73 %), placebo effects (72 %), muscle activity (68 %), and neuromuscular responses (62 %) were commonly endorsed. The data indicated that socio-demographic and work-related characteristics are weakly associated to specific beliefs, emphasizing the complex nature of these perspectives. The findings underscore the diversity in physical therapists' beliefs and highlight the importance of understanding the mechanisms, as they significantly contribute to the perceived effectiveness of MT.</div></div><div><h3>Conclusion</h3><div>This study provides valuable insights into the current landscape of beliefs among German physical therapists, contributing to the ongoing dialogue between basic research and clinical practice in MT.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101231"},"PeriodicalIF":3.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}