Journal of Orthopaedic & Sports Physical Therapy最新文献

{"title":"Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Revision 2026.","authors":"Mia Erickson, Marsha Lawrence, Melissa J Lazinski, Kylie Scott, RobRoy L Martin","doi":"10.2519/jospt.2026.0301","DOIUrl":"https://doi.org/10.2519/jospt.2026.0301","url":null,"abstract":"<p><p>APTA Orthopedics and APTA Hand and Upper Extremity Physical Therapy, Academies of the American Physical Therapy Association, have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for physical therapy management and prevention of upper extremity musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline is a revision of the 2019 CPG that focuses on hand pain and sensory deficits in carpal tunnel syndrome. <i>J Orthop Sports Phys Ther 2026;56(4):CPG1-CPG79. Epub 12 February 2026. doi:10.2519/jospt.2026.0301</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 4","pages":"CPG1-CPG79"},"PeriodicalIF":5.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Is a Prognostic Prediction Model Ready for Clinical Use? A Primer for Clinicians.","authors":"Daniel Feller, Alessandro Chiarotto","doi":"10.2519/jospt.2026.13868","DOIUrl":"https://doi.org/10.2519/jospt.2026.13868","url":null,"abstract":"<p><p><b>BACKGROUND:</b> In clinical practice, accurately estimating a patient's prognosis is essential for clinical decision making. Prognostic prediction models can support this process by combining multiple patients' characteristics into individualized predictions. However, prognostic models require careful methodological evaluation before being applied in practice. <b>CLINICAL QUESTION:</b> How can clinicians determine whether a prognostic prediction model is ready for use in routine practice? <b>KEY RESULTS:</b> Prognostic prediction models are algorithms that combine multiple variables to estimate the likelihood of an outcome. They can be developed using regression-based methods or machine learning approaches. They are usually developed in a specific data set. However, good performance in the data set does not guarantee that the model will perform well when applied to new patient data in practice. Prognostic models must undergo validation (internal and/or external) and clinical impact evaluation before being implemented in practice. The performance of the model (at development and validation) should be evaluated across 3 key aspects: discrimination, calibration, and clinical utility. The risk of bias of a model should also be assessed, as weaknesses in study design or analysis can undermine the reliability of results. An effectiveness study should finally evaluate whether a model improves patients' outcomes. <b>CLINICAL APPLICATION:</b> Clinicians should follow a structured process to review prognostic models before adopting them in practice. Clinicians should verify that the model has been validated in the target population, evaluate its performance metrics, and appraise its risk of bias. Only models that meet minimum standards across these domains should be considered suitable for clinical use. <i>J Orthop Sports Phys Ther 2026;56(4):227-234. Epub 12 February 2026. doi:10.2519/jospt.2026.13868</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 4","pages":"227-234"},"PeriodicalIF":5.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are You Counting? Effectiveness of Interventions Using Activity Trackers and Smartphone Applications for Increasing Physical Activity in Older People Living in the Community: A Systematic Review With Meta-Analysis.","authors":"Nusrat Hamdani, Juliana Oliveira, Paloma Santana, Gabriel Ferretti, Poonam Mehta, Peter Stubbs, Catherine Sherrington, Arianne Verhagen, Anne Tiedemann, Bruno Saragiotto","doi":"10.2519/jospt.2026.13825","DOIUrl":"https://doi.org/10.2519/jospt.2026.13825","url":null,"abstract":"<p><p><b>OBJECTIVE</b>: To evaluate the effectiveness of interventions using activity trackers and smartphone applications (apps) for increasing physical activity (steps per day) in people aged ≥60 years. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> We searched 6 electronic databases (including EMBASE and MEDLINE) from inception to January 2025. <b>SELECTION CRITERIA:</b> We included randomized controlled trials that used activity trackers or smartphone apps to promote physical activity in people aged ≥60 years. <b>DATA SYNTHESIS:</b> Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were conducted using random-effects models, and certainty of the evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. <b>RESULTS:</b> We included 29 trials with 3005 participants. In the short term (data point closest to the end of the intervention), activity trackers and apps may increase physical activity by about 1113 steps per day compared to minimal intervention (95% CI: 669, 1557; 20 trials; low-certainty evidence). When compared to other active interventions, activity trackers and apps may increase physical activity by 912 steps per day (95% CI: 412, 1413; 8 trials; very low-certainty evidence). Single trials reported intermediate (6 months) and long-term (12 and 24 months) effects, and suggested no sustained benefits. <b>CONCLUSION:</b> Activity tracker and app-based interventions may cause short-term increases in physical activity among older adults, but effects were not sustained. <i>J Orthop Sports Phys Ther 2026;56(4):235-247. Epub 2 March 2026. doi:10.2519/jospt.2026.13825</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 4","pages":"235-247"},"PeriodicalIF":5.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Changes of the Anterior Cruciate Ligament (ACL), Evaluated by MRI, and Their Relation to Clinical Outcomes, Within 2 Years After ACL Injury. Results From the NACOX Cohort Study.","authors":"Joanna Kvist, Angie Liu, Nicola Giannotti, Stephanie Filbay, Henrik Hedevik, Anders Stålman, Richard Frobell, Håkan Gauffin, Martin Englund","doi":"10.2519/jospt.2026.13397","DOIUrl":"10.2519/jospt.2026.13397","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> The aim was to (1) describe structural changes of the anterior cruciate ligament (ACL), evaluated by magnetic resonance imaging (MRI), within 6 weeks until 24 months after ACL injury, and (2) investigate the relationship between ACL structural continuity and patient-reported and clinically assessed outcomes. <b>DESIGN:</b> Longitudinal pragmatic cohort study. <b>METHODS:</b> We included 129 patients, aged 15 to 40 years, with acute ACL injury from the NACOX (natural corollaries and recovery after an acute ACL injury) cohort. Patients were treated according to usual clinical practice, which comprised supervised rehabilitation before considering ACL reconstruction. At baseline and at 3, 6, 12, and 24 months follow-up, 3-Tesla 3-dimensional proton-density fat-saturated MRI scans, and patient-reported and objectively measured outcomes were assessed. The ACL Continuity, Thickness, and Shape (ACTS) scoring system was used for MRI assessment. <b>RESULTS:</b> At 24 months, 60 (47%) participants had received ACL reconstruction. At the last available MRI, 55 (48%) patients had overall ACL structure in continuity and 49 (43%) had ACL fibers in continuity. The overall ACL structure and fiber continuity on ACTS improved by at least 1 step in 31% to 81% of the patients at the different follow-ups. Ligament structure in continuity was associated with fewer giving-way episodes (11% versus 50%, <i>P</i> = .033) and reduced knee laxity at 12 months (side-to-side difference ≥ 3 mm: 53% versus 88%, <i>P</i> = .026) and 24 months (52% versus 100%, <i>P</i> = .013). Results for patient-reported outcomes were inconclusive due to wide confidence intervals. <b>CONCLUSION:</b> The ACL structure improved during the first 24 months after ACL injury when managed without ACL reconstruction. Continuity of ligament structure was associated with fewer giving-way episodes and lower knee laxity. <i>J Orthop Sports Phys Ther 2026;56(3):209-219. Epub 4 February 2026. doi:10.2519/jospt.2026.13397</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"209-219"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Patient Education and Self-management Program on Pain and Disability Among Adult Patients With Osteoarthritis: An Overview of Systematic Reviews.","authors":"Ching Long Chan, Hau Yan Chan, Cheuk Him Curtis Yu, Yan Yu Chan, Yung Chuen Tsoi, Siu-Ngor Fu, Shahnawaz Anwer, Owis Eilayyan, Arnold Y L Wong, Nathan Hutting, Fadi M Al Zoubi","doi":"10.2519/jospt.2026.13407","DOIUrl":"10.2519/jospt.2026.13407","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To estimate the effectiveness of patient education and self-management interventions for osteoarthritis (OA) in adults aged ≥18 years. <b>DESIGN:</b> Overview of intervention systematic reviews (SRs). <b>LITERATURE SEARCH:</b> Eight databases (MEDLINE [Medical Literature Analysis and Retrieval System Online], Cochrane Library, EMBASE [Excerpta Medica Database], Epistemonikos, Web of Science, Scopus, PEDro [Physiotherapy Evidence Database], and CINAHL [Cumulative Index to Nursing and Allied Health Literature]) were searched from inception to June 26, 2024. <b>STUDY SELECTION CRITERIA:</b> We included intervention SRs, with or without meta-analysis (MA), that evaluated patient education or self-management interventions for adults with OA, reporting pain or functional outcomes. <b>DATA SYNTHESIS:</b> Data were extracted using a standardized template. We extracted intervention effects on pain and function. Methodological quality was evaluated using the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) checklist. We assessed the overlap of studies included in the SRs using the corrected covered area (CCA) method. <b>RESULTS:</b> Nineteen SRs (12 with MA) encompassing 171 trials were included. Patient education interventions had modest effects on reducing short-term pain (standardized mean difference [SMD], -0.22 to -0.35). There were no sustained or consistent effects of patient education interventions on function. Self-management interventions yielded small and consistent effects on reducing pain (SMDs ranging approximately from -0.20 to -1.51) and improving function (SMDs up to 1.95), especially over the long term and when combined with patient education. Methodological quality was generally low; 1 SR was rated as high quality. There was a slight overlap among included trials (CCAs of 1.5% for patient education and 4.6% for self-management). <b>CONCLUSION:</b> Self-management interventions, particularly when integrated with patient education or other therapies, may offer more robust and lasting benefits for OA management than patient education alone. <i>J Orthop Sports Phys Ther 2026;56(3):176-192. Epub 4 February 2026. doi:10.2519/jospt.2026.13407</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"176-192"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Supervised Physical Therapy to Home Exercise Programs in Patients With Distal Radius Fractures: A Systematic Review With Meta-Analysis of Randomized Clinical Trials.","authors":"Héctor Gutiérrez-Espinoza, Felipe Araya-Quintanilla, Iván Cuyúl-Vásquez, Daniela Celi-Lalama, Juan Valenzuela-Fuenzalida, Elisabet Hagert, José Francisco López-Gil","doi":"10.2519/jospt.2026.13561","DOIUrl":"10.2519/jospt.2026.13561","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare the effects of supervised physical therapy to home exercise programs on functional outcomes in patients after distal radius fractures. <b>DESIGN:</b> Intervention systematic review with meta-analysis of randomized clinical trials (RCTs). <b>LITERATURE SEARCH:</b> We searched MEDLINE, EMBASE, Web of Science, Scopus, CENTRAL, Epistemonikos, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and LILACS databases from inception to April 2025. <b>STUDY SELECTION CRITERIA:</b> We included RCTs comparing supervised physical therapy with a home exercise program on functional outcomes in patients with distal radius fracture. <b>DATA SYNTHESIS:</b> We used a random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0 and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to judge the certainty of evidence. <b>RESULTS:</b> Thirteen RCTs were included. At 6 weeks, there were significant differences for Patient-Rated Wrist Evaluation (mean difference [MD] = -11.64 points, <i>P</i> < .001) with moderate certainty of evidence, for grip strength relative to the unaffected side (MD = 12.85%, <i>P</i> = .03) with low certainty of evidence, and for wrist extension range of motion (MD = 8.99°, <i>P</i> = .03) with moderate certainty of evidence. All results were in favor of the supervised physical therapy group. There were significant differences in favor of supervised physical therapy for wrist function and extension range of motion in patients over 65 years (<i>P</i> < .05). A greater number and frequency of supervised physical therapy sessions were associated with greater pain relief and improved wrist range of motion (<i>P</i> < .05). <b>CONCLUSION:</b> Supervised physical therapy had statistically significant short-term benefits in wrist function, grip strength, and wrist extension range of motion. <i>J Orthop Sports Phys Ther 2026;56(3):158-175. Epub 4 February 2026. doi:10.2519/jospt.2026.13561</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"158-175"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving Forward Together. Part 2: Enhancing Physical Therapy Clinical Care for Indigenous Peoples' Musculoskeletal Health.","authors":"Ivan Lin, Jane Linton, Philippa Cotter, Blair Dixon, Allyson Jones, Wesley Lagolago, Scott Willis, Brooke Conley","doi":"10.2519/jospt.2026.13739","DOIUrl":"10.2519/jospt.2026.13739","url":null,"abstract":"<p><p><b>SYNOPSIS:</b> The <i>Moving Forward Together</i> series was developed to inform, guide, and inspire musculoskeletal physical therapists to bring Indigenous health to the forefront of their work in clinical practice, research, and education and to strengthen their roles in allyship and advocacy for Indigenous Communities. In this, the second article of the series, we examine the clinical practice of individual physical therapists and physical therapy services. Our group-comprising Indigenous and non-Indigenous clinicians and/or academics from Aotearoa/New Zealand, Australia, Canada, and Samoa-reflected on current initiatives and explored future directions to offer suggestions on how physical therapists can contribute to positive change within Indigenous musculoskeletal clinical practice in order to improve the musculoskeletal health of Indigenous Peoples. Here, we take a practical, skills-based approach in describing ways to provide respectful and equitable musculoskeletal health care for Indigenous Peoples. <i>J Orthop Sports Phys Ther 2026;56(3):128-134. doi:10.2519/jospt.2026.13739</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"128-134"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators for the Implementation of an Osteoarthritis Management Programs in a Low-Income Setting: An Exploratory Study of Malawian Physical Therapists.","authors":"Nonhlanhla S Mkumbuzi, Esther Jiya, Enock M Chisati, Joanne L Kemp, Christian J Barton, Allison M Ezzat","doi":"10.2519/jospt.2026.13317","DOIUrl":"10.2519/jospt.2026.13317","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To (1) examine Malawian physical therapists' knowledge and beliefs about osteoarthritis (OA), and their perceived capabilities to deliver an OA management program to people with knee and hip OA, and (2) identify barriers and facilitators for an OA management program in Malawi. <b>DESIGN:</b> Two-phased mixed-methods formative evaluation. <b>METHODS:</b> In phase 1, Malawian physical therapists participated in the Good Life with osteoArthritis in Denmark (GLA:D) Australia training course and answered quantitative precourse and postcourse questions that were descriptively summarized, and analysed using McNemar's test, where appropriate. In phase 2, semistructured focus groups generated qualitative data that were thematically analyzed and mapped to the Consolidated Framework for Implementation Research. Mixed-methods data were integrated through triangulation. <b>RESULTS:</b> Eleven Malawian physical therapists (9 [82%] female, 10 [91%] with 5-10 years of clinical experience) participated. From pretraining to posttraining course, participants' knowledge of OA management (percentage change) increased regarding the benefits of therapeutic exercise (91%), importance of weight management (82%), and acceptable symptoms profile (73%). Participants' confidence and beliefs in managing knee and hip OA also increased. Implementation barriers included program costs, current medical management of OA with painkillers, and infrastructure challenges. Implementation facilitators included the content and organization of GLA:D, adaptability of the program, and OA awareness and education among other health professionals. <b>CONCLUSION:</b> Knowledge, confidence, and beliefs in managing knee and hip OA improved post-GLA:D training in Malawian physical therapists. Increasing education of physical therapists, other health professionals, and the public about evidence-based OA management and making contextual adaptions to the GLA:D training and program structure may facilitate implementation of OA management program, such as GLA:D, in low- and-middle-income countries. <i>J Orthop Sports Phys Ther 2026;56(3):193-208. Epub 4 February 2026. doi:10.2519/jospt.2026.13317</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"193-208"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More Than Fear of Reinjury - A Multidimensional Experience of Reinjury Concerns: A Systematic Review With Qualitative Evidence Synthesis of Athletes' Experience and Interpretation of \"<i>Reinjury Concerns</i>\" After Anterior Cruciate Ligament Injury.","authors":"Cobie Starcevich, Clare L Ardern, Samantha Bunzli, Brendan J Smith, Darren Beales, Mervyn Travers, Anne Smith","doi":"10.2519/jospt.2026.13852","DOIUrl":"10.2519/jospt.2026.13852","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To explore athletes' experiences of \"reinjury concerns\" in those with lived experience of anterior cruciate ligament (ACL) injury. <b>DESIGN:</b> Systematic review with qualitative evidence synthesis. <b>LITERATURE SEARCH:</b> CINAHL, SPORTDiscus, Scopus, MEDLINE, PsychINFO, and ProQuest Dissertations were searched until January 2025. <b>STUDY SELECTION CRITERIA:</b> Two reviewers independently and in parallel screened studies for inclusion if they were (1) qualitative or mixed-methods; (2) included participants who were athletes with lived experience of an ACL injury; (3) reported the phenomenon of interest, \"reinjury concerns,\" within the findings; and (4) published in English. <b>DATA SYNTHESIS:</b> We applied thematic synthesis based on Thomas and Harden's approach aligned to a constructivist paradigm and followed relevant checklists for performing and reporting a systematic review and qualitative evidence synthesis. Confidence in the findings was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual). <b>RESULTS:</b> Forty-five studies were included, comprising 611 participants. Themes described how athletes assessed the threat of reinjury (theme 1), experienced reinjury concerns across a multidimensional spectrum (theme 2), and coped with reinjury concerns (theme 3). Confidence in the findings was mostly rated moderate-high according to the GRADE-CERQual assessment. <b>CONCLUSION:</b> Athletes' experiences of reinjury concerns after ACL injury were multidimensional and shaped by individual beliefs and contexts. Our findings support shifting from the narrow construct <i>fear of reinjury</i> toward a broader conceptualization of reinjury concerns that more accurately reflects athletes' lived experiences and may better inform assessment and clinical approaches after ACL injury. <i>J Orthop Sports Phys Ther 2026;56(3):135-157. Epub 5 February 2026. doi:10.2519/jospt.2026.13852</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 3","pages":"135-157"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: A Systematic Evidence and Gap Map of Risk Factors and Preventive Strategies for Patellofemoral Pain.","authors":"Ronaldo Valdir Briani, Lisa Hoglund, Marina Cabral Waiteman, Gamze Arın-Bal, Michelle Boling, Helder Dos Santos Lopes, Saleh Alsaleh, Natanael Pereira Batista, Neal Glaviano, Volga Bayrakci Tunay, Joshua Stefanik, Kai-Yu Ho, Claudio Belvedere, Christopher M Powers, David M Bazett-Jones, Jessica G Bell, Paulo Roberto Garcia Lucareli, Sinead Holden","doi":"10.2519/jospt.2025.13489","DOIUrl":"https://doi.org/10.2519/jospt.2025.13489","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To systematically review, map, and appraise the existing prospective evidence on risk factors for, and preventive strategies against, the development of patellofemoral pain (PFP), and to identify key gaps. <b>DESIGN:</b> The study design was a systematic evidence and gap map (EGM). <b>LITERATURE SEARCH:</b> Nine electronic databases (PubMed, CINAHL, PEDro, Scopus, SPORTDiscus, Embase, Cochrane, Web of Science, CENTRAL) were searched from inception to the end of March 2024. <b>STUDY SELECTION CRITERIA:</b> Published prospective observational studies and randomized controlled trials (RCTs) investigating the development of PFP in individuals without baseline PFP were included. Studies of other knee conditions, older adults (mean age > 45), or retrospective designs were excluded. <b>DATA SYNTHESIS:</b> Evidence was mapped across the following domains: sociodemographic, neurobiological, anthropometric, psychological, biomechanical, and behavioral. <b>RESULTS:</b> From 57,897 identified records, 36 studies were included: 24 prospective observational studies and 12 RCTs. Most studies focused on biomechanical risk factors (n=22), with limited exploration of psychological (n=1), behavioral (n=2), and neurobiological (n=1) domains. Preventive interventions involved orthoses (n=4), exercise (n=3), bracing (n=2), gait retraining (n=1), stretching (n=1), or running intensity/volume modification. Nonbiomechanical strategies such as education or graded exposure were rarely tested. Risk of bias was low to moderate for most prospective observational studies and moderate to high for most RCTs. <b>CONCLUSION:</b> This EGM reveals an overreliance on biomechanical perspectives within the context of PFP risk factor research, with limited attention to psychosocial, behavioral, and load-related risk factors. Preventive trials are few, often low in quality, and narrowly focused. Addressing these evidence gaps is essential for developing effective, multifactorial prevention strategies for PFP. <i>J Orthop Sports Phys Ther 2026;56(2):85-97. Epub 15 December 2025. doi:10.2519/jospt.2025.13489</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"56 2","pages":"85-97"},"PeriodicalIF":5.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}