Physiotherapy Theory and Practice最新文献

Background: Social participation levels of individuals with Multiple Sclerosis (iwMS) are lower than those of healthy individuals.

Objective: This study aimed to evaluate to which extent the walking capacity, balance, and fear of falling (FoF) affect the community integration levels of iwMS.

Methods: Thirty-nine iwMS were evaluated for their participation levels [The Community Integration Questionnaire (CIQ)], walking capacity [The Six-Minute Walk Test (6MWT)], balance [Kinesthetic Ability Trainer (SportKAT®)], and FoF [The Modified Falls Efficacy Scale (MFES)]. Correlation and regression analyses were performed to detect the effects of SportKAT®, 6MWT, and MFES on CIQ.

Results: CIQ scores were significantly correlated with 6MWT (p = .043) and MFES (p = .005) scores, while CIQ was not related with static (for two feet test p = .356, for right single-leg stance test p = .412, for left single-leg stance test p = .730) and dynamic balance (for clockwise test p = .097, for counterclockwise test p = .540) measured with the SportKAT®. It was found that CIQ could be predicted by 6MWT and MFES at the level of 16% and 25%, respectively.

Conclusion: FoF and walking capacity are associated with community integration in iwMS. Therefore, physiotherapy and rehabilitation programs of iwMS should be combined with treatment goals to increase community integration, balance, and gait and decrease the disability and FoF from an early stage. Comprehensive studies examining other factors that may impact participation in iwMS with different levels of disability are needed.

Background: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint.

Objectives: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles.

Methods: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated.

Results: The PFP group exhibited less trunk flexion (SLS, p = .006; SD, p = .016) and greater forward knee displacement (SLS, p = .001; SD, p = .004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p = .074; SD, p = .278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = -0.439, p = .000; SD, r = -0.365, p = .004) and ankle dorsiflexion (SLS, r = -0.339, p = .008; SD, r = -0.356, p = .005).

Conclusion: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent.

Objective: To evaluate the effects of exercise therapy on neuropathic symptoms, signs, psychosocial aspects, and physical function in people with diabetic neuropathy (DN).

Methods: A search in PubMed, Web of Science, Physiotherapy Evidence (PEDro), and Cochrane databases was performed from inception to Invalid Date NaN, . Randomized clinical trials (RCTs) were selected in patients with DN comparing exercise therapy with a control group. The studies' methodological quality was assessed with the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the overall quality.

Results: Eleven RCTs (n = 517 participants) were included. Nine studies showed high methodological quality. Mean (MD) and standardized mean differences (SMD) were observed in favor of exercise therapy for symptoms (MD = -1.05; confidence interval 95% = -1.90 to -0.20), signs (SMD = -0.66; confidence interval 95%= -1 to -0.32), and physical function (SMD = -0.45; confidence interval 95% = -0.66 to -0.24). No changes were found in psychosocial aspects (SMD = -0.37; confidence interval 95% = -0.92 to 0.18). The overall quality of evidence was very low.

Conclusion: The quality of evidence suggesting that exercise therapy provides short-term benefits in neuropathic symptoms, signs, and physical function in patients with DN is very low. Furthermore, there were no effects found on psychosocial aspects.

Background: Pain catastrophization (PC) is related to motor control changes in individuals with nonspecific chronic low back pain (NSCLBP). However, differences in dynamic balance control based on the level of PC still remain unclear in these individuals.

Objective: The aim of this study was to compare the dynamic balance control between healthy controls and individuals with NSCLBP with high and low PC.

Methods: Forty individuals with NSCLBP and 20 healthy participants were enrolled in this cross-sectional study. Individuals with NSCLBP were classified into two groups of high and low PC. Dynamic balance control was assessed using the Modified Star Excursion Balance Test (MSEBT), Five-Time Sit-to-Stand Test (FTSST), and Timed Up and Go Test (TUGT).

Results: Statistical analyses showed that mean values of reach distances in the anterior, posteromedial, and posterolateral directions of the MSEBT were significantly lower in individuals with NSCLBP with high PC compared to low PC (p = .04, p = .01, and p = .04, respectively) and healthy controls (p < .001, p = .001, and p = .006, respectively). In addition, for both the FTSS and TUG tests, the mean time was significantly greater in individuals with NSCLBP with high PC compared to low PC (p < .001 and p = .004, respectively) and healthy controls (p < .001).

Conclusions: Our results showed poor dynamic balance control in individuals with NSCLBP with high PC. This suggests that PC could contribute to the impaired dynamic balance control in individuals with NSCLBP. Combining balance exercises and cognitive-behavioral treatments targeting PC may be useful for the improvement of dynamic balance control in individuals with NSCLBP with high PC.

Background: The demand for physiotherapy student clinical placements is increasing in many countries, including Australia, and there is continued reliance on physiotherapists to assume the student clinical educator role. Exploring factors influencing physiotherapists' decision to be involved in clinical education is essential to maintaining and building clinical education capacity for the future.

Objective: To explore factors influencing Australian physiotherapists' decision to be involved in student clinical education.

Methods: A qualitative study using data collected from a valid and reliable online survey tool. Respondents were physiotherapists representing public and private workplaces across varied geographical settings in Australia. Data were thematically analyzed.

Results: Surveys were completed by 170 physiotherapists. Most respondents were employed in hospital (81/170, 48%) and private (53/170, 31%) settings in metropolitan locations (105/170, 62%). Six themes representing factors influencing physiotherapists' involvement in student clinical education were identified, including perceptions of: professional duty, personal benefits or gains, suitability of workplace, support requirements, role related challenges, and readiness to be a clinical educator.

Conclusion: Many factors influence physiotherapists' decisions to assume the clinical educator role. This study could assist clinical education stakeholders to provide practical and targeted strategies to overcome challenges, and optimize support, for physiotherapists in the clinical educator role.

Background: The current workforce does not meet the demand for physiotherapy services in Australia. Future demand is predicted to expand driven primarily by the aging population. Previous research describes significant attrition and short career intentions of junior physiotherapists.

Objective: This study explored factors associated with physiotherapy graduates' early career intentions and satisfaction.

Method: Four cohorts of student physiotherapists completed two online surveys designed specifically for this study assessing their immediate and future career intentions and satisfaction. Surveys were completed after undergraduate training (Student Survey) and 2 years later (Practitioner Survey). Question formats included single or multiple select, Likert scale, and free-text responses. Responses were analyzed via descriptive statistics and content and relational analysis.

Results: Despite most early career practitioners (83%) reporting career satisfaction, 27% intended to pursue long-term physiotherapy careers (>20 years) and 15% intended to work for 5 years or less. Fewer (11%) reported a longer career intention and 26% a shorter career intention compared to their student survey. Extrinsic occupational factors, such as support, were mentioned as influential in increasing intended future career length since course completion.

Conclusion: This study found some evidence of factors contributing to shorter career intentions of early career physiotherapists. Specific support of early career physiotherapists may encourage longer career intentions and help build future workforce capacity.

Background: Inflammatory conditions often mimic musculoskeletal presentations, causing diagnostic delays in primary and secondary care. Physiotherapists can play a pivotal role in the early recognition, triage, and onward referral for inflammatory conditions such as polymyalgia rheumatica (PMR). While PMR is relatively rare, recognition of its characteristic presentation, alongside elevated serum inflammatory markers, is a much-needed step to initiate appropriate intervention following specialized rheumatological consultation.

Case description: This case details the assessment and diagnosis of a 62-year-old male referred to a secondary care spine center for persisting bilateral buttock pain presumed to be of spinal origin. A thorough initial evaluation by an orthopedic-triage physiotherapist raised the suspicion of PMR upon identification of the following salient inflammatory features: sudden onset of bilateral buttock and shoulder pain and stiffness, morning stiffness lasting one hour, pain aggravated by prolonged inactivity, and a positive response to non-steroidal anti-inflammatory medication.

Outcomes: Further investigations revealed elevated inflammatory markers warranting prompt rheumatology consultation and subsequently confirming the diagnosis of PMR. Early initiation of high dose oral corticosteroid therapy resulted in immediate relief of pain and associated symptoms.

Conclusion: This case highlights the significance of recognizing salient inflammatory features in persistent musculoskeletal complaints, particularly in the context of the evolving scope of physiotherapy roles internationally. While further investigations and rheumatological consultation are required for the definitive diagnosis of many inflammatory conditions, including PMR, greater clinician awareness of salient inflammatory features can aid the earlier identification and subsequent triage of such cases.

Background: Understanding the relationship between self-efficacy and academic and clinical education outcomes may improve professional physical therapist education.

Objectives: To document the longitudinal responsiveness of Self-Efficacy of Physical Therapist Student Outcomes (SEPTSO) scores from a single cohort throughout a three-year professional physical therapist curriculum and also to explore relationships between SEPTSO, grade point average (GPA), clinical education outcomes, and first-time pass rate on the National Physical Therapy Examination (NPTE).

Methods: Thirty-five Doctor of Physical Therapy (DPT) students participated. The SEPTSO was administered electronically during semesters one and nine. The final GPA, Physical Therapist Manual for the Assessment of Clinical Skills (PT MACS), and NPTE outcomes were recorded.

Results: There was a significant increase in SEPTSO scores from semester 1 to 9 (t₍₁₆₎ = 34.55, p < .01, Cohen's d = 9.79, n = 17). In semester 1 (n = 35), there were no significant associations between SEPTSO scores and GPA (r = .011, p = .949), PT MACS outcomes (r = .092, p = .867), or first-time NPTE pass rate (r_s = -0.088, p = .634).

Conclusion: Longitudinal responsiveness of the SEPTSO in a three-year DPT curriculum was demonstrated. There were no associations between SEPTSO scores and other outcome measures.

Background: Peer assisted learning (PAL), where student leaders facilitate their peers' learning, is prevalent in higher education. However, PAL leaders' development in physiotherapy education and their role perceptions relating to their future professional practice are understudied.

Purpose: We aimed to understand how PAL leaders in physiotherapy education perceive their own academic learning and personal development, and how they view their experiences as PAL leaders in relation to future physiotherapy practice.

Methods: Focus group interviews were used to collect qualitative data from third-semester students who had been PAL leaders (n = 19). Data were analyzed using a reflexive, thematic analysis.

Results: Three main themes were generated: "Being a PAL leader consolidates knowledge and facilitates new learning," "Personal growth through experiential learning outside the comfort zone within a community of practice," and "Learning by leading - transferability of being a PAL leader to future physiotherapy practice."

Conclusion: Overall, physiotherapy students leading PAL study groups demonstrated academic, personal, and professional growth via experiential learning in a community of practice. They developed skills likely transferable into their future physiotherapy roles. Our findings propose PAL study groups as an arena for PAL leaders to practice complex physiotherapy competences, positioning PAL study groups as valuable preclinical practice for physiotherapy students.

Background: Sustainability has become a ubiquitous imperative across all sectors of society, including healthcare. Building on the broader discourse on sustainable development, sustainability is used in relation to social, ecological, and economic concerns with varying degrees of emphasis and often related to a sense of durability.

Objective: To provide a detailed analysis of the concept of sustainability in current physical therapy literature and advance its deliberate future implementation.

Methods: Setting out from a critical exposition of prevalent models of sustainability, we conducted a critical discourse analysis to (1) examine the implementation of the concept of sustainability in physical therapy academic literature and (2) critically evaluate its hitherto use in light of the broader discourse surrounding sustainability.

Results: Our analysis identified a focus on the cost-effectiveness of healthcare interventions, and the use of so-called "weak" and "strong sustainability" models in the physical therapy literature. Other models and the broader critical discourse surrounding sustainability are only gradually finding their way into physical therapy literature.

Conclusion: Physical therapy lacks comprehensive exploration of both general and profession-specific understandings of sustainability. Nuanced engagement with sustainability and its alternatives is necessary to ensure its meaningful implementation in physical therapy research, education, and practice.