Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.09.007
Jackie L Whittaker
{"title":"Appraisal of Clinical Practice Guideline: The Formal European Union (EU)-United States (US) Meniscus Rehabilitation 2024 Consensus: A European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), American Orthopaedic Society for Sports Medicine (AOSSM) and American Academy of Sports Physical Therapy (AASPT) Initiative: Part I—Rehabilitation Management After Meniscus Surgery (Meniscectomy, Repair and Reconstruction)","authors":"Jackie L Whittaker","doi":"10.1016/j.jphys.2025.09.007","DOIUrl":"10.1016/j.jphys.2025.09.007","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Page 282"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132270","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.09.012
Rakel Gabrielsen , Tina Tellum , Kari Bø , Marie Ellström Engh , Helena Frawley , Synne Nedregård Tveito , Merete Kolberg Tennfjord
Question
How much does adding supervised group and independent individual exercise including pelvic floor muscle training (PFMT) to multidisciplinary pain management affect pelvic and genital pain in women with endometriosis? How much does it affect dyspareunia, dysuria, quality of life (with emphasis on psychological distress, including symptoms of depression and anxiety), symptoms of chronic constipation and pelvic floor muscle (PFM) function?
Design
A two-armed, parallel-group, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment of some outcomes.
Participants
Women aged 18 to 45 years with laparoscopically confirmed endometriosis experiencing pelvic/genital pain.
Intervention
All participants attended a pain management course. The exercise group (n = 41) then performed weekly supervised general exercise training including PFMT for 4 months, and home training two to three times/week. The control group (n = 40) received no further intervention.
Outcome measures
Primary outcomes were the change in worst pelvic/genital pain over 1 month and current pelvic/genital pain measured on a numerical rating scale at 4 and 12 months. Secondary outcomes measured at the same time points were: location and concerns related to dyspareunia; presence of dysuria; symptoms of chronic constipation assessed with the Knowles-Eccersley-Scott-Symptom scale; and quality of life with emphasis on psychological distress, including symptoms of depression and anxiety assessed with Hopkins Symptom Checklist-5. PFM function was measured with surface electromyography and manometry at baseline and 4 months.
Results
The intervention did not improve worst pelvic/genital pain but it did have a clear benefit on current pelvic/genital pain at the end of the intervention (MD 1.1, 95% CI 0.2 to 2.1). This benefit was still present at the 12-month follow-up (MD 1.5, 95% CI 0.2 to 2.7). The effects on other outcome measures were unclear.
Conclusion
Adding supervised group and independent individual exercise including PFMT to pain management did not improve worst pelvic/genital pain but improved current pelvic/genital pain. Effects on other outcomes warrant further investigation.
Registration
NCT05091268.
问题：在多学科疼痛管理中加入监督组和独立个体运动（包括盆底肌肉训练（PFMT））对子宫内膜异位症女性骨盆和生殖器疼痛的影响有多大？它对性交困难、排尿困难、生活质量（重点是心理困扰，包括抑郁和焦虑症状）、慢性便秘症状和盆底肌（PFM）功能的影响有多大？设计：一项双臂、平行组、随机对照试验，采用隐蔽分配、意向治疗分析和部分结果的盲法评估。参与者：年龄在18至45岁之间，经腹腔镜确认的子宫内膜异位症，经历盆腔/生殖器疼痛。干预：所有参与者都参加了疼痛管理课程。运动组（n = 41）随后每周进行有监督的一般运动训练，包括PFMT，持续4个月，每周进行2 - 3次家庭训练。对照组（n = 40）不接受进一步干预。结果测量：主要结果是1个月内最严重盆腔/生殖器疼痛的变化，以及4个月和12个月时用数值评定量表测量的当前盆腔/生殖器疼痛。在同一时间点测量的次要结局是：与性交困难有关的部位和关注点；存在排尿困难；用knowles - eccersley - scott症状量表评估慢性便秘的症状；和生活质量，重点是心理困扰，包括用霍普金斯症状检查表-5评估的抑郁和焦虑症状。在基线和4个月时用表面肌电图和测压法测量PFM功能。结果：干预没有改善最严重的盆腔/生殖器疼痛，但在干预结束时对当前盆腔/生殖器疼痛有明显的益处（MD 1.1, 95% CI 0.2至2.1）。在12个月的随访中，这种获益仍然存在（MD 1.5, 95% CI 0.2至2.7）。对其他结果指标的影响尚不清楚。结论：在疼痛管理中加入监督组和独立个体运动（包括PFMT）不能改善最严重的盆腔/生殖器疼痛，但可以改善当前的盆腔/生殖器疼痛。对其他结果的影响有待进一步调查。注册:NCT05091268。
{"title":"Supervised exercise and pelvic floor muscle training eases current pelvic and genital pain but not worst pelvic and genital pain in women with endometriosis: a randomised trial","authors":"Rakel Gabrielsen , Tina Tellum , Kari Bø , Marie Ellström Engh , Helena Frawley , Synne Nedregård Tveito , Merete Kolberg Tennfjord","doi":"10.1016/j.jphys.2025.09.012","DOIUrl":"10.1016/j.jphys.2025.09.012","url":null,"abstract":"<div><h3>Question</h3><div>How much does adding supervised group and independent individual exercise including pelvic floor muscle training (PFMT) to multidisciplinary pain management affect pelvic and genital pain in women with endometriosis? How much does it affect dyspareunia, dysuria, quality of life (with emphasis on psychological distress, including symptoms of depression and anxiety), symptoms of chronic constipation and pelvic floor muscle (PFM) function?</div></div><div><h3>Design</h3><div>A two-armed, parallel-group, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment of some outcomes.</div></div><div><h3>Participants</h3><div>Women aged 18 to 45 years with laparoscopically confirmed endometriosis experiencing pelvic/genital pain.</div></div><div><h3>Intervention</h3><div>All participants attended a pain management course. The exercise group (n = 41) then performed weekly supervised general exercise training including PFMT for 4 months, and home training two to three times/week. The control group (n = 40) received no further intervention.</div></div><div><h3>Outcome measures</h3><div>Primary outcomes were the change in worst pelvic/genital pain over 1 month and current pelvic/genital pain measured on a numerical rating scale at 4 and 12 months. Secondary outcomes measured at the same time points were: location and concerns related to dyspareunia; presence of dysuria; symptoms of chronic constipation assessed with the Knowles-Eccersley-Scott-Symptom scale; and quality of life with emphasis on psychological distress, including symptoms of depression and anxiety assessed with Hopkins Symptom Checklist-5. PFM function was measured with surface electromyography and manometry at baseline and 4 months.</div></div><div><h3>Results</h3><div>The intervention did not improve worst pelvic/genital pain but it did have a clear benefit on current pelvic/genital pain at the end of the intervention (MD 1.1, 95% CI 0.2 to 2.1). This benefit was still present at the 12-month follow-up (MD 1.5, 95% CI 0.2 to 2.7). The effects on other outcome measures were unclear.</div></div><div><h3>Conclusion</h3><div>Adding supervised group and independent individual exercise including PFMT to pain management did not improve worst pelvic/genital pain but improved current pelvic/genital pain. Effects on other outcomes warrant further investigation.</div></div><div><h3>Registration</h3><div>NCT05091268.</div></div>","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Pages 246-253"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179716","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.08.005
Vincent Singh Paramanandam, Lori Lewis
{"title":"Clinimetrics: The lower limb lymphoedema quality of life tool (LYMQOL-leg)","authors":"Vincent Singh Paramanandam, Lori Lewis","doi":"10.1016/j.jphys.2025.08.005","DOIUrl":"10.1016/j.jphys.2025.08.005","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Page 280"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082162","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.07.001
Amy Dennett
{"title":"Critically appraised paper: In adults following adjuvant chemotherapy for colon cancer, a 3-year exercise program increased disease-free survival and overall survival compared with health education [commentary]","authors":"Amy Dennett","doi":"10.1016/j.jphys.2025.07.001","DOIUrl":"10.1016/j.jphys.2025.07.001","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Page 277"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082251","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.09.003
Tim Noblet , Richard Newsham-West , Catherine Dean , Alison Rushton
{"title":"Defining our future: international use of contemporary levels of clinical practice will ensure the future of physiotherapy","authors":"Tim Noblet , Richard Newsham-West , Catherine Dean , Alison Rushton","doi":"10.1016/j.jphys.2025.09.003","DOIUrl":"10.1016/j.jphys.2025.09.003","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Pages 219-224"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103123","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}
Pub Date : 2025-10-01DOI: 10.1016/j.jphys.2025.09.005
Emily Walker , Matthew D Jones , Mitchell T Gibbs , Tania Gardner , Lorraine Smith , Kathryn Refshauge , James H McAuley , Aidan G Cashin
Question
How much do pain self-efficacy, kinesiophobia, stress and health-related quality of life mediate reductions in pain intensity and disability in people with chronic low back pain receiving a patient-led goal setting and pain science education intervention compared with general exercise advice?
Design
Secondary causal mediation analysis of a two-arm randomised controlled trial.
Participants
Seventy-five people with chronic low back pain.
Data analysis
Analyses were conducted in R software following a prospectively registered analysis plan. Four potential mediators were investigated independently using causal mediation analysis for pain intensity and disability. Mediator–outcome confounders were identified and controlled for, with sensitivity analyses used to assess robustness to confounding assumptions.
Results
All hypothesised mechanisms mediated the intervention effect on pain intensity (–1.8 points on a 0 to 10 scale): kinesiophobia (–1.0 indirect effect (IE), 95% CI –1.9 to –0.4, proportion mediated (PM), 58%), health-related quality of life (–0.7 IE, 95% CI –1.2 to –0.2, PM 36%), pain self-efficacy (–0.6 IE, 95% CI –1.2 to –0.2, PM 32%) and stress (–0.4 IE, 95% CI –0.9 to –0.0, PM 20%). Three hypothesised mechanisms mediated the intervention effect on disability (–10.6 points on a 0 to 100 scale): pain self-efficacy (–7.5 IE, 95% CI –13.0 to –3.1, PM 71%), health-related quality of life (–6.4 IE, 95% CI –11.3 to –2.3, PM 60%) and stress (–4.1 IE, 95% CI –8.6 to –0.9, PM 38%).
Conclusion
Targeting pain self-efficacy, kinesiophobia and health-related quality of life may drive important reductions in pain intensity and disability following a goal setting and educational intervention for people with chronic low back pain. These mechanisms can be addressed through strategies that actively build confidence, reframe threat and support re-engagement in valued activities. Targeting self-efficacy can include grading individual goals and enabling individuals to experience improvements that build confidence. Kinesiophobia can be targeted by refining education to address unhelpful beliefs about activity and harm. Health-related quality of life can be targeted through focusing on meaningful, values-based goals that foster intrinsic motivation and help individuals reconnect with important roles and activities.
Registration
OSF osf.io/w6kdr.
问题：在接受患者主导的目标设定和疼痛科学教育干预的慢性腰痛患者中，与一般运动建议相比，疼痛自我效能、运动恐惧症、压力和与健康相关的生活质量对疼痛强度和残疾的减轻有多大作用？设计：一项双组随机对照试验的二次因果中介分析。参与者：75名慢性腰痛患者。数据分析：根据前瞻性注册分析计划，在R软件中进行分析。使用疼痛强度和残疾的因果中介分析，对四个潜在的中介进行了独立调查。确定和控制中介结果混杂因素，并使用敏感性分析来评估对混杂假设的稳健性。结果：所有假设的机制介导了干预对疼痛强度的影响（0至10分中的-1.8分）：运动恐惧症（-1.0间接影响（IE）， 95% CI -1.9至-0.4，比例介导（PM）， 58%），健康相关生活质量（-0.7 IE, 95% CI -1.2至-0.2,PM 36%），疼痛自我效能（-0.6 IE, 95% CI -1.2至-0.2,PM 32%）和压力（-0.4 IE, 95% CI -0.9至-0.0,PM 20%）。三种假设的机制介导了干预对残疾的影响（0至100分中的-10.6分）：疼痛自我效能（-7.5 IE, 95% CI -13.0至-3.1,PM 71%），健康相关生活质量（-6.4 IE, 95% CI -11.3至-2.3,PM 60%）和压力（-4.1 IE, 95% CI -8.6至-0.9,PM 38%）。结论：针对疼痛自我效能、运动恐惧症和健康相关的生活质量，在慢性腰痛患者设定目标和教育干预后，可能会显著减少疼痛强度和残疾。这些机制可以通过积极建立信心、重新定义威胁和支持重新参与有价值活动的战略来解决。以自我效能为目标可以包括对个人目标进行分级，并使个人能够体验到建立自信的改进。运动恐惧症可以通过改进教育来解决有关运动和伤害的无益信念。与健康相关的生活质量可以通过关注有意义的、基于价值观的目标来实现，这些目标可以培养内在动机，帮助个人重新参与重要的角色和活动。注册：OSF OSF .io/w6kdr。
{"title":"Pain self-efficacy, kinesiophobia and health-related quality of life mediate pain and disability improvements with goal setting and education in people with chronic low back pain: a mediation analysis of a randomised trial","authors":"Emily Walker , Matthew D Jones , Mitchell T Gibbs , Tania Gardner , Lorraine Smith , Kathryn Refshauge , James H McAuley , Aidan G Cashin","doi":"10.1016/j.jphys.2025.09.005","DOIUrl":"10.1016/j.jphys.2025.09.005","url":null,"abstract":"<div><h3>Question</h3><div>How much do pain self-efficacy, kinesiophobia, stress and health-related quality of life mediate reductions in pain intensity and disability in people with chronic low back pain receiving a patient-led goal setting and pain science education intervention compared with general exercise advice?</div></div><div><h3>Design</h3><div>Secondary causal mediation analysis of a two-arm randomised controlled trial.</div></div><div><h3>Participants</h3><div>Seventy-five people with chronic low back pain.</div></div><div><h3>Data analysis</h3><div>Analyses were conducted in R software following a prospectively registered analysis plan. Four potential mediators were investigated independently using causal mediation analysis for pain intensity and disability. Mediator–outcome confounders were identified and controlled for, with sensitivity analyses used to assess robustness to confounding assumptions.</div></div><div><h3>Results</h3><div>All hypothesised mechanisms mediated the intervention effect on pain intensity (–1.8 points on a 0 to 10 scale): kinesiophobia (–1.0 indirect effect (IE), 95% CI –1.9 to –0.4, proportion mediated (PM), 58%), health-related quality of life (–0.7 IE, 95% CI –1.2 to –0.2, PM 36%), pain self-efficacy (–0.6 IE, 95% CI –1.2 to –0.2, PM 32%) and stress (–0.4 IE, 95% CI –0.9 to –0.0, PM 20%). Three hypothesised mechanisms mediated the intervention effect on disability (–10.6 points on a 0 to 100 scale): pain self-efficacy (–7.5 IE, 95% CI –13.0 to –3.1, PM 71%), health-related quality of life (–6.4 IE, 95% CI –11.3 to –2.3, PM 60%) and stress (–4.1 IE, 95% CI –8.6 to –0.9, PM 38%).</div></div><div><h3>Conclusion</h3><div>Targeting pain self-efficacy, kinesiophobia and health-related quality of life may drive important reductions in pain intensity and disability following a goal setting and educational intervention for people with chronic low back pain. These mechanisms can be addressed through strategies that actively build confidence, reframe threat and support re-engagement in valued activities. Targeting self-efficacy can include grading individual goals and enabling individuals to experience improvements that build confidence. Kinesiophobia can be targeted by refining education to address unhelpful beliefs about activity and harm. Health-related quality of life can be targeted through focusing on meaningful, values-based goals that foster intrinsic motivation and help individuals reconnect with important roles and activities.</div></div><div><h3>Registration</h3><div>OSF osf.io/w6kdr.</div></div>","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 4","pages":"Pages 260-267"},"PeriodicalIF":9.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132291","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}
Pub Date : 2025-07-01DOI: 10.1016/S1836-9553(25)00080-3
{"title":"Cover image and highlights","authors":"","doi":"10.1016/S1836-9553(25)00080-3","DOIUrl":"10.1016/S1836-9553(25)00080-3","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 3","pages":"Page OFC"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522192","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}
Pub Date : 2025-07-01DOI: 10.1016/j.jphys.2025.03.001
Linda C Li , Dawn P Richards , Codie A Primeau
{"title":"Research Note: Patient and public involvement in research","authors":"Linda C Li , Dawn P Richards , Codie A Primeau","doi":"10.1016/j.jphys.2025.03.001","DOIUrl":"10.1016/j.jphys.2025.03.001","url":null,"abstract":"","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"71 3","pages":"Pages 208-210"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340543","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}
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