Pub Date : 2026-06-01Epub Date: 2025-12-08DOI: 10.1016/j.physio.2025.101866
Andrea Hams , Chloe Prudden , Emmah Baque , Tyler Collings , Sandy Edwards , Renae Shepherd , Taryn Jones
Background
Musculoskeletal conditions contribute significantly to global health burden through impaired function and pain. Physiotherapy student-led services provide a model for addressing community healthcare needs while offering clinical training experiences. Despite their prevalence, description of patient demographics and clinical outcomes (function and pain) remains under-explored.
Objectives
To evaluate changes in self-reported function and pain and describe patient demographics and presenting musculoskeletal conditions of patients accessing a student-led service.
Design setting and participants
Observational pre-post study at a student-led musculoskeletal physiotherapy service in Australia involving ninety-nine community-dwelling participants (Mdn age = 29 years, IQR = 22–40).
Methods
Final-year physiotherapy students managed patient care under senior physiotherapist supervision. Demographic and presenting condition data were collected at the initial appointment, while self-reported outcome measures of function (Patient Specific Functional Scale: PSFS) and pain (Numeric Pain Rating Scale: NPRS) were recorded at all appointments.
Results
A significant positive correlation was observed between appointment frequency and PSFS scores. At each appointment, the PSFS score increased by 0.8 units (95% CI 0.4 to 1.1, p < .001). There was a significant negative correlation between appointment frequency and NPRS scores, with each appointment associated with a 0.6 unit decrease in NPRS scores (95% CI: -0.8 to -0.4, p < 0.001).
Conclusions
This study adds to growing evidence describing patient-reported outcomes within student-led physiotherapy services, showing that patients attending reported improvement in self-reported function and pain. Limitations of a pragmatic service evaluation are acknowledged; further multi-site longitudinal research is recommended.
Contribution of the Paper
•
Patients attending a physiotherapy student-led service reported improvement in self-reported function and reduction in pain.
•
Student-led services may support addressing the community need for musculoskeletal care while providing meaningful clinical learning for students.
肌肉骨骼疾病通过功能受损和疼痛对全球健康负担做出了重大贡献。理疗学生主导的服务为解决社区医疗保健需求提供了一种模式,同时提供临床培训经验。尽管它们很普遍,但对患者人口统计学和临床结果(功能和疼痛)的描述仍未得到充分探讨。目的评估自我报告的功能和疼痛的变化,描述患者的人口统计学特征,并呈现学生主导服务的患者的肌肉骨骼状况。设计环境和参与者:澳大利亚一项由学生主导的肌肉骨骼物理治疗服务的观察性前后研究,涉及99名社区居民参与者(Mdn年龄= 29岁,IQR = 22-40)。方法:高年级物理治疗学生在高级物理治疗师的监督下管理患者护理。在初次预约时收集人口统计学和表现状况数据,同时在所有预约时记录自我报告的功能(患者特定功能量表:PSFS)和疼痛(数字疼痛评定量表:NPRS)的结果测量。结果就诊次数与PSFS评分呈显著正相关。每次就诊时,PSFS评分增加0.8个单位(95% CI 0.4 ~ 1.1, p < 0.001)。预约频率与NPRS评分之间存在显著的负相关,每次预约与NPRS评分下降0.6个单位相关(95% CI: -0.8至-0.4,p < 0.001)。结论:本研究增加了越来越多的证据,描述了学生主导的物理治疗服务中患者报告的结果,表明参加治疗的患者报告自我报告的功能和疼痛有所改善。认识到实用服务评价的局限性;建议进一步开展多地点纵向研究。•参加物理治疗学生主导服务的患者报告自我报告的功能改善和疼痛减轻。•学生主导的服务可以支持解决社区对肌肉骨骼护理的需求,同时为学生提供有意义的临床学习。
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Pub Date : 2026-06-01Epub Date: 2025-12-11DOI: 10.1016/j.physio.2025.101868
Harry Ford , Jeremy Lewis , Vasileios Tyros , Daniel C. Low , William R. Bateman , Youmin Lee , Raj Sakadasariya , Joshua Rex , Matthew Oldfield , Marco Davare , Aliah Faisal Shaheen
<div><h3>Objectives</h3><div>Introduce The ExtRA Capacity Test, a measure for assessing shoulder muscle performance. Assess its reliability, validity and present normative scores in a large sample of asymptomatic adults.</div></div><div><h3>Design</h3><div>Cross-sectional observational study with test–retest.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Volunteers (<em>n</em> = 344, age 20–90 years).</div></div><div><h3>Interventions</h3><div>The ExtRA Capacity Test involves two capacity tests completed to a 30 beats per minute metronome: maximal scapular plane lateral raises to 90° abduction with 2.5 kg of external load, and maximal external rotations in unsupported prone lying with the shoulder at 90° abduction.</div><div>Reliability was assessed in 30 asymptomatic participants, tested by two raters over two sessions, one week apart, using Bland–Altman analysis to determine mean bias and 95 % limits of agreement (LoA) as measures of error. Criterion validity was evaluated in 20 participants using Pearson correlation to examine the relationship between ExtRA and isokinetic dynamometry measures. A normative dataset was also established from 344 asymptomatic individuals across a range of ages, physical activity levels, and both sexes.</div></div><div><h3>Results</h3><div>The intra-rater and inter-rater agreement for the ExtRA Capacity Test was assessed in a sample of 30 participants. The 95 % LoA for abduction and external rotation measurements ranged from 2.9 to 13.1 repetitions. In a sample of 20 participants, the abduction test showed good/moderate correlation with muscle strength measures but not with the external rotation test. Older age, female sex and not achieving the WHO activity guidelines have a negative impact on ExtRA performance.</div></div><div><h3>Conclusions</h3><div>Within the caveats discussed in this paper, ExtRA can be considered a reasonably reliable tool for assessing shoulder strength and control in a clinical setting. The normative database will help clinicians set rehabilitation or return-to-play targets based on sex, age, and physical activity level.</div></div><div><h3>Contributions of Paper</h3><div><ul><li><span>•</span><span><div>This study introduces the ExtRA Capacity Test as a reliable tool for assessing shoulder muscle performance in both sporting and non-sporting populations.</div></span></li><li><span>•</span><span><div>The test demonstrates clinically acceptable intra- and inter-rater reliability, with the abduction component showing a strong correlation with strength measures from Isokinetic Dynamometry.</div></span></li><li><span>•</span><span><div>The normative database established in this study facilitates the evaluation of shoulder performance relative to reference values stratified by age, sex, and physical activity level.</div></span></li><li><span>•</span><span><div>Given its high reliability, the ExtRA Capacity Test can be used to monitor performance change
{"title":"The ExtRA Capacity Test: Reliability, validity and normative data of a new clinical tool for assessing shoulder muscle performance","authors":"Harry Ford , Jeremy Lewis , Vasileios Tyros , Daniel C. Low , William R. Bateman , Youmin Lee , Raj Sakadasariya , Joshua Rex , Matthew Oldfield , Marco Davare , Aliah Faisal Shaheen","doi":"10.1016/j.physio.2025.101868","DOIUrl":"10.1016/j.physio.2025.101868","url":null,"abstract":"<div><h3>Objectives</h3><div>Introduce The ExtRA Capacity Test, a measure for assessing shoulder muscle performance. Assess its reliability, validity and present normative scores in a large sample of asymptomatic adults.</div></div><div><h3>Design</h3><div>Cross-sectional observational study with test–retest.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Volunteers (<em>n</em> = 344, age 20–90 years).</div></div><div><h3>Interventions</h3><div>The ExtRA Capacity Test involves two capacity tests completed to a 30 beats per minute metronome: maximal scapular plane lateral raises to 90° abduction with 2.5 kg of external load, and maximal external rotations in unsupported prone lying with the shoulder at 90° abduction.</div><div>Reliability was assessed in 30 asymptomatic participants, tested by two raters over two sessions, one week apart, using Bland–Altman analysis to determine mean bias and 95 % limits of agreement (LoA) as measures of error. Criterion validity was evaluated in 20 participants using Pearson correlation to examine the relationship between ExtRA and isokinetic dynamometry measures. A normative dataset was also established from 344 asymptomatic individuals across a range of ages, physical activity levels, and both sexes.</div></div><div><h3>Results</h3><div>The intra-rater and inter-rater agreement for the ExtRA Capacity Test was assessed in a sample of 30 participants. The 95 % LoA for abduction and external rotation measurements ranged from 2.9 to 13.1 repetitions. In a sample of 20 participants, the abduction test showed good/moderate correlation with muscle strength measures but not with the external rotation test. Older age, female sex and not achieving the WHO activity guidelines have a negative impact on ExtRA performance.</div></div><div><h3>Conclusions</h3><div>Within the caveats discussed in this paper, ExtRA can be considered a reasonably reliable tool for assessing shoulder strength and control in a clinical setting. The normative database will help clinicians set rehabilitation or return-to-play targets based on sex, age, and physical activity level.</div></div><div><h3>Contributions of Paper</h3><div><ul><li><span>•</span><span><div>This study introduces the ExtRA Capacity Test as a reliable tool for assessing shoulder muscle performance in both sporting and non-sporting populations.</div></span></li><li><span>•</span><span><div>The test demonstrates clinically acceptable intra- and inter-rater reliability, with the abduction component showing a strong correlation with strength measures from Isokinetic Dynamometry.</div></span></li><li><span>•</span><span><div>The normative database established in this study facilitates the evaluation of shoulder performance relative to reference values stratified by age, sex, and physical activity level.</div></span></li><li><span>•</span><span><div>Given its high reliability, the ExtRA Capacity Test can be used to monitor performance change","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"131 ","pages":"Article 101868"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090654","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}
Exercise therapy is a commonly recommended intervention for managing musculoskeletal disorders. Utilizing virtual reality (VR) could prove effective in enhancing exercise therapy. Consequently, the objective of this study is to design and develop a prototype of a VR-based therapeutic exercise game called Vitality, which is suitable for patients with lower limb musculoskeletal disorders.
Methods
This development-applied study was conducted in three phases, determining the identification and confirming requirements, development, and performance evaluation. In the first phase, functionality was extracted by the Delphi technique. In the second phase, the prototype was developed using the Unity 2018 reconstruction engine. Finally, the Vitality was evaluated using the ISO/IEC 25010:2011 product quality model.
Results
The implementation of the first phase led to the extraction of therapeutic practice and the selection of 54 information items during two Delphi rounds for the VR game. A game prototype was then developed, focusing on each of the 16-step therapy exercises in an avatar-based fashion. The evaluation results showed that the functional suitability of the Vitality was 88% and its usability was 94%.
Conclusions
This research presents the VR game for the rehabilitation of different types of musculoskeletal disorders by considering more exercises and a customizable user interface that allows for game difficulty adjustment.
{"title":"Development of a virtual reality game for rehabilitation of patients with lower extremity musculoskeletal disorders","authors":"Shamim Kiani , Iman Rezaei , Naghmeh Ebrahimi , Sanaz Abasi , Azita Yazdani","doi":"10.1016/j.physio.2025.101870","DOIUrl":"10.1016/j.physio.2025.101870","url":null,"abstract":"<div><h3>Introduction</h3><div>Exercise therapy is a commonly recommended intervention for managing musculoskeletal disorders. Utilizing virtual reality (VR) could prove effective in enhancing exercise therapy. Consequently, the objective of this study is to design and develop a prototype of a VR-based therapeutic exercise game called Vitality, which is suitable for patients with lower limb musculoskeletal disorders.</div></div><div><h3>Methods</h3><div>This development-applied study was conducted in three phases, determining the identification and confirming requirements, development, and performance evaluation. In the first phase, functionality was extracted by the Delphi technique. In the second phase, the prototype was developed using the Unity 2018 reconstruction engine. Finally, the Vitality was evaluated using the ISO/IEC 25010:2011 product quality model.</div></div><div><h3>Results</h3><div>The implementation of the first phase led to the extraction of therapeutic practice and the selection of 54 information items during two Delphi rounds for the VR game. A game prototype was then developed, focusing on each of the 16-step therapy exercises in an avatar-based fashion. The evaluation results showed that the functional suitability of the Vitality was 88% and its usability was 94%.</div></div><div><h3>Conclusions</h3><div>This research presents the VR game for the rehabilitation of different types of musculoskeletal disorders by considering more exercises and a customizable user interface that allows for game difficulty adjustment.</div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"131 ","pages":"Article 101870"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950129","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}
Pub Date : 2026-06-01Epub Date: 2025-12-13DOI: 10.1016/j.physio.2025.101869
Beatrice Occhetto , Martina Ballesio , Firas Mourad , Marco Trucco , Filippo Maselli , Alessandro Chiarotto , Daniel Feller
Introduction
Neck pain is a prevalent condition that can occasionally indicate serious underlying pathologies, such as tumours. Red flags are clinical indicators used to identify patients at risk of such conditions. This scoping review systematically maps and summarizes the literature on red flags for tumours in patients presenting with neck pain in primary care, highlighting evidence gaps and priorities for future research.
Methods
A comprehensive search across four databases up to June 2025 targeted studies on patients of any age or gender presenting with neck pain as the primary complaint and a final diagnosis of a tumour. Only studies conducted in primary care were included, with no time or geographical restrictions. Data were synthesized quantitatively and thematically.
Results
From 10,211 initial records, 25 studies met the inclusion criteria, all being case reports. The most frequently reported red flags were severe neck pain, which may become progressive and constant, neurological signs and symptoms, and nocturnal neck pain. However, inconsistencies in reporting were observed: many commonly discussed red flags were absent from case reports, while some red flags highlighted in case reports are not extensively covered in the literature.
Conclusion
Evidence on red flags for tumours in patients with neck pain in primary care remains fragmented. While certain red flags were frequently reported, their clinical utility is limited by inconsistent reporting and a lack of robust evidence. Further research is needed to standardize red flags and assess their diagnostic accuracy to improve early tumour detection in patients with neck pain.
Contribution of paper
•
Evidence regarding red flags for tumours in patients with neck pain in primary care is fragmented, underscoring the need for comprehensive history-taking and thorough clinical examination.
•
Key red flags, such as progressive pain, neurological symptoms, and nocturnal pain, are frequently reported, though inconsistencies in their documentation across studies are evident.
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Pub Date : 2026-03-01Epub Date: 2025-07-02DOI: 10.1016/j.physio.2025.101819
Renske Annevelink , Sanneke Don , Jo Nijs , David Beckwée , Kelly Ickmans , Wilfried Cools , Lennard Voogt
{"title":"Reply to comment on “socio-cultural associates of pain, disability and health-related quality of life in 1350 primary care physiotherapy patients with non-specific musculoskeletal pain”","authors":"Renske Annevelink , Sanneke Don , Jo Nijs , David Beckwée , Kelly Ickmans , Wilfried Cools , Lennard Voogt","doi":"10.1016/j.physio.2025.101819","DOIUrl":"10.1016/j.physio.2025.101819","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101819"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318912","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}
Pub Date : 2026-03-01Epub Date: 2025-07-31DOI: 10.1016/j.physio.2025.101835
B. Caird , N. McGowan , J. Depiazzi , R. Marpole , N. Gibson
Objective
To describe the physiotherapy interventions provided to children with cerebral palsy (CP) at risk of respiratory illness and determine criteria for safe in-home treatment.
Design
Descriptive study of physiotherapy interventions received by children enrolled in the treatment arm of a 12-month feasibility randomised controlled trial between March 2022 and July 2023.
Setting
Tertiary hospital, community and in-home.
Participants
Ten children with CP aged 28 months to 12 years.
Interventions
All types of respiratory physiotherapy interventions.
Main outcome measures
Types of physiotherapy interventions, the number, location, and duration of occasion of service (OOS), patient symptoms at baseline and post intervention, stability of participant during treatment sessions.
Results
There were 159 physiotherapy intervention OOS, median (range) 15.5 (4 to 27). All 10 children had at least one new or worsened symptom at a follow up visit that was present before physiotherapy commenced and was not present at their initial baseline assessment on entry to the study. Nine children received individualised respiratory action plans, seven received airway clearance-based plans and two exercise-based plans. The most frequently used airway clearance techniques were manual techniques and positioning. Lung health education was delivered to all participants on every visit. No negative events related to physiotherapy interventions occurred. Criteria for children deemed unsuitable for respiratory physiotherapy interventions outside the hospital were developed.
Conclusion
Airway clearance, positioning and lung health education were the most frequently used respiratory physiotherapy interventions in the community. These were safe when children had clear action plans and were delivered by a skilled respiratory paediatric physiotherapist with tertiary experience.
Contribution of the Paper
•
Types of, and responses to respiratory physiotherapy interventions for children with cerebral palsy and respiratory illness, at risk of deterioration are described in detail.
•
Respiratory physiotherapy interventions are safe when guided by clear safety criteria and respiratory action plans.
•
Skilled paediatric physiotherapists with tertiary experience are vital to the safe delivery of these interventions.
{"title":"Unpacking the “black box” of safe respiratory physiotherapy interventions delivered in the home for children with cerebral palsy and medical complexity","authors":"B. Caird , N. McGowan , J. Depiazzi , R. Marpole , N. Gibson","doi":"10.1016/j.physio.2025.101835","DOIUrl":"10.1016/j.physio.2025.101835","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the physiotherapy interventions provided to children with cerebral palsy (CP) at risk of respiratory illness and determine criteria for safe in-home treatment.</div></div><div><h3>Design</h3><div>Descriptive study of physiotherapy interventions received by children enrolled in the treatment arm of a 12-month feasibility randomised controlled trial between March 2022 and July 2023.</div></div><div><h3>Setting</h3><div>Tertiary hospital, community and in-home.</div></div><div><h3>Participants</h3><div>Ten children with CP aged 28 months to 12 years.</div></div><div><h3>Interventions</h3><div>All types of respiratory physiotherapy interventions.</div></div><div><h3>Main outcome measures</h3><div>Types of physiotherapy interventions, the number, location, and duration of occasion of service (OOS), patient symptoms at baseline and post intervention, stability of participant during treatment sessions.</div></div><div><h3>Results</h3><div>There were 159 physiotherapy intervention OOS, median (range) 15.5 (4 to 27). All 10 children had at least one new or worsened symptom at a follow up visit that was present before physiotherapy commenced and was not present at their initial baseline assessment on entry to the study. Nine children received individualised respiratory action plans, seven received airway clearance-based plans and two exercise-based plans. The most frequently used airway clearance techniques were manual techniques and positioning. Lung health education was delivered to all participants on every visit. No negative events related to physiotherapy interventions occurred. Criteria for children deemed unsuitable for respiratory physiotherapy interventions outside the hospital were developed.</div></div><div><h3>Conclusion</h3><div>Airway clearance, positioning and lung health education were the most frequently used respiratory physiotherapy interventions in the community. These were safe when children had clear action plans and were delivered by a skilled respiratory paediatric physiotherapist with tertiary experience.</div></div><div><h3><strong>Contribution of the Paper</strong></h3><div><ul><li><span>•</span><span><div>Types of, and responses to respiratory physiotherapy interventions for children with cerebral palsy and respiratory illness, at risk of deterioration are described in detail.</div></span></li><li><span>•</span><span><div>Respiratory physiotherapy interventions are safe when guided by clear safety criteria and respiratory action plans.</div></span></li><li><span>•</span><span><div>Skilled paediatric physiotherapists with tertiary experience are vital to the safe delivery of these interventions.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101835"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571697","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}
Pub Date : 2026-03-01Epub Date: 2025-08-16DOI: 10.1016/j.physio.2025.101838
C. Bernal-Utrera , A. Bravo-Vázquez , F.J. Montero-Bancalero , A. Suárez-Vega , M.J. Casuso-Holgado , E. Anarte-Lazo
Objective
To assess the accuracy and reliability of an artificial intelligence (AI) chatbot (ChatGPT) in providing answers about exercise recommendations for breast cancer survivors.
Design
Cross-sectional study.
Methods
We extracted recommendations from recent systematic reviews of clinical practice guidelines (CPGs) on therapeutic physical exercise in breast cancer survivors. Clinical questions were developed and queried to ChatGPT-4. We evaluated the performance of ChatGPT-4 as a counseling tool by assessing the accuracy of responses (percentage of agreement with CPGs recommendations, weighted Cohen’s kappa and the percentage of text wording similarity) and the intra-rater and inter-rater reliability in grading ChatGPT answers (kappa value).
Results
We tested 15 clinical questions. The accuracy of the AI chatbot´s responses was considered unacceptable, with only 7% of responses being reasonably accurate (1/14), 64% of responses being partially accurate (9/14) and 29% being completely incorrect (4/14). It was observed a low Kappa coefficient (k = 0.244, CI: 0.089 to 0.577) and the similarity of responses was also considered unacceptable, with 27.2% of overlapping text wording. Intra and inter-rater reliability showed moderate to good values in all cases.
Conclusions
ChatGPT does not appear to be an accurate counselling tool for answering questions about exercise recommendations for breast cancer survivors. Compared to CPG´s recommendations, the accuracy of ChatGPT responses was considered poor, with moderate to good reliability. It is important to make patients know that they should not only base their decisions on information coming from ChatGPT.
Contribution of the Paper
•
ChatGPT is not an accurate tool for answering questions about exercise recommendations for breast cancer survivors.
•
Breast cancer survivors should not make decisions about exercise based on ChatGPT information alone.
•
The feasibility of therapeutic exercise in breast cancer survivors needs to be supported by expert advice.
{"title":"Evaluation of ChatGPT accuracy and reliability in answering questions about exercise recommendations for breast cancer survivors","authors":"C. Bernal-Utrera , A. Bravo-Vázquez , F.J. Montero-Bancalero , A. Suárez-Vega , M.J. Casuso-Holgado , E. Anarte-Lazo","doi":"10.1016/j.physio.2025.101838","DOIUrl":"10.1016/j.physio.2025.101838","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the accuracy and reliability of an artificial intelligence (AI) chatbot (ChatGPT) in providing answers about exercise recommendations for breast cancer survivors.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We extracted recommendations from recent systematic reviews of clinical practice guidelines (CPGs) on therapeutic physical exercise in breast cancer survivors. Clinical questions were developed and queried to ChatGPT-4. We evaluated the performance of ChatGPT-4 as a counseling tool by assessing the accuracy of responses (percentage of agreement with CPGs recommendations, weighted Cohen’s kappa and the percentage of text wording similarity) and the intra-rater and inter-rater reliability in grading ChatGPT answers (kappa value).</div></div><div><h3>Results</h3><div>We tested 15 clinical questions. The accuracy of the AI chatbot´s responses was considered unacceptable, with only 7% of responses being reasonably accurate (1/14), 64% of responses being partially accurate (9/14) and 29% being completely incorrect (4/14). It was observed a low Kappa coefficient (k = 0.244, CI: 0.089 to 0.577) and the similarity of responses was also considered unacceptable, with 27.2% of overlapping text wording. Intra and inter-rater reliability showed moderate to good values in all cases.</div></div><div><h3>Conclusions</h3><div>ChatGPT does not appear to be an accurate counselling tool for answering questions about exercise recommendations for breast cancer survivors. Compared to CPG´s recommendations, the accuracy of ChatGPT responses was considered poor, with moderate to good reliability. It is important to make patients know that they should not only base their decisions on information coming from ChatGPT.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>ChatGPT is not an accurate tool for answering questions about exercise recommendations for breast cancer survivors.</div></span></li><li><span>•</span><span><div>Breast cancer survivors should not make decisions about exercise based on ChatGPT information alone.</div></span></li><li><span>•</span><span><div>The feasibility of therapeutic exercise in breast cancer survivors needs to be supported by expert advice.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101838"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571692","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}
Pub Date : 2026-03-01Epub Date: 2025-09-15DOI: 10.1016/j.physio.2025.101846
Lalit E. Braem , Fanny Lacour , Antoine Fourré , Etienne Panchout , Grégory Reychler , Joachim Van Cant
{"title":"Clarifying the concept of advanced practice in physiotherapy for global model development","authors":"Lalit E. Braem , Fanny Lacour , Antoine Fourré , Etienne Panchout , Grégory Reychler , Joachim Van Cant","doi":"10.1016/j.physio.2025.101846","DOIUrl":"10.1016/j.physio.2025.101846","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101846"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574956","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}
Pub Date : 2026-03-01Epub Date: 2025-09-09DOI: 10.1016/j.physio.2025.101841
Ciara Hanrahan , Joseph G. McVeigh , Terence M. O’Connor , Thierry Troosters , Julie Broderick
<div><h3>Objectives</h3><div>Behaviour change interventions may support physical activity behaviour in people with chronic respiratory disease. The most effective interventions for long-term physical activity behaviour change in this cohort remains unclear. This aim of this study was to explore the use and perceptions of behaviour change interventions by both providers of physical activity programmes for people with chronic respiratory disease and by people living with chronic obstructive pulmonary disease (COPD) in The Republic of Ireland.</div></div><div><h3>Design</h3><div>Two anonymous online and paper-copy cross-sectional surveys, piloted and mapped to the COM-B model of behaviour change, were distributed via social media and relevant gate-keepers (e.g Irish Society of Chartered Physiotherapists, COPD Support Ireland) between November 2023 and April 2024. Findings were summarised using descriptive statistics including frequencies, percentages, means and medians. Relationships between variables were investigated using Chi<sup>2</sup> (<em>p</em> = 0.05).</div></div><div><h3>Results</h3><div>The response rate to the provider survey was 71% (107/150), and 112 participants responded to the COPD cohort survey. Providers perceived encouragement, pertaining to theoretical constructs such as self-confidence, optimism and reinforcement to be the most effective techniques influencing physical activity behaviour. People with COPD perceived social support, pertaining to theoretical constructs such as interpersonal skills and social identity, to be the most effective interventions influencing their physical activity behaviour. Motivation was frequently identified as a common COM-B component, suggesting important links to this mechanism of action in influencing behaviour.</div></div><div><h3>Conclusions</h3><div>Interventions with motivational components are perceived as effective influencers of physical activity behaviour by providers of physical activity programmes and by those living with chronic respiratory disease.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Providers of physical activity programmes for people with chronic respiratory disease in The Republic of Ireland perceive that they are using encouragement, education, goal setting, education and social support as effective interventions to support behaviour change in chronic respiratory disease.</div></span></li><li><span>•</span><span><div>People with COPD perceive social support and one-to-one interaction with trainers as effective interventions to support their physical activity behaviour.</div></span></li><li><span>•</span><span><div>There may be discrepancies between male and female perceptions of effective interventions in the COPD cohort, and this warrants further research.</div></span></li><li><span>•</span><span><div>Interventions containing motivational components are perceived by both providers and people living with chronic respiratory dise
{"title":"Perceptions and use of behaviour change interventions for physical activity in chronic respiratory disease in The Republic of Ireland","authors":"Ciara Hanrahan , Joseph G. McVeigh , Terence M. O’Connor , Thierry Troosters , Julie Broderick","doi":"10.1016/j.physio.2025.101841","DOIUrl":"10.1016/j.physio.2025.101841","url":null,"abstract":"<div><h3>Objectives</h3><div>Behaviour change interventions may support physical activity behaviour in people with chronic respiratory disease. The most effective interventions for long-term physical activity behaviour change in this cohort remains unclear. This aim of this study was to explore the use and perceptions of behaviour change interventions by both providers of physical activity programmes for people with chronic respiratory disease and by people living with chronic obstructive pulmonary disease (COPD) in The Republic of Ireland.</div></div><div><h3>Design</h3><div>Two anonymous online and paper-copy cross-sectional surveys, piloted and mapped to the COM-B model of behaviour change, were distributed via social media and relevant gate-keepers (e.g Irish Society of Chartered Physiotherapists, COPD Support Ireland) between November 2023 and April 2024. Findings were summarised using descriptive statistics including frequencies, percentages, means and medians. Relationships between variables were investigated using Chi<sup>2</sup> (<em>p</em> = 0.05).</div></div><div><h3>Results</h3><div>The response rate to the provider survey was 71% (107/150), and 112 participants responded to the COPD cohort survey. Providers perceived encouragement, pertaining to theoretical constructs such as self-confidence, optimism and reinforcement to be the most effective techniques influencing physical activity behaviour. People with COPD perceived social support, pertaining to theoretical constructs such as interpersonal skills and social identity, to be the most effective interventions influencing their physical activity behaviour. Motivation was frequently identified as a common COM-B component, suggesting important links to this mechanism of action in influencing behaviour.</div></div><div><h3>Conclusions</h3><div>Interventions with motivational components are perceived as effective influencers of physical activity behaviour by providers of physical activity programmes and by those living with chronic respiratory disease.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Providers of physical activity programmes for people with chronic respiratory disease in The Republic of Ireland perceive that they are using encouragement, education, goal setting, education and social support as effective interventions to support behaviour change in chronic respiratory disease.</div></span></li><li><span>•</span><span><div>People with COPD perceive social support and one-to-one interaction with trainers as effective interventions to support their physical activity behaviour.</div></span></li><li><span>•</span><span><div>There may be discrepancies between male and female perceptions of effective interventions in the COPD cohort, and this warrants further research.</div></span></li><li><span>•</span><span><div>Interventions containing motivational components are perceived by both providers and people living with chronic respiratory dise","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101841"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618252","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}
Pub Date : 2026-03-01Epub Date: 2025-10-15DOI: 10.1016/j.physio.2025.101850
B. Langley , M. Greig , T.N. Board
Background
Single camera markerless motion capture technology offers a potential means of assessing joint function in patients with musculoskeletal disorders/diseases. The aim of this study was to determine the validity and within-session reliability of sagittal plane knee joint kinematics quantified using the Deep Vision platform in patients with knee osteoarthritis.
Methods
Sagittal plane knee joint kinematics were quantified using a 3D motion capture system, the msk.ai Deep Vision platform and Kinovea in fifteen patients with knee osteoarthritis. Bland Altman plots with 95 % limits of agreement were used to assess validity and within-session reliability, with mean differences and limits of agreement explored relative to ± 5° and 10° clinically meaningful thresholds, respectively. This is based on the assumption that changes in joint angles greater than 5° are clinically meaningful.
Results
Mean differences and 95 % limits of agreement were within the clinically meaningful thresholds when using the Deep Vision platform to quantify peak knee flexion and extension, and range of motion. Mean differences were within the clinically meaningful threshold for Kinovea based assessments, but 95 % limits of agreement exceeded the ± 10° clinically meaningful threshold for peak flexion and range of motion. All assessment methods displayed mean differences and 95 % confidence intervals within the clinically meaningful thresholds on average when comparing across repetitions to quantify within-session reliability.
Conclusion
The findings of the study demonstrate that the msk.ai Deep Vision platform provides a valid and reliable means of quantifying peak knee flexion, extension and range of motion.
Contribution of the Paper
•
The Deep Vision platform, a smartphone based markerless motion capture technology, provides a valid means of measuring knee range of motion.
•
The Deep Vision platform displays high reliability when measuring knee range of motion.
{"title":"Exploring the validity of smartphone based single camera markerless motion capture technology to quantify knee range of motion in patients with knee osteoarthritis","authors":"B. Langley , M. Greig , T.N. Board","doi":"10.1016/j.physio.2025.101850","DOIUrl":"10.1016/j.physio.2025.101850","url":null,"abstract":"<div><h3>Background</h3><div>Single camera markerless motion capture technology offers a potential means of assessing joint function in patients with musculoskeletal disorders/diseases. The aim of this study was to determine the validity and within-session reliability of sagittal plane knee joint kinematics quantified using the Deep Vision platform in patients with knee osteoarthritis.</div></div><div><h3>Methods</h3><div>Sagittal plane knee joint kinematics were quantified using a 3D motion capture system, the msk.ai Deep Vision platform and Kinovea in fifteen patients with knee osteoarthritis. Bland Altman plots with 95 % limits of agreement were used to assess validity and within-session reliability, with mean differences and limits of agreement explored relative to ± 5° and 10° clinically meaningful thresholds, respectively. This is based on the assumption that changes in joint angles greater than 5° are clinically meaningful.</div></div><div><h3>Results</h3><div>Mean differences and 95 % limits of agreement were within the clinically meaningful thresholds when using the Deep Vision platform to quantify peak knee flexion and extension, and range of motion. Mean differences were within the clinically meaningful threshold for Kinovea based assessments, but 95 % limits of agreement exceeded the ± 10° clinically meaningful threshold for peak flexion and range of motion. All assessment methods displayed mean differences and 95 % confidence intervals within the clinically meaningful thresholds on average when comparing across repetitions to quantify within-session reliability.</div></div><div><h3>Conclusion</h3><div>The findings of the study demonstrate that the msk.ai Deep Vision platform provides a valid and reliable means of quantifying peak knee flexion, extension and range of motion.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>The Deep Vision platform, a smartphone based markerless motion capture technology, provides a valid means of measuring knee range of motion.</div></span></li><li><span>•</span><span><div>The Deep Vision platform displays high reliability when measuring knee range of motion.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101850"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589923","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}