Physiotherapy最新文献

{"title":"Do individuals with ankle instability show altered lower extremity kinematics and kinetics during walking? A systematic review and meta-analysis","authors":"Lijiang Luan ,&nbsp;Dominic Orth ,&nbsp;Phillip Newman ,&nbsp;Roger Adams ,&nbsp;Doa El-Ansary ,&nbsp;Jia Han","doi":"10.1016/j.physio.2024.101420","DOIUrl":"10.1016/j.physio.2024.101420","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if individuals with chronic ankle instability (CAI) demonstrate altered lower extremity kinematics and kinetics during walking.</div></div><div><h3>Data sources</h3><div>Relevant studies were sourced from PubMed, Embase, Cochrane Library, Web of Science, EBSCO and PEDro.</div></div><div><h3>Study selection</h3><div>Kinematic and kinetic studies involving joint angle and/or joint moment measured in individuals with CAI were included.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>The Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tool was used to assess literature quality. Weighted mean differences (WMDs) in joint angles and moments between CAI and controls were analyzed as continuous variables.</div></div><div><h3>Results</h3><div>1261 articles were screened, with a final selection of 13 studies involving 729 participants. Compared to non-CAI controls, CAI participants showed significantly greater ankle inversion angle (degree) (WMD: 3.71, 95% CI: 3.15 to 4.27, <em>p</em> &lt; 0.001), hip adduction angle (degree) (WMD: 1.60, 95% CI: 0.09 to 3.11, <em>p</em> = 0.04), and knee valgus moment (N m/kg) (WMD: 0.07, 95% CI: 0.01 to 0.13, <em>p</em> = 0.02) during walking. Additionally, there were no consistent findings or specific altered patterns in other lower extremity joint angles, or moment changes, regardless of the motion plane (sagittal, coronal, horizontal), for CAI compared with controls.</div></div><div><h3>Conclusions</h3><div>This review provides further evidence of altered lower limb kinematics and kinetics in the frontal plane in CAI participants during certain walking phases, which may partially explain the high level of recurrent ankle sprains observed in the CAI population, and support hip abduction and ankle eversion motor control exercises for CAI rehabilitation.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42023420418.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Individuals with CAI exhibit greater ankle inversion and hip adduction angles during certain phases of walking compared to non-CAI controls.</div></span></li><li><span>•</span><span><div>There may be an increase in the knee valgus moment of individuals with CAI.</div></span></li><li><span>•</span><span><div>Altered lower extremity kinematics and kinetics may be associated with the occurrence of recurrent ankle sprains in CAI.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101420"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal days of application of kinesiotaping for the treatment of lumbo-pelvic pain during pregnancy. A systematic review and dose-response meta-analysis","authors":"Joaquín Salazar-Méndez ,&nbsp;Rodrigo Núñez-Cortés ,&nbsp;Iván Cuyul-Vásquez ,&nbsp;Sergio Sazo-Rodriguez ,&nbsp;Joaquín Calatayud ,&nbsp;Eduardo Guzmán-Muñoz ,&nbsp;Anyela Aguayo ,&nbsp;Benjamín Carrasco ,&nbsp;Areli González ,&nbsp;Luis Suso-Martí","doi":"10.1016/j.physio.2024.101418","DOIUrl":"10.1016/j.physio.2024.101418","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the optimal dose and short-term effectiveness of kinesiotaping (KT) on pain intensity and disability in pregnant women with lumbo-pelvic pain.</div></div><div><h3>Data sources</h3><div>MEDLINE (via PubMed Central), CINAHL, Epistemonikos, Scopus, and Web of Science from inception to 21st March 2023.</div></div><div><h3>Study selection</h3><div>We included randomized controlled trials (RCT) conducted on pregnant women with lumbo-pelvic pain treated with KT.</div></div><div><h3>Data extraction</h3><div>The outcomes included pain intensity and disability. ROB-2 and GRADE were used to assess the risk of bias and the certainty of the evidence, respectively. A random effects meta-analysis was performed using the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). The dose-response association was evaluated using a restricted cubic spline model.</div></div><div><h3>Data synthesis</h3><div>Seven RCTs involving 527 patients were included. Meta-analysis revealed a statistically significant effect in favor of KT on pain intensity (SMD = −1.71; 95% CI = −2.51 to −0.90; <em>P</em> = &lt;0.001) and on disability (SMD = −1.15; 95% CI = −2.29 to −0.02; <em>P</em> = &lt;0.001). The total duration of KT use ranged from 5 to 35 days. It was estimated that a dose of 5–10 days exceeded the minimal clinically important difference (MCID) for pain intensity (mean difference at 10 days = −2.63; 95% CI = −3.05 to −2.22). Low certainty of evidence was identified for both outcomes.</div></div><div><h3>Conclusions</h3><div>In pregnant women with lumbo-pelvic pain, the use of KT for 5 to 10 days produces a short-term reduction in pain intensity that exceeds the MCID, with a low certainty of evidence.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42023388174.</div></div><div><h3>Contribution of Paper</h3><div><ul><li><span>•</span><span><div>The meta-analysis showed that KT reduces pain intensity and improves disability in women with lumbo-pelvic pain.</div></span></li><li><span>•</span><span><div>A duration of 5 to 10 days of KT is sufficient to exceed the minimal clinically important difference (MCID) for pain intensity.</div></span></li><li><span>•</span><span><div>Studies of high methodological quality with longer follow-up are needed.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101418"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors and dose–response effect of rehabilitation for upper limb induced recovery after stroke: systematic review with proportional meta-analyses","authors":"Silvia Salvalaggio ,&nbsp;Silvia Gianola ,&nbsp;Martina Andò ,&nbsp;Luisa Cacciante ,&nbsp;Greta Castellini ,&nbsp;Alex Lando ,&nbsp;Gianluca Ossola ,&nbsp;Giorgia Pregnolato ,&nbsp;Sebastian Rutkowski ,&nbsp;Anna Vedovato ,&nbsp;Chiara Zandonà ,&nbsp;Andrea Turolla","doi":"10.1016/j.physio.2024.101417","DOIUrl":"10.1016/j.physio.2024.101417","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To date, factors with predictive value for upper limb (UL) recovery after stroke are acknowledged, but little is known on clinical features predicting outcome in response to rehabilitation. The purpose of this review is to investigate whether any factor allows identification of Responders to rehabilitation, and whether clinically important recovery of motor function relies on modalities and dose of intervention received, at different times after stroke.</div></div><div><h3>Methods</h3><div>A systematic review with proportional meta-analysis was conducted. Longitudinal single-cohort studies on patients undergoing rehabilitation after stroke were included. Predictive features investigated in the included studies were reported. The primary outcome was the Fugl-Meyer Assessment for Upper Extremity, and effect sizes (ES) of different rehabilitation doses were calculated.</div></div><div><h3>Results</h3><div>Only 6% of the included studies (<em>n</em> = 141) investigated predictive factors. Studies providing more than 30 hours of therapy induced small to large clinical effect (ES from 0.38 to 0.88). Task-oriented approach led to the largest effect, both in the subacute (ES = 0.88) and chronic (ES = 0.71) phases. Augmenting interventions provided higher effect in the chronic rather than subacute phase. Integrity of the corticospinal tract, preservation of arm motor function and specific genetic biomarkers were found to be associated with motor recovery</div></div><div><h3>Discussion and conclusions</h3><div>Trials on motor recovery after stroke should incorporate analysis of factors associated with rehabilitation outcomes. Task-oriented interventions should be delivered more than 30 hours (high dose) to induce the greatest improvement.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42021258188.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Demographic characteristics of patients are not associated with rehabilitation-induced upper limb motor outcomes after stroke.</div></span></li><li><span>•</span><span><div>Brain lesion characteristics and residual motor function were found to be the main potential predictive factors of rehabilitation-induced upper limb recovery after stroke.</div></span></li><li><span>•</span><span><div>Task-oriented interventions had the most significant clinical effect, both in the subacute and chronic phases after stroke.</div></span></li><li><span>•</span><span><div>Augmenting interventions are useful in the chronic phase after stroke, if delivered for a minimum of 10 hours.</div></span></li><li><span>•</span><span><div>Priming interventions are more useful in the chronic phase after stroke when 10 to 30 hours of treatment are delivered.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101417"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: “Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial”","authors":"Fatima Abdul Rashid, Ram Prasad M","doi":"10.1016/j.physio.2024.101414","DOIUrl":"https://doi.org/10.1016/j.physio.2024.101414","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"76 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors","authors":"","doi":"10.1016/S0031-9406(24)00417-6","DOIUrl":"10.1016/S0031-9406(24)00417-6","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"124 ","pages":"Page i"},"PeriodicalIF":3.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0031940624004176/pdfft?md5=543818b87123e59e2da6a1aeef94d28c&pid=1-s2.0-S0031940624004176-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers, facilitators and referral patterns of general practitioners, physiotherapists, and people with osteoarthritis to exercise","authors":"Avantika Bhardwaj ,&nbsp;Peter Hayes ,&nbsp;Jacqui Browne ,&nbsp;Stacey Grealis ,&nbsp;Darragh Maguire ,&nbsp;John O’Hora ,&nbsp;Ian Dowling ,&nbsp;Norelee Kennedy ,&nbsp;Clodagh M. Toomey","doi":"10.1016/j.physio.2024.101416","DOIUrl":"10.1016/j.physio.2024.101416","url":null,"abstract":"<div><h3>Background</h3><div>Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments for OA.</div></div><div><h3>Objective</h3><div>To identify barriers and facilitators of GPs, PTs and PwOA to uptake of and referral to exercise treatments for OA.</div></div><div><h3>Methods</h3><div>An online survey was circulated to GPs, PTs, and PwOA in Ireland from March to September 2021. Data were collected on demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. Frequency distributions were used to illustrate demographics, barriers and facilitators, and referral patterns to exercise treatments for OA.</div></div><div><h3>Results</h3><div>388 stakeholders responded (GPs = 148; PTs = 154; PwOA = 86). Barriers and facilitators were related to (1) stakeholder (e.g., patient tiredness and fatigue), (2) healthcare setting (e.g., appropriate referrals from GP or other sources), and (3) treatment (e.g., low-cost community-based exercise programmes) factors. While 91% of GPs would refer PwOA to physiotherapy if no barriers existed, only 60% would in their current practice. Only 33% of PwOA reported receiving a GP referral to physiotherapy.</div></div><div><h3>Conclusion</h3><div>Stakeholder, healthcare setting and treatment barriers and facilitators of GPs, PTs, and PwOA influence uptake of and referral to exercise treatments for OA. Future strategies Future strategies addressing these factors may improve implementation of guideline-based management for OA.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Despite an established evidence-based consensus, uptake of and referral to exercise as a first-line treatment for OA is suboptimal, partly influenced by the barriers and facilitators of stakeholders (e.g., GPs, PTs, and PwOA).</div></span></li><li><span>•</span><span><div>Barriers and facilitators that influence uptake of and referral to exercise treatments for OA are related to stakeholder, healthcare setting, and treatment factors.</div></span></li><li><span>•</span><span><div>Majority of PwOA are not receiving GP referrals to physiotherapy, and a mismatch between GPs intentions to and actual referrals to physiotherapy exists, primarily due to long waitlists to access services.</div></span></li><li><span>•</span><span><div>These findings may be adapted to inform strategies for the successful implementation of exercise treatments that are effective in encouraging guideline-based management of OA.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101416"},"PeriodicalIF":3.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the effectiveness of circuit training rehabilitation on balance, gait, and fatigue in multiple sclerosis: a systematic review and meta-analysis","authors":"Rebecca Cardini ,&nbsp;Chiara Corrini ,&nbsp;Rita Bertoni ,&nbsp;Denise Anastasi ,&nbsp;Davide Cattaneo ,&nbsp;Elisa Gervasoni","doi":"10.1016/j.physio.2024.101413","DOIUrl":"10.1016/j.physio.2024.101413","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;People with Multiple Sclerosis (PwMS) often experience imbalance, gait dysfunction, and fatigue. Circuit Training (CT) can be viable for improving balance, gait, and fatigue in MS. To the author’s knowledge, no studies have systematically reviewed the existing literature evaluating the effectiveness of CT in PwMS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To investigate the effectiveness of CT in improving balance, gait, and reducing fatigue in PwMS and provide a quantitative and qualitative synthesis of Randomized Controlled Trials (RCTs).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data sources&lt;/h3&gt;&lt;div&gt;MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Google Scholar, and PEDro Database (Dec 2021 to May 2024).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study selection&lt;/h3&gt;&lt;div&gt;RCTs using CT in PwMS including balance, gait, or fatigue outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data synthesis&lt;/h3&gt;&lt;div&gt;Search inclusion criteria were: i) available full text, ii) CT rehabilitation, iii) balance, gait, or fatigue measured as outcomes, and iv) articles in English. Full text articles were analyzed by two screeners. If there was disagreement regarding inclusion, a further reviewer was consulted. No discrepancies were found.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 878 studies, 14 studies were eligible including 716 PwMS with a mean (standard deviation) age of 49.9 (10.9) years, disease duration of 10.8 (7.2) years, and Expanded Disability Status Scale score of 4.3 (0.9) points. RevMan 5.4.1 was used to run the meta-analysis. We found a significant overall effect on Berg Balance Scale (Mean Difference (MD) = 6.07 points, 95%CI:1.40,10.75; &lt;em&gt;p&lt;/em&gt; = 0.01) and in Fatigue Severity Scale (MD = 0.98 points, 95%CI:0.30,1.66; &lt;em&gt;p&lt;/em&gt; = 0.005) in favor of CT. We did not find a significant effect in Timed Up and Go (MD = 0.46 second, 95%CI:−0.04,0.96; &lt;em&gt;p&lt;/em&gt; = 0.07), in Six-Minute Walk Test (MD = 17.46 m, 95%CI:−8.06,42.97; &lt;em&gt;p&lt;/em&gt; = 0.18), and in Modified Fatigue Impact Scale (MD = 3.34 points, 95%CI:−0.41,7.09; &lt;em&gt;p&lt;/em&gt; = 0.08) in favor of CT. We assessed methodological quality using RoB 2.0, and quality of evidence using GRADE.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Small number of studies, all identifying having some risk of bias.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Circuit training can have positive effects on PwMS in terms of increasing balance, gait, and reducing fatigue. Further research is needed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Systematic Review Registration Number&lt;/h3&gt;&lt;div&gt;PROSPERO CRD42021286834.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Contribution of the Paper&lt;/h3&gt;&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;-&lt;/span&gt;&lt;span&gt;&lt;div&gt;Circuit training rehabilitation seems to be an effective option for the treatment of balance, gait, and fatigue in people with Multiple Sclerosis.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;-&lt;/span&gt;&lt;span&gt;&lt;div&gt;Circuit training rehabilitation comprising balance and resistance exercises may improve balance and reduce fatigue symptoms in People with Multiple Sclerosis with mild to mo","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101413"},"PeriodicalIF":3.1,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A core capability framework for physiotherapists to deliver quality care when working with people living with dementia and their families/caregivers: an international modified e-Delphi study","authors":"Morag E. Taylor ,&nbsp;Karen Sverdrup ,&nbsp;Julie Ries ,&nbsp;Erik Rosendahl ,&nbsp;Gro Gujord Tangen ,&nbsp;Elisabeth Telenius ,&nbsp;Katherine Lawler ,&nbsp;Keith Hill ,&nbsp;Annika Toots ,&nbsp;Hans Hobbelen ,&nbsp;Vanina Dal Bello-Haas ,&nbsp;Abi Hall ,&nbsp;Susan W. Hunter ,&nbsp;Victoria A. Goodwin ,&nbsp;Julie Whitney ,&nbsp;Michele L. Callisaya","doi":"10.1016/j.physio.2024.07.002","DOIUrl":"10.1016/j.physio.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>What are the core capabilities physiotherapists need to deliver quality care when working with people with dementia and their families/caregivers?</div></div><div><h3>Design</h3><div>A three-round modified e-Delphi study.</div></div><div><h3>Participants</h3><div>Panel members were physiotherapists experienced in working with people with dementia and/or educating and/or researching in the dementia field.</div></div><div><h3>Methods</h3><div>A steering group (16 international physiotherapists and a consumer) developed a draft framework including 129 core capabilities across 5 domains for panel members to rate their appropriateness for inclusion as a core capability to provide high quality care to people with dementia and their caregivers/families. The RAND/UCLA method was used to assess consensus.</div></div><div><h3>Results</h3><div>Thirty-five physiotherapists from 11 countries participated in Round 1, 31 (89%) in Round 2 and 28 (80% of Round 1) in Round 3. All core capabilities were rated appropriate for inclusion in each round. Panel members recommended wording refinements across the rounds and suggested 51 core capabilities for consideration. Three rounds were needed to reach consensus, resulting in 137 core capabilities rated appropriate for inclusion across 5 domains: 1) Knowledge and understanding, <em>n</em> = 36; 2) Assessment, <em>n</em> = 39; 3) Management, interventions and prevention <em>n</em> = 40; 4) Communication, therapeutic relationship and person-centred care, <em>n </em>= 17; and 5) Physiotherapists self-management and improvement, <em>n</em> = 5.</div></div><div><h3>Conclusions</h3><div>This e-Delphi study outlines the core capabilities physiotherapists need to provide high quality care to people with dementia and their families/caregivers. These core capabilities can be used by physiotherapists to help identify knowledge/skill gaps, as well as by educators to improve their training of undergraduate and postgraduate students, and clinicians.</div></div><div><h3>Contribution of Paper</h3><div><ul><li><span>•</span><span><div>This e-Delphi study has developed, through expert consensus, the first comprehensive physiotherapy specific core capability framework for providing high-quality care to people with dementia and their families/caregivers.</div></span></li><li><span>•</span><span><div>The core capability framework can be used by physiotherapists to identify knowledge and/or skill gaps, and by physiotherapy educators to assist with entry-level and post-graduate curriculum development and student/workforce training.</div></span></li><li><span>•</span><span><div>As physiotherapists play a vital role in working with people with dementia and their caregivers/families, and competencies lie at the heart of effective quality care and service delivery, the newly developed core capability framework serves as basis for broader consultation and input.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101411"},"PeriodicalIF":3.1,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141614862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychologically-enhanced cardiac rehabilitation for psychological and functional improvement in patients with cardiovascular disease: a systematic review with meta-analysis and future research directions","authors":"Adam Wrzeciono ,&nbsp;Justyna Mazurek ,&nbsp;Błażej Cieślik ,&nbsp;Paweł Kiper ,&nbsp;Robert Gajda ,&nbsp;Joanna Szczepańska-Gieracha","doi":"10.1016/j.physio.2024.07.003","DOIUrl":"10.1016/j.physio.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease.</p></div><div><h3>Data sources</h3><p>A systematic search was performed in PubMed, Scopus, Cochrane Library, Embase, and Web of Science, up to January 31, 2024.</p></div><div><h3>Study selection</h3><p>Two reviewers independently identified randomized clinical trials that evaluated the effectiveness of psychologically-enhanced CR in improving psychological and functional outcomes in patients with cardiovascular disease. The search yielded 1848 results. Finally, data from 14 studies (1531 participants) were included in the review.</p></div><div><h3>Data extraction and data synthesis</h3><p>Information regarding cardiac rehabilitation phase, duration of the intervention, group characteristics, measured outcomes, and the conclusions drawn by the authors was extracted. The Revised Cochrane risk-of-bias tool for Randomized Trials was used to evaluate the methodological quality.</p></div><div><h3>Results</h3><p>Pooled results indicate that psychologically-enhanced CR is more effective than specific cardiac training alone in maintaining lower resting blood pressure, with a mean difference of -3.09 (95% CI: -5.18 to -1.00). Furthermore, psychologically-enhanced CR shows superiority in improving patients' quality of life compared to specific cardiac training alone, with a standardized mean difference of 0.15 (95% CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise tolerance, and blood lipid profile did not show significant differences between the two treatment conditions.</p></div><div><h3>Conclusion</h3><p>Psychologically-enhanced CR shows a positive effect on reducing resting blood pressure and improving the quality of life. However, the supportive methods were of limited effectiveness in addressing the psychological aspects of health.</p></div><div><h3>Systematic Review Registration Number</h3><p>PROSPERO CRD42022304063.</p></div><div><h3>Contribution of the paper</h3><p></p><ul><li><span>•</span><span><p>Psychologically-enhanced cardiac rehabilitation (CR) has the potential to improve the effectiveness of CR.</p></span></li><li><span>•</span><span><p>Limited effectiveness in the psychological aspects of health requires consideration.</p></span></li><li><span>•</span><span><p>New therapeutic solutions to manage mental health during CR should be sought.</p></span></li></ul></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101412"},"PeriodicalIF":3.1,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141611321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia content and delivery in physiotherapy curricula: an international study of entry level physiotherapy programmes in Ireland the United Kingdom and New Zealand","authors":"Trish O’Sullivan ,&nbsp;Tony Foley ,&nbsp;Suzanne Timmons ,&nbsp;Joseph G. McVeigh","doi":"10.1016/j.physio.2024.07.001","DOIUrl":"10.1016/j.physio.2024.07.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Physical impairments associated with dementia include reduced gait speed, and diminished postural control, which can lead to an increase in falls and hip fractures. Physiotherapy can play a key role in many aspects of dementia care, including falls risk prevention, gait re-education and end of life care. However, there is a lack of dementia education in entry level physiotherapy programmes. The aim of this study was to map the dementia content and delivery in the current undergraduate and entry level physiotherapy curricula in Ireland the United Kingdom and New Zealand.</div></div><div><h3>Design</h3><div>This cross-sectional survey-based study was distributed via the online survey tool Qualtrics XM. The survey was designed using the map of Kern’s curriculum design framework.</div></div><div><h3>Setting</h3><div>Higher educational institutes (HEIs) that offered an undergraduate (BSc) and/or MSc (entry level) physiotherapy programmes in Ireland United Kingdom and New Zealand were included.</div></div><div><h3>Participants</h3><div>The academic lead for dementia education in the HEI was invited to participate in the survey.</div></div><div><h3>Results</h3><div>Of the 69 eligible HEIs contacted, 49 responded, giving a response rate of 71%. Different sources informed curriculum design, including patient and public involvement, published guidelines and policies and expert clinicians. The time allocated to dementia teaching across the curricula varied, with under half of the programmes only allocating two hours. The lack of service user input was seen as a perceived weakness of many programmes as was the non-standardisation and generalisability of teaching.</div></div><div><h3>Conclusion</h3><div>Whilst dementia education is included in many HEI programmes, we need to consider more time, a curriculum that meets learner’s needs and include the patient voice. Further research is needed to develop bespoke dementia curricula specific to physiotherapy.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>The findings of this study have identified current strengths as well as weaknesses of entry level physiotherapy programmes in dementia care.</div></span></li><li><span>•</span><span><div>This study highlights what is most and least commonly taught at entry level physiotherapy programmes in dementia care.</div></span></li><li><span>•</span><span><div>More time needs to be allocated to dementia teaching, to reflect the clear work-related educational needs of physiotherapists in both the acute and community care sector.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101410"},"PeriodicalIF":3.1,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141611322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}