Physiotherapy最新文献

英文中文

From impairment to environment: Rethinking physiotherapy practice through social determinants of health 从损害到环境：通过健康的社会决定因素重新思考物理治疗实践

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-29 DOI: 10.1016/j.physio.2025.101849

Davy Vancampfort , Brendon Stubbs , Tine Van Damme

引用次数: 0

Reply to Letter to the Editor regarding article “Redefining the role of physiotherapy in modern healthcare: a shift from pain relief to functional empowerment” 回复关于文章“重新定义物理治疗在现代医疗保健中的作用：从缓解疼痛到功能赋权的转变”的致编辑的信。

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-17 DOI: 10.1016/j.physio.2025.101844

Kate Purcell

引用次数: 0

On “Redefining the role of physiotherapy in modern healthcare: a shift from pain relief to functional empowerment” 关于“重新定义物理治疗在现代医疗保健中的作用：从缓解疼痛到增强功能的转变”。

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-17 DOI: 10.1016/j.physio.2025.101845

Seth Peterson

引用次数: 0

Nasopharyngeal/tracheal suctioning – “Blind”, challenging and not without risk-we must do better 鼻咽/气管吸引——“盲目”、具有挑战性且并非没有风险——我们必须做得更好

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-16 DOI: 10.1016/j.physio.2025.101847

George Ntoumenopoulos

引用次数: 0

Clarifying the concept of advanced practice in physiotherapy for global model development 阐明物理治疗先进实践的概念，促进全球模式发展。

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-15 DOI: 10.1016/j.physio.2025.101846

Lalit E. Braem , Fanny Lacour , Antoine Fourré , Etienne Panchout , Grégory Reychler , Joachim Van Cant

引用次数: 0

Reliability and validity of the Six-Spot Step Test in patients with total hip arthroplasty 全髋关节置换术患者6点步检验的信度和效度。

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-15 DOI: 10.1016/j.physio.2025.101848

Elif Aygun-Polat , Yusuf Polat , Yunus Emre Ozbilen , Alperen Altun , Sevim Acaroz , Alper Cirakli

Objectives

To assess the validity and reliability of the Six-Spot Step Test (SSST) in total hip arthroplasty (THA) patients.

Design

Cross-sectional cohort study.

Setting

Outpatient clinic.

Participants

Sixty-one patients at least six months post-primary THA.

Main outcome measures

The SSST was performed twice on the same day by Rater 1, along with the Timed Up and Go (TUG), Four-Square Step Test (FSST), and Berg Balance Scale (BBS). It was repeated 5–7 days later by Raters 1 and 2. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland–Altman analysis; validity with Spearman’s correlation. A fall-risk cut-off was identified via receiver operating characteristic (ROC) analysis.

Results

Participants’ mean (SD) age was 64 (7) years, with an Oxford Hip Score of 37 (8). As defined by the Bland–Altman analysis, the agreement intervals, within which 95% of the differences of the second measurement, compared to the first one, fall were: within day −1.7 to 2.3 seconds (s), −2.3 to 2.0 seconds between day and −2.0 to 1.9 between raters. Reliability was excellent within-day (ICC: 0.95), between-day (ICC: 0.94), and inter-rater (ICC: 0.95). The SSST correlated strongly with the TUG (ρ = 0.70) and FSST (ρ = 0.81), and moderately with the BBS (ρ = −0.62). A cut-off of 10.7 seconds indicated fall risk (sensitivity: 75%; specificity: 73%; AUC = 0.82, 95% CI: 0.71–0.94, p < 0.001).

Conclusion

The SSST is a reliable and valid tool for assessing mobility in THA patients. It effectively identified fall risk in this sample, supporting its clinical use. However, further validation in different samples is required.

Clinical Trial Registration number

NCT06704217

Contribution of paper

•
The SSST is a reliable and valid tool for assessing functional mobility in patients after total hip arthroplasty.
•
A variation exceeding the 95% limits of agreement (−2.3 to 2.0 seconds) can be considered a true performance change.
•
SSST effectively identified fall risk in this sample, with a cutoff time of 10.7 seconds.
•
Strong correlations with established balance and mobility tests support SSST’s clinical utility.

目的：评价6点步测（SSST）在全髋关节置换术（THA）患者中的效度和信度。设计：横断面队列研究。单位：门诊。参与者：61例原发性THA术后至少6个月的患者。主要结果测量：由Rater 1在同一天进行两次SSST，以及计时上升和前进（TUG），四方步骤测试（FSST）和Berg平衡量表（BBS）。5-7天后，评分员1和2重复。采用类内相关系数（ICC）和Bland-Altman分析评估信度；与斯皮尔曼相关的有效性。通过受试者工作特征（ROC）分析确定跌倒风险截止值。结果：参与者的平均（SD）年龄为64(7)岁，牛津髋关节评分为37(8)。根据Bland-Altman分析的定义，与第一次测量相比，第二次测量的95%差异的一致性区间为：在-1.7到2.3秒(s)之间，在-2.3到2.0秒之间，在-2.0到1.9秒之间。信度在日内（ICC: 0.95）、日内（ICC: 0.94）和间（ICC: 0.95）均极好。SSST与TUG （ρ = 0.70）和FSST （ρ = 0.81）相关性强，与BBS （ρ = -0.62）相关性中等。10.7秒的截止时间表明有跌倒风险（敏感性：75%；特异性：73%；AUC = 0.82, 95% CI: 0.71-0.94, p < 0.001）。结论：SSST是一种可靠有效的评估THA患者活动能力的工具。它有效地识别了该样本的跌倒风险，支持其临床应用。然而，需要在不同样品中进一步验证。临床试验注册号：NCT06704217

{"title":"Reliability and validity of the Six-Spot Step Test in patients with total hip arthroplasty","authors":"Elif Aygun-Polat , Yusuf Polat , Yunus Emre Ozbilen , Alperen Altun , Sevim Acaroz , Alper Cirakli","doi":"10.1016/j.physio.2025.101848","DOIUrl":"10.1016/j.physio.2025.101848","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the validity and reliability of the Six-Spot Step Test (SSST) in total hip arthroplasty (THA) patients.</div></div><div><h3>Design</h3><div>Cross-sectional cohort study.</div></div><div><h3>Setting</h3><div>Outpatient clinic.</div></div><div><h3>Participants</h3><div>Sixty-one patients at least six months post-primary THA.</div></div><div><h3>Main outcome measures</h3><div>The SSST was performed twice on the same day by Rater 1, along with the Timed Up and Go (TUG), Four-Square Step Test (FSST), and Berg Balance Scale (BBS). It was repeated 5–7 days later by Raters 1 and 2. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland–Altman analysis; validity with Spearman’s correlation. A fall-risk cut-off was identified via receiver operating characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div>Participants’ mean (SD) age was 64 (7) years, with an Oxford Hip Score of 37 (8). As defined by the Bland–Altman analysis, the agreement intervals, within which 95% of the differences of the second measurement, compared to the first one, fall were: within day −1.7 to 2.3 seconds (s), −2.3 to 2.0 seconds between day and −2.0 to 1.9 between raters. Reliability was excellent within-day (ICC: 0.95), between-day (ICC: 0.94), and inter-rater (ICC: 0.95). The SSST correlated strongly with the TUG (ρ = 0.70) and FSST (ρ = 0.81), and moderately with the BBS (ρ = −0.62). A cut-off of 10.7 seconds indicated fall risk (sensitivity: 75%; specificity: 73%; AUC = 0.82, 95% CI: 0.71–0.94, p < 0.001).</div></div><div><h3>Conclusion</h3><div>The SSST is a reliable and valid tool for assessing mobility in THA patients. It effectively identified fall risk in this sample, supporting its clinical use. However, further validation in different samples is required.</div></div><div><h3>Clinical Trial Registration number</h3><div>NCT06704217</div></div><div><h3>Contribution of paper</h3><div><ul><li><span>•</span><span><div>The SSST is a reliable and valid tool for assessing functional mobility in patients after total hip arthroplasty.</div></span></li><li><span>•</span><span><div>A variation exceeding the 95% limits of agreement (−2.3 to 2.0 seconds) can be considered a true performance change.</div></span></li><li><span>•</span><span><div>SSST effectively identified fall risk in this sample, with a cutoff time of 10.7 seconds.</div></span></li><li><span>•</span><span><div>Strong correlations with established balance and mobility tests support SSST’s clinical utility.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101848"},"PeriodicalIF":3.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607495","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}

引用次数: 0

Perceptions and use of behaviour change interventions for physical activity in chronic respiratory disease in The Republic of Ireland 爱尔兰共和国慢性呼吸道疾病患者对身体活动行为改变干预措施的认识和使用情况

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-09 DOI: 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

目的行为改变干预措施可能支持慢性呼吸道疾病患者的身体活动行为。在这一队列中，最有效的长期体育活动行为改变干预措施尚不清楚。本研究的目的是探讨爱尔兰共和国慢性呼吸系统疾病患者和慢性阻塞性肺疾病（COPD）患者的身体活动方案提供者对行为改变干预措施的使用和看法。在2023年11月至2024年4月期间，两项匿名在线和纸质横断面调查通过社交媒体和相关守门者（如爱尔兰特许物理治疗师协会、爱尔兰慢性阻塞性肺病支持协会）进行了试点和映射到COM-B行为改变模型。使用包括频率、百分比、平均值和中位数在内的描述性统计对研究结果进行总结。采用Chi2分析变量间的关系（p = 0.05）。结果对提供者调查的响应率为71%(107/150)，112名参与者对COPD队列调查有响应。提供者认为鼓励是影响身体活动行为的最有效的技术，这与自信、乐观和强化等理论结构有关。COPD患者认为社会支持（与人际交往能力和社会认同等理论结构有关）是影响其身体活动行为的最有效干预措施。动机经常被确定为共同的COM-B组成部分，这表明在影响行为方面与这一作用机制有重要联系。结论：具有动机成分的干预措施被体育活动计划提供者和慢性呼吸系统疾病患者认为是体育活动行为的有效影响因素。•爱尔兰共和国慢性呼吸道疾病患者身体活动方案的提供者认为，他们正在利用鼓励、教育、目标设定、教育和社会支持作为有效干预措施，支持改变慢性呼吸道疾病患者的行为。•COPD患者认为社会支持和与教练的一对一互动是支持其体育活动行为的有效干预措施。•在COPD队列中，男性和女性对有效干预措施的看法可能存在差异，这值得进一步研究。•提供者和慢性呼吸道疾病患者都认为，包含动机成分的干预措施最有效地影响慢性呼吸道疾病患者的身体活动行为。

{"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":"2025-09-09","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}

引用次数: 0

The essential role of the physiotherapy profession in incretin-based weight loss 物理治疗专业在以肠促胰岛素为基础的减肥中的重要作用

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-09 DOI: 10.1016/j.physio.2025.101840

Jade Sampford , Richard Myers-Ingram , Gareth D. Jones , Simon Cork

Obesity is a global health concern requiring multidisciplinary approaches for effective management. Incretin-based pharmacotherapies, such as glucagon-like peptide 1 receptor agonists and dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists, have demonstrated significant weight loss outcomes, yet their impact on body composition remains underexplored. Evidence indicates that weight loss with these medications may lead to disproportionate fat-free mass loss, heightening risks of sarcopenia and sarcopenic obesity, which are associated with frailty, comorbidities, and reduced functionality. Exercise, particularly resistance training, has proven effective in preserving fat-free mass and optimising long-term weight maintenance. Physiotherapists are uniquely positioned, as one of the largest professions within the Allied Healthcare Professional workforce, their expertise in exercise prescription, rehabilitation, and behaviour change, has the potential to address these challenges. However, concerningly, much of the guidance around the prescription of incretin-based therapies for weight loss fails to mention the inclusion of physiotherapists in the patient management team, and the impact that they can have on clinical outcomes. This debate article argues for the inclusion of physiotherapy within interdisciplinary teams managing patients on incretin-based pharmacotherapy to optimise their efficacy and promote healthier weight loss.

Contribution of the Paper

•
This paper highlights the underutilised role of physiotherapists in incretin-based pharmacotherapy and their potential contribution to obesity management.
•
It discusses secondary health risks, particularly the often-overlooked loss of muscle mass during active weight loss, which could lead to long-term issues such as sarcopenia, sarcopenic obesity and weight regain post-treatment.
•
It advocates for integrating physiotherapists into interdisciplinary obesity management teams, emphasising their role in exercise prescription, rehabilitation and long-term condition management to improve treatment outcomes and patient experiences.

肥胖是一个全球性的健康问题，需要多学科方法进行有效管理。以肠促胰岛素为基础的药物治疗，如胰高血糖素样肽1受体激动剂和双重GLP-1和葡萄糖依赖性胰岛素性多肽受体激动剂，已经证明了显著的减肥效果，但它们对身体成分的影响仍未得到充分研究。有证据表明，使用这些药物减肥可能导致不成比例的无脂肪质量减少，增加肌肉减少症和肌肉减少性肥胖的风险，这与虚弱、合并症和功能下降有关。运动，特别是阻力训练，已被证明在保持无脂肪质量和优化长期体重维持方面是有效的。作为联合医疗保健专业人员队伍中最大的专业之一，物理治疗师具有独特的定位，他们在运动处方，康复和行为改变方面的专业知识具有解决这些挑战的潜力。然而，令人担忧的是，许多关于以肠促胰岛素为基础的减肥治疗处方的指导没有提到在患者管理团队中包括物理治疗师，以及他们对临床结果的影响。这篇辩论文章主张将物理治疗纳入跨学科团队中，管理以肠促胰岛素为基础的药物治疗患者，以优化其疗效并促进更健康的体重减轻。•这篇论文强调了物理治疗师在基于胰岛素的药物治疗中未充分利用的作用，以及他们对肥胖管理的潜在贡献。•它讨论了次要健康风险，特别是在积极减肥期间经常被忽视的肌肉质量损失，这可能导致长期问题，如肌肉减少症、肌肉减少性肥胖和治疗后体重反弹。•倡导将物理治疗师纳入跨学科肥胖管理团队，强调他们在运动处方、康复和长期状况管理方面的作用，以改善治疗效果和患者体验。

{"title":"The essential role of the physiotherapy profession in incretin-based weight loss","authors":"Jade Sampford , Richard Myers-Ingram , Gareth D. Jones , Simon Cork","doi":"10.1016/j.physio.2025.101840","DOIUrl":"10.1016/j.physio.2025.101840","url":null,"abstract":"<div><div>Obesity is a global health concern requiring multidisciplinary approaches for effective management. Incretin-based pharmacotherapies, such as glucagon-like peptide 1 receptor agonists and dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists, have demonstrated significant weight loss outcomes, yet their impact on body composition remains underexplored. Evidence indicates that weight loss with these medications may lead to disproportionate fat-free mass loss, heightening risks of sarcopenia and sarcopenic obesity, which are associated with frailty, comorbidities, and reduced functionality. Exercise, particularly resistance training, has proven effective in preserving fat-free mass and optimising long-term weight maintenance. Physiotherapists are uniquely positioned, as one of the largest professions within the Allied Healthcare Professional workforce, their expertise in exercise prescription, rehabilitation, and behaviour change, has the potential to address these challenges. However, concerningly, much of the guidance around the prescription of incretin-based therapies for weight loss fails to mention the inclusion of physiotherapists in the patient management team, and the impact that they can have on clinical outcomes. This debate article argues for the inclusion of physiotherapy within interdisciplinary teams managing patients on incretin-based pharmacotherapy to optimise their efficacy and promote healthier weight loss.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This paper highlights the underutilised role of physiotherapists in incretin-based pharmacotherapy and their potential contribution to obesity management.</div></span></li><li><span>•</span><span><div>It discusses secondary health risks, particularly the often-overlooked loss of muscle mass during active weight loss, which could lead to long-term issues such as sarcopenia, sarcopenic obesity and weight regain post-treatment.</div></span></li><li><span>•</span><span><div>It advocates for integrating physiotherapists into interdisciplinary obesity management teams, emphasising their role in exercise prescription, rehabilitation and long-term condition management to improve treatment outcomes and patient experiences.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"130 ","pages":"Article 101840"},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571695","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}

引用次数: 0

Beyond technical training: continuing to embrace complexity in physiotherapy education 超越技术培训：继续拥抱物理治疗教育的复杂性

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-09 DOI: 10.1016/j.physio.2025.101843

Michael Mansfield , Clive Liles , Danny Armitage

引用次数: 0

The RESISTANT study (Respiratory Muscle Training in Patients with Spinal Muscular Atrophy): results of a randomized controlled trial 抗药研究（脊髓性肌萎缩患者的呼吸肌训练）：一项随机对照试验的结果

IF 3 3区医学 Q1 REHABILITATION

Physiotherapy

Pub Date : 2025-09-06 DOI: 10.1016/j.physio.2025.101842

Kim Kant-Smits , Bart Bartels , Ruben P.A. van Eijk , Fay-Lynn Asselman , Esther S. Veldhoen , Kors van der Ent , W. Ludo van der Pol , Erik H.J. Hulzebos

Objectives

To investigate the efficacy and feasibility of respiratory muscle training (RMT) in patients with spinal muscular atrophy (SMA) and respiratory muscle weakness.

Design

A 4-month, single-blinded RCT, followed by an 8-month extension phase.

Setting

The outpatient clinic of the Neurology department and the Child Development and Exercise Center at the University Medical Center Utrecht, The Netherlands.

Participants

30 participants, ≥eight years, SMA type 1 to 4, and respiratory muscle weakness.

Interventions

The training group started RMT at 30% of their maximum inspiratory (PImax) and expiratory pressure (PEmax) and adjusted their training intensity based on perceived exertion. The control group started and continued RMT at 10% of PImax and PEmax. After four months, the control group received the same RMT as the training group.

Main outcome measures

The primary outcome was the between-group difference in PImax after the RCT phase. Additionally, we explored the association between training volume (i.e., number of training sessions x training intensity) and increase in PImax over 1 year.

Results

25 participants completed the study. Mean PImax after four months (corrected for baseline value) training group: 61.1 cmH₂O, control group: 54.3 cmH₂O, mean difference in PImax: 6.8 cmH₂O [95% CI: −2.0 to 15.6]. Despite the study being underpowered, we did find an association between training volume and increase in PImax (R² = 0.531).

Conclusion

There was a small between-group difference in PImax after the RCT phase. The training was safe, but the feasibility of the training needs further improvement.

Clinical Trial Registration Number

NL73280.041.20.

Contribution of the Paper

•
There was a small difference in PImax improvement between training at different intensities (10% vs 30% of PImax).
•
Higher training volume (frequency times intensity) is associated with improvement of inspiratory muscle strength.
•
Supervision (by physiotherapists) might contribute to better adherence to respiratory muscle training.

目的探讨呼吸肌训练（RMT）治疗脊髓性肌萎缩症（SMA）伴呼吸肌无力的疗效和可行性。DesignA 4个月的单盲随机对照试验，随后是8个月的延长期。荷兰乌得勒支大学医学中心神经内科和儿童发展与运动中心门诊。参与者：30名参与者，年龄≥8岁，SMA 1 - 4型，呼吸肌无力。干预措施：训练组在最大吸气压（PImax）和最大呼气压（PEmax）的30%时开始RMT，并根据感知到的用力调整训练强度。对照组开始并继续以10%的哌甲哌啶和哌甲哌啶进行RMT治疗。四个月后，对照组接受与训练组相同的RMT。主要结局指标：主要结局指标为RCT期后PImax的组间差异。此外，我们探讨了训练量（即训练次数x训练强度）与1年内PImax增加之间的关系。结果25名参与者完成了研究。4个月后平均PImax（校正基线值）训练组：61.1 cmH2O，对照组：54.3 cmH2O，平均PImax差异：6.8 cmH2O [95% CI:−2.0至15.6]。尽管这项研究的效力不足，但我们确实发现训练量与PImax增加之间存在关联（R2 = 0.531）。结论RCT期结束后，PImax组间差异较小。培训是安全的，但培训的可行性有待进一步提高。临床试验注册号：bernl73280.041.20。•在不同强度的训练中，PImax的改善有微小的差异（10% vs 30%的PImax）。•更高的训练量（频率乘以强度）与吸气肌力量的改善有关。•监督（由物理治疗师）可能有助于更好地坚持呼吸肌训练。

{"title":"The RESISTANT study (Respiratory Muscle Training in Patients with Spinal Muscular Atrophy): results of a randomized controlled trial","authors":"Kim Kant-Smits , Bart Bartels , Ruben P.A. van Eijk , Fay-Lynn Asselman , Esther S. Veldhoen , Kors van der Ent , W. Ludo van der Pol , Erik H.J. Hulzebos","doi":"10.1016/j.physio.2025.101842","DOIUrl":"10.1016/j.physio.2025.101842","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the efficacy and feasibility of respiratory muscle training (RMT) in patients with spinal muscular atrophy (SMA) and respiratory muscle weakness.</div></div><div><h3>Design</h3><div>A 4-month, single-blinded RCT, followed by an 8-month extension phase.</div></div><div><h3>Setting</h3><div>The outpatient clinic of the Neurology department and the Child Development and Exercise Center at the University Medical Center Utrecht, The Netherlands.</div></div><div><h3>Participants</h3><div>30 participants, ≥eight years, SMA type 1 to 4, and respiratory muscle weakness.</div></div><div><h3>Interventions</h3><div>The training group started RMT at 30% of their maximum inspiratory (PImax) and expiratory pressure (PEmax) and adjusted their training intensity based on perceived exertion. The control group started and continued RMT at 10% of PImax and PEmax. After four months, the control group received the same RMT as the training group.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was the between-group difference in PImax after the RCT phase. Additionally, we explored the association between training volume (i.e., number of training sessions x training intensity) and increase in PImax over 1 year.</div></div><div><h3>Results</h3><div>25 participants completed the study. Mean PImax after four months (corrected for baseline value) training group: 61.1 cmH<sub>2</sub>O, control group: 54.3 cmH<sub>2</sub>O, mean difference in PImax: 6.8 cmH<sub>2</sub>O [95% CI: −2.0 to 15.6]. Despite the study being underpowered, we did find an association between training volume and increase in PImax (R<sup>2</sup> = 0.531).</div></div><div><h3>Conclusion</h3><div>There was a small between-group difference in PImax after the RCT phase. The training was safe, but the feasibility of the training needs further improvement.</div></div><div><h3>Clinical Trial Registration Number</h3><div>NL73280.041.20.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>There was a small difference in PImax improvement between training at different intensities (10% vs 30% of PImax).</div></span></li><li><span>•</span><span><div>Higher training volume (frequency times intensity) is associated with improvement of inspiratory muscle strength.</div></span></li><li><span>•</span><span><div>Supervision (by physiotherapists) might contribute to better adherence to respiratory muscle training.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"129 ","pages":"Article 101842"},"PeriodicalIF":3.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265464","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Physiotherapy

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀