Archives of physical medicine and rehabilitation最新文献

{"title":"Psychometric Properties of Free-Living Step-Based Metrics (Daily Steps and Peak Cadence) in Multiple Sclerosis","authors":"Peixuan Zheng PhD,&nbsp;Robert W. Motl PhD","doi":"10.1016/j.apmr.2025.05.005","DOIUrl":"10.1016/j.apmr.2025.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>We examined the reliability, precision, and clinically detectable change of step-based metrics (daily steps, peak 30-min cadence [Peak-30_CAD], and peak 1-min cadence [Peak-1_CAD]) over 6 months in the absence of intervention and evaluated the construct validity through correlations with laboratory-assessed walking and gait performance among persons with multiple sclerosis (MS).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>University-based laboratory.</div></div><div><h3>Participants</h3><div>Seventy-eight ambulatory adults (18-64y) with MS.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Free-living physical activity (via ActiGraph GT3X accelerometer), the Timed 25-Foot Walk, 6-minute walk, gait assessment (gait velocity, step length, and time), and disability status (the 12-item MS Walking Scale, Patient-Determined Disease Steps, and Self-Report Expanded Disability Status Scale) were measured before and after 6 months without any intervention.</div></div><div><h3>Results</h3><div>Step-based metrics were stable with no significant changes across time (<em>P</em>&gt;.05) and demonstrated good test–retest reliability (intraclass correlation coefficients: 0.80-0.85) and acceptable precision (SEM%s:14.4%∼24.3%). The minimal detectable changes at 95% CIs (MDC₉₅) values for Peak-30_CAD, Peak-1_CAD, and daily steps were 25.6 steps/min, 31.0 steps/min, and 2909.2 steps/d, respectively. There were consistent, strong associations between peak cadence with walking tests, gait parameters, and disability status at both time points (|<em>r_s</em>|=.52-.79), even after controlling for daily steps (|<em>pr_s</em>|=.25-.58; <em>P</em>&lt;.05).</div></div><div><h3>Conclusions</h3><div>Walking represents an important clinical endpoint in people with MS, yet it is often measured in controlled settings using performance-based tests that might not reflect real-world status. Our findings support step-based metrics via accelerometry as reliable and valid measures of free-living ambulatory performance and may inform the inclusion of these metrics in clinical trials among people with MS.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1837-1843"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Orthosis Improve Outcomes of Conservative Treatment in Trigger Fingers? A 3-Arm Prospective Randomized Controlled Trial","authors":"Kathryn Minkhorst MD, MSc ,&nbsp;Alexandra Munn MD ,&nbsp;Joy MacDermid PhD ,&nbsp;Ruby Grewal MD, MSc","doi":"10.1016/j.apmr.2025.05.015","DOIUrl":"10.1016/j.apmr.2025.05.015","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether the addition of an orthosis improved the efficacy of cortisone injection for the nonoperative management of trigger finger.</div></div><div><h3>Design</h3><div>Block randomized controlled trial.</div></div><div><h3>Setting</h3><div>Outpatient hand clinic.</div></div><div><h3>Participants</h3><div>Individuals presenting to our center with Green severity grade 1-3 trigger finger, aged 18-80, were eligible for inclusion (N=226). Exclusion criteria were previous treatment with either a splint or cortisone injection, trigger thumb, &gt;2 digits involved, grade 4 trigger, or an allergy to cortisone (N=118).</div></div><div><h3>Interventions</h3><div>Patients’ hands were randomized to nighttime extension orthosis, cortisone injection, or combined treatment, stratified by the Green severity score and comorbid diabetes.</div></div><div><h3>Main Outcome Measures</h3><div>Patient-reported outcome measures and the number of triggering occurrences with 10 repeated grips were collected at 6 weeks and 3, 6, and 12 months.</div></div><div><h3>Results</h3><div>The study included 104 patients representing 122 trigger fingers in 115 hands, with an average follow-up of 29 months. At 6 weeks, there was no significant difference in the incidence of triggering, symptom relief, or the Patient-Reported Wrist and Hand Evaluation score between injection or combined treatment groups. The overall success rate with conservative treatment was high, with 68.9% experiencing resolution or improvement of their symptoms. Grade 3 trigger fingers had a significantly higher rate of surgical release compared with lower-grade trigger fingers (39.1% vs 22.4%, <em>P</em>=.05).</div></div><div><h3>Conclusions</h3><div>Our study shows no significant benefit of adding an orthosis to cortisone injection in all trigger grades. Overall success with conservative treatment was high (68.9%) in this cohort. Conservative management of grade 1 and 2 triggers is successful in about 75% of patients, regardless of whether treatment is an orthosis, injection, or both, compared with a 60% success rate for grade 3.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1798-1806"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Interview and Online Self-report Versions of Motor and Sensory Components of a Neurological Exam for Classifying Spinal Cord Injury (One-SCI)","authors":"Thomas N. Bryce MD ,&nbsp;Laiba Afzal MS ,&nbsp;Stephen P. Burns MD ,&nbsp;Marcel P. Dijkers PhD ,&nbsp;Steven Kirshblum MD ,&nbsp;Ralph J. Marino MD ,&nbsp;Jayme O’Connor BS ,&nbsp;Arianny Ramirez BA ,&nbsp;Brittany Snider DO ,&nbsp;Lisa Spielman PhD ,&nbsp;Chung-Ying Tsai PhD","doi":"10.1016/j.apmr.2024.10.021","DOIUrl":"10.1016/j.apmr.2024.10.021","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a patient-reported outcome (PRO) survey measure of the motor, sensory, and anorectal components needed for classifying spinal cord injury (SCI) according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).</div></div><div><h3>Design</h3><div>Questionnaire development through an iterative process of review, feedback provision, and consensus revision incorporating 2 rounds of cognitive interviewing (CI).</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Individuals with SCI (N=34) who were English-speaking and aged ≥18 years were recruited nationally through social media and advertisements to complete CI. Purposive sampling was used to ensure participants with complete and incomplete injuries in 6 cohorts based upon neurological level of injury (C1-4, C5-6, C7-T1, T2-T6, T7-T12, and L1-S5) were enrolled.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Online Neurological Exam for Spinal Cord Injury (One-SCI).</div></div><div><h3>Results</h3><div>A group of SCI clinicians, a graphic artist, ISNCSCI experts, researchers with expertise in questionnaire development, cognitive interviewing, and statistics, and a person with SCI who has lived experience with SCI developed the initial One-SCI questionnaire. A CI script with predetermined verbal probing questions was developed, designed to assess language appropriateness, vocabulary, concept simplicity, grammar, question structure, visual aids, emotional and mental burden both in the instructions and in the questions and available responses. Participants completed an online or interview version of the survey during 2 rounds of CI. After each round, changes were made to the instructions, questions, responses, and graphics. The final survey has a minimum of 154 and a maximum of 210 items, depending on branching logic driven by previous answers.</div></div><div><h3>Conclusions</h3><div>One-SCI allows online or interviewer-administered self-report documentation of the motor and sensory components of a neurologic examination for classifying SCI. Developed using an in-depth CI process, it may allow remote assessments of the elements required by an individual trained to interpret ISNCSCI examination findings to determine neurological status and classify SCI when an in-person ISNCSCI examination is not obtainable.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1815-1820"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Archives I/EP Guidelines","authors":"","doi":"10.1016/S0003-9993(25)01019-6","DOIUrl":"10.1016/S0003-9993(25)01019-6","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1943-1945"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Assessment of Resilience in Individuals With Spinal Cord Injury and Chronic Pain: A Feasibility, Reliability, and Validity Study","authors":"Duygu Kuzu PhD,&nbsp;Anna L. Kratz PhD","doi":"10.1016/j.apmr.2025.04.022","DOIUrl":"10.1016/j.apmr.2025.04.022","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>This observational study examined the feasibility, between-person reliability, and convergent and discriminant validity of an </span>ecological momentary assessment (EMA) measure of resilience in individuals with </span>spinal cord injury (SCI) and chronic pain.</div></div><div><h3>Design</h3><div>Participants completed self-report assessments of resilience twice a day for 7 days using a 6-item EMA measure adapted from the SCI Quality of Life (QOL) Resilience Item Bank. Data were collected via a smartphone.</div></div><div><h3>Setting</h3><div>General community<strong>.</strong></div></div><div><h3>Participants</h3><div>Individuals with SCI and chronic pain (N=53; 54.7% men and 45.3% women).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Besides the 6-item EMA resilience measure, we included the full SCI-QOL Resilience Item Bank, the Connor-Davidson Resilience Scale, the Patient-Reported Outcomes Measurement Information System Depression Short Form, the SCI-QOL Anxiety Short Form, the National Institutes of Health Toolbox Perceived Stress Survey, the SCI-QOL Positive Affect and Well-Being Short Form, and the SCI-QOL Ability to Participate in Social Roles and Activities.</div></div><div><h3>Results</h3><div>Our results showed that the resilience EMA measure revealed high feasibility, with an overall response rate of 88%, and strong between-person reliability (&gt;0.90). The measure also demonstrated good convergent validity with related constructs, such as depression, anxiety, and social participation, and good discriminant validity with unrelated factors, like age and injury level.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that the EMA resilience measure is a reliable and valid tool for capturing the dynamic nature of resilience in real-time. Our study highlights the importance of the application of a real-time assessment, given that understanding daily functioning contributes to more person-centered rehabilitation interventions for individuals with SCI and chronic pain.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1866-1873"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Obesity and Cardiometabolic, Physical, and Psychosocial Health in Chronic Traumatic Spinal Cord Injury.","authors":"Jesse S Brenman, Arthur S Berg, Allen W Heinemann, Yuying Chen, Elizabeth R Felix, Gary J Farkas","doi":"10.1016/j.apmr.2025.11.018","DOIUrl":"10.1016/j.apmr.2025.11.018","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between obesity, defined using the spinal cord injury (SCI)-specific (>22 kg/m²) and the standard (≥30 kg/m²) body mass index (BMI) thresholds, and determine which index better discriminates against BMI-related cardiometabolic, physical, and psychosocial associations reported among the general population in chronic traumatic SCI (TSCI).</p><p><strong>Design: </strong>Multicenter cross-sectional study.</p><p><strong>Setting: </strong>Sixteen SCI Model System (SCIMS) sites.</p><p><strong>Participants: </strong>Adults with TSCI (n=1523, 78.7% men, age 45.7±15.9y, 56.7% tetraplegia, 8.5±10.5y post-SCI). Participants were stratified into groups based on BMI >22 (n=1123) and BMI ≥30 kg/m² (n=376), using available height and weight, follow-up data, and complete outcomes data from the 2016-2020 SCIMS database.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Prevalence and odds of self-reported cardiometabolic (diabetes, hypertension, and hyperlipidemia), physical (arthritis, pressure injuries [PI], urinary tract infections [UTI], falls, and rehospitalizations), and psychosocial (Patient Health Questionnaire-9, Resilience Short Form, Satisfaction with Life Scale, and Self-perceived Health [SPH]) measures.</p><p><strong>Results: </strong>Obesity prevalence was 73.7% using the SCI-specific threshold and 24.7% using the standard threshold. Individuals classified as obese by either definition had higher odds of diabetes, hypertension, and hyperlipidemia, with consistent findings across all neurologic impairment categories. Arthritis was more prevalent among individuals with than without obesity, but increased odds were observed only for those with a BMI ≥30 kg/m². UTIs and PI were more common among participants with a BMI >22 kg/m², whereas poorer SPH was associated with a BMI ≥30 kg/m². No significant associations with psychosocial outcomes were found using either threshold.</p><p><strong>Conclusions: </strong>The SCI-specific BMI classified more persons as obese than the standard threshold, yet both thresholds were associated with cardiometabolic risk. Patterns diverged for other outcomes (arthritis, SPH at ≥30), suggesting common obesity-health risk patterns may not generalize to SCI. These findings highlight the complexity of obesity in SCI, underscoring that despite BMI's common use, more accurate, clinically accessible measures are needed to improve risk identification.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Step Count and the Timed Up and Go and L Test of Functional Mobility Among Adults With Transtibial Amputation","authors":"Kyle R. Leister PhD, CPO ,&nbsp;Tiago V. Barreira PhD","doi":"10.1016/j.apmr.2025.04.007","DOIUrl":"10.1016/j.apmr.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the relationship between daily steps measured by the activPAL 3 and Fitbit Inspire 3 accelerometers and performance on the Timed Up and Go test (TUG) and L Test of Functional Mobility (L test) in adults with transtibial amputation.</div></div><div><h3>Design</h3><div>Observational design.</div></div><div><h3>Setting</h3><div>Six outpatient prosthetic clinics located in the United States and the participant’s home environment.</div></div><div><h3>Participants</h3><div>Adults (n=96) with unilateral transtibial amputation.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Each participant wore the activPAL and Fitbit concurrently for 7 days. Pearson correlation was used to assess the relationship between daily steps from each device and TUG and L test completion times. Regression was employed to control for sex, body mass index, age, and type 2 diabetes status.</div></div><div><h3>Results</h3><div>Moderate negative correlations were observed between daily steps recorded by the activPAL and TUG (<em>r</em>=−.52) and L test (<em>r</em>=−.51) times. Moderate negative correlations were also found between daily steps from the Fitbit Inspire 3 and TUG (<em>r</em>=−.55) and L test (<em>r</em>=−.56) times. These relationships remained statistically significant with minimal influence by the included covariates.</div></div><div><h3>Conclusions</h3><div>Participants who performed well on the TUG and L test tend to have higher daily step counts, highlighting a meaningful association between clinical mobility performance and free-living physical activity. This finding provides evidence that TUG and L test completion times may reflect both functional capacity in a clinical setting and real-world ambulatory behavior. Although step counts and clinical performance measures are not interchangeable, together they offer complementary insights that can enhance the evaluation and monitoring of mobility in individuals with transtibial amputation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1933-1936"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Impact of Intermittent Blood Flow Restriction Training and High-Load Resistance Training in Individuals With Patellofemoral Pain: A Randomized Controlled Trial","authors":"Weiya Kong PhD ,&nbsp;Ziru Wang PhD ,&nbsp;Qiang Zhou MS ,&nbsp;Xinyi Yan MS ,&nbsp;Jinyu Li MS ,&nbsp;Yangyang Zhao MS ,&nbsp;Xinran Wang BS ,&nbsp;Haonan Wang PhD ,&nbsp;Guoxin Ni PhD","doi":"10.1016/j.apmr.2025.06.003","DOIUrl":"10.1016/j.apmr.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness of intermittent blood flow restriction (iBFR) training with that of high-load resistance training in improving patellofemoral pain (PFP).</div></div><div><h3>Design</h3><div>Double-blind randomized trial.</div></div><div><h3>Setting</h3><div>A college rehabilitation center.</div></div><div><h3>Participants</h3><div>Individuals with PFP (N=42).</div></div><div><h3>Interventions</h3><div>Participants were randomly assigned to 2 groups: iBFR group and control group. iBFR group performed low-load resistance training at 30% of 1 RM under individualized limb occlusion pressure (LOP) at 80% of their individualized LOP. Control group engaged in high-load resistance training with a sham BFR at 70% of 1 RM, using a BFR cuff inflated to 20 mm Hg. Training sessions were conducted 3 times per week for 8 weeks, with follow-up assessments at 8 and 24 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>Pain and self-report function assessed at baseline, postintervention, and 24-week follow-up. Quadriceps muscle strength and thickness assessed at baseline and postintervention. All adverse events were recorded during the trial.</div></div><div><h3>Results</h3><div>Both iBFR and standard exercise resulted in significant improvements, but between-group comparisons indicated no conclusive difference in the primary outcomes [<em>P</em>=.163; mean difference, –8.75 (95% confidence interval, –21.18 to 3.69)]. Muscle strength and thickness increased similarly in both groups, with no significant differences observed. However, patients from the iBFR group had higher adherence and fewer adverse events, highlighting its safety and tolerability.</div></div><div><h3>Conclusions</h3><div>iBFR combined with low-load resistance training was found to be not statistically significant different from high-load resistance training in terms of pain relief and function improvement in PFP patients, with fewer adverse events, indicating that it may be a safer and more patient-friendly rehabilitation option that is sutiable for tailored treatment based on individual preferences and tolerance levels.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1789-1797"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Thoracic Spine Manual Therapy in Treating Subacromial Impingement Syndrome: A Systematic Review and Meta-analysis","authors":"Shiya Yu BS ,&nbsp;Shuqi Chen MSc ,&nbsp;Zhimo Yang MM ,&nbsp;Xixi Ma MSc ,&nbsp;Jielei Huang BS ,&nbsp;Lin Yang MD","doi":"10.1016/j.apmr.2025.07.008","DOIUrl":"10.1016/j.apmr.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effects of thoracic spine manual therapy (TSMT) in managing shoulder impingement syndrome (SIS) through a systematic review and meta-analysis.</div></div><div><h3>Data Sources</h3><div>Five databases (Medline, Embase, Web of science, Physiotherapy Evidence Database, and Cochrane Central) were searched from inception to October 2024.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials evaluating TSMT combined with other physiotherapy versus physiotherapy alone, or TSMT versus placebo, in individuals with SIS were included. Outcomes included pain, disability, and range of motion.</div></div><div><h3>Data Extraction</h3><div>Two authors independently performed data extraction, risk of bias assessment, and evidence quality evaluation.</div></div><div><h3>Data Synthesis</h3><div>A total of 10 randomized controlled trials involving 444 participants were included. Pooled mean difference and standardized mean difference (SMD) with 95% confidence interval (CI) were calculated. Four studies examined TSMT as an adjunct to exercise; 6 used placebo comparators. Pain was commonly assessed using Numeric Pain Rating Scale or Visual Analog Scale in 7 studies; disability was measured by Shoulder Pain And Disability Index or Disabilities of Arm, Shoulder, and Hand in 6 studies. High-quality evidence showed large effect size in favor of TSMT at short terms (2-6 wk after baseline) (SMD [95% CI]=−0.94 [−1.23 to −0.65]) and at intermediate-term (4-6 wk after intervention completion) (SMD [95% CI]=−0.83 [−1.26 to −0.40]) follow-up. Disability improved significantly at intermediate-term follow-up (SMD [95% CI]=−0.82 [−1.25 to −0.38]), supported by high-quality evidence. Subgroup analysis revealed that significant disability reduction in TSMT groups compared with placebo with a moderate effect size (SMD [95% CI]=−0.75 [−1.18 to −0.32]), supported by high-quality evidence. Furthermore, moderate evidence also supported improved internal rotation (SMD [95% CI]=0.61 [0.21-1.02]) and external rotation (SMD [95% CI] = 0.58 [0.17-1.00]).</div></div><div><h3>Conclusions</h3><div>The TSMT is effective in reducing pain, disability, and improving range of motion in individuals with SIS over short terms.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1886-1898"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect Size Guidelines for Individual and Group Differences in Physiotherapy","authors":"Grzegorz Zieliński PT, PhD, MBA","doi":"10.1016/j.apmr.2025.05.013","DOIUrl":"10.1016/j.apmr.2025.05.013","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the distribution of effect sizes in individual and group differences within physiotherapy to provide standardized estimates of effect sizes in the field.</div></div><div><h3>Design</h3><div>Meta-analysis of effect sizes extracted from published studies in physiotherapy.</div></div><div><h3>Setting</h3><div>Data were collected from 6 physiotherapy journals with the highest H-index.</div></div><div><h3>Participants</h3><div>A total of 111 meta-analyses (N=111) were analyzed, yielding 3374 extracted effect sizes.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Effect sizes were categorized as diagnostic methods, kinesiotherapy, manual therapy, and a group labeled \"laser therapy, magnetic therapy, electrotherapy, etc.\" Hedges’ <em>g</em> effect sizes were determined, and percentiles were calculated to establish thresholds for small, medium, and large effects.</div></div><div><h3>Results</h3><div>For individual differences (Pearson’s <em>r</em>), the 25th, 50th, and 75th percentiles were 0.33, 0.45, and 0.62, respectively. For group differences (Hedges’ <em>g</em>), these values were 0.13, 0.35, and 0.79, respectively. In kinesiotherapy, small, medium, and large effect sizes were determined as 0.1, 0.3, and 0.7, respectively. For physiotherapy diagnostics, the thresholds were 0.2, 0.5, and 1.0, respectively. For physical treatments such as laser therapy, magnetic therapy, and electrotherapy, the corresponding values were 0.1, 0.4, and 1.1. For manual therapy, the thresholds were 0.1 for small effects, 0.3 for medium effects, and 0.8 for large effects.</div></div><div><h3>Conclusions</h3><div>For individual differences (Pearson’s <em>r</em>), small, medium, and large effect sizes should be considered 0.3, 0.5, and 0.6, respectively. For group differences (Cohen's <em>d</em> or Hedges’ <em>g</em>), small, medium, and large effect sizes should correspond to 0.1, 0.4, and 0.8, respectively. These findings provide standardized effect size estimates for various physiotherapy interventions, aiding in the interpretation of research outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 12","pages":"Pages 1844-1849"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}