Physical Therapy Outcomes Research Articles

Feasibility of Using Standardized Outcome Measures in the Remote Assessment of Patients with Chronic Stroke: A Case Series

Introduction: With the increase of telerehabilitation utilization worldwide after the COVID-19 pandemic, a review of the current literature shows a concurrent increase in telerehabilitation studies focusing on interventions and delivery models. There is a gap in research on valid and reliable tests and measures that can be used in the physical therapy examination of people with stroke via telerehabilitation. Current reports on psychometric properties of most standardized outcome measures are only applicable in an in-person setting and may not be directly applicable in a remote setting where various challenges contribute to the reliability of results. This report describes the feasibility of administering selected standardized outcome measures in the remote assessment of three patients with chronic stroke with different contexts. Methods: Three patients with chronic stroke underwent physical therapy examination and intervention sessions via telerehabilitation with varying contexts. Results: Various factors affected the results of the assessment including patient and caregiver’s (if present) ability to follow instructions, availability of material and spatial resources, and stability of internet connection. Strategies to improve reliability of assessment results can also be employed such as performing repeat trials, reviewing recordings for accuracy and confirmation, using highly visible markers, and confirming measurement accuracy on video. Discussion: Physical therapy outcome measures that can feasibly be administered remotely are the Timed Up and Go Test, the 10-Meter Walk Test, the 6-Minute Walk Test, the 5-Times Sit to Stand Test, and the Stroke Impact Scale. The Mini Balance Evaluation Systems Test could not be administered remotely as close to standard protocol as possible due to the difficulty of administering the reactive postural component with patient anxiety and safety considerations and materials required.

Evaluating the Effectiveness of Physical Therapy in Patients Post-Arthroscopic Partial Meniscectomy for Traumatic Meniscal Tears.

ABSTRACT Background: Meniscal tears are among the most common knee injuries, often resulting from sports-related activities or trauma. The menisci are vital for maintaining knee health and function, and a tear can lead to pain, swelling, and impaired mobility. Arthroscopic partial meniscectomy (APM) is a common surgical intervention aimed at alleviating symptoms by removing the damaged portion of the meniscus. Despite the benefits, postoperative challenges such as pain, reduced knee function, and prolonged recovery times are common, making rehabilitation a critical component of recovery. Objective: This study aims to evaluate the effectiveness of physical therapy in patients who have undergone APM for traumatic meniscal tears. The objective is to determine the impact of structured rehabilitation on pain levels, knee function, and overall quality of life compared to standard postoperative care without intensive physical therapy. Methods: A retrospective cross-sectional study was conducted with a sample size of under 50 participants from various private and public orthopedic clinics in Karachi. The study involved patients who had undergone APM and were assessed using the Visual Analog Scale (VAS) and Lysholm scoring scale. The exclusion criteria included patients with meniscal tears less than 10mm, non-traumatic meniscal tears, other knee surgeries, and pre-existing conditions that might interfere with physical therapy outcomes. Results: The average age of participants was approximately 36 years, with a mean body weight of 69 kg. Sports-related trauma was the leading cause of meniscal tears (41.9%), followed by accidents (34.9%) and age-related degeneration (23.3%). Physical therapy led to significant improvements in knee function, with 76.7% of participants reporting good functionality and 93% noting reduced pain and swelling. However, challenges such as difficulty with stair climbing (51.2%) and muscle soreness (27.9%) were also reported. Conclusion: Physical therapy plays a crucial role in the postoperative rehabilitation of patients following APM. The findings indicate that structured rehabilitation significantly improves functional outcomes, reduces pain, and enhances the quality of life. However, variability in patient outcomes suggests the need for further research to optimize rehabilitation protocols, considering individual factors such as the extent of the injury, pre-existing conditions, and patient adherence.

Dual‐Modal Stretchable Sensing Patches for In Situ Monitoring of Electromyography and Acoustic Myography

AbstractElectromyography (EMG) and acoustic myography (AMG) play crucial roles in assessing muscle function, providing valuable insights into neural control, muscle activation, and fatigue levels. However, the current landscape reveals a gap in dual‐modal stretchable sensing patches, highlighting the need for comfortable and wearable solutions in the field of in situ monitoring of synchronous EMG and AMG sensing. In this work, a dual‐modal stretchable patch (DMSP) is developed that fully integrates a multi‐channel EMG electrode with AMG sensors. It possesses stable electromechanical properties even at strains exceeding 200%. With an overall modulus of under 40 kPa and a skin adhesion force surpassing 30 N m−1, the DMSP exhibits exceptional durability, enduring 1000 stretching cycles. The DMSP enables in situ simultaneous monitoring of EMG and AMG signals from sternocleidomastoid muscle during neck rotation where the mechanical strain reaches up to 30%. The DMSP proves instrumental in characterizing muscle activity, facilitating in‐depth research on muscle movement, and thus enhancing clinical outcomes in rehabilitation medicine and physical therapy.

Disparities in Physical Therapy Outcomes Based on Race and Ethnicity: A Scoping Review.

This scoping review synthesizes and summarizes the evidence on racial and ethnic disparities in outcomes after physical therapist treatment. Four databases from 2001 through 2021 were searched for articles reporting physical therapy outcomes across racial and ethnic groups. The Arksey and O'Malley methodological framework was adapted for this scoping review. Two reviewers screened the abstracts, and 5 reviewers screened full texts for inclusion. Five reviewers extracted information including study design, diagnoses, setting, outcomes reported, the domains the outcomes measured, and racial and ethnic groups included. To identify disparities, summarized differences in outcomes (better, worse, no difference) for each racial and ethnic group compared to White patients were calculated. Of 1511 abstracts screened, 65 met inclusion criteria, 57 of which were observational designs. All 65 articles included non-Hispanic White patients as the reference group. A majority of the physical therapy outcomes reported by race were for Black patients and/or Hispanic or Latino patients, whereas outcomes for Asian, American Indian, Alaskan Native, and/or Native Hawaiians or Pacific Islander patients were reported infrequently. Most articles reported disparities in health outcomes for patients in the inpatient rehabilitation setting (n = 48) and for adults (n = 59) with neurologic diagnoses (n = 36). Compared to White patients, worse outcomes were reported more frequently for all marginalized racial and ethnic groups after physical therapy, with the exception of marginalized groups having the same or better outcomes for successful post-rehabilitation community discharge. Gaps remain in understanding outcome disparities beyond older adult and neurologic populations as well as for musculoskeletal diagnoses frequently treated by physical therapists. The presence of racial and ethnic disparities in physical therapy outcomes should motivate physical therapists to understand the mechanisms underlying disparities and focus on social and structural drivers of health inequity in their clinical decision-making.

Comparison of clinical and functional outcomes of physical therapy alone versus additional intraarticular injection of platelet rich plasma in treatment of frozen shoulder in Indian population

Background: Frozen shoulder (adhesive capsulitis) involves significant restriction of shoulder motion due to an inflammatory process and typically follows stages of pain, stiffness, and recovery over 2-3 years. This study explores the efficacy of platelet-rich plasma (PRP) injections, alongside conventional physiotherapy, as a non-operative treatment to enhance recovery in patients with adhesive capsulitis. Methods: This prospective, randomized, open, blinded, single-center clinical study involving 50 patients with adhesive capsulitis, comparing intra-articular PRP injections and physical therapy with physical therapy alone over 24 weeks. Primary outcomes were assessed using the shoulder pain and disability index (SPADI) and visual analog scale (VAS), with follow-ups at 6, 12, and 24 weeks to evaluate pain, function, and patient satisfaction. Results: In adhesive capsulitis (AC), intra-articular platelet-rich plasma (IA-PRP) injections with physical therapy (PT) provided superior pain relief, functional improvement, and higher treatment satisfaction after 24 weeks compared to PT alone. The IA-PRP group also showed better VAS scores and reduced acetaminophen use, indicating more effective pain management. Conclusions: In AC, IA-PRP injections showed greater pain relief and improved shoulder mobility compared to PT alone after 12 weeks. PRP's effectiveness highlights its potential, especially when corticosteroids are unsuitable, though longer-term studies are needed to confirm these results.

Anatomic Total Shoulder Arthroplasty Outcomes Were Not Negatively Affected by the COVID-19 Pandemic.

Objective To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Methods Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. Results The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; p = 0.008), external rotation (ER; 33.0° to 47.7°; p < 0.001), and internal rotation (IR; S1 to L4; p = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; p = 0.009), ER (32.9° to 42.0°; p = 0.037), and IR (S1 to L3; p = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; p = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; p = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Conclusion Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019.

Understanding social determinants of health and physical therapy outcomes in patients with low back pain: A scoping review.

Low back pain (LBP) is the number one cause of disability worldwide; however, it is not clear how social determinants of health (SDOH) impact care management and outcomes related to physical therapy (PT) services for patients with LBP. The purposes of this scoping review are to examine and assimilate the literature on how SDOH and PT care relate to non-specific LBP outcomes and identify gaps in the literature to target for future research. Data were extracted from eight electronic databases from January 2011 to February 2022. Reviewers independently screened all studies using the PRISMA extension for scoping review guidelines. Data related to study design, type of PT, type of non-specific LBP, patient demographics, PT intervention, SDOH, and PT outcomes were extracted from the articles. A total of 30,523 studies were screened, with 1961 articles undergoing full text review. Ultimately, 76 articles were identified for inclusion. Sex and age were the most frequent SDOH examined (88% and 78% respectively) followed by education level (18%). Approximately half of the studies that examined age, sex, and education level identified no effect on outcomes. The number of studies examining other factors was small and the types of outcomes evaluated were variable, which limited the ability to pool results. Sex and age were the most frequent SDOH examined followed by education level. Other factors were evaluated less frequently, making it difficult to draw conclusions. Study design and heterogeneity of determinants and outcomes were barriers to examining the potential impact on patients with LBP.

Bridging the gap: The need for physical therapy and patient-reported outcome measures in vaginoplasty recovery

Bridging the gap: The need for physical therapy and patient-reported outcome measures in vaginoplasty recovery

Cortical signals analysis to recognize intralimb mobility using modified RNN and various EEG quantities

Electroencephalogram (EEG) signals are critical in interpreting sensorimotor activities for predicting body movements. However, their efficacy in identifying intralimb movements, such as the dorsiflexion and plantar flexion of the foot, remains suboptimal. This study aims to explore whether various EEG signal quantities can effectively recognize intralimb movements to facilitate the development of Brain-Computer Interface (BCI) devices for foot rehabilitation. This research involved twenty-two healthy, right-handed participants. EEG data were collected using 21 electrodes positioned over the motor cortex, while two electromyography (EMG) electrodes recorded the onset of ankle joint movements. The study focused on analyzing slow cortical potential (SCP) and sensorimotor rhythms (SMR) in alpha and beta bands from the EEG. Five key features—fourth-order Autoregressive feature, variance, waveform length, standard deviation, and permutation entropy—were extracted. A modified Recurrent Neural Network (RNN) including Long Short-term Memory (LSTM) and Gated Recurrent Unit (GRU) algorithms was developed for movement recognition. These were compared against conventional machine learning algorithms, including nonlinear Support Vector Machine (SVM) and k Nearest Neighbourhood (kNN) classifiers. The performance of the proposed models was assessed using two data schemes: within-subject and across-subjects. The findings demonstrated that the GRU and LSTM models significantly outperformed traditional machine learning algorithms in recognizing different EEG signal quantities for intralimb movement. The study indicates that deep learning models, particularly GRU and LSTM, hold superior potential over standard machine learning techniques in identifying intralimb movements using EEG signals. Where the accuracies of LSTM for within and across subjects were 98.87 ± 1.80 % and 87.38 ± 0.86 % respectively. Whereas the accuracy of GRU within and across subjects were 99.18 ± 1.28 % and 86.44 ± 0.69 % respectively. This advancement could significantly benefit the development of BCI devices aimed at foot rehabilitation, suggesting a new avenue for enhancing physical therapy outcomes.

Comparative Analysis of Physical Therapy Outcomes in Acute Ischemic and Hemorrhagic Stroke Rehabilitation

Background: Stroke rehabilitation demands an effective therapeutic approach to enhance functional recovery. This study aims to compare the outcomes of physical therapy in patients with acute ischemic and hemorrhagic stroke using the Motor Relearning Programme (MRP). Methodology: Based on stroke type, confirmed via CT thirty-eight participants were stratified into ischemic &amp; hemorrhagic stroke group. Eligible participants were over 35 years old, had a Glasgow Coma Scale score above 5, and presented with hemiplegia. Exclusion criteria included trauma-induced hemorrhage, cerebellar or brainstem stroke, severe cognitive impairment, or pre-existing disabilities. The participants underwent a standardized four-week physiotherapy regimen based on the MRP, with assessments using the Motor Assessment Scale (MAS) and Functional Independence Measure (FIM) to evaluate the outcomes. Results: These results underscore the significant improvements in the functional outcomes observed in both ischemic and hemorrhagic stroke patients following physical therapy, with hemorrhagic stroke patients showing more substantial gains in both MAS and FIM scores. Conclusion: Our study contributes to a nuanced understanding of stroke rehabilitation, emphasizing that while both ischemic and hemorrhagic stroke patients significantly benefit from structured physical therapy interventions like MRP, the specifics of their recovery processes vary.

Pediatric Considerations in Pompe Disease: A Comprehensive Review

Pompe disease, also known as glycogen storage disease type II, is a rare inherited disorder caused by a deficiency of the enzyme acid alpha-glucosidase (GAA), leading to the accumulation of glycogen in various tissues, particularly muscles. While Pompe disease can affect individuals of all ages, its presentation and management in pediatric patients present unique challenges. This review aims to provide a comprehensive overview of the clinical manifestations, diagnosis, and management of Pompe disease in pediatric populations. Special considerations in the areas of respiratory support, nutrition, physical therapy, and long-term outcomes will be discussed. Understanding these aspects is crucial for optimizing the care and quality of life for children with Pompe disease

Impact of Weekday on Short-term Surgical Outcomes After Lumbar Fusion Surgery.

Retrospective cohort study. The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes. Timing of surgery has been implicated as a factor that may impact outcomes after spine surgery. Previous literature suggests that there may be an adverse effect to having surgery on the weekend. All patients ≥18 years who underwent primary lumbar spinal fusion from 2014 to 2020 were retrospectively identified. Patients were subdivided into an early subgroup (surgery between Monday and Wednesday) and a late subgroup (surgery between Thursday and Friday). Surgical outcome variables included inpatient complications, 90-day readmissions, and 1-year revisions. PT data from the first inpatient PT session included hours to PT session, AM-PAC Daily Activity or Basic Mobility scores, and total gait trial distance achieved. Of the 1239 patients identified, 839 had surgery between Monday and Wednesday and 400 had surgery between Thursday and Friday. Patients in the later surgery subgroup were more likely to experience a nonsurgical neurologic complication (3.08% vs. 0.86%, P =0.008); however, there was no difference in total complications. Patients in the early surgery subgroup had their first inpatient PT session earlier than patients in the late subgroup (15.7 vs. 18.9h, P <0.001). However, patients in the late subgroup achieved a farther total gait distance (98.2 vs. 75.4, P =0.011). Late surgery was a significant predictor of more hours of PT (est.=0.256, P =0.016) and longer length of stay (est.=2.277, P =0.001). There were no significant differences in readmission and revision rates. Patients who undergo surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. This analysis showed no adverse effect of later weekday surgery as it relates to total complications, readmissions, and reoperations. Level III.

Exploring how common factors influence experience and outcomes in painful musculoskeletal conditions: a qualitative study

Background/Aims In studies exploring the effectiveness of physical therapy treatment for painful musculoskeletal conditions, interventions appear to improve patient-reported outcomes. The interventions adopt different approaches, but there is a lack of agreement about which approach is most effective. Thus, research is needed to look at the potential influence of other variables present, such as common factors. Common factors are elements present across different treatments, which are necessary conditions for forming a therapeutic alliance and providing patient-centred care. While there is a positive relationship between common factors and patient outcomes noted in physical therapy, the mechanism through which these factors influence patient outcomes is less understood. The aim of this study was to explore participants' perceptions of the influence of common factors on physical therapy outcomes. Methods Interviews were undertaken with seven individuals participating in physical therapy. The contextual model provided the framework to move beyond defining common factors to discussing how these elements contribute to the therapeutic changes seen in physical therapy. Results Participants discussed how the therapeutic relationship is influenced by perceived trust and credibility, enhanced by goal setting, and individualised care. When these common factors are present, the potential for engaging in the work of physical therapy and enacting healthy behaviours and actions by patients were enhanced. Conclusions By understanding common factors in physical therapy, a more complete view of the effects of interventions may be possible. Implications for practice This study sheds light on the clinical impact of common factors in physical therapy, highlighting the pivotal role of therapeutic relationships built on trust, credibility, and individualized care. Recognizing and integrating these common factors into practice may enhance patient engagement and foster better therapeutic outcomes in musculoskeletal conditions.

What are patients' perspectives on the value of physical therapy? A prospective cohort study.

To assess and identify patients' perceptions about the overall value of physical therapy services for musculoskeletal conditions and how these values were associated with their outcomes. The association between the perceived value of physical therapy (as a score) and Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference and physical function at 6-weeks was assessed in a prospective cohort. Generalised linear models were used to identify relationships between the value of physical therapy score and PROMIS outcomes. Kendall's tau was used to identify correlations between responses and outcomes. A total of 133 participants met the final inclusion criteria. The majority of participants were female (63.9%) with a mean age of 55.53 (SD 15.36) years. A majority of participants (63.9%) reported a previous positive personal experience with physical therapy. There was no significant relationship between perceived value of physical therapy and pain interference (β -0.32, p=0.07, 95% CI-0.67, 0.03) or physical function (β 0.19, p=0.29, 95% CI-0.16, 0.54). Stronger beliefs in agreement with the value of non-invasive treatment were significant, but weakly correlated with lower pain interference (r=-0.18, p=0.048) and higher physical function scores (r=0.22, p=0.03). Participants had an overall positive perception of the value of physical therapy prior to initiating physical therapy, but this perception was not associated with 6-week pain and function outcomes. A better understanding of the driving factors encouraging patients to seek physical therapy services is needed to provide value-based care.

The role of patient treatment specific expectations on the outcomes of musculoskeletal physical therapy treatment: A scoping review

AbstractBackgroundIt is unknown how well patient treatment expectations are related to outcomes within musculoskeletal physical therapy. The purpose of this scoping review was to examine the association between patient treatment expectations and outcomes following physical therapy care for musculoskeletal injury and to identify gaps in the literature on this topic.Data SourcesPubMed, CINAHL Complete, PEDro, SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and PsycINFO were searched from January 2005. Concepts represented in the search included physical therapy, patient expectations, and patient outcomes, as well as their relevant synonyms.Data Extraction and SummaryA custom spreadsheet was used to chart demographic details, study design, and key findings from eligible studies. The critical appraisal skills programme (CASP) for cohort studies was used to determine reporting comprehensiveness and fit for inclusion into the review.ResultsTwelve (12) studies were included in this review representing 1855 patients across a variety of patients with musculoskeletal disorders. Studies were most commonly secondary analyses of controlled trials (n = 10) or controlled trials (n = 2) and yielded high CASP scores. A wide range of methods were used to determine patient expectations. The impact of patient treatment expectations was mixed, with some studies indicating a positive relationship between expectation fulfilment and improved outcomes, while others indicate no such relationship.ConclusionThe relationship between treatment expectations and outcomes within musculoskeletal physical therapy practice is not clear. Future studies with planned comparisons are needed to define appropriate methods to seek patient expectations and measure outcome differences between groups based on expectation fulfilment.

Development and pilot of equine facilitated physical therapy outcome measure tool for chronic low back pain patients

Equine Facilitated Physical Therapy (EFPT) lacks consistent documentation due to being an unconventional physical therapy treatment to chronic low back pain patients (LBP) and lacking rehabilitation outcome measure tools for a stable (equestrian) environment. The objectives were to develop an online evaluation tool as well as to define inter- and intra-rater reliability to validate the outcome measurement tool “Evaluation of maintaining sitting position (on a horse) and walking (short distances)” designed for LBP patients in EFPT”.A total of 48 movement related functions (n = 48), were derived from the International Classification of Functioning (ICF) and organized to an online evaluation tool. Depending on the state of validation two to six (2–6) raters scored randomized patient (n = 22) video material, recorded during a 12-week EFPT intervention, with the designed tool.Inter-rater agreement level between the experts reached good (α = 87) reliability for the scoring of the items and calculated per patient excellent (α = 100). Intra-rater reliability reached good (α = 87) and per patient good (α = 80) repeatability. For the healthy adults the reliability between raters reached acceptable (α = 72) levels and per rated excellent (α = 100). The developed assessment tool was found satisfactory to fulfil the requirement for the therapeutic practice.With the use of the tool physical therapist may detect postural changes for LBP patients as outcome report in EFPT. The tool may be used to identify treatment progress and to help design home exercises. The created tool will help to collect similar outcome measures from LBP patients in EFPT and to validate the treatment within industry.

An Exploration of Physical Therapy Outcomes and Psychometric Properties of the Patient-Specific Functional Scale Following an Interdisciplinary Pain Management Program.

The Patient-Specific Functional Scale (PSFS) has been used to assess physical functioning in various chronic pain populations. There is a lack evidence for its use with diverse pain populations who have high impact chronic pain (HICP). The primary aim of this study was to assess the psychometric properties of the PSFS with a heterogeneous sample of patients with HICP. A retrospective observational study of prospective functional outcomes collected before and after participation an intensive pain management program (IPMP): (PSFS, Disabilities of the Arm, Shoulder, and Hand; Lower Extremity Functional Scale; Neck Disability Index; Oswestry Disability Index), Multidimensional Patient Impression of Change, pain intensity, pain limitation, and fear avoidance from the charts of 509 IPMP completers. The reliability, validity, and responsiveness of the PSFS were analyzed using Cronbach's alpha, Pearson correlations, and receiver operating characteristic. Significant improvements were found for all outcomes following program participation (all p's <0.0001). Correlations of the PSFS with similar outcomes (convergent validity) were lower than expected (r's 0.16 - 0.33). A low correlation (r=-0.12) with an unrelated measure, fear-avoidance, supported divergent validity. PSFS change score correlations with similar outcome measures ranged from 0.46 to 0.53. The area under the curve values for the PSFS ranged from 0.801 to 0.857 suggesting a moderate ability for the PSFS to detect improvement. The psychometric properties of the PSFS showed mixed support for construct validity but good support for the responsiveness of the PSFS when used with a heterogeneous sample of patients with HICP.

Review of the Role of Biomechanical Research in Developing Rehabilitation Physiotherapy Programs for Patients with Coxarthrosis

modern biomechanical research has introduced innovative possibilities for crafting re-habilitation physiotherapy programs. These investigations are transforming conventional approaches&#x0D; in designing rehabilitation physiotherapy programs for coxarthrosis treatment, leading to enhancedpatient outcomes through pain reduction and improved quality of life. The objective of this study is to&#x0D; emphasize the contemporary application of biomechanical research in shaping rehabilitation phys-iotherapy programs for individuals with coxarthrosis. The following hypothesis is put forward within&#x0D; the framework of the raised issue: «Integration of biomechanical studies in the development of re-habilitation physiotherapy programs for patients with coxarthrosis will have a positive effect in the&#x0D; development of rehabilitation personal software techniques». The article anticipates the application ofsynthesis and analysis methods aimed at a comprehensive study of the role of biomechanical researchin the development of effective physiotherapy rehabilitation programs for patients. The analysis andsynthesis of scientific literature in the review article serve not only to summarize existing data but alsoto form a new level of understanding of the problem, which is an important step in improving clinicalpractice and developing new physiotherapy methods. Based on the specified methods, an analysis isbeing conducted to identify challenges in the implementation of biomechanical research methods andexplore potential solutions within the framework of monitoring the outcomes of physical therapy in thetreatment of coxarthrosis. Conclusion – examining the role of biomechanical research in rehabilitatingpatients with coxarthrosis is justified in terms of addressing the relevance of the issue and outlining thecontemporary need for effective treatment methods, increased objectivity and quality of rehabilitation,and the search for ways to improve the quality of life for patients. During this review, it was establishedthat biomechanical research of rehabilitation physiotherapy programs for coxarthrosis is an importantmethod for evaluating the effectiveness of these programs.

International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19

Objectives: The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19. Design: An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted. Setting: The study was conducted in adult intensive care units. Participants: A total of 309 physical therapists participated in the study. Interventions: A survey was used to determine current cardiopulmonary physical therapy practices in ICU. Results: Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning. Conclusion: This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.

Type, Timing, Frequency, and Durability of Outcome of Physical Therapy for Parkinson Disease

Parkinson disease (PD) is a neurodegenerative syndrome affecting approximately 1% of the population older than 60 years, and a major goal of treatment is preservation of physical function through physical therapy (PT). Although PT outcomes for PD are well documented, aggregate information on the parameters of PT are needed to guide implementation. To evaluate current evidence on the types, timing, frequency, duration, and outcomes of PT regimens applied for PD. PubMed, Embase, Medline, and the Web of Science Core Collection were searched for articles published from January 1, 2000, to August 10, 2022. Search terms included terms related to Parkinson disease, PT interventions, and PT-related outcomes. Included studies were peer-reviewed randomized clinical trials available in English of any PT intervention for patients with PD that included PT-related outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Two reviewers extracted data and assessed quality using the Cochrane Risk of Bias Tool. Data were analyzed using a random-effects model. A meta-analysis compared outcomes of nonstandard PT vs standard PT and standard PT vs no intervention for Unified Parkinson's Disease Rating Scale (UPDRS) score and measures of gait and balance. A total of 46 trials with 3905 patients were included (range of mean ages, 61-77 years). Ten trials (22%) compared 2 types of nonstandard PT interventions; 26 (57%), nonstandard PT vs standard PT; and 10 (22%), PT vs no intervention. The most common nonconventional PT intervention was aquatic physiotherapy (5 trials [11%]). Durations of PT regimen ranged from 2 to 12 weeks in 39 trials (85%), and PT was most commonly performed with frequencies of either twice or 3 times weekly (27 [59%]). In most trials (39 [85%]), PT session length ranged from 30 to 60 minutes. Across trials, PT outcomes were reported for gait (14 trials [30%]), balance (10 [22%]), quality of life (3 [9%]), and cognition (1 [2%]). Approximately half of the trials (22 [48%]) documented durability of some level of benefit after completion of the prescribed regimen. Meta-analysis showed no significant difference for PT vs no intervention in UPDRS scores (standardized mean difference [SMD], -1.09; 95% CI, -2.50 to 0.33) or for nonstandard PT vs standard PT in measures of gait (SMD, 0.03; 95% CI, -0.53 to 0.59), balance (SMD, 0.54; 95% CI, -0.03 to 1.12), and UPDRS score (SMD, -0.49; 95% CI, -1.04 to 0.06). Meta-analytic regression of moderators revealed no significant differences in outcomes by frequency of PT per week (SMD, 0.17; 95% CI, -0.03 to 0.36). The findings suggest that although a wide range of types and regimens of PT for PD have been tested, comparative effectiveness of different models of care and implementation strategies as well as long-term durability of their outcomes remain undetermined.