BACKGROUND:The World Confederation for Physical Therapy (WCPT), now World Physiotherapy, was founded in Copenhagen on September 8, 1951. Although its establishment is often portrayed as an inevitable consequence of post-Second World War international cooperation, recently examined archival material suggests a more complex history. PURPOSE:To reflect on the foundation of WCPT on its seventy-fifth anniversary and consider the lessons its formation offers the contemporary physiotherapy profession. KEY THEMES:International collaboration among physiotherapists long predated WCPT. While there was broad agreement that an international organization was needed, there was considerable disagreement regarding its structure, governance and representation. The creation of WCPT emerged through sustained negotiation between competing organizational models and professional traditions. The leadership of figures including Mildred Elson, Muriel Neilson and Andrѐ Nicolle was pivotal in navigating these differences and establishing an organization founded on cooperation rather than uniformity. CONCLUSIONS:The history of WCPT demonstrates that enduring international organizations are built through diplomacy, compromise and shared purpose rather than unanimous agreement. Seventy-five years later, the circumstances surrounding its foundation remain relevant to contemporary discussions of professional leadership, governance and international collaboration.
BACKGROUND:Clinical sensory testing comprises pragmatic, relatively low-cost bedside approaches for appraising somatosensory function. However, clinicians' perceptions of these approaches and the barriers they associate with their use in Italy are poorly characterized. OBJECTIVE:To describe self-reported perceptions of clinical sensory testing, preferred approaches to the assessment of different sensory modalities, and perceived barriers among Italian physicians and physiotherapists. METHODS:A cross-sectional web-based survey was conducted disseminating nationally through non-probability recruitment between January and August 2025. Eligible respondents self-identified as licensed physicians or physiotherapists practicing in Italy and reported at least partial involvement in assessment of musculoskeletal or neuromuscular conditions. Questionnaire comprised 18 mandatory closed-ended items covering professional characteristics, perceived barriers, conceptual/methodological perceptions, preferred sensory-assessment options, and perceived clinical applicability. Results were summarized separately by profession using frequencies and percentages. RESULTS:Four hundred and ninety-six complete questionnaires were analyzed (105 physicians, 391 physiotherapists). Time constraints were the most frequently selected barrier among physicians (90/105, 85.7%) and physiotherapists (302/391, 77.2%). A low-cost screening approach for somatosensory alterations was selected as the preferred CST definition by 69 physicians (65.7%) and 280 physiotherapists (71.6%). Small-fiber assessment was rated as "quite important" by 67 physicians (63.8%) and 214 physiotherapists (54.7%). For tactile, thermal, nociceptive, and vibratory assessment, respondents most often selected cotton swabs, warm/cold coins, toothpicks, and tuning forks, respectively, although the response distributions differed between the two samples. CONCLUSIONS:Respondents generally perceived clinical sensory testing as a low-cost and potentially useful approach, and time was the most frequently selected barrier. The findings describe perceptions and preferred response options rather than objective knowledge, verified professional competence, or actual CST use. They should not be interpreted as nationally representative estimates. Future studies should evaluate the validity, reliability, feasibility, and implementation of brief standardized CST approaches using more representative recruitment and direct measures of clinical behavior.
BACKGROUND:Performance-based assessments reflecting environmental walking demands remain limited in subacute stroke rehabilitation. OBJECTIVE:To evaluate the measurement properties of a 300-m Community-Based Walking Test (CBWT) designed to reflect environmental walking demands in individuals with subacute stroke. METHODS:We retrospectively analyzed prospectively collected clinical data from 26 ambulatory individuals with subacute stroke (13 men and 13 women; mean age, 56.8 years [range, 26-81 years]) who completed the CBWT in both forward and reverse directions during rehabilitation. Assessments were performed at baseline and weeks 1, 2, and 4. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC2,1), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman analysis. Responsiveness was assessed using standardized response mean (SRM) and effect size (ES), and convergent and longitudinal validity using Spearman correlations with gait, balance, and mobility measures. RESULTS:CBWT completion time demonstrated excellent test-retest reliability in both directions (ICC = 0.92-0.93; 95% CI = 0.83-0.96). SEM ranged from 30 to 31 s and MDC from 83 to 86 s. Four-week responsiveness was moderate to high (SRM = 0.91-1.01; ES = 0.53-0.55). CBWT completion time showed moderate to high correlations with gait speed (r = -0.70 to -0.84), walking endurance (r = -0.76 to -0.81), and mobility (r = 0.78-0.83). Variability was observed even among independently ambulatory participants. CONCLUSION:The present findings provide preliminary evidence supporting the measurement properties of the CBWT in individuals with subacute stroke. The CBWT may provide complementary clinical information regarding walking performance under structured environmental demands beyond conventional indoor gait assessments, which may support the evaluation of environmental walking adaptation and inform clinical judgment regarding community mobility during rehabilitation and discharge planning.
BACKGROUND:Clinical outcomes are shaped not only by patient characteristics and treatment interventions but also by the process through which care is delivered. These care process factors, the events, interactions, and structures that occur during the continuum of receiving care, remain under-recognized contributors to patient recovery. PURPOSE:This commentary examines key domains of care process factors and synthesizes emerging evidence on how these elements influence outcomes independent of the specific treatment provided. DISCUSSION AND RECOMMENDATIONS:We outline several major categories of care process factors: 1)timing/timeliness of care (early vs. delayed access); 2) point of entry (initial provider type); 3) care pathway design (triage models, referral structures); 4)insurance and payment models; and 5) continuity of care (consistent vs. fragmented clinician contact). Across these domains, research suggests that the process of care delivery can meaningfully shape patient expectations, engagement, and clinical trajectories, often with effects that are similar to well-designed, targeted treatments. CONCLUSION:Care process factors represent a critical but underappreciated layer of clinical practice and research. Understanding and optimizing these elements may enhance outcomes regardless of the treatment modality used. Future research should prioritize systematic evaluation of care processes to better integrate them into clinical decision-making and health system re-design.
BACKGROUND:Many shoulder patient-reported outcome measures (PROMs) rely on response categories that may be difficult to interpret in routine care. OBJECTIVE:To develop and validate the 12-item Shoulder Problems Assessment Scale (SPAS), an activity-based PROM that uses a hierarchical stepwise yes/no format to identify the first threshold of difficulty during daily activities. METHODS:The study used a multicenter design combining qualitative item development with psychometric testing. Items were generated from patient interviews, literature review, and clinician input, then refined through expert review. Pilot testing (n = 52) supported item refinement. Field testing (n = 415) was conducted at 12 outpatient physical therapy centers. The final SPAS includes 12 activity-based items, each with four ordered difficulty statements scored 4-0. For structural validation, exploratory factor analysis (EFA) and confirmatory factor analysis were performed in separate subsamples (n = 207 and n = 208), respectively. Internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficient (ICC(3,1))), convergent validity (Shoulder Pain and Disability Index (SPADI) correlations), and discriminative ability were evaluated using receiver operating characteristic analysis. Analyses followed COSMIN recommendations. RESULTS:The results of EFA indicated a three-factor structure (Joint Mobility, Functionality, Pain), accounting for 56.16% of the variance. The proposed three-factor structure demonstrated excellent model fit (χ2/df = 1.07, CFI = 0.999, TLI = 0.998, RMSEA = 0.021, SRMR = 0.056). Total-scale internal consistency was α = 0.834; test-retest reliability was excellent (ICC(3,1) = 0.913). The SPAS correlated strongly with SPADI (r = 0.790; p < .001). Discriminative ability was acceptable (area under the curve = 0.862). CONCLUSION:The SPAS is a 12-item, culturally relevant, activity-based shoulder PROM that uses a hierarchical yes/no response format to identify the activity level at which difficulty first occurs. It may support goal setting and follow-up in routine outpatient physiotherapy by assessing shoulder-related functional limitation.
BACKGROUND:Chronic low back pain (CLBP) is a heterogeneous condition, and some individuals may exhibit high levels of central sensitization (CS) symptoms. PURPOSE:This study aimed to compare pain, physical and cognitive functions, circadian rhythm characteristics, and psychosocial factors in individuals with CLBP with high and low CS symptoms, and asymptomatic controls. METHODS:This study included 45 participants. Individuals with CLBP were classified based on the Central Sensitization Inventory (CSI) scores: high-CSI and low-CSI.The high-CSI [age:45(37-54) years], low-CSI [age:50(39-59) years], and asymptomatic control group [age:44(28-52) years] each consisted of 15 individuals. Visual Analog Scale for pain intensity; an algometer for pressure pain threshold (PPT); an algometer and an ischemic cuff for conditioned pain modulation (CPM); Oswestry Disability Index for disability; Montreal Cognitive Assessment for cognitive function; Morningness-Eveningness Questionnaire for chronotype; Pittsburgh Sleep Quality Index for sleep quality; Epworth Sleepiness Scale for daytime sleepiness; Hospital Anxiety and Depression Scale for anxiety and depression; and Pain Self-Efficacy Questionnaire for pain self-efficacy were used. Independent samplest-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, and Fisher exact test were used for statistical analyses. RESULTS:Compared with the low-CSI group, the high-CSI group had higher rest, activity, and night pain intensity (p = .025, p = .004, and p = .012, respectively), lower PPTs at the thumbnail and low back (p = .043 and p = .012, respectively), lower CPM at the thumbnail (p = .035), higher physical disability (p = .032), and greater sleep disturbance (p = .001). Compared with the asymptomatic control group, the high-CSI group had shorter sleep duration (p = .007), greater sleep disturbance (p = .001), and poorer sleep quality (p = .009). CONCLUSION:Individuals with CLBP and high CS symptoms exhibit higher pain intensity, lower PPTs, reduced CPM, greater physical disability, and poorer sleep. By emphasizing the heterogeneity of CLBP and the clinical relevance of central sensitization symptoms, this study supports individualized and mechanism-informed rehabilitation planning.
BACKGROUND:Adolescent idiopathic scoliosis (AIS) is frequently accompanied by shoulder and scapular asymmetry. OBJECTIVE:The aim of this study was to investigate the effect of scapular stabilization exercises (SSE) combined with Schroth exercises on scoliosis severity, scapula position and shoulder imbalance in individuals with AIS. We hypothesized that this combined exercise protocol would significantly reduce scoliosis severity and improve both scapular positioning and shoulder balance. METHODS:Twenty-six individuals with AIS and Lenke Type 1 main thoracic curvature were included. Participants were recruited from a scoliosis rehabilitation clinic and randomly assigned to one of two groups: the Scapular Stabilization Exercises Group (SSEG) (n = 13) or the Schroth Exercises Group (SchEG) (n = 13). While both groups underwent a Schroth exercise program, the SSEG additionally performed SSE three times per week for eight weeks. Outcome measures assessed at baseline and post-intervention (Week 8) included Cobb angle (radiography), trunk rotation (scoliometer), scapular position (Lateral Scapular Slide Test, Scapular Index), periscapular muscle strength, and shoulder imbalance (radiographic/clinical assessments). RESULTS:At the end of the 8-week intervention, SSE combined with Schroth exercises were found to be more effective than Schroth exercises alone in reducing neck tilt (F = 4.701, p = .042, η2 = 0.183) and scapular angle (F = 7.165, p = .014, η2 = 0.254). Moreover, the SSEG demonstrated significant improvements from baseline across the majority of outcome measures at week 8 (p < .05). In contrast, in the SchEG, significant improvements were observed in thoracic trunk rotation, convex-side upper trapezius strength, and concave-side serratus anterior strength at the end of 8 weeks (p < .05). CONCLUSION:In individuals with AIS, SSE combined with Schroth exercises appear to be an effective way to reduce shoulder imbalance. However, the effectiveness of this combination on the Cobb angle and scapula position is limited. Studies with larger sample sizes and longer follow-up periods are needed.
INTRODUCTION:Bladder Pain Syndrome (BPS) is a chronic pelvic pain condition characterized by urinary symptoms, psychological distress, and reduced quality of life (QoL). Given its biopsychosocial nature, physiotherapy approaches targeting peripheral and central pain mechanisms may provide broader benefits than symptom-focused interventions. Objective: To investigate the effects of functional and conventional physiotherapy on symptom severity, pain-related and psychological outcomes, and QoL in women with BPS. METHODS:Twenty-eight women with BPS were randomly allocated to a functional program consisting of pain science education, cognition-targeted exercises, and relaxation exercises (n = 13) or a conventional program including transcutaneous electrical nerve stimulation (TENS) and pelvic floor stretching exercises (n = 15). Both interventions were delivered twice weekly for six weeks. Primary outcomes were symptom severity and pain intensity. Secondary outcomes included urinary symptoms, pain cognitions, pain-related disability, psychological symptoms, and QoL. RESULTS:Both groups improved in symptom severity and pain intensity, with no significant between-group differences for primary outcomes (all p > .05). In the functional group, symptom severity (Mean difference (MD) = 5.92, 95% CI: 2.61-9.24; p = .002; d = 1.08) and pain intensity (MD = 2.17, 95% CI: 0.77-3.56; p = .005; d = 0.94) decreased significantly. Significant improvements were observed in pain-related disability (p = .001; d = 1.18), pain catastrophizing (p = .004; d = 0.98), and pain self-efficacy (p = .003; d = 1.03). The conventional group showed improvements in pain-related disability (p = .049; d = 0.56) and energy/fatigue (p = .006; d = 0.84). A significant group × time interaction favored the functional group for social functioning (p = .027). CONCLUSION:Both approaches reduced symptom severity and pain intensity, while the functional program yielded broader improvements across pain-related, psychological and QoL domains. These findings support multidimensional, biopsychosocial rehabilitation in BPS management and warrant multicenter trials. CLINICAL TRIAL REGISTRATION:This trial was registered at ClinicalTrials.gov (NCT05155384).
INTRODUCTION:Rehabilitation following posterior cruciate ligament (PCL) reconstruction can be challenging because of improper muscle activation and excessive joint loading which could further delay graft healing. Aquatic therapy provides a buoyancy-assisted aquatic environment, where reduced effective body weight and joint loading may facilitate early functional recovery while minimizing stress on the reconstructed ligament. However, evidence regarding aquatic rehabilitation following PCL reconstruction remains limited. CASE DESCRIPTION:A 51-year-old woman presented for physiotherapy 4 weeks after arthroscopic reconstruction of right PCL avulsion injury. The patient reported knee pain, limited range of motion, trouble climbing stairs, walking and difficulties with functional activities. Clinical examination demonstrated quadriceps weakness, antalgic gait, reduced balance, and limited knee mobility. A structured 4-week rehabilitation program combining aquatic physiotherapy and land-based (given for first week only) was implemented 5 sessions per week. OUTCOMES:Following 4 weeks of rehabilitation, knee flexion ROM improved by 35° (41.2%) and full knee extension was restored. Lower-limb muscle strength increased across all muscle groups, with the greatest gain observed in quadriceps strength (75.8%). Dynamic balance improved substantially, with SEBT reach distances increasing by 22-25 cm (42-49%). Patient-reported outcomes demonstrated clinically meaningful improvement, with KOOS subscale scores increasing by 25-34 points, exceeding the established MCID of 8-10 points. These findings indicate substantial improvements in knee mobility, strength, balance, and function. CONCLUSION:Early integration of aquatic therapy following PCL reconstruction was a safe and effective adjunct to conventional physiotherapy rehabilitation. The supportive aquatic environment facilitated improvements in pain, mobility, muscle strength, balance, and functional outcomes while maintaining graft protection.
Physiotherapy has long resisted the forces that restructured manufacturing, journalism, and finance. This resistance is ending. Drawing on Gilles Deleuze's prescient analysis of societies of control, this paper argues that physiotherapy - along with the orthodox health professions more broadly - is entering a post-professional era characterized by the progressive marginalization of practitioners in the coordination and delivery of care. Three concurrent forces drive this transformation: the atomization of bodies and health into commodifiable fragments under late-stage capitalism; the systematic unbundling of professional claims to goodness and expertise from both political left and right; and digitally mediated technological disruption that promises efficiency gains while hollowing out professional jurisdiction. Yet Deleuze's framework, written before the internet and artificial intelligence, requires updating. The paper proposes that we are now witnessing the emergence of a "society of indifference" - a post-neoliberal formation in which predictive algorithms replace individual choice altogether, offering consumers the benefits of personalization without the burden of decision-making. Using the case of Flok Health, the UK's first AI physiotherapy clinic, the paper demonstrates how this shift threatens not merely physiotherapy tasks but physiotherapists' agency itself. When artificial intelligence can autonomously assess, diagnose, treat, and discharge patients with musculoskeletal conditions, what remains for human practitioners? More troublingly, if the disciplinary infrastructure that sustained professional physiotherapy is progressively dismantled, how will populations' rehabilitation needs be met when algorithms and personal choice prove insufficient? The paper concludes by considering how physiotherapy might respond - not by defending professional territory, but by identifying and sharing the "intensities" that have sustained physical therapy practices for millennia.
BACKGROUND:The gluteus maximus (GM) and multifidus (MF) play important roles in maintaining the stability and mobility of the lumbopelvic-hip complex during various activities. Variations in bridge and hip thrust exercises can affect muscle activity in the GM, MF, and biceps femoris (BF). PURPOSE:To investigate the exercise position that elicited the greatest GM activation, this study examined the muscle activity of the GM, MF, and BF, as well as the GM/BF and GM/MF ratios, across five modified bridge and hip thrust exercise conditions in healthy individuals. METHODS:Twenty healthy male individuals were enrolled in this study. An electromyographic device was used to assess the activity of the GM, MF, and BF muscles. Participants were asked to perform bridge exercises in a randomized order: conventional bridge exercise (BE), bridge exercise with elevated feet (BEEF), conventional hip thrust (HT), hip thrust with the feet placed on a balance cushion (HTFB), and hip thrust with the trunk placed on a balance cushion (HTTB). RESULTS:The muscle activity of the GM showed larger increases in BEEF, HT, HTFB, and HTTB than BE across the five conditions (padj <0.005). Furthermore, larger increases were observed in HT, HTFB, and HTTB than in BEEF, and HTTB showed higher activity than HT (padj <0.005). For the bilateral MF, increases in HT, HTFB, and HTTB were noted compared to BE, and higher muscle activity was observed in HT, HTFB, and HTTB compared to BEEF (padj <0.005). The GM/BF ratio showed a higher muscle activity ratio in HT, HTFB, and HTTB than in BE (padj <0.005). CONCLUSION:HTTB may promote GM activation with relatively lower BF involvement in healthy individuals. Exercise progression may be applied from BE to BEEF, HT, HTFB, and finally HTTB according to functional level.
BACKGROUND:Walking skills are negatively affected in people with Parkinson's disease (PwPD) when performing dual-tasks. However, the factors that contribute to this negative dual-task cost (DTC) remain unclear. PURPOSE:This study was planned to investigate the factors associated with the DTC of walking in PwPD. METHODS:Seventy-seven PwPD were included. Single task walking speed and dual-task walking speed were assessed with the 10-Meter Walking Test (10MWT). The following tests were used in the assessments: the Unified Parkinson's Disease Rating Scale (UPDRS) for clinical symptoms, the Single Leg Stance Test (SLST) for static balance, the Four-Square Step Test (FSST) for dynamic balance, the Trail Making Test (TMT) for attention, the Symbol Digit Modalities Test (SDMT) for processing speed, the Word List Generation Test (WLGT) for verbal fluency, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, the Falls Efficacy Scale-International (FES-I) for fear of falling, the Freezing of Gait Questionnaire (FOGQ) for freezing of gait, and the International Physical Activity Questionnaire (Short Form) (IPAQ-SF) for level of physical activity. RESULTS:Dual-task 10MWT scores of PwPD were significantly worse than single-task 10MWT scores (p < .001). Multiple linear regression analysis revealed that only SDMT (Β = -0.361, p < .001), dual-task 10MWT (Β = 0.294, p = .001), and TMT-B (Β = 0.338, p = .001) determined the DTC in PwPD. CONCLUSION:Dual-tasking has a negative impact on walking in PwPD and this DTC is associated with processing speed, dual-task walking speed and attention.
BACKGROUND:Following lumbar spinal fusion surgery (LSFS), some patients experienced a disruptive recovery, characterized by persistent pain, functional limitations, and difficulty resuming life. However, little is known about their preoperative experiences. OBJECTIVE:To explore the preoperative experiences of patients in disruptive recovery following LSFS. METHODS:A secondary analysis was performed on qualitative data aligned with the Standards for Reporting Qualitative Research. Participants from four UK surgery centers underwent two semi-structured interviews following LSFS and completed weekly diaries. Three recovery trajectories emerged from the first month's diaries: meaningful, progressive, and disruptive. Transcripts from the interviews with participants in disruptive recovery, conducted two weeks following LSFS, were analyzed using interpretative phenomenological analysis, focusing on their preoperative experiences. Two independent researchers defined themes through an iterative process. Collaborative analytical process and reflexive dialogs were used to enhance trustworthiness, with ideography maintained through constant data comparison and discussion. RESULTS:Seven themes were interpreted from eight participants. Patients' experiences while living with back problems captured in "compounded struggles" and "multidimensional effects of back problems." Their experiences with the treatment process and the factors influencing their decision to undergo surgery were described in "experiences in the treatment process" and "journey to surgery." Their experiences before surgery were identified in "understanding surgery: awareness and expectations," "psychological burden," and "preparation for surgery." CONCLUSIONS:Findings revealed complex patient challenges, diverse treatment interactions, long waits, multifactorial surgery decisions, with identified preoperative gaps, informing future research of patient needs to improve LSFS outcomes.
BACKGROUND:It is known that individuals with multiple sclerosis (MS) have lower levels of physical activity compared to the healthy population. Encouraging and continuous monitoring ofphysical activity through digital reminders can be beneficial in increasing physical activity levels. OBJECTIVE:The aim of this study was to investigate the effects of continuous monitoring of walking-based physical activity, supported by reminders using a messaging application, on physical activity level, psychological health, and quality of life. METHODS:Forty-two individuals with MS were randomly assigned to either experimental (EG = 22) or control (CG = 20) groups. The EG group was informed three times a week about the benefits of daily physical activity, then reminded to walk, and their daily step counts were recorded.The CG received a general briefing at baseline and then only recorded daily step counts. The outcomes were change in step count after 8 weeks of follow-up and International Physical Activity Questionnaire-Short Form (IPAQ), Beck Depression Inventory II (BDI), Beck Anxiety Inventory (BAI), and International Multiple Sclerosis Quality of Life Study (MSQoL-54). RESULTS:A significant difference was found between the IPAQ-Walking and IPAQ-Total groups (p = .042 and p = .010, respectively). In EG, IPAQ-Walking showed a significant increase with a large effect (p = .001, Cohen d = 0.843), while there was no difference in CG (p = .108). No significant difference was observed in BDI and BAI after the intervention (p > .05). In MSQoL-54, no significant difference was observed between groups in all subscales (p > .05). In EG, a significant change with moderate to large effect sizes was recorded in all subgroups (p < .05, Cohen d = 0.661-1.483). A significant group ×time interaction was shown for step counts (F = 192.63, p = .018). CONCLUSION:While improvements in psychological health and quality of life indicators did not differ significantly between groups, findings suggest that digital reminder-based apps arefeasible, accessible, and cost-effective option for supporting physical activity in MS.
OBJECTIVE:This study investigated the effects of myofascial release (MFR) on chest mobility, trunk impairment, and respiratory function in patients with chronic stroke. METHODS:In this randomized controlled trial, 20 participants with chronic stroke were assigned to either an MFR group (n = 10) receiving MFR plus inspiratory muscle training (IMT) or a stretching and diaphragmatic breathing (SDB) group (n = 10) receiving chest stretching, diaphragmatic breathing, and IMT three and two times per week, respectively, for 8 weeks. The primary outcome was chest mobility measured at the axillary, xiphisternal, and basal levels. Secondary outcomes included trunk impairment (Trunk Impairment Scale, TIS), inspiratory muscle strength, pulmonary function, and quality of life (SS-QoL). RESULTS:Significant group × time interactions were observed for xiphisternal chest mobility (estimate = 1.34 cm, 95% CI 0.24-2.43; Cohen's d = 1.15; p = .019), basal chest mobility (estimate = 1.33 cm, 95% CI 0.28-2.39; Cohen's d = 1.19; p = .016), and trunk impairment (estimate = 2.10 points, 95% CI 0.13-4.07; Cohen's d = 1.00;p = .038), favoring the MFR group. At the axillary level, both groups demonstrated significant improvements over time (p = .001), but no significant group × time interaction was observed (p = .098). MIP increased significantly in both groups over time (p = .001), with no between-group difference (p = .255). No significant between-group differences were observed for pulmonary function or SS-QoL outcomes (all p > .05). CONCLUSIONS:These preliminary findings suggest that eight weeks of MFR combined with IMT may improve lower chest mobility and reduce trunk impairment in patients with chronic stroke. MFR may be considered a potentially useful adjunct intervention to address thoracoabdominal mobility restrictions during stroke rehabilitation. Larger randomized controlled trials are needed to confirm these findings and determine their clinical significance.
INTRODUCTION:Physical activity engagement can improve wellbeing and social participation for individuals living with long-term neurological conditions. Student-led services enable healthcare access for those clinically underserved and increase student clinical opportunities. Furthermore, attendees become important facilitators of student learning. UMove is a free undergraduate physiotherapy student-led physical activity program aimed at improving wellbeing for people living with long-term neurological conditions. Its ongoing nature is unique for a physical activity program, with some attendees coming for over 12 years. Student experiences within physiotherapy student-led programs are well-documented, however, those of attendees, particularly those with long-term neurological conditions, remain underexplored. OBJECTIVE:The primary objective was to explore the experiences of long-term UMove attendees. Secondary objectives included identifying perceived benefits and barriers to participation, and evaluating whether and how UMove affected attendees' wellbeing. METHOD:Participants were 11 adults with a long-term neurological condition attending UMove for over one year. Employing Interpretive Description qualitative methodology, individualized interviews were semi-structured, audio-recorded, transcribed verbatim, and analyzed. Questions included experiences, reasons for joining, and perceived barriers and motivators to attendance. RESULTS:The key theme, "Valuing UMove," epitomized the value participants placed not only on this accessible program but their work with students. The flexible, tailored program met diverse and evolving needs of attendees ("Person-Centered Care"). Opportunities for social interaction with other attendees and students facilitated meaningful social connection and a sense of community, driving adherence and engagement ("Connection Conundrum" and Wise Participation). "Challenges and Improvements" highlighted improvements that could be made. CONCLUSION:Participants had positive experiences and valued the opportunities UMove provided them which went beyond physical activity to include socialization and supporting student learning.
BACKGROUND:Although the Timed Up and Go (TUG) test is frequently used in lumbar pathologies, its test - retest reliability, convergent validity, and measurement error have not yet been established in the postoperative period. OBJECTIVE:The purpose of this study was to comprehensively evaluate the test - retest reliability, convergent validity, andmeasure menterr or of the TUG test in individuals after lumbar spinal surgery. METHODS:A cross-sectional study was conducted with 100 individuals (mean age 55.0 ± 8.9 years; 48 women, 52 men) at least 6 weeks after lumbar spinal surgery. Participants performed the TUG, Five-Repetition Sit-to-Stand Test (5xSTS), and 10-Meter Walk Test (10MWT). The TUG was repeated after a 1-hour rest period. Test - retest reliability was evaluated using the intraclasss correlation coefficient (ICC2,1). Measurement error was evaluated using the standard error of measurement (SEM), the minimal detectable change at the 95% confidence level (MDC95), and the Bland - Altman limits of agreement (LoA). Convergent validity was assessed using the Pearson correlation coefficient with the 5xSTS and 10MWT. RESULTS:Excellent test - retest reliability was demonstrated (ICC2,1 = 0.99; 95% CI: 0.98-0.99). The SEM and MDC95were 0.26 seconds (s) and 0.72 s, respectively. The mean difference (bias) was -0.00 s (95% CI: -0.80 to 0.70), with lower and upper limits of agreement of -0.74 s (95% CI: -0.87 to -0.61) and 0.73 s (95% CI: 0.60 to 0.86), respectively. The TUG showed strong positive correlations with the 5xSTS (r = 0.95, p < .001) and the 10MWT (r = 0.92, p < .001). CONCLUSION:The TUG is a reliable and valid tool for measuring functional mobility in individuals after lumbar spinal surgery, providing objective data to complement subjective assessments.
BACKGROUND:Chronic low back pain (CLBP) frequently involves lifting as a pain-provoking activity. Pain-related cognitions, such as pain-related fear, pain catastrophizing, and pain self-efficacy, are suggested to influence lifting behavior. However, the longitudinal relationship between changes in lifting kinematics and pain-related cognitions within individuals remains unexplored. OBJECTIVE:To investigate longitudinal within-person relationships between changes in lifting kinematics and changes in pain-related cognitions in people with lifting-related CLBP. METHODS:Five adults (2 females, aged 26-47 years) with lifting-related CLBP participated in a single-case design study. Weekly assessments were conducted during a 4-6-week baseline period, a 12-week Cognitive Functional Therapy intervention (up to 10 sessions), and a 3-month follow-up. Sagittal plane lifting kinematics of the spine and lower extremities were measured using wearable sensors, and pain-related cognitions (pain-related fear, pain catastrophizing, pain self-efficacy) were assessed via online questionnaires. Cross-correlation analyses examined within-person relationships between changes in lifting kinematics and changes in pain-related cognitions. RESULTS:Relationships between changes in lifting kinematics and pain-related cognitions were individual-specific. Changes in lifting techniques were frequently associated with reduced pain-related fear (15/25 relationships, 60%) and pain catastrophizing (16/25 relationships, 64%), and occasionally with improved pain self-efficacy (12/25 relationships, 48%). Where relationships were observed, reduced pain-related fear and pain catastrophizing, along with improved pain self-efficacy, were usually (39/43 relationships, 91%) associated with increased trunk flexion and velocity, decreased knee flexion and velocity, and faster lifting speed. CONCLUSIONS:For individuals with lifting-related CLBP, reduced pain-related fear and pain catastrophizing, along with improved pain self-efficacy, often occurred alongside a transition from squat-like to more semi-squat or stoop-like lifting techniques, accompanied by faster movement speed.
