Abstract Telerehabilitation (TR) has emerged as a significant development in physiotherapy care. While research has examined physiotherapists’ perspectives on TR in Germany, patients’ experiences and views remain understudied. Previous research has primarily examined physiotherapists’ perspectives on TR; this study complements it by exploring the patients’ perspective, including satisfaction, barriers and facilitators. A qualitative study was conducted using individual and focus group interviews in 10 purposefully recruited patients with experience in TR-based physiotherapy. Data were analyzed using conventional content analysis, focusing on use patterns, satisfaction levels, and factors influencing TR adoption. Patients demonstrated high acceptance of TR, reporting positive experiences in establishing therapeutic relationships through digital means. Key facilitators included technical accessibility, professional digital platforms, and enhanced flexibility in care delivery. Primary barriers encompassed concerns about data security, technical infrastructure limitations, and preferences for hands-on treatment in specific conditions. A notable finding was that 7 out of 10 participants viewed TR as comparable to conventional therapy. Patients generally accept TR as a viable treatment option in German physiotherapy, particularly valuing its flexibility and integration into daily life.
Abstract Basic research constitutes an important foundation for knowledge development in physiotherapy science. The newly established section “Basic Research” of the DGPTW is guided by an empirical-analytical, explanation-based understanding of research that focuses on theory-driven modeling and the examination of causal relationships. Accordingly, it aims to understand the biological, biomechanical, neurophysiological, and psychological mechanisms underlying functional disorders and therapeutic interventions. Although basic research is highly relevant for the development and refinement of evidence-based therapeutic strategies, it has thus far received limited attention within the discourse of physiotherapy research. The section addresses this gap by supporting theory-driven research, creating interdisciplinary exchange, and improving the scientific visibility of physiotherapeutic perspectives in basic research contexts. Application domains such as pain management in physiotherapy or movement analysis illustrate the potential of mechanistic insights for advancing diagnostics, therapeutic interventions, and professional development. By integrating experimental and theoretical-conceptual approaches, basic research contributes to the advancement of evidence-based, individualized interventions and strengthens the scientific identity of physiotherapy within interprofessional discourse. In an increasingly complex and evidence-oriented healthcare system, basic science is therefore indispensable for a future-oriented, reflective, and effectiveness-driven practice of care, as it clarifies underlying mechanisms and refines diagnostic and therapeutic concepts, among other things; however, its findings only reveal their full relevance for clinical decision-making in close interaction with translational, interventional, and healthcare research.
A culturally sensitive, content-valid pilot version of the D-PECET for the systematic assessment of ethical competence among physiotherapists in Germany was developed using the process of good-practice translation and adaptation. The tool can be used for quality development and assurance within the profession, for evaluating educational content, and for making comparisons in the international context. In total, 24 adaptations were made in Parts A and B, including six cultural, eleven content-related, and seven stylistic. In Part B, two items were removed from the competency scale and a new item was added to the D-PECET. Quantitative content validation to assess the relevance of all 57 items in Part B on ethical competence yielded a high scalevalue (S-CVI) of 0.91. This result suggests that the scale has a very high content validity.
Abstract Physiotherapy in Germany is currently undergoing a process of professionalization. A critical element of this transition is the implementation of research findings into clinical practice. This process, frequently referred to as “second translation”, represents a primary focus of health services research. To develop a definition for “physiotherapy health services research”. In the first step, essential characteristics of health services research and physiotherapy are outlined. Based on this, the definition of physiotherapy health services research is derived. Physiotherapy health services research is engaged in the systematic evaluation of physiotherapy care structures, processes and outcomes in the context of the respective healthcare system. The systematic evaluation of innovations, their implementation and access matters are also considered. If physiotherapeutic interventions are the subject of research, physiotherapeutic expertise should be represented in the research team. The definition of physiotherapy health services research provides a foundation for identifying, planning and conducting research in this field. It promotes a common understanding and thus a well-founded national and international exchange as well as cooperation with other disciplines. The methods used in health services research must be further examined for their suitability for physiotherapy health services research and continuously developed. In addition, the definition developed must be reviewed at regular intervals to ensure its continued validity.
Abstract Pain Neuroscience Education (PNE) has established itself as a potential treatment for chronic pain. However, the evidence on the applicability of PNE in clinical practice for chronic pain syndromes such as migraine is limited. Investigation of the effectiveness of PNE in adults with migraine with regard to headache intensity, migraine and headache frequency and migraine-related impairments in activities of daily living. In this non-randomized hypothesis-generating pilot study, participants received PNE as a group intervention after an initial four-week control phase. Assessments took place before the control-phase, at baseline as well as 4 and 12 weeks after the intervention and were statistically analyzed. 14 participants were recruited. Headache intensity (NRS) decreased by a mean of 0.88 points after the intervention (median: 0.25; IQR: 1.63) and by 0.91 points during follow-up (median: 0,25; IQR: 1.38). Headache frequency decreased by 1.68 days after the intervention (median: 2; IQR: 4.5) and by 1.3 days during follow-up (median: 1; IQR: 2.5). Migraine days were reduced by 1.21 days both after the intervention and during follow-up (median: 1; IQR: 3.00; median: 1; IQR: 2.75). Anxiety, assessed using the total score of the Hospital Anxiety and Depression Scale (HADS-D/A), was reduced by 1.5 (median: 1.5; IQR: 3.5) after the intervention and by 2.07 (median: 3; IQR: 4) at follow-up. Depression, as assessed by the total score of the HADS-D/D, showed a mean difference of 1.33 (median: 0; IQR: 3) after the intervention and 1.46 (median: 1; IQR: 2) in the follow-up. Restrictions in activities of daily living (HIT-6) showed an improvement of 2.57 points after the intervention (median: 3; IQR: 5.75) and 4.69 points at follow-up (median: 4; IQR: 8). HDQ-G showed a post-intervention decrease of 8.79 points (median: 7; IQR: 6.25) and a follow-up decrease of 7.88 points (median: 5.5; IQR: 11.3). No adverse events were observed during the study. In adults with migraine, PNE leads to a clinically relevant improvement in anxiety and the restriction of activities of daily living, as well as to a moderate reduction in headache or migraine frequency and headache intensity. Further research is required to validate results. The study was registered with the German Register of Clinical Studies (DRKS00034262).
Background The ongoing digitalisation is creating new opportunities for physiotherapy, particularly through Exergames (digital movement games) to gamify therapy content. Objective The study aimed to evaluate the feasibility of training with the Nintendo Wii Fit Balance Board (NWBB) for improving balance and gait in lower limb amputees, compared to conventional exercise therapy. Method This randomised, controlled feasibility study was conducted as a monocentric, single-blind trial. Adults with unilateral leg amputation, prostheses and mobility level 2 or 3 (restricted and unrestricted outdoor walker) were included. Participants were randomly assigned to the intervention group (IG, NWBB therapy) or control group (CG, exercise therapy). Both groups trained 3 times per week for 30 minutes over 3 weeks in addition to standard therapy. Feasibility was assessed based on recruitment and dropout rates, adverse events, applicability of assessments and practicality of NWBB therapy. Data were analysed descriptively. Results Of 67 potential participants, 32 were included (recruitment rate: 47.8 %). Data for 12 participants (8 men, 4 women; average age 55 +/- 11.8 years) were analysed, with 6 per group. 37.5 % (n = 12) of participants dropped out prematurely, while 25 % (n = 8) were excluded retrospectively due to a randomisation error. Reasons for discontinuation were unrelated to the study context. No adverse events occurred, all assessments were completed and the NWBB intervention was implemented according to protocol without any complications. Conclusions Overall, it has been shown that training with the NWBB is feasible for the rehabilitation of lower limb amputees. As a simple and cost-effective posturography system, NWBB-based training may complement standard rehabilitation programs. This investigation used a study design that can be further developed with targeted adjustments in future studies. Further research involving larger and more homogeneous samples is required in order to evaluate the feasibility and effectiveness of exergaming in lower limb amputees.
Background Limited professional development opportunities are a common reason for physiotherapists to consider leaving the profession. The career entry phase already plays a critical role in the decision to stay or leave outpatient care. So far, specific developmental tasks for the career entry phase, which according to Havighurst's model [17] offer potential for development, have been insufficiently investigated. Objective To identify the perceived challenges faced by new entrants to the field of outpatient physical therapy in order to draw conclusions about the demands of starting a career and to identify career stage-specific development tasks that are relevant for individual professional growth. Method Socio-demographic questionnaires and semi- structured guided interviews were used to collect data. Physiotherapists were included if they had a maximum of 5 years of experience, worked exclusively in outpatient care with statutory health insurance license in Germany, and were employed at least 20 hours per week. The data analysis was carried out according to the content-structuring content analysis of Kuckartz and R & auml;diker [29]. Results 13 physical therapists were interviewed for the study. 4 development tasks were derived from a total of 14 identified requirement areas. These cover the areas of professional role, learning culture, interaction and structures. The developmental tasks identified were significant both for the novice physiotherapists who had been working in physiotherapy practice for a maximum of 2 years and for the physiotherapists who reflected their career entry. Conclusions Physiotherapists in outpatient care in Germany are confronted with a wide range of demands and therefore experience their career entry as challenging. However, overcoming these challenges individually also holds potential for subjectively meaningful development. At this point, further research should be conducted on the basis of the identified development tasks to find targeted interventions that support young professionals in coping with the four developmental tasks.
Background Physiotherapy in Germany is currently undergoing a process of professionalization. A critical element of this transition is the implementation of research findings into clinical practice. This process, frequently referred to as "second translation", represents a primary focus of health services research. Objective To develop a definition for "physiotherapy health services research". Method In the first step, essential characteristics of health services research and physiotherapy are outlined. Based on this, the definition of physiotherapy health services research is derived. Results Physiotherapy health services research is engaged in the systematic evaluation of physiotherapy care structures, processes and outcomes in the context of the respective healthcare system. The systematic evaluation of innovations, their implementation and access matters are also considered. If physiotherapeutic interventions are the subject of research, physiotherapeutic expertise should be represented in the research team. Conclusions The definition of physiotherapy health services research provides a foundation for identifying, planning and conducting research in this field. It promotes a common understanding and thus a well-founded national and international exchange as well as cooperation with other disciplines. The methods used in health services research must be further examined for their suitability for physiotherapy health services research and continuously developed. In addition, the definition developed must be reviewed at regular intervals to ensure its continued validity.
Basic research constitutes an important foundation for knowledge development in physiotherapy science. The newly established section "Basic Research" of the DGPTW is guided by an empirical-analytical, explanation-based understanding of research that focuses on theory-driven modeling and the examination of causal relationships. Accordingly, it aims to understand the biological, biomechanical, neurophysiological, and psychological mechanisms underlying functional disorders and therapeutic interventions. Although basic research is highly relevant for the development and refinement of evidence-based therapeutic strategies, it has thus far received limited attention within the discourse of physiotherapy research. The section addresses this gap by supporting theory-driven research, creating interdisciplinary exchange, and improving the scientific visibility of physiotherapeutic perspectives in basic research contexts. Application domains such as pain management in physiotherapy or movement analysis illustrate the potential of mechanistic insights for advancing diagnostics, therapeutic interventions, and professional development. By integrating experimental and theoretical-conceptual approaches, basic research contributes to the advancement of evidence-based, individualized interventions and strengthens the scientific identity of physiotherapy within interprofessional discourse. In an increasingly complex and evidence-oriented healthcare system, basic science is therefore indispensable for a future-oriented, reflective, and effectiveness-driven practice of care, as it clarifies underlying mechanisms and refines diagnostic and therapeutic concepts, among other things; however, its findings only reveal their full relevance for clinical decision-making in close interaction with translational, interventional, and healthcare research.
Background Pain Neuroscience Education (PNE) has established itself as a potential treatment for chronic pain. However, the evidence on the applicability of PNE in clinical practice for chronic pain syndromes such as migraine is limited.Aim Investigation of the effectiveness of PNE in adults with migraine with regard to headache intensity, migraine and headache frequency and migraine-related impairments in activities of daily living.Method In this non-randomized hypothesis-generating pilot study, participants received PNE as a group intervention after an initial four-week control phase. Assessments took place before the control-phase, at baseline as well as 4 and 12 weeks after the intervention and were statistically analyzed.Results 14 participants were recruited. Headache intensity (NRS) decreased by a mean of 0.88 points after the intervention (median: 0.25; IQR: 1.63) and by 0.91 points during follow-up (median: 0,25; IQR: 1.38). Headache frequency decreased by 1.68 days after the intervention (median: 2; IQR: 4.5) and by 1.3 days during follow-up (median: 1; IQR: 2.5). Migraine days were reduced by 1.21 days both after the intervention and during follow-up (median: 1; IQR: 3.00; median: 1; IQR: 2.75). Anxiety, assessed using the total score of the Hospital Anxiety and Depression Scale (HADS-D/A), was reduced by 1.5 (median: 1.5; IQR: 3.5) after the intervention and by 2.07 (median: 3; IQR: 4) at follow-up. Depression, as assessed by the total score of the HADS-D/D, showed a mean difference of 1.33 (median: 0; IQR: 3) after the intervention and 1.46 (median: 1; IQR: 2) in the follow-up. Restrictions in activities of daily living (HIT-6) showed an improvement of 2.57 points after the intervention (median: 3; IQR: 5.75) and 4.69 points at follow-up (median: 4; IQR: 8). HDQ-G showed a post-intervention decrease of 8.79 points (median: 7; IQR: 6.25) and a follow-up decrease of 7.88 points (median: 5.5; IQR: 11.3). No adverse events were observed during the study.Conclusions In adults with migraine, PNE leads to a clinically relevant improvement in anxiety and the restriction of activities of daily living, as well as to a moderate reduction in headache or migraine frequency and headache intensity. Further research is required to validate results.Registration The study was registered with the German Register of Clinical Studies (DRKS00034262).
Background Osteoarthritis is the most common degenerative joint disease worldwide and is also highly prevalent in Germany. Education and exercise therapy are recommended as first-line treatments in clinical practice guidelines to reduce pain and improve physical function. Physiotherapy can be complemented by mobile health apps that provide home exercise programs. However, it is unclear to what extent such applications are used for disease management. Aim To investigate the use of mobile health apps among individuals with hip and knee osteoarthritis in Germany. Method In a nationwide web-based survey conducted between July and August 2024, individuals with hip and knee osteoarthritis were asked about awareness and use of mobile health apps, particularly those specific for osteoarthritis, as well as potential reasons for non-use and other influencing factors. The data were analyzed descriptively using Microsoft Excel. Results A total of 88 individuals participated in the survey, of whom 68 were included in the analysis. The mean age of participants was 65.8 (+/- 8,7) years, and 85.3 % (58/68) were female. Most respondents (58/68, 85.3 %) were familiar with mobile health apps, and 41.2 % (28/68) had previously used at least one. Apps specifically developed for persons with osteoarthritis were less well known (31/68, 45.6 %). Nevertheless, 58,9 % (40/68) of respondents expressed interest to use exercise-based apps in the future, if recommended by healthcare professionals. The main barriers to mobile health app use were lack of personal contact and uncertainty about how to perform the exercises correctly. Conclusions Although there was a widespread interest among participants in using mobile health apps for osteoarthritis management, actual usage remained low. In order to integrate such applications more effectively into osteoarthritis management, healthcare professionals, in particular physicians and physiotherapists, should provide targeted education and recommendations. The use of mobile health apps can complement exercise therapy and encourage patients to take a more active role in managing their condition.
This reporting guideline was developed to address the gap in methodological reporting standards for trials investigating physical exercise or training in older adults, aiming to enhance the quality, transparency, and replicability of such research. The aim is to improve the reporting of key elements, including population characteristics, intervention components [e.g., Frequency, Intensity, Time, Type (FITT) principles, tailoring, use of technology], study design and methods (e.g., recruitment, randomization, statistical analysis), as well as study results, including outcomes and adherence measures. A six-stage process was used to develop this guideline. This included a three-round Delphi process involving experts from a large European network (COST Action PhysAgeNet), a comprehensive literature review of existing reporting guidelines, consensus meetings with international experts, and validation with journal editors who evaluated and refined the guideline. The final PETIO guideline includes an expanded checklist of items to report in the context of physical exercise interventions in older adults. Experts and editors agreed on essential items for improving quality, transparency, and replicability, such as intervention components (FITT) and setting, tailoring aspects, adverse events, and control group specifications. Notably, it was also emphasized that standardized reporting is critical for future meta-analyses and the implementation of future research protocols. The guideline is expected to support researchers, peer reviewers, and journal editors in improving the quality and transparency of research on physical exercise interventions in older adults. 2025 (original version). The guideline is freely accessible online in the supplemental material.
Since November 2024, various shoulder pathologies can be treated on the basis of a so-called “blank prescription” in Germany. This means that physiotherapists are free to choose the type of treatment and frequency. Suitable practice guidelines would be helpful to make this process more transparent and provide a decision-making corridor. Although guidelines from the Association of Scientific Medical Societies in Germany (AWMF) provide instructions regarding recommended and non-recommended interventions, they do not comment on the physiotherapy examination or the exact parameters for treatment. To evaluate the question: What recommendations can be made for the physiotherapy examination and treatment of patients with shoulder complaints? In order to create a basis for the development of a German-language physiotherapy practice guideline, a team of physiotherapists from the fields of clinical practice and science translated, summarized and commented on English-language practice guidelines on muscle-tendon-associated shoulder pain. Text passages and recommendations from literature were transferred into a joint document by at least 2 people per guideline, summarized in 4 consensus conferences and reviewed for the need for updates. Eight international guidelines were analyzed. The following objectives were identified for the medical history and physical examination: (1) recognition of red flags, (2) recognition of clinical patterns and differentiation of various shoulder pathologies, (3) assessment of impairment at the functional and participation level and (4) selection of initial treatment. The following physiotherapy goals were set for the treatment: (1) minimization of pain and reduction of acute signs of inflammation, (2) improvement of mobility, strength, stability and posture, (3) promotion of self-management, (4) reduction of psychosocial risk factors and promotion of participation. For these objectives, recommendations were derived from literature or, in the absence of information, a gap in evidence was pointed out. The results of this study present the current evidence on international practice guidelines as a basis for systematic reviews on the identified topics, which in turn enable the creation of a practice guideline.
Approximately 73 % of stroke patients have additional neglect symptoms. This impacts the re-acquisition of autonomy in activities of daily living. Therapy guidelines for neglect recommend occupational- and physiotherapeutic interventions. Bobath-Therapy focusses on sensorimotor integration for the process of motor learning and is frequently applied in occupational- and physiotherapy treatment of neurologic patients. Until now it is unknown whether guideline recommendations for neglect will be integrated into BTH and the Bobath-Concepts teaching. This research wants to find out whether I.: guideline recommendations for neglect treatment are integrated into Bobath-Therapy from the Bobath-tutors point of view, II.: Bobath-Therapy offers additional treatment options for neglect, III.: whether and which aspects of neglect treatment are taught in Basic-Bobath-Courses. An internet based mixed-methods survey was conducted among the German group of the International Bobath Instructor Training Association (IBITA) (n = 47). Sociodemographic and quantitative data were descriptively analysed, compared for feature-related representativity and evaluated with a-priori defined consensus according to “Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaften e. V.” Qualitative data was analysed with “thematic analysis” according to Braun and Clarke. 36 Data-Sets could be analysed. Ad-I: 4/6 goals and 5/7 methods reached > 75 % ( = consensus). 2 compensation-oriented goals reached > 50 % ( = majority agreement) and 2 visual neglect-focussed treatment-methods reached < 50 % ( = no majority agreement). Ad-II: The respondents stated additional BTH aspects for neglect: “enhancement of body schema and postural control” and “shaping of daily-life-oriented therapy onto neglect-related problems”. Ad-III: > 85 % of the respondents teach knowledge about neglect and guideline recommended methods in basic-Bobath-courses. This research discloses treatment foci of Bobath-Therapy for neglect: treatment of sensorimotor neglect and neglect-adapted shaping strategies for ADL-oriented treatment. Respondent Bobath-tutors evaluate Bobath-Therapy and Bobath-basic-course teaching as being adherent to guideline recommendations in many aspects. The results may serve as foundation of evaluating knowledge and competencies of basic-Bobath-course participants.
