Abstract Peripheral facial palsy is the most common form of cranial nerve lesion. Currently, exercise therapy is not part of standard care in Germany. Existing systematic reviews on the effectiveness of exercise-based treatment do not currently distinguish between the different stages of recovery at which treatment begins, even though these might significantly influence treatment outcomes. The aim of this systematic review is to investigate the effectiveness of exercise therapy for the facial muscles specifically during the acute and subacute phases (up to six months after the onset of the condition). A systematic review was conducted. The literature search was performed in MEDLINE via PubMed, the Cochrane Library, and via Epistemonikos. Randomised trials were included that compared exercise therapy within the first 6 months of onset with standard care in adult patients with peripheral facial palsy, with regard to the severity of paralysis, the risk of synkinesis and disease-specific quality of life. The methodological quality of the studies was assessed using the revised Cochrane risk of bias tool for randomised trials (RoB 2). The assessment of the certainty of the evidence was based on the recommendations of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. 8 RCTs with a total of 590 participants were included. There is currently low certainty of evidence that facial muscle exercise therapy improves the severity of paralysis (4 out of 7 studies showed statistically significant improvements in favour of the intervention) and reduces the development of synkinesis (3 out of 5 studies showed a statistically significant lower number of synkinesis). The certainty of the evidence is limited by a high risk of bias in the included studies, a small sample size, limited comparability of the study populations, differences in the type and duration of the interventions, and incomplete reporting of outcomes. The results indicate the effectiveness of exercise-based treatment. However, further high-quality efficacy studies are needed to determine the extent of the effect and to derive recommendations regarding the type and dosage of exercise therapy. The study was prospectively registered on 23 April 2025 in the OSF Registry (osf.io) under the registration DOI: 10.17 605/OSF.IO/58SQJ.
Abstract Immobility in hospitalized patients is associated with increased morbidity and mortality. In early rehabilitation, device-assisted bedside training may enhance recovery and functional outcomes. To evaluate the feasibility, safety, and user-friendliness of a bedside training device in an early rehabilitation setting (non-neurological/neurosurgical, non-geriatric). In this single-center randomized pilot study, 20 patients were allocated to an intervention group (bedside training with THERA-Trainer bemo plus standard rehabilitation) or a control group (standard rehabilitation). Outcomes included usability (System Usability Scale, SUS), patient satisfaction, mobility (CHARMI), independence (Barthel Index), muscle strength and safety. The intervention was safe, no device-related adverse events occurred. Usability was rated high by patients (SUS 83.8) and therapists (78.8). Patient satisfaction reached 77.4/100. Bedside device-assisted training is feasible, safe, and well accepted in early rehabilitation. Larger confirmatory trials are needed to determine its clinical effectiveness.
Abstract Systematic reviews form a crucial foundation for evidence-based decision-making in healthcare, and consequently in physiotherapy. They are utilized for various purposes, including clinical decision-making, the planning and design of clinical trials, and guideline development. For users, it is essential that systematic reviews can be located quickly and easily, and that the retrieved reviews demonstrate high methodological quality. Only methodologically rigorous systematic reviews can provide trustworthy results. Methodological flaws introduce a risk of biased or inaccurate findings, which can ultimately lead to flawed healthcare decisions. The scientific literature has long highlighted problems with systematic reviews that undermine confidence in their results and, thus, question their utility. Although these problems have been widely documented, they appear to remain insufficiently recognized and addressed to date, including within the German-speaking region. In a German-language article published in November 2025, the authors of the present paper, together with colleagues, addressed these problems with systematic reviews and called for proactive measures to improve or resolve them. This article revisits the contents of that publication with a specific focus on physiotherapy. It is based on the closing lecture delivered at the Physiotherapy Research Symposium (Forschungssymposium Physiotherapie, FSPT) at Hochschule Bremen in November 2025 (Speaker: Cordula Braun).
Abstract Balance training is a core component of physiotherapy. Despite extensive research, education, practice, and guidelines continue to be dominated by the assumption of a general balance ability that can be improved through non-specific training and measured using standardized assessments. The empirical evidence consistently shows that training effects are largely task‑specific and concentrate on the trained demands, while transfer to other tasks remains limited. Building on this evidence, the present paper adopts a discursive-analytic perspective to reflect on how the notion of a general balance ability nevertheless remains professionally stable. It illustrates how standardized assessments, guidelines, and curricular frameworks promote particular interpretations of balance and become guiding-action in practice. Balance thus emerges not only as motor performance but as a normatively framed category of professional action. Finally, implications for assessment, training, and research are derived from a context-specific understanding of functional ability that aligns with the World Health Organization’s vision of healthy ageing.
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.
