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Latest & greatest articles for physical therapy
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on physical therapy or other clinical topics then use Trip today.
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Benefits of Musculoskeletal PhysicalTherapy in Emergency Departments: A Systematic Review Over the past few decades, physical therapists have emerged as key health care providers in emergency departments (EDs), especially for patients with musculoskeletal disorders (MSKD).The purpose of this review was to update the current evidence regarding physical therapist care for patients with MSKD in EDs and to update current recommendations for these models of care.Systematic searches were conducted (...) in 5 bibliographic databases.The studies selected presented quantitative data related to the care of patients with MSKD by physical therapists in an ED setting.Raters reviewed studies and used the Effective Public Health Practice Project Quality Assessment Tool to assess their methodological quality.Fifteen studies were included. Two studies, 1 of weak and 1 of strong quality, demonstrated that physical therapist care in EDs was as effective as or more effective than usual medical care for pain
Effect of a Multicomponent Home-Based PhysicalTherapy Intervention on Ambulation After Hip Fracture in Older Adults: The CAP Randomized Clinical Trial. Disability persists after hip fracture in older persons. Current rehabilitation may not be sufficient to restore ability to walk in the community.To compare a multicomponent home-based physicaltherapy intervention (training) with an active control on ability to walk in the community.Parallel, 2-group randomized clinical trial conducted at 3 US (...) , control: 0), urinary tract infection (training: 2, control: 0), dehydration (training: 0, control: 2), and dyspnea (training: 0, control: 2).Among older adults with a hip fracture, a multicomponent home-based physicaltherapy intervention compared with an active control that included transcutaneous electrical nerve stimulation and active range-of-motion exercises did not result in a statistically significant improvement in the ability to walk 300 m or more in 6 minutes after 16
The dose of physical activity to minimise functional decline in older general medical patients receiving 24-hr acute care: A systematic scoping review To identify evidence for a recommended and feasible activity dose to minimise functional decline in older hospitalised general medical patients.Quality 24-hr care of older patients involves balancing activity to minimise functional decline, with rest to aid recovery. However, there is limited guidance regarding an optimal type and dose (...) were included. Study contexts were general medical wards (n = 11, 73.3%), Acute care of the elderly unit (n = 3, 20%) and a nursing unit (n = 1, 6.7%) located in tertiary referral acute hospitals. Most participants were aged 75-84 years (n = 10, 66%), had variable medical diagnoses and samples were either physically capable (n = 4, 26.7%) of limited physical capability (n = 1, 6.7%) or of mixed capability to mobilise independently (n = 10, 66.7%). Walking at least twice a day for approximately 20
PhysicalTherapy on Postoperative Day Zero Following Total Knee Arthroplasty: A Randomized, Controlled Trial of 394 Patients Surgeons have increasingly emphasized early mobilization as a way to facilitate discharge following total knee arthroplasty (TKA). The purpose of this study was to determine whether starting formal physicaltherapy (PT) the afternoon of postoperative day (POD) 0, instead of starting PT the morning of POD 1, could shorten hospital length of stay (LOS).Patients undergoing
2018 John N. Insall Award: Recovery of Knee Flexion With Unsupervised Home Exercise Is Not Inferior to Outpatient PhysicalTherapy After TKA: A Randomized Trial Concerns about the cost and convenience of postsurgical physicaltherapy (PT) have sparked interest in unsupervised, home-based rehabilitation. However, the effectiveness of unsupervised home exercise after primary TKA has not been previously evaluated.(1) Can unsupervised home exercise after surgery provide noninferior recovery
programs after TKR and to explore heterogeneity of treatment effects.Three-arm single-blind randomized clinical trial (January 7, 2015, to November 9, 2017) using an intent-to-treat approach with follow-ups at 3 months and 6 months. The setting was Allegheny County, Pennsylvania (an outpatient physicaltherapy clinic and 4 community centers). Participants had primary TKR performed more than 2 months previously, were 60 years or older, experienced moderate functional limitations, and were medically (...) Effectiveness of Later-Stage Exercise Programs vs Usual Medical Care on Physical Function and Activity After Total Knee Replacement: A Randomized Clinical Trial Several functional limitations persist after total knee replacement (TKR). Intensive exercise programs could resolve these limitations but are not well tolerated by many patients until a later stage (>2 months) after surgery. Evidence for exercise at a later stage after TKR is limited.To compare the effectiveness of later-stage exercise
The comparative efficacy of theta burst stimulation or functional electrical stimulation when combined with physicaltherapy after stroke: a randomized controlled trial To study the long-term effectiveness of Theta Burst Stimulation (TBS) or Functional Electrical Stimulation (FES) combined with Physicaltherapy (PT) as compared to PT alone for improving arm functions in patients with acute stroke.Single blind randomized controlled trial.Outpatient clinics and inpatient wards at tertiary care (...) neurology center.Adult patients with acute middle cerebral artery territory ischemic stroke.60 patients were randomized into three groups of 20 each: TBS+PT; FES+PT; and PT alone. TBS group received intermittent TBS of ipsilesional hemisphere and continuous TBS of contralesional hemisphere while FES group received FES of paretic limb, both for four weeks. All groups received supervised physicaltherapy for four weeks followed by home physiotherapy for one year.Fugl Meyer Assessment upper limb score (FMA
Psychological therapies for anxiety and depression in children and adolescents with long-term physical conditions. Long-term physical conditions affect 10% to 12% of children and adolescents worldwide. These individuals are at greater risk of developing psychological problems, particularly anxiety and depression, sometimes directly related to their illness or medical care (e.g. health-related anxiety). There is limited evidence regarding the effectiveness of psychological therapies for treating (...) anxiety and depression in this population. Therapies designed for children and adolescents without medical issues may or may not be appropriate for use with those who have long-term physical conditions.This review was undertaken to assess the effectiveness and acceptability of psychological therapies in comparison with controls (treatment-as-usual, waiting list, attention placebo, psychological placebo, or non-psychological treatment) for treating anxiety and depression in children and adolescents
Effect of Early Surgery vs PhysicalTherapy on Knee Function Among Patients With Nonobstructive Meniscal Tears: The ESCAPE Randomized Clinical Trial. Despite recent studies suggesting arthroscopic partial meniscectomy (APM) is not more effective than physicaltherapy (PT), the procedure is still frequently performed in patients with meniscal tears.To assess whether PT is noninferior to APM for improving patient-reported knee function in patients with meniscal tears.Noninferiority, multicenter (...) to APM (n = 159) or a predefined PT protocol (n = 162). The PT protocol consisted of 16 sessions of exercise therapy over 8 weeks focused on coordination and closed kinetic chain strength exercises.The primary outcome was change in patient-reported knee function on the International Knee Documentation Committee Subjective Knee Form (range, 0 to 100; from worse to best) from baseline over a 24-month follow-up period. The noninferiority margin was defined as a difference between treatment groups of 8
Effectiveness and Downstream Healthcare Utilization for Patients That Received Early PhysicalTherapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial Randomized controlled trial.The aim of this study was to compare early physicaltherapy versus usual care in patients with low back pain.Early physicaltherapy (PT) has been associated with reduced downstream healthcare utilization in retrospective studies, but not investigated prospectively in the military health system.Military (...) service members seeking care from a general practitioner were recruited. Patients attended a 20-minute self-management class with focus on psychosocial resilience and then randomized to usual care only (UC) versus immediately starting a 3-week physicaltherapy program (PT). Primary outcome was the Oswestry Disability Index at 1 year. Secondary outcomes included Oswestry scores at 4- and 12-week follow-up, numeric pain rating scale, global rating of change, and healthcare utilization at 1 year
Clinical and ultrasound remission after 6 months of treat-to-target therapy in early rheumatoid arthritis: associations to future good radiographic and physical outcomes To explore associations between remission, based on clinical and ultrasound definitions, and future good radiographic and physical outcome in early rheumatoid arthritis (RA).Newly diagnosed patients with RA followed a treat-to-target strategy incorporating ultrasound information in the Aiming for Remission in rheumatoid (...) were defined: no radiographic progression and good outcome (no radiographic progression+physical function≥general population median), both sustained 12-24 months. We calculated the ORs of these outcomes for the remission definitions.Of 103 patients, 42%-82% reached remission at 6 months, dependent on definition. Seventy-one per cent of patients had no radiographic progression and 37% had good outcome. An association between 6-month remission and no radiographic progression was observed for ACR
Cost-effectiveness of internet-based cognitiveâ€“behavioural therapy and physical exercise for depression Both internet-based cognitive-behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.To determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.Economic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use (...) questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.The primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76
The impact of implementing a fall prevention educational session for communityâ€dwelling physicaltherapy patients The aim of this study was to evaluate the impact of a fall prevention educational session on fall risk knowledge, use of fall prevention interventions and the number of falls in community-dwelling older persons attending physical therapy.This pilot study used a mixed method design consisting of a quantitative pretest-posttest quasi-experimental design followed by a qualitative (...) and subsequent evaluation. An increase in fall risk knowledge (p = 0.031) and implementation of fall prevention techniques was noted. One fall was sustained 60 days after therapy discharge.
Ethics reporting practices in randomized controlled trials of physicaltherapy interventions after stroke Adequate reporting of ethics-related research methods promotes convergence on best ethics practices. In physicaltherapy, studies on ethics reporting are limited to few aspects, and none focuses on stroke research. Our objectives were to investigate the reporting of multiple ethics-related features and its variation over time, and the characteristics of the studies associated with ethics (...) reporting in Randomized Controlled Trials (RCTs) of physicaltherapy interventions after stroke.A random sample of RCTs published in the years 2004, 2009 and 2014, was extracted from the PubMed database, regardless of the publishing journal. For each trial we investigated year of publication, trial registration, sample size, stroke subtype, phase of the disease, setting, interventions and dosing, outcome measures, outcome of the study, PEDro score and 5-year impact factor of the publishing journal
Caregiver-Provided PhysicalTherapy Home Programs for Children with Motor Delay: A Scoping Review Caregiver-provided physicaltherapy home programs (PTHP) play an important role in enhancing motor outcomes in pediatric patient populations.This scoping review systematically mapped clinical trials of caregiver-provided PTHP that were aimed at enhancing motor outcomes in children who have or who are at risk for motor delay, with the purpose of (1) describing trial characteristics; (2) assessing
Minimally Displaced, Isolated Radial Head and Neck Fractures Do Not Require Formal PhysicalTherapy: Results of a Prospective Randomized Trial Nondisplaced and minimally displaced fractures of the radial head and neck are common injuries, yet the role of physicaltherapy (PT) in their treatment is unclear. The aim of this trial was to assess the need for formal PT following a simple fracture of the radial head or neck.Patients who had a nondisplaced or minimally displaced fracture of the radial