Search Results (55)

Background/Objectives: A state-wide survey was conducted in Florida to evaluate skill in manual and manipulative therapy as a therapeutic intervention, explore its use in the field of physical therapy, and understand how physical therapists quantify skill to aid in creating a definition of what comprises manual and manipulative skills. A survey was developed utilizing the Delphi approach, which was entered into an electronic survey platform and distributed via email to physical therapists licensed in the state of Florida. Questions of the survey addressed the physical therapists’ demographics, education, training, use of MT, and Likert scales to quantify physical therapists’ perspectives on characteristics contributing to MT skills and how various characteristics contribute to skills in manual and manipulative therapies. Results: The response rate was 1.6% (307/19,523). Ninety-four percent of participants had more than 10 years of experience in physical therapy, and all respondents had at least 1 year of experience. Participants were 59.3% female and 40.7% male, with a mean age of 48 years (SD = 12.7). No association between gender and use of manual therapy was found (p = 0.44). Of respondents, 33.3% said they use manual and manipulative therapy on every patient, and 38.1% said they use it at least once a day. The most common specialty board certification that respondents held was in orthopedics. Among participants who believe that skill in manual and manipulative therapy is measurable, a Pearson’s correlation showed the following factors as key contributors of “skill” in manual therapy: therapeutic alliance, therapeutic touch, the ability to differentiate subtle nuances between grades I–IV, and adherence to evidence-based practice. Conclusions: The definition of skill found in this study could be used in future studies to determine how skilled MT interventions can influence patient outcomes. Future research should be conducted to discover how these aspects of manual and manipulative therapy can impact intervention results in patient care and how these definitions may influence physical therapy education. Full article

Multisystemic Therapy (MST) is an intensive family and community-based treatment targeting antisocial behaviours in adolescents. Treatment fidelity has proved crucial for successful implementation of the MST intervention, with prior research demonstrating a strong association with positive and enduring treatment outcomes. The Therapist Adherence Measure (TAM) is a standardised measure reported by caregivers and comprised of 28 items based on the nine treatment principles of MST. Several randomised control trials have confirmed that therapist adherence to the MST model is a valid predictor for a reduction of antisocial behaviours in adolescents. However, there is limited understanding of mechanisms by which therapist model adherence is related to positive changes in family relations and association with decreased adolescent behavioural problems. In this retrospective study, we evaluated effects of therapist adherence on changes in parental factors (e.g., parental mental well-being, monitoring and discipline approach) which in turn were associated with decreased behavioural problems in adolescents. We extracted data collected from 186 families engaged with the MST research program operating within the Western Australian Child and Adolescent Mental Health Service (CAMHS) during 2018–2024. Data for TAMs were collected monthly during treatment, and family outcome measures were collected at pre-treatment and post-treatment. The finding highlights the importance of therapists maintaining treatment fidelity and addressing treatment barriers throughout MST intervention to ensure the desired therapeutic outcomes. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Background/Objectives: Robot-led rehabilitative exercise offers a promising avenue to enhance the care provided by exercise specialists (ESs). ESs, such as physical and occupational therapists, prescribe exercise regimens to clinical populations to improve patients’ adherence to prescribed exercises outside the clinic, such as at home. Collaborative efforts among roboticists, clinical ESs, and patients are essential for developing interactive, personalized exercise systems that meet each stakeholder’s needs. This work builds upon research involving individuals with Parkinson’s disease (PD) that evaluated a robotic rehabilitative exercise system designed to address strength and flexibility deficits. Methods: To complement the findings of our previous work in people with PD (PWP), we conducted a pilot user study in which 11 ESs evaluated a novel robot-led exercise system for PWP, focusing on perceptions of the system’s efficacy and acceptance. Utilizing a mixed-methods approach, including technology acceptance questionnaires, task load questionnaires, and inductively coded semi-structured interviews, we gathered comprehensive insights into ES perspectives and experiences after interacting with the system. Results: Findings reveal a broadly positive reception, which highlights the system’s capacity to augment traditional rehabilitative exercise for PD, enhance patient engagement, and ensure consistent exercise support. We also identified two key areas for improvement: incorporating more human-like feedback systems and increasing the robot’s ease of use. Conclusion: This research emphasizes the value of incorporating robotic assistants into rehabilitative exercise for PD, offering insights that can guide the development of more effective and user-friendly rehabilitation technologies. Full article

Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT. Full article

Background/Objectives: Occupational therapy (OT) plays a crucial role in addressing functional limitations and promoting independence in Parkinson’s disease (PD) patients. OT interventions target motor skills, daily activities, and engagement in meaningful tasks. Telehealth, the remote delivery of healthcare services, has expanded access to rehabilitation, including OT for PD. While several studies have examined the benefits of online OT, a comprehensive assessment of its impact on functional outcomes and quality of life (QoL) is needed. This review aimed to evaluate the effects of online OT interventions on functional outcomes and QoL of patients with PD. Methods: This review employed a systematized approach, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, though it did not constitute a full systematic review or meta-analysis. A comprehensive search was conducted across PubMed, Web of Science, Scopus, and Embase databases between August 2023 and September 2024. The search targeted randomized controlled trials (RCTs) investigating telerehabilitation interventions in OT for individuals with PD. Studies were excluded if they were not published in English, did not employ an RCT design, or lacked a focus on telerehabilitation within the scope of occupational therapy for PD. Additionally, systematic reviews, meta-analyses, qualitative studies, and studies without measurable outcomes were excluded. Nine studies met the inclusion criteria, with four involving occupational therapists directly and five evaluating interventions within the scope of OT practice. Results: The primary outcomes of this review focused on mobility improvements in PD patients, assessed through gait metrics such as gait speed, stride length, and gait variability. Secondary outcomes evaluated the impact of telerehabilitation on QoL, using tools such as the Parkinson’s Disease Questionnaire (PDQ-39) and other disease-specific instruments. The findings demonstrated that online OT interventions significantly improved motor skills, cognitive function, and activities of daily living in PD patients. Furthermore, these interventions enhanced overall well-being and QoL. The remote format fostered sustained engagement and adherence to therapy, contributing to better long-term outcomes. Conclusions: Online OT interventions show promising potential for improving functional outcomes and QoL in PD patients. These findings underscore the potential of telehealth to expand access to OT services, thereby enhancing long-term rehabilitation outcomes for this population. Full article

Background: Non-surgical management of adolescent idiopathic scoliosis (AIS) includes physiotherapeutic scoliosis-specific exercise (PSSE). Determining the efficacy of PSSE in AIS has been challenging as the clinical effect is closely linked to exercise compliance (a dose–response relationship), with home exercise programs (HEPs) showing a general trend for decreased participation over time. The existing literature reports contradictory definitions and parameters of appropriate PSSE compliance in AIS. As such, this scoping review is necessary for therapists to identify PSSE prescription consistency, enabling clear guidelines for improved PSSE compliance. Methods: A scoping review of the literature was conducted to synthesize original research from inception to November 2024 and reference lists were examined for studies reporting compliance, adherence, or motivational strategies for PSSE in AIS. Results: Fifteen articles with a focus on PSSE in AIS were included in this review. The results demonstrate that compliance (C) and adherence (A) are terms commonly used interchangeably, only half of the studies clearly define compliance and/or adherence, and some utilize motivational strategies; however, outcomes of compliance/adherence were often not reported in the Results section or reflected in the discussion of results. Conclusions: Compliance and/or adherence are inconsistently reported within studies and numerous variations exist in (1) the section of the paper it is mentioned, (2) whether the inclusion criteria hinged on patient compliance/adherence, and (3) whether motivational strategies were employed and outcomes reported. Notably, there was a lack of compliance or adherence reporting in Results and Discussion sections of papers. The definition of appropriate compliance and any effective motivational strategies to improve compliance to achieve the desired results for treatment of AIS remain undetermined. Full article

Background/Objectives: Appointment planning in physical therapy (PT) is crucial for optimizing patient outcomes and resource efficiency, yet determinants of these plans and deviations from them remain underexplored. This study aimed to explore how physical therapists in Saudi Arabia determine appointment numbers, their preferred planning methods, and the prevalence and contributing factors of deviations from planned appointments. Methods: A cross-sectional observational study was conducted using an electronic questionnaire distributed to PTs practicing in outpatient departments and homecare settings across Saudi Arabia. Descriptive statistics were used to summarize therapists’ methods, preferences, and the prevalence of and potential reasons for deviations. Results: A total of 434 responses were collected. Most therapists (66%) relied on their evaluation to determine the number of appointments, and this was their preferred method (76%). However, 50% reported patients usually requiring more appointments than initially planned, and 14% did not complete all the planned appointments. Faster-than-expected progress (61%) and slower-than-expected progress (58%) were the primary reasons for deviations. Conclusions: Despite most therapists determining the number of appointments based on their evaluation, the majority reported usual deviations from planned appointments, highlighting a gap in appointment planning. Future research should investigate the impact of deviations on patient outcomes and healthcare costs. Strategies to reduce deviations, such as improving adherence to clinical practice guidelines (CPGs), are warranted. Full article

Background/Objectives: The aging population presents significant challenges to healthcare systems, with conditions like dementia severely affecting the quality of life for older adults, especially those in long-term care. Gamification has the potential to motivate older adults to engage in exercise by transforming physical activities into enjoyable experiences. Incorporating gaming elements in cycling exercises can foster a sense of interest and achievement, potentially improving health outcomes. This pilot study aims to explore interdisciplinary staff perspectives on using a digital game to motivate cycling exercise among residents living with dementia in long-term care (LTC). Methods: This study applied a qualitative description design. Using an interpretive description approach, we conducted focus groups with 29 staff members, including recreational therapists, rehabilitation therapists, nurses, care aides, and leadership in an LTC home. The consolidated framework for implementation research (CFIR) guided the data analysis to identify barriers and facilitators to adopting the digital game. Results: Engaging LTC residents living with dementia presents various challenges. Identified potential barriers to implementing the cycling game include cognitive and physical limitations, resistance to change, and intervention complexity. Frontline staff strategies include flexible invitations, social groups, making it fun, and building rapport. Success relies heavily on its cultural and individual relevance, along with strong support from leadership, peers, and family. Conclusions: This pilot study explored staff perspectives on the potential integration of a gamified cycling intervention for older adults with dementia in long-term care settings. Staff emphasized that successful implementation would depend on addressing key barriers and identifying enabling strategies. Based on these findings, practice implications were provided to support effective integration. Further research, including resident input and long-term evaluations, is needed to assess the feasibility, acceptance, and effectiveness of gamification in promoting health outcomes for this population. This study adhered to the COREQ Checklist. Full article

Background/Objectives: In cardiac rehabilitation, the 6-minute walk test (6-MWT) is a standard assessment of initial evaluation. It measures walking distance as a surrogate of submaximal physical performance. Thereby, a subjective rating of perceived exertion, assessed by the Borg Scale, plays an important role. It has been observed that patients with coronary heart disease often rate themselves lower than the person supervising the test. Since this discrepancy might lead to inadequate exercise prescription, this study aims to explore reasons for low self-rating. Methods: In a qualitative study, influencing factors for low self-rating were collected from patients using interviews and questionnaires and from a focus group of physiotherapists. The evaluation was based on the grounded theory. Results: Self-image after retirement emerged as the central factor, as it shaped patients’ behavior during the 6-MWT and their subsequent self-assessment. Additionally, five different categories of causal conditions were detected from ten patients and five therapists: fears, physical limitations, test instruction, testing conditions, and therapists’ expectations. Conclusions: Patients with coronary heart disease had poor self-perception of exercise intensity and limited understanding of the meaning of the Borg Scale and the 6-MWT. Physiotherapists should place greater emphasis on patients’ perceived exertion to be able to effectively tailor exercise prescription and, therefore, improve attainment of cardiac rehabilitation goals and long-term adherence. Full article

Background and Objectives: This systematic review aims to present the latest developments in next-generation CBT interventions of digital support tools, teletherapies, and personalized treatment modules in enhancing accessibility, improving treatment adherence, and optimizing therapeutic outcomes for depression. Materials and Methods: This review analyzed 81 PRISMA-guided studies on the efficacy, feasibility, and applicability of NG-CBT approaches. Other important innovations include web-based interventions, AI-operated chatbots, and teletherapy platforms, each of which serves as a critical challenge in delivering mental health care. Key messages have emerged regarding technological readiness, patient engagement, and the changing role of therapists within the digital context of care. Results: Findings indicate that NG-CBT interventions improve treatment accessibility and engagement while maintaining clinical effectiveness. Personalized digital tools enhance adherence, and teletherapy platforms provide scalable and cost-effective alternatives to traditional therapy. Conclusions: Such developments promise great avenues for decreasing the global burden of depression and enhancing the quality of life through novel, accessible, and high-quality therapeutic approaches. Full article

Children with autism spectrum disorder (ASD) can have serious deficits in their social interactions, due to their limited social skills. There are many ways to use music as an intervention tool. One of them is by using musical instruments. Music emerges as a potential method of intervention, which can be used to address these deficits. The aims of this review are (a) to lay out internationally acclaimed and peer-reviewed studies, describing the elements of interventions with the use of musical instruments by children with autism, (b) to assess and analyze the effects of interventions with the use of musical instruments on the children’s social skills and (c) to provide recommendations to therapists, educators and researchers for future research and implementation. The process of article selection was carried out in strict adherence to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, ensuring methodological rigor and transparency in the systematic review process. A systematic search was conducted, using the following electronic databases: (a) PsycINFO, (b) Education Resources Information Center (ERIC), (c) Scopus and (d) Web of Science. Twelve studies were selected, with their results suggesting that the use of musical instruments, tangible or electronic ones, can have a positive effect on the social skills of children with autism. Inadequacies detected in the mentioned studies are also mentioned, as well as any important topics that should be gradually examined in future research. The present review is conducted within the framework of a doctoral thesis focusing on interventions that utilize music and technology as primary tools. Full article

Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare. Methods: This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists’ involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136). Results: The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices. Conclusions: Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes. Full article

Artificial intelligence (AI)-based digital patient twins have the potential to make breakthroughs in research and clinical practices in rehabilitation. They make it possible to personalise treatment plans by simulating different rehabilitation scenarios and predicting patient-specific outcomes. DTs can continuously monitor a patient’s progress, adjusting therapy in real time to optimise recovery. They also facilitate remote rehabilitation by providing virtual models that therapists can use to guide patients without having to be physically present. Digital twins (DTs) can help identify potential complications or failures at an early stage, enabling proactive interventions. They also support the training of rehabilitation professionals by offering realistic simulations of different patient conditions. They can also increase patient engagement by visualising progress and potential future outcomes, motivating adherence to therapy. They enable the integration of multidisciplinary care, providing a common platform for different professionals to collaborate and improve rehabilitation strategies. The article aims to trace the current state of knowledge, research priorities, and research gaps in order to properly guide further research and shape decision support in rehabilitation. Full article

Background: The aim of this study was to analyze the influence of beliefs and attitudes of practicing physical therapists (PTs) about aging on their expectations concerning the behavior and outcomes of patients with orthopedic conditions. We hypothesized that some beliefs and attitudes would be related to expectations of worse outcomes in older patients compared to clinically identical younger patients. Methods: Seventy-one (71) practicing PTs with a mean age of 40 years (±10.44, range 24–67) were recruited via snowball sampling and asked to participate in a three-part online questionnaire. For part 1, participants were randomly assigned a hypothetical case involving either a 42-year-old or an 85-year-old patient s/p surgical repair of a femoral shaft fracture. Thirty-five (35) participants were randomly assigned to the young case group (YCG) and 37 to the old case group (OCG). Participants were asked questions related to their expectations concerning the patient’s clinical and functional potential, response and adherence to physical therapy, and patient responsibility for their own outcomes. For part 2, all participants completed the Kogan Attitude Toward Old People Scale consisting of 34 paired (positive/negative) statements. Part 3 consisted of subject demographics. Results: Participants in the YCG and the OCG were similar in age (41 vs. 40 years), PT experience (16.7 vs. 14.8 years), gender (82.9% vs. 86.5% female), and positive Kogan score (69.5 vs. 68.2). The groups differed in belief the patient would return to their prior level of function. YCG believed it was “extremely likely”, while the OCG believed it was “moderately likely”. In the OCG, greater likelihood that the patient would return to prior level of function was related to stronger belief that “Most ageing adults are really no different from anybody else” (r = 0.35). Conclusion: In general, physical therapist participants in this study agreed with positive attitudes and beliefs about aging adults as measured by total positive Kogan score. The only outcome expectation that appeared to be influenced by the age of hypothetical patient was return to prior level of function. Although some specific age-related beliefs were correlated to expectation of return to prior level of function, the positive Kogan score was not. It is possible that age related differences in expectations of return to prior level of function were influenced by clinical experience rehabilitating older patients rather than negative attitudes and beliefs about aging. Full article