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The article discusses the disparities in research publications in physiotherapy and rehabilitation, especially in low-income and middle-income countries (LMICs). It reports that challenges include lack of funding, research culture, infrastructure, language barriers, and prioritization of high-income countries. It highlights the need urgent action to address these barriers and calls for international physiotherapy journals to support research in LMICs, emphasizing the need for urgent action.

The article presents recommendations from the International Society of Physiotherapy Journal Editors on statistical inference through estimation:.

The authors discuss three strategies to identify potential bias in the results of clinical trials and protect against publication spin in such trials. Topics mentioned include spin as the distortion of the interpretation of a study result, the International Clinical Trials Registry Platform, and the use of confidence intervals around estimates in reporting clinical trial results in lieu of or in addition to reporting statistical significance.

Background. The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence base for interventions to improve participation remains inconclusive. In particular, whether exercise interventions improve participation in life roles is unclear. Purpose. The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles in older adults residing in the community. Data sources. The PubMed, Embase, CINAHL, Cochrane, and PEDro databases were searched from inception through March 2015. Study selection. Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults who were 60 years of age or older were included in this review. Data extraction. Teams of 2 investigators independently extracted data on participation. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The protocol was registered with Prospero (CRD42014014880). Data synthesis. Eighteen randomized controlled trials with a total of 2,315 participants met the inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. A meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD = 0.03; 95% CI = -0.10 to 0.16). Subgroup analysis showed that exercise interventions lasting 12 months or more had a small positive effect on participation (SMD = 0.15; 95% CI = 0.02 to 0.28). Limitations. Limitations included variability in definitions and measures of participation. Conclusions. In general, exercise interventions do not improve participation in life roles in older adults. The results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted. [ABSTRACT FROM AUTHOR]

The author reflects on the feasibility of telerehabilitation in physical therapy, particularly during the COVID-19 pandemic. Also cited are a study on the use of telerehabilitation in conducting physical therapy interventions like therapeutic exercises, manual therapy, functional training, and electrotherapy, as well as the guidelines issued by the World Confederation for Physical Therapy (WCPT) on telerehabilitation.

Importance: For many older people, long-term functional limitations persist after a hip fracture. The efficacy of a home exercise program with minimal supervision after formal hip fracture rehabilitation ends has not been established.Objective: To determine whether a home exercise program with minimal contact with a physical therapist improved function after formal hip fracture rehabilitation ended.Design, Setting, and Participants: Randomized clinical trial conducted from September 2008 to October 2012 in the homes of 232 functionally limited older adults who had completed traditional rehabilitation after a hip fracture.Interventions: The intervention group (n = 120) received functionally oriented exercises (such as standing from a chair, climbing a step) taught by a physical therapist and performed independently by the participants in their homes for 6 months. The attention control group (n = 112) received in-home and telephone-based cardiovascular nutrition education.Main Outcomes and Measures: Physical function assessed at baseline, 6 months (ie, at completion of the intervention), and 9 months by blinded assessors. The primary outcome was change in function at 6 months measured by the Short Physical Performance Battery (SPPB; range 0-12, higher score indicates better function) and the Activity Measure for Post-Acute Care (AM-PAC) mobility and daily activity (range, 23-85 and 9-101, higher score indicates better function).Results: Among the 232 randomized patients, 195 were followed up at 6 months and included in the primary analysis. The intervention group (n=100) showed significant improvement relative to the control group (n=95) in functional mobility (mean SPPB scores for intervention group: 6.2 [SD, 2.7] at baseline, 7.2 [SD, 3] at 6 months; control group: 6.0 [SD, 2.8] at baseline, 6.2 [SD, 3] at 6 months; and between-group differences: 0.8 [95% CI, 0.4 to 1.2], P < .001; mean AM-PAC mobility scores for intervention group: 56.2 [SD, 7.3] at baseline, 58.1 [SD, 7.9] at 6 months; control group: 56 [SD, 7.1] at baseline, 56.6 [SD, 8.1] at 6 months; and between-group difference, 1.3 [95% CI, 0.2 to 2.4], P = .03; and mean AM-PAC daily activity scores for intervention group: 57.4 [SD, 13.7] at baseline, 61.3 [SD, 15.7] at 6 months; control group: 58.2 [SD, 15.2] at baseline, 58.6 [SD, 15.3] at 6 months; and between-group difference, 3.5 [95% CI, 0.9 to 6.0], P = .03). In multiple imputation analyses, between-group differences remained significant for SPPB and AM-PAC daily activity, but not for mobility. Significant between-group differences persisted at 9 months for all functional measures with and without imputation.Conclusions and Relevance: Among patients who had completed standard rehabilitation after hip fracture, the use of a home-based functionally oriented exercise program resulted in modest improvement in physical function at 6 months after randomization. The clinical importance of these findings remains to be determined.Trial Registration: clinicaltrials.gov Identifier: NCT00592813. [ABSTRACT FROM AUTHOR]

In the article, the editor discusses the articles published by the journal on topics like the use of telehealth during the COVID-19 pandemic, severe acute respiratory syndrome (SARS), and treatment for adults with post-intensive care syndrome, as well as the 100th anniversary of the journal in 2021.

The authors reflect on the challenges in research to enhance the clinical practice guideline (CPG) for the management of patients with total knee replacement (TKA) by physical therapists. Also cited are the problems faced by researchers like the lack of true placebo-control groups, as well as some tips to overcome the challenges like designing clinical trials of rehabilitation solutions based on theory and conducting multisite trials to achieve higher samples.

America is about to experience a demographic shift of enormous magnitude: increasing longevity, declining fertility, and the aging of the baby boomers, which are triggering an enormous "age wave." We are facing the challenge of limited access to health care services by millions of our citizens, and unsustainable cost escalation. In response, health care is changing fundamentally. In the 2012 McMillan Lecture, Jette discusses 3 critical "system skills" that physical therapists must develop to practice successfully in a changing health care environment. First, therapists must become interested in data Second, they must become skilled in the ability to devise solutions for the system problems that data and experience uncover. Third, the physical therapy profession must develop the ability to implement at scale-the ability to get therapists along the entire chain of care functioning in concert, in collaboration. Jette discusses the American Physical Therapy Association's Vision 2020 as it relates to these challenges and the degree to which he believes physical therapists are equipped with the system skills needed to function within effective health care systems to identify what works in physical therapy, for what conditions, under what circumstances, and at what cost. Jette articulates a revised vision for physical therapy that includes being a leader in teaching systems skills to practice successfully in interconnected heath care teams; being a recognized national leader in implementing evidence-based strategies; using standardized collection, analysis, and dissemination of intervention and outcomes data as a regular part of practice to determine what interventions best improve the health of individuals and society; and being a profession that is a central player in devising, evaluating, and implementing cost-effective health care innovations for communities as well as for individuals. [ABSTRACT FROM AUTHOR]

In this article the author discusses aspects of the "International Classification of Functioning, Disability and Health (ICF)," by R. Escorpizo and colleagues and its use in physical therapist practice documentation. The author cites ideas and proposals outlined in the ICF regarding its implementation and shares both his thoughts on the feasibility of adopting the system. A response by the authors is included.

The author discusses issues concerning the translation of evidence-based practice (EBP) into clinical practice in the field of physical therapy. He cites researcher C. D. Naylor's four distinct phases of EBP adoption in physical therapy. He also discusses the priority of the U.S. National Institutes of Health for translational research and the types of implementation research interventions.

Abstract: Latham NK, Jette AM, Ngo LH, Soukup J, Iezzoni LI. Did the 1997 Balanced Budget Act reduce use of physical and occupational therapy services? Objective: To investigate whether use of physical therapy (PT) and occupational therapy (OT) services decreased after the passage of the 1997 Balanced Budget Act (BBA). Design: Data from the nationally representative Medicare Current Beneficiary Survey (MCBS) were merged with Medicare claims data. We conducted cross-sectional analyses of data from 1995 (n=7978), 1999 (n=7863), and 2001 (n=7973). All analyses used MCBS sampling weights to provide estimates that can be generalized to the Medicare population with 5 common conditions. Settings: Skilled nursing facilities (SNFs), home health agencies, inpatient rehabilitation facilities (IRFs), and outpatient rehabilitation settings. Participants: Medicare beneficiaries who participated in the MCBS survey in each of the study years and had 1 or more of the following conditions: acute stroke, acute myocardial infarction, chronic obstructive pulmonary disease, arthritis or degenerative joint disease, or mobility problems. Interventions: Not applicable. Main Outcome Measures: Percentage of persons meeting our inclusion criteria who received PT or OT in each setting, and total units of PT and OT received in each setting. Results: Multivariable logistic regression revealed no statistically significant differences in the proportion of people who met our inclusion criteria who used PT or OT from home health agencies across the 3 time points. For SNFs, an increase in the odds of receiving PT was statistically significant from 1995 to 1999 (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.19−1.69) and 1995 to 2001 (OR=1.69; 95% CI, 1.39−2.05). For IRF and outpatient settings, a significant increase was observed between 1995 and 2001 (OR=1.71, OR=1.27, respectively). For OT, a statistically significant increase was observed for IRF and outpatient rehabilitation settings from 1995 to 2001. For SNF, the increase was statistically significant from 1995 to 1999 and 1995 to 2001. Mean total PT and OT units received also increased across all settings from 1995 to 2001 except for IRFs. Conclusions: Despite BBA mandates restricting postacute care expenditures, this nationally representative study showed no decreases in the percentage of Medicare beneficiaries with 5 common diagnoses receiving PT and/or OT across all settings and no decreases in units of PT and/or OT services received between 1995 and 2001 except for those in IRFs. This study suggests that the delivery of PT and OT services did not decline among persons with conditions for which rehabilitation services are often clinically indicated. [Copyright &y& Elsevier]

Background and Purpose The purpose of this study was to prospectively evaluate the practical and psychometric adequacy of the Activity Measure for Post-Acute Care (AM-PAC) "item bank" and computerized adaptive testing (CAT) assessment platform (AM-PAC-CAT) when applied within orthopedic outpatient physical therapy settings. Method This was a prospective study with a convenience sample of 1,815 patients with spine, lower-extremity, or upper-extremity impairments who received outpatient physical therapy in 1 of 20 outpatient clinics across 5 states. The authors conducted an evaluation of the number of items used and amount of time needed to complete the CAT assessment; evaluation of breadth of content coverage, item exposure rate, and test precision; as well as an assessment of the validity and sensitivity to change of the score estimates. Results Overall, the AM-PAC-CAT's Basic Mobility scale demonstrated excellent psychometric properties while the Daily Activity scale demonstrated less adequate psychometric properties when applied in this outpatient sample. The mean length of time to complete the Basic Mobility scale was 1.9 minutes, using, on average, 6.6 items per CAT session, and the mean length of time to complete the Daily Activity scale was 1.01 minutes, using on average, 6.8 items. Background and Conclusion Overall, the findings are encouraging, yet they do reveal several areas where the AM-PAC-CAT scales can be improved to best suit the needs of patients who are receiving outpatient orthopedic physical therapy of the type included in this study. [ABSTRACT FROM AUTHOR]

The author discusses the complex elements that constitute the practice of rehabilitation interventions and their role in the reporting of randomized controlled clinical trials for rehabilitation. Topics discussed include the development of the Template for Intervention Description and Replication checklist to improve intervention reporting, the relationship between clinician actions and treatment results, and the principle of the Rehabilitation Treatment Specification System.

The author discusses a report on the fundamental roles that physical therapists can play in the examination, evaluation, and treatment of patients with heart failure (HF). Topics mentioned include participation of individuals with HF in some sort of physical activity, the problem of a culture of physical inactivity among U.S. adults, and an increase in time spent on sedentary activity between 2007-2008 and 2015-2016.

Within physical therapy, the disablement model has proven useful as a language to delineate the consequences of disease and injury. This perspective provides an update on the changing language of disablement, reviews selected contemporary disablement models, and discusses some challenges that need to be addressed to achieve a universal disablement language that can be used to discuss physical therapy research and clinical interventions. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework has the potential of becoming a standard for disablement language that looks beyond mortality and disease to focus on how people live with their conditions. If widely adopted, the ICF framework could provide the rehabilitation field with a common, international language with the potential to facilitate communication and scholarly discourse across disciplines and national boundaries, to stimulate interdisciplinary research, to improve clinical care, and ultimately to better inform health policy and management. [ABSTRACT FROM AUTHOR]

The author discusses a report about the application of population health to physical therapist practice, research, and education. Topics covered include the classic definition of population health, the definition of social determinants of health by the World Health Organization, and how the emergence of large-scale genome studies and precision medicine initiatives might offer a means to improve population health.

Describes outpatient physical therapy treatments provided to patients with lumbar, cervical, or knee impairments. Results of a study of patients who received outpatient physical therapy for a primary orthopedic complaint; Frequent use of physical agents in physical therapy episodes of care.

Discusses outcomes research in physical therapy (PT) and places its conceptual roots within the work on quality-of-care assessment. Assessment of the quality of PT; Paradigms in PT; Shift in the dominant impairment research paradigm; Relevance of disability and impairment outcomes in PT.

The author discusses the highlights of a workshop sponsored by the National Academy of Sciences, Engineering, and Medicine titled "The Role of Nonpharmacological Approaches to Pain Management" in December 2018. Topics covered include the short-term benefits of opioids and other pharmacological treatments, a 2016 U.S. Centers for Disease Control and Prevention guideline on nonpharmacological and nonopioid pharmacological treatments, and care for people with pain in the U.S.

The author discusses why the journal "PTJ" requires prospective registration, clarifying what research designs are considered clinical trials under the clinical trial registration policy. The International Committee of Medical Journal Editors' view on clinical trial registration is presented. The most compelling reason for prospective registration is prevention of selective reporting of research outcomes. The National Institutes of Health's definition of a health-related intervention is given.

An introduction is presented in which the author discusses various reports published within the issue on topics including physical therapy following arthroscopic hip surgery, the role of scientific journals, and the risk factors for musculoskeletal pain after PT.

The author reflects on peer review, the process by which experts advise journal editors about the manuscripts submitted for publication. Topics mentioned include the completion of full peer review for more than 300 manuscripts submitted to "Physical Therapy" journal in 2017, criticism against peer review by authors as being too slow, and protection from open reviews against procrastination and the stealing of ideas.

The author discusses the interest of the U.S. Department of Health & Human Services' Centers for Medicare and Medicaid (CMS) in value-based purchasing to achieve the triple aims of better health, better health care, and lower costs. Topics mentioned include the overall goal of the CMS G-coding, the ICD-9 or ICD-10 diagnostic code on the beneficiary claim form, and reasons why experts in the U.S. have had difficulty arriving at a credible system of outcome performance assessment.

The author conveys his thoughts about how "Physical Therapy" journal, or PTJ, handles conflict of interests (COI) and protects against bias in PTJ.

The article offers information on the World Confederation of Physical Therapy (WCPT) Congress to be held in Cape Town, South Africa in July 2017.

The author reflects on the need to improve hospital discharge planning and the transition to postacute care in the U.S. Topics covered include the noted reasons for the high rates of 30-day hospital readmissions in the U.S., the important role of physical therapists and other rehabilitation professionals in reducing hospital readmissions, and why acute care hospitals should engage in activities designed to reduce the number of short-term readmissions.

The author talks about the state of U.S. healthcare and its problems such as rising rates of preventable chronic conditions, the increasing cost of care, and poor application of evidence-based prevention and management strategies. Topics include the concept of high-need, high-cost (HNHC) patients, or those with three or more chronic conditions coupled with a functional limitation to daily activities, care management models for HNHC patients, and the misalignment of U.S. health care resources.

The author applauds the decision of the American Physical Therapy Association's (APTA) Board of Directors to enter into a partnership with Oxford University Press (OUP) to co-publish "Physical Therapy Journal" (PTJ) starting January 2017. Topics discussed include the publishing platform to be offered by OUP powered by Silverchair Information Systems, the two types of OA licensing to be provided to PTJ authors and other assistance OUP will extend to APTA.

The author reflects on the 95 years existence of the magazine "The PT Review" which started as an important educational medium during the First World War. As the journal approaches 100 years, PTJ's vision is to become a preeminent international journal in physical therapy and rehabilitation by publishing and promoting original research and key information that advances clinical practice and informs policy. He cites his mission as editor in chief to make PTJ a compelling read.