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Objectives: Exercise, support and advice are the key treatment strategies of musculoskeletal problems. The aims of this study were to determine patients', physiotherapists', and other stakeholders' perspectives about supported home physiotherapy for the management of musculoskeletal problems and to identify the barriers and facilitators to rolling out this model of physiotherapy service delivery.
Methods: This study was conducted as part of a process evaluation run alongside a large trial designed to determine whether supported home physiotherapy is as good or better than a course of in-person physiotherapy. Forty interviews were conducted with 20 trial participants, 15 physiotherapists, and 5 other stakeholders. The interviews were semi-structured and based on interview guides. Each interview was transcribed and a three-tiered coding tree was developed.
Results: Six key themes were identified. Supported home physiotherapy (i) is convenient for some patients, (ii) does not always align with patients' and therapists' expectations about treatment (iii) is suitable for some but not all, (iv) can reduce personal connection and accountability, (v) has implications for physiotherapists' workloads, and (vi) has barriers and facilitators to future implementation.
Conclusions: Findings suggest that patients are far more accepting of supported home physiotherapy than physiotherapists assume. This model of service delivery could be rolled out to improve access to physiotherapy and to provide a convenient and effective way of delivering physiotherapy to some patients with musculoskeletal conditions if our trial results indicate that supported home physiotherapy is as good or better than in-person physiotherapy.
Clinical Trial Registry Number: ACTRN12619000065190 CONTRIBUTIONS OF THIS PAPER.
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http://dx.doi.org/10.1016/j.physio.2024.01.006 | DOI Listing |
Musculoskelet Sci Pract
September 2025
School of Physical Therapy, Western University, London, Canada.
Background: Neck pain and headaches are highly prevalent, often presenting a challenge for physiotherapists when considering differential diagnoses. For guidance, the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) created the International IFOMPT Cervical Framework. Its purpose is to improve clinical reasoning through various functional objectives and design principles.
View Article and Find Full Text PDFNeurol Ther
September 2025
Department of Neurology, Neurocritical Care, and Neurorehabilitation, Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Paracelsus Medical University, Member of ERN EpiCARE, 5020, Salzburg, Austria.
Introduction: Migraine headache not only is associated with high levels of suffering but also represents a considerable socioeconomic challenge. It is linked to various psychological and physiological impairments, including sensorimotor and somatosensory dysfunction, like those observed in other persistent pain syndromes. This study aims to determine whether individuals with high-frequency episodic (HFEM) or chronic migraine (CM) exhibit differences in somatosensory perception compared to healthy individuals and to explore potential correlations with neuropsychological features.
View Article and Find Full Text PDFPerfusion
September 2025
Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
IntroductionWe report the successful use of erector spinae (ESP) plane block in the management of a patient with severe respiratory failure secondary to chest trauma requiring invasive ventilation and Veno-venous extracorporeal membrane oxygenation (V-V ECMO).Case reportA 64-year-old man with flail chest and severe respiratory failure required V-V ECMO. An ESP plane block on day 3 enabled extubation, mobilisation, and secretion clearance, leading to ECMO weaning after six days and discharge 18 days post-injury.
View Article and Find Full Text PDFOper Orthop Traumatol
September 2025
Sektion Sportorthopädie, TUM Universitätsklinikum, Ismaninger Str. 22, 81675, München, Deutschland.
Objective: Anatomical reconstruction of the posterior cruciate ligament (PCL) with suture tape augmentation to enhance primary stability.
Indications: Acute or chronic PCL ruptures, either isolated or as part of multiligamentous injuries, in cases of symptomatic instability or failure of conservative treatment.
Contraindications: Fixed posterior drawer, active infection, bony avulsion.
Ann Rheum Dis
September 2025
Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Rheumatology, Oslo University Hospital, Oslo, Norway. Electronic address:
Background: Interstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases (CTDs) and is associated with high morbidity and mortality. Clinical practice guidelines to standardise screening, diagnosis, treatment and follow-up for CTD-ILD are of high importance for optimised patient care.
Methods: A European Respiratory Society and European Alliance of Associations for Rheumatology task force committee, composed of pulmonologists, rheumatologists, pathologists, radiologists, methodologists and patient representatives, developed recommendations based on PICO (Patients, Intervention, Comparison, Outcomes) questions with grading of the evidence according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology and complementary narrative questions agreed on by both societies.