Physical Medicine

Home-based PT in frail PD with cognitive impairment is feasible and safe in a pilot RCT

In a pilot randomized trial of 15 frail Parkinson disease patients with cognitive impairment, a 16-session home-based physiotherapy program achieved 100% session completion and no adverse events. Exploratory analyses suggested improvements in frailty, functional performance, disease severity, and quality of life in the intervention arm. The study is small and hypothesis-generating; efficacy requires confirmation in larger, adequately powered trials. 1

Smartphone app did not increase 6-month exercise adherence in chronic low back pain

In an RCT of 110 adults completing a 3-week rehabilitation program, adding a smartphone app produced no difference in the primary adherence score at 6 months (group difference 0.01; 95% CI -2.4 to 2.4). There were no between-group differences in pain or disability at 6 months. The app improved several physical capacity tests and correctness of exercise execution, suggesting capacity gains despite unchanged adherence. 2

Care gap: few older adults with fall-related mTBI receive PT/OT referrals despite high fall risk

In a prospective cohort of 141 older adults (mean age 76) with fall-related mTBI, only 24% received a PT/OT discharge referral. At two weeks post-injury, 53% had impaired SPPB, 62% had impaired FSST, and 65% had gait speed <0.80 m/s, indicating elevated fall risk. Inpatient PT/OT consultation strongly predicted discharge referral, but many patients with objective deficits were not referred, revealing a post-discharge rehabilitation gap. 3