Physical Therapy, Sports Therapy and Rehabilitation
17
Scopus Publications
Scopus Publications
ACTIVATE: physical activity assessment, prescription and promotion in clinical practice by healthcare professionals – a consensus study initiated by the International Federation of Sports Physical Therapy Alessio Bricca, Mette Aadahl, Søren T Skou, Jane S Thornton, Thomas Bandholm, Julie Midtgaard, Heidi Klakk Egebæk, Lars Hermann Tang, Julie Sandell Jacobsen, Nonhlanhla S Mkumbuzi, Greet Cardon, Luciana De Michelis Mendonça, Mario Bizzini, Pablo O Policastro, Ummukulthoum Bakare, Joanne L Kemp, Theodora Papadopoulou, Maria Constantinou, Britt Elin Øiestad, Michael Skovdal Rathleff, Lori A Michener, Christopher Napier, Phathokuhle Cele Zondi, Nicola Phillips, Anthony G Schneiders, Janus Laust Thompsen, Kristian Thorborg British Journal of Sports Medicine, 2026 The ACTIVATE consensus aimed to develop recommendations for assessing, prescribing and promoting physical activity when healthcare professionals consult patients with non-communicable diseases in clinical practice. We developed the consensus through a comprehensive, multistep approach including 27 experts with professionally diverse backgrounds from 13 different countries, including three patient representatives. Initially, we conducted a survey at the World Congress for Sport Physical Therapy in 2022 to document the need for a consensus, which was followed up by development of a conceptual framework with guiding principles and research questions at a stakeholder meeting. We subsequently conducted three rapid umbrella reviews, covering the existing scientific literature to inform the statements for a Delphi survey. The Delphi survey involved two voting rounds (email survey) and one face-to-face (online) round. Finally, we identified recommendations on how to assess, prescribe and promote physical activity through consensus. We recommend routine physical activity assessments using quick and easy tools, documenting physical activity levels and providing tailored prescriptions for patients not meeting WHO guidelines for physical activity. Furthermore, the ACTIVATE consensus highlights the necessity for regular follow-ups to facilitate patients’ integration of physical activity into their daily routines, to enhance overall well-being and quality of life.
Beyond the capsule: an integrated perspective on the wide world of frozen shoulder. A collaborative viewpoint Fabrizio Brindisino, Michel Gcam Mertens, Paul Salamh, Santiago Navarro Ledesma, Dina Hamed Hamed, Filip Struyf, Filip Vanhoenacker, Pablo Oscar Policastro, Paula Rezende Camargo, Giacomo Rossettini Pain Management, 2026 BACKGROUND: Frozen Shoulder (FS) is a highly disabling glenohumeral condition marked by severe pain and restricted active and passive motion, typically without significant radiological changes. While conventionally viewed as a self-limiting and idiopathic disorder, recovery is often incomplete, suggesting that peripheral-only interventions are insufficient. OBJECTIVE: This manuscript reviews the contemporary understanding of FS etiopathogenesis, clarifying the underlying pain processing mechanisms, metabolic patterns, and psychological domains. Evidence about diagnostic tests and imaging for FS, and updated treatment strategies were also discussed. KEY FINDINGS: The latest evidence suggests FS is the musculoskeletal manifestation of systemic metabolic, inflammatory, and neuroendocrine dysregulation. Pain mechanisms extend beyond the periphery, showing links to sensitization and possible central involvement, though further clarity is needed. Moreover, FS significantly impacts mood, beliefs, and social well-being. Imaging remains a tool for diagnosis and differential ruling, and treatment should be "tailorized" from biopsychosocial perspective. Individualization involves the understanding of the individual's personal history, clinical characteristics, context, and goals in combination with tissue irritability. CONCLUSION: Clinicians must move beyond solely addressing FS as a "local" pathology. Modern research indicates that FS is a complex pathology involving an inflammatory phase followed by a fibrotic shift, fueled by metabolic, inflammatory, neuroendocrine, and psychological factors.
Cross-cultural adaptation and psychometric properties of the Argentine version of the shoulder pain and disability index (SPADI) in patients with shoulder disorders Juan C. Porollan, Santiago Soliño, Franco J. Fabani, María G. de Ilzarbe, Micaela Oyola, Tomás A. Bossio, Julián M. Morales, Joaquín López, Federico J. Villalba, Gastón Muhafara, Pablo O. Policastro Jses International, 2025 Background: Shoulder disorders are some of the leading causes of musculoskeletal conditions with a significant economic impact worldwide. The Shoulder Pain and Disability Index (SPADI) questionnaire has proved to be a valid and useful tool for the assessment of disability; however, reporting of properties in several languages has been inconsistent, and the quality of the studies available is low. Moreover, there is only one version in Spanish, designed in Spain, which does not consider the linguistic differences existing in Argentina. Therefore, the aim of the present study was to conduct the cross-cultural adaptation of the SPADI and assess its reliability, validity, responsiveness, and interpretability in subjects with shoulder disorders. Materials and methods: The study was conducted following the COSMIN Guidelines (COnsensus-based Standards for the Selection of health Measurement INstruments). We included Argentine residents, older than 18 years of age, referred to physiotherapy for shoulder disorders. Results: A total of 101 patients were evaluated. Reliability was acceptable with an intraclass correlation coefficient of 0.89. The standard error of measurement and minimal detectable change were 2.18 and 6.05, respectively. Construct validity was excellent, and responsiveness was high. Also, the minimal clinically important difference was 18.46 points, the substantial clinical benefit was 27.69 points, and the symptom acceptable level value was 21.35 points. Conclusion: A cross-cultural adaptation of the Argentine version of the SPADI was conducted. This version proved to be valid, reliable, and responsive with interpretability values.
Beliefs and use of contextual factors in musculoskeletal pain among Argentine physiotherapists: a nationwide cross-sectional study Mauro Federico Andreu, Pablo Oscar Policastro, Santiago Soliño, Federico Villalba, Giacomo Rossettini, Yolanda Pardo Physiotherapy Theory and Practice, 2025 Background Contextual factors (CFs), such as clinician’s words and patient’s expectation, influence musculoskeletal pain outcomes through biopsychosocial processes. While physiotherapists’ views on CFs have been studied elsewhere, no such research exists in Argentina.Objective This study examines Argentine physiotherapists’ perspectives and their link to professional characteristics.Methods A cross-sectional online survey was distributed to 512 Argentine physiotherapists, members of a scientific society specializing in musculoskeletal care. It gathered demographic, professional data, two clinical vignettes on decision-making, and closed-ended questions on CF use, ethical and communication aspects, beliefs, use frequency, mechanisms of action, and perceived benefits. Associations between professional factors and both CF beliefs and use were analyzed using univariate and multivariate regression models.Results Response rate was 45.5%. The most influential CFs were therapeutic alliance, verbal communication, and positive attitudes and behavior; in contrast, professional reputation, patient’s previous experience, and a patient-centered approach were rated less influential. While frequently used CFs generally matched perceived influence, some discrepancies emerged. Reading more than five scientific articles in the past three months was significantly associated with stronger CF beliefs (B = 0.178, 95% CI [0.055–0.301], p < .01) and higher CF use (B = 0.181, 95% CI [0.053–0.309], p < .01). Teaching activities were also linked to greater CF use (B = 0.178, 95% CI [0.027–0.329], p = .021).Conclusion Argentine physiotherapists recognize the importance of CFs, especially therapeutic alliance and communication. Discrepancies between beliefs and use, along with regression results, suggest that academic exposure and teaching play a key role in CF integration, underscoring the need to strengthen education and training in clinical practice.
Physical functions assessed by lower limb performance-based and self-reported outcome measures for knee musculoskeletal conditions: A scoping review Andrés Pierobon, Will Taylor, Richelle Caya, Federico Villalba, Santiago Soliño, Pablo Oscar Policastro, Richard Siegert, Ben Darlow Brazilian Journal of Physical Therapy, 2025 BACKGROUND: Physical function assessment is key for the management of knee musculoskeletal conditions. There are a wide variety of self-reported outcome measures (SROMs) and performance-based outcome measures (PBOMs) to assess physical function of individuals with knee conditions. However, the content of these measures has not been explored. OBJECTIVE: To explore the range and frequency of physical functions assessed by lower limb PBOMs and SROMs for people with knee osteoarthritis (OA), anterior cruciate ligament (ACL) injuries, and patellofemoral pain (PFP). METHODS: A scoping review was conducted. We included development or measurement properties studies of knee functional outcome measures for populations with knee OA, ACL injuries, and PFP. We extracted the physical functions assessed in each measure. Each identified physical function was linked to a code from the International Classification of Functioning, Disability and Health (ICF) framework. RESULTS: 4146 articles were screened. A total of 143 articles were included. The median number of physical functions assessed was nine for SROMs and one for PBOMs. The three most assessed physical functions were climbing stairs, walking short distances, and standing up from sitting. Climbing stairs was the most assessed physical function in measures for knee OA and PFP populations, whereas jumping was in measures for the ACL-injured population. CONCLUSION: SROMs assess a broader range of physical functions, whereas PBOMs focus on discrete activities. ACL and PFP measures evaluated more challenging physical functions than knee OA measures. Current physical function outcome measures are not well suited to assess performance in knee OA populations with mild or diverse levels of impairment.
Contextual Factors-Enriched Standard Care on mechanical neck pain (ContextualizAR trial): Protocol for a randomised controlled trial Mauro Federico Andreu, Santiago Soliño, Federico Villalba, Pablo Oscar Policastro, María Lourdes Laurens, Gonzalo D’Aversa, Martín Mastandrea, Federico Rodriguez, Alexis Ramirez, Chad Cook, Giacomo Rossettini Musculoskeletal Care, 2024 BackgroundUnderstanding the influence of contextual factors (CFs) on interventions for mechanical neck pain (MNP) is essential for evidence‐based practice in physical therapy. However, the specific effects and synergies of combining different CFs remain unclear.ObjectiveThe primary purpose of this study will be to determine if a CFs‐Enriched Standard Care (SC) approach is an effective treatment for MNP in terms of reducing pain and improving function.MethodsThis will be an assessor‐blinded, 2‐group (1:1) randomised clinical trial (RCT) aiming to enrol 94 participants with neck pain persisting for more than 4 weeks. Both groups will undergo 4 weeks of SC twice weekly, following established clinical practice guidelines. In the intervention group, CFs will be enhanced, encompassing the physical, psychological, and social elements inherent in the clinical encounter, based on existing evidence. The primary outcomes will encompass changes in pain and disability after 4 weeks of treatment, with a follow‐up reassessment at week 12 post‐treatment. Secondary outcomes will include changes in Active Range of Motion, Global Rating of Change, and Satisfaction with treatment. The change between groups after treatment and at the 12‐week follow‐up will be reported for all outcomes, considering the difference from scores recorded at baseline.ResultsWe hypothesise that a 4‐week CFs‐Enriched SC approach will be superior to SC alone in terms of patient‐reported disability and pain, with measurements conducted using the Northwick Park Neck Pain Questionnaire and the Numeric Pain Rating Scale, respectively.ConclusionThis RCT rigorously assesses the effect of purposeful manipulation of CFs during MNP treatment. By elucidating the role of these factors, our findings have the potential to significantly refine clinical practice in managing MNP, thereby enhancing patient care, and advancing the fields of physical therapy and rehabilitation.
Injury Surveillance and Training Load Methods Used by Health Professionals in Tennis: An Online Multinational Survey Diego H. Méndez, Pablo O. Policastro, Danilo De Oliveira Silva Journal of Sport Rehabilitation, 2023 Context: Injury surveillance and training load monitoring are both essential for the development of preventative strategies for gradual-onset musculoskeletal injuries in elite sport. Our aim was to survey health professionals working with elite tennis players on whether and how they monitor injuries and training load. Design: A cross-sectional multinational online open-survey. Methods: The survey was developed and advertised in English, Spanish, and Portuguese languages on social media channels, a tennis academic journal, professional tennis associations, and clinical networks of the research team, from December 2020 to April 2021. Results: 72 health professionals from 27 different countries working with elite tennis players responded to the survey. Injury surveillance is performed by 94% (68/72) of the survey respondents, with only 10% (7/68) using the consensus-recommended Oslo Sports Trauma Research Center questionnaire. Most common barriers identified by health professionals to injury surveillance are time constraints (66%), lack of knowledge (43%), and technology (31%). Training load monitoring is performed by 50% (36/72) of the health professionals working with elite tennis players. Main metrics monitored are weekly differences in training load (72%) and acute:chronic workload ratio (58%). Most common reasons for training load monitoring are injury prevention (94%), training planning (81%), and player feedback (53%). Conclusions: Despite a high percentage of health professionals implementing injury surveillance metrics, most of them do not use any validated method. Only half of health professionals working with elite tennis players monitor training load. Lack of knowledge and technology were the main barriers reported for adequately monitoring injuries.
