Michal Elboim-Gabyzon

Empathy is a cognitive and affective construct that involves understanding and feeling someone else's pain and suffering. Empathy is fundamental to effective physical therapy practice, a basis for therapeutic relationships that enhances patient concordance to recovery. Physical therapists working with populations experiencing heightened psychological distress, such as injured servicemembers, may face greater empathetic requirements. Limited research has examined how physical therapists' empathy levels vary across different patient populations. Therefore, this study aimed to map empathy levels among physical therapists treating injured servicemembers and identify personal and professional characteristics associated with those levels. This study employed a cross-sectional, anonymous online survey of 85 physical therapists who were actively treating injured servicemembers. Participants were identified through physical therapy social media forums and dedicated groups, and at a professional conference. Empathy levels were assessed using the Interpersonal Reactivity Index (IRI), a multidimensional tool measuring four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Personal and professional characteristics were assessed using a sociodemographic questionnaire. Associations between empathy subscales and personal and professional characteristics were analyzed. Physical therapists demonstrated mean Perspective Taking levels of 25.46 ± 1.01, Fantasy levels of 21 ± 1.32, Empathic Concern levels of 26.93 ± 1.02, and Personal Distresslevels of 19.16 ± 1.24. Age approached significance for Empathic Concern (p = .074). Longer clinical experience was significantly associated with higher Empathic Concern (p = .023), and participation in post-degree courses on psychological aspects of physical therapy treatment was significantly associated with lower Personal Distress (p = .003). This study establishes initial empathy benchmarks for physical therapists treating injured servicemembers. Findings indicate the need for enhanced support for younger physical therapists, aged 20-40, and less experienced physical therapists, with 0-5 years of experience, and emphasize the importance of encouraging participation in courses on psychological aspects of physical therapy treatment to mitigate Personal Distress.

Medial tibial stress syndrome (MTSS) affects up to 35% of military recruits during basic training, yet no validated patient-reported outcome measure (PROM) exists to assess this condition in Hebrew-speaking populations. The MTSS score is a validated PROM for assessing symptom severity; however, it requires linguistic adaptation for use among Hebrew-speaking individuals. To translate and assess psychometric properties of the Hebrew version of the Medial Tibial Stress Syndrome score (MTSS-He) among active-duty servicemembers. Following Beaton's guidelines, the MTSS score was translated into Hebrew and culturally adapted. A total of 133 participants were recruited. A cross-sectional validation study was conducted with 72 active-duty servicemembers diagnosed with MTSS (mean age 19.32 ± 0.8 years, 63.9% male). Psychometric properties, including internal consistency (Cronbach's Alpha (α) and McDonald's Omega (ω)), test-retest reliability (ICC3,1), concurrent validity (Spearman correlations with Short Form 12 and numerical pain rating scales), and discriminative validity were assessed. The MTSS-He demonstrated acceptable internal consistency (α = 0.66, ω = 0.68), good test-retest reliability (ICC3,1 = 0.75), and significant correlations with pain measures (rho = 0.32-0.61, p < .01). The instrument significantly discriminated between patients with MTSS and asymptomatic controls (p < .001), with median MTSS-He scores of 3 (IQR: 2-4). The MTSS-He is a reliable and valid instrument for assessing MTSS in Hebrew-speaking active-duty servicemembers, addressing a critical gap in Hebrew-language assessment tools. It enables standardized symptom quantification and outcome comparison, with potential for broader application in clinical and research settings. Future studies should investigate structural validity based on internal consistency test results and extend validation to civilian and athletic populations.

Objective: This study aimed to compare post–total knee arthroplasty (TKA) outcomes (function, pain, and quadriceps strength) between femoral nerve block (FNB), intra-articular block, and a control group. In addition, it sought to identify predictors of postoperative functional capacity. Methods: Fifty-four TKA patients were evaluated. Preoperative assessments included quadriceps strength and the Oxford knee score. Postoperative assessments on days 1 and 3/4 included the timed up and go (TUG), Elderly Mobility Scale, and Five Times Sit-to-Stand tests. Pain levels, hospitalization duration, surgical time, complications, and falls were also recorded. Results: No significant differences in functional outcomes, pain levels, or quadriceps strength were found between the FNB, intra-articular block, and control groups, except for the TUG test on day 3/4, which favored FNB (P < 0.01). Preoperative quadriceps strength was a valuable predictor of early functional outcomes, with FNB improving TUG scores on day 3/4. Discussion: The choice of pain block technique had limited effect on short-term functional outcomes post-TKA, except for early mobility as measured by the TUG test on day 3/4. Preoperative quadriceps strength markedly predicted initial functional performance. Additional research is needed to enhance postoperative pain management and early rehabilitation strategies. Clinical Trial Registration Number: NCT05478005.

Background/objectives: Malnutrition and sarcopenia are interrelated health concerns among the elderly. Each condition is associated with increased mortality, morbidity, rehospitalization rates, longer hospital stays, higher healthcare costs, and reduced quality of life. Their combination leads to the development of “Malnutrition–Sarcopenia Syndrome” (MSS), characterized by reductions in body weight, muscle mass, strength, and physical function. Despite being preventable and reversible through nutritional and physical interventions, the clinical competence of physical therapists (PTs) in managing MSS remains underexplored. This study aims to assess the clinical competency of PTs in MSS management. Methods: An anonymous cross-sectional survey was conducted from January to August 2024 among 337 certified PTs in Israel, using the “Qualtrics” platform. The survey assessed prior familiarity with MSS concepts, MSS knowledge levels, screening and treatment skills, attitudes and beliefs toward MSS management, and interprofessional collaboration practices. Results: While 52% of PTs were familiar with MSS, familiarity with diagnostic guidelines was low (EWGSOP2: 3.6%; GLIM: 0.6%). The MSS knowledge score was moderate, but screening and treatment skills were low. Attitudes toward MSS management were moderately positive, but self-belief in diagnosing and treating MSS was low. Interprofessional collaboration was limited, particularly in malnutrition care. PTs familiar with MSS had higher knowledge, better skills, more positive attitudes and beliefs, and greater interprofessional collaboration. Conclusions: Significant gaps exist in the clinical competency of Israeli PTs in MSS management. Integrating MSS content into physical therapy curricula and providing continuing professional development are necessary to enhance competencies. Equipping PTs with essential tools, clarifying roles, and promoting interprofessional collaboration can optimize MSS management and improve patient outcomes.

Physiotherapy has demonstrated significant benefits in enhancing quality of life and managing symptoms of people in need of palliative care (PC). Despite these benefits, palliative physiotherapy is infrequently integrated into community-based care, where most PC services are delivered. The limited prevalence of these treatments highlights the need to explore the factors influencing their delivery in home settings. This study‎ aimed to elucidate the factors that influence the scope of occasional in-home palliative physiotherapists' interventions as perceived by the physiotherapists who provide these treatments. A qualitative study was conducted, involving 15 physiotherapists (nine women and six men), all employed by a Health Maintenance Organization (HMO), who typically work in community-based clinics but occasionally provide palliative physiotherapy treatments outside of their regular working hours. Data were collected via in-depth, semi-structured interviews, using an interview guide and analyzed using reflective thematic analysis. Two main themes emerged: (1) External factors influencing the scope of palliative physiotherapy treatments. These include patients' characteristics and their disposition toward palliative physiotherapy treatments, family dynamics amongst each other and with the physiotherapists, and interactions of the physiotherapists with the palliative multidisciplinary team; (2) Physiotherapists‎'‎ inclination to provide PC treatments. This theme encompasses the physiotherapists' knowledge, role perception, emotional experiences, and coping strategies during the provision of PC. External and personal factors shape the scope of in-home PC treatments. Improving communication and addressing emotional challenges and coping strategies could enhance care delivery.

Falls among older adults are influenced by both physical and psychological risk factors. This pilot study specifically examined the impact of integrating Dance/Movement Therapy (DMT) into a regimen of physical therapy exercises (PTE) for fall prevention. The primary objectives included examining the effect of post-PTE+DMT intervention on heart rate variability (HRV), a psychophysiological marker, and fall risk factors. Additionally, this study aimed to examine correlations between HRV and levels of fall risk. Eight community-dwelling older adults (median = 83 [interquartile ranges: 80.5–85.75]) from a day center for senior citizens were randomly assigned to either a PTE+DMT group or a PTE group. A post intervention battery of HRV, physical and psychological fall risk assessments, was conducted. The results of nonparametric analysis demonstrated the potential impact of the PTE+DMT intervention in improving balance and self-efficacy measures related to falls when compared to participation in PTE alone. No statistically significant differences were observed between the groups in term of HRV and other physical and psychological fall risk factors. The emerging trends in the associations between HRV, fall risk, and balance levels suggest the potential utility of HRV as an objective psychophysiological marker for assessing fall risk levels. Moreover, the results underscore the potential advantages of interventions that integrate both physical and psychological components to mitigate fall risk in older adults, emphasizing the intricate mind–body connection. The ClinicalTrials.gov ID: NCT05948735, July 7, 2023.

INPLASY202480043 Nutritional-Related Knowledge, Attitudes, and Practices among Physical Therapists and Physical Therapy Students: A Scoping Review Keywords: Nutrition; Physical Therapy; Knowledge; …

Introduction: Skin melanoma is the most severe form of skin cancer. Recent years have seen an increase in melanoma incidence. Melanomas often appear on the back, a hidden area, leading to late diagnoses. Physical therapists, who frequently treat patients with lower back pain, could play a crucial role in early melanoma detection.Methods: An anonymous online survey was conducted among 254 Israeli physical therapists to assess their perspectives on melanoma detection, their knowledge in identifying suspicious lesions, and their referral patterns. The survey included sections on demographics, professional perspectives, melanoma knowledge, personal or family experiences with melanoma, and referral frequency for dermatological evaluation.Results: The survey revealed that 75.2% of physical therapists viewed melanoma detection as part of their professional duties, yet 59.1% reported insufficient knowledge in identifying suspicious lesions. Despite this, 94.1% expressed a desire to improve their knowledge. However, only 44.1% actively referred patients with suspicious lesions to dermatologists. There was a significant positive correlation between professional experience and referral rates (p-value < 0.001), indicating that more experienced therapists were more likely to refer patients.Discussion: The study highlights the critical need for incorporating melanoma detection training into physical therapy education and professional development. Enhancing physical therapists’ knowledge and skills in this area could improve early detection and patient outcomes. Despite the potential role of physical therapists in melanoma detection, current training programs lack emphasis on this aspect, underscoring the importance of revising educational curricula to include skin cancer detection techniques.Conclusion: The findings suggest that while physical therapists recognize their role in melanoma detection, there is a significant knowledge gap. Addressing this through targeted education and training could enhance early detection efforts and improve patient care.

Background: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. Methods: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. Results: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach’s alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. Conclusions: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. Trial registration NR: Not applicable.