2026-02-28
Ameen Masoudi, Bashir Bello, Nomzamo Chemane, Ushotanefe Useh, Nontembiso Magida
Background: Recreational cycling is increasingly popular in Al Madinah, Saudi Arabia. However, many cyclists lack structured self-management programmes (SMPs) to address patellofemoral pain syndrome (PFPS), a common overuse injury that significantly affects knee function and cycling performance. Despite the growing interest in cycling, a critical gap remains in culturally relevant, evidence-based SMP. Objectives: Our study aimed to develop expert consensus on the essential components of SMP for recreational cyclists with PFPS. Method: Our study employed a two-round modified Delphi to develop expert consensus on the components of an SMP for recreational cyclists with PFPS. A panel of 25 experts, comprising physiotherapists, biokinetists, sports medicine professionals and exercise physiologists, participated in Round 1, with 19 experts (76% retention) completing Round 2. The process involved rating proposed programme objectives, principles, outcome measures and pain relief strategies using a four-point Likert scale. Consensus was defined as ≥ 70% of respondents selecting either ‘disagree’ to ‘strongly agree’. Results: Consensus was reached on strengthening exercises (88%), evidence-based practice (84%), pain education (84%), PFPS education (92%) and knee pain management (92%). Round 2 results were streamlined and ranked according to pain, function, adherence, cultural resources and engagement supports, following clarifications and the addition of new items from experts. Conclusion: Our study establishes an evidence-based, region-specific framework for self-managing PFPS among recreational cyclists. Clinical implications: The proposed programme is designed to enhance adherence, reduce the risk of injury and improve cycling performance. Future research should evaluate the effectiveness of this approach, its scalability, outcomes and integration into national sports and rehabilitation strategies.
2026-02-27
Marisa Coetzee, Amanda Clifford, Dominique C. Leibbrandt, Jacobus Jordaan, Quinette Louw
Background: Osteoarthritis (OA) of the knee is a common, disabling condition influenced by multiple biopsychosocial factors and often requiring a total knee replacement (TKR). However, most rehabilitation programmes are developed in high-income countries, potentially limiting transferability to lower-income settings with distinct health equity challenges. Objectives: This study aimed to describe the demographic and health equity profiles of adults undergoing TKR for primary OA across low-, middle- and high-income countries. Method: A systematic literature search was conducted in PubMed, Scopus, EBSCOhost, Web of Science and ProQuest for peer-reviewed primary research, including observational studies, randomised controlled trials and grey literature published between 2020 and 2024. Studies reporting on individuals undergoing TKR were selected. Data extraction followed the PROGRESS-Plus framework, and a descriptive synthesis of demographic and health equity information was performed. Results: The review included 101 studies with over 3.2 million participants, predominantly from high- and upper-middle-income countries, with no representation from Africa. Although females consistently represented the majority (54% – 86%), key health equity indicators such as socioeconomic status and education were inadequately reported. Clinical characteristics also varied, with a higher mean BMI observed in high-income country studies. Substantial methodological heterogeneity precluded meta-analysis. Conclusion: There is extensive global research on TKR; however, data from lower-income countries is scarce, and health equity factors are poorly reported. Clinical implications: Inconsistent reporting of outcome measures and limited reporting of health equity in global studies limit the implementation of rehabilitation programmes in low-resource settings. These settings would benefit from detailed equity data to adapt interventions to local patient needs. In addition, better integration of social determinants of health into physiotherapy practice can enhance personalised care and fair resource distribution.
2026-02-20
Maurice Kanyoni, Margaret I. Fitch, Joliana Phillips, Lena Nilsson-Wikmar, David K. Tumusiime
Background: When a traumatic spinal cord injury (TSCI) happens to healthy individuals, it requires an adjustment to life situations in the community. Exploring the lived experience of spinal cord injury survivors is important because it forms a foundation for designing strategies to improve their reintegration back into the community. There are limited studies in the East and Central African region regarding the experience of community reintegration following a TSCI. Objectives: This study explored lived experiences of persons with TSCI in Rwanda. Specifically, it sought to identify and understand the barriers and facilitators to living in the community following a TSCI. Method: A descriptive qualitative design was employed. Nineteen individuals, purposively selected for diversity, were interviewed face to face. Interviews were audio-recorded and transcribed. Data were thematically analysed. Results: The mean age of the informants was 40 years, ranging from 21 years to 72 years old. Ten participants had paraplegia, and nine were living with tetraplegia. The themes identified were personal factors, social relationships, community-related factors, preinjury status, and having common conditions. Strong personal resources, a supportive family, health insurance coverage, and peer counselling were reported as facilitators. Barriers include inaccessibility to public buildings and transport, inappropriate assistive devices, inappropriate language and pre-injury conditions. Conclusion: The challenges experienced by people with TSCI range from personal to environmental factors, and from employment to policy issues. This study sheds light on the lived experience of individuals with TSCI. There is a need to review current relevant policies in Rwanda as a first step to addressing these issues. Clinical implications: Rehabilitation services in Rwanda need to be designed to include home-based care. Introducing peer counselling could be beneficial within the rehabilitation programme.
2026-02-14
Danielle Foot, Joanne L. Potterton
Background: Parents are intricately involved in managing their child’s lower respiratory tract infection (LRTI). While medical and physiotherapy management of childhood respiratory infections has been studied, little is known about parents’ perspectives on the condition and its care. Objectives: The aim of this study was to explore the experiences and challenges of parents of children with LRTI concerning medical and physiotherapy management. Method: Parents of children under 3 years with LRTIs were invited to participate in a qualitative exploratory study. Semi-structured interviews were conducted. Each interview was coded, and deductive thematic analysis was used to identify themes. Results: Data saturation was reached after 10 interviews and confirmed after 12 interviews. The mean ages of participants and their children were 34.3 (standard deviation [s.d.] ± 4.9) years and 18.8 (s.d. ± 6.5) months, respectively. The codes that emerged formed sub-themes within a main theme, which was labelled ‘It is tough taking care of a sick child’. The sub-themes identified were ‘personal challenges’, ‘treatment options’ and ‘parent understanding’. Conclusion: Parents still felt ineffective and stressed about taking care of their child’s LRTI, despite the integral role that they play in the management of their child’s respiratory condition. Timely access to a multidisciplinary team of paediatric healthcare professionals who practice family-centred care positively influences the experience of caring for a sick child. Clinical implications: Understanding parent perspectives will help healthcare professionals enhance a family-centred care approach, leading to better health outcomes.