Australian Physiotherapy Association

Binge Eating Disorder (BED) is the most prevalent eating disorder and is associated with psychiatric comorbidities, health impairments, and decreased quality of life. Emerging evidence suggests that psilocybin-assisted therapy may promote cognitive and emotional flexibility and disrupt maladaptive behavioral patterns, making it a promising candidate for BED treatment. This open-label pilot study evaluated the feasibility, safety, and preliminary therapeutic effects of a single 25mg dose of psilocybin administered in the context of Acceptance and Commitment Therapy (ACT)-based psychotherapy in adults with BED (N = 5). Primary outcomes included safety measures, and exploratory outcomes included self-reported binge eating frequency, depression, anxiety, psychological flexibility, anthropometric indices, and neuroimaging biomarkers assessed over a 14-week follow-up. Psilocybin was well tolerated, with no serious adverse events. Reductions in self-reported binge eating frequency were observed across all participants and sustained through week 14. Improvements were also noted in depression, anxiety, and psychological inflexibility. Three participants showed reductions in body mass index and waist circumference. Given the open label design and small sample size, causality cannot be inferred. fMRI analyses generated preliminary signals of change-such as increased functional activation from pre- to post-intervention in the middle frontal gyrus, angular gyrus, and supramarginal gyrus in response to processed versus unprocessed food cues. Psilocybin-assisted therapy was feasible and well-tolerated in individuals with BED. The clinical and neurobiological observations provide directions for future adequately powered trials.

Female, woman and/or girl athletes’ sport participation rates are rising and associated with high injury rates and burden. Using best-practice consensus methodology, we developed recommendations to guide injury prevention for female/woman/girl athletes. The Female/woman/girl Athlete Injury pRevention (FAIR) International Olympic Committee Consensus meeting was held from 31 March to 2 April 2025 (Lausanne, Switzerland).The FAIR Consensus followed an eight-step hybrid method. 109 authors from six continents conducted: (1) systematic reviews synthesising evidence on injury prevention strategies and modifiable risk factors for lower-extremity and upper-extremity injuries, concussions and spine/chest/abdominal/pelvic injuries/pain, (2) a scoping review synthesising dissemination and implementation (D&I) approaches; and (3) a concept mapping project generating knowledge on gender/sex-related factors for injury prevention. These projects underpinned draft recommendations subsequently voted on by a steering committee (n=24) and an external advisory committee chair over two anonymous survey rounds. Recommendations, Round 1 voting results and suggestions/dissenting comments were discussed between Round 1 and 2 voting. Consensus was defined as ‘critical to include’ (≥70% scored recommendation as 7–9 (9-point Likert scale, 1=not important; 9=critically important) AND ≤15% scored recommendation as 1–3).The 56 FAIR recommendations address: primary injury prevention (n=16) (policy/rules/laws=6; personal protective equipment=8; training=2); secondary injury prevention (n=4); modifiable risk factors (n=12); approaches to D&I (n=14); and promoting gender/sex-supportive environments (n=10).The FAIR Consensus informs evidence-based best practices and policy for injury prevention, approaches to implementation and creation of supportive environments for female/woman/girl athletes. Every person at all levels of sport can, and should, take responsibility for actions that positively influence female/woman/girl athlete health and safety.

Post-intensive care syndrome is a significant challenge for survivors of critical illness. However, little is understood about fear of falls and the concern for falls. This study sought to quantify the prevalence of fear of falls within the first year after hospital discharge and identify factors associated with high fear of falls. Using a mixed-methods approach, fear of falls was assessed using the Falls Efficacy Scale International short-form questionnaire with participants dichotomized into low/moderate (7-12) and high (13-28) fear of falls. Persistence was defined as high fear of falls across at least 2 assessment time points. Data were also collected on physical parameters, frailty, cognition, mood, quality of life, and physical activity levels. Participants were assessed at hospital discharge and at 3, 6, and 12 months postdischarge. A high fear of falls was reported in 66 participants in the first 12 months with 41% reporting persistent high fear. High fear primarily commenced at hospital discharge (79%). Hospital discharge factors associated with reduced odds of experiencing high fear of falls in the first 12 months were higher cognition, strength, physical function, balance, and health-related quality of life. Increased odds of experiencing high fear were shown with older age, comorbidities, ICU delirium, frailty, delayed quadriceps time to peak force, and mental health impairments. The final multivariate model found that intensive care unit (ICU) survivors who had ICU delirium were more likely to have high fear of falls (odds ratio [OR], 4.67 [95% CI, 1.18-18.48]) whereas those with better balance were less likely to have high fear (OR, 0.83 [95% CI, 0.74-0.94]). High fear of falls was not predictive of physical activity or function at 6 months; however, it was a significant predictor of depression. Qualitative data highlighted participant concern for further incapacitation through injury and loss of independence. Perceived causes were reduced strength, balance, and fatigue. Participants described strategies they adopted to reduce their risk of falling, including environmental scanning, gait aid use, and slow, deliberate movement. Fear of falls is a significant and persistent challenge for ICU survivors. Modifiable discharge factors exist such as strength, physical function/balance, ICU-related delirium, and mood, which could be the target of future posthospital interventions. NCT03141762.

Background. High-Intensity Interval Training (HIIT) and Plyometric Training (PT) are commonly used to enhance athletic performance in sports requiring speed, agility, and explosive lower-limb power, such as basketball. While both methods improve neuromuscular and physiological capacities, their comparative effectiveness on specific motor abilities remains unclear. Objectives. This study aimed to evaluate and compare the effects of HIIT and PT on speed, agility, and lower-limb explosive performance in male basketball players. Materials and methods. A total of 22 male basketball players (overall age; 21.27 ± 1.34 years) were randomly assigned to two intervention groups: High-Intensity Interval Training (HIIT, n = 8) and Plyometric Training (PT, n = 14). Both groups underwent their respective training programs over a specified intervention period. Key performance variables, including speed, agility, squat jump (SJ), and countermovement jump (CMJ), were assessed before and after the training. A two-way repeated measures ANOVA (2 × 2) was employed to evaluate the interaction effects between time (pre- and post-intervention) and group (HIIT vs. PT) on all outcome measures. Results. Both the HIIT and PT groups showed significant improvements in sprint time, agility, jump height, velocity, power, and power-to-bodyweight ratio (all p < .001). No marked changes were found in SJ force. A two-way ANOVA revealed a significant time effect for all variables (p < .001), with no substantial group or interaction effects (p > .05), indicating comparable improvements across both interventions. Conclusions. These findings confirmed that both High-Intensity Interval Training and Plyometric Training were effective in enhancing speed, agility, and lower-limb explosive performance among male basketball players. The absence of significant differences between groups suggests that either training method can be effectively incorporated into performance enhancement programs based on athlete preference, training context, or resource availability.

<bold>Background:</bold> ‘Treatable traits’ is transforming the medical management of people with chronic lung disease. Its potential application beyond medical care is not well established but it could reform embedded practices regarding exercise training in pulmonary rehabilitation (PR) to potentially enhance its effectiveness. This study sought to develop a new model of personalised exercise training underpinned by treatable traits (ExTra+). <bold>Methods:</bold> 25 experienced PR clinicians and academics from Australia and New Zealand participated in online roundtable workshops over two days in Dec 2021. Findings informed an online international Delphi survey via DelphiManager. Clinicians and academics rated the importance of ExTra+ traits in terms of their impact upon exercise training via a 9-point Likert scale (higher = better). <italic>A priori</italic> consensus criteria involved median score, IQR and % of scores >7. <bold>Results:</bold> The roundtable meetings established a feasible prototype for ExTra+ and 24 candidate ExTra+ traits. The Delphi study was completed by 70 people from 14 countries (49% Australia, 16% United Kingdom, 35% other; 47% academics, 53% clinicians; median 11.5 [7.5-17] years PR experience). 61 completed round 1; 49 completed round 2 (80% retention). 12 traits achieved consensus in round 1; 4 more reached consensus after round 2. The top traits affecting exercise training were ‘dyspnoea’, ‘a recent lung-related event’ and ‘pulmonary hypertension’. <bold>Conclusion:</bold> ExTra+ sets a vital foundation to advance personalised exercise training in PR. The identified traits should be targeted for future research in this field.

BACKGROUND: Diabetic foot ulcer was characterized by the infection, ulceration, or destruction of the deep tissues associated with neurological anomalies and to a greater degree of peripheral vascular disease in the lower limbs. Low-level laser therapy has a stimulating effect on cells, whereas high-energy radiation has an inhibiting effect. So, the application of laser to stimulate wound healing in cases of non- healing ulcers has been recommended. So, the purpose of the study was to know about the effects of low- level laser therapy on wound healing and quality of life in foot ulcers with diabetic neuropathy. METHODOLOGY: A total of 30 patients fulfilled the inclusion criteria were assigned to two Groups by using a simple random sampling technique. The subjects are divided into 15 for each group. Group A received treatment with low-level laser therapy for 4 weeks, whereas Group B received conventional treatment. RESULT: After a period of therapeutic intervention using the low-level laser therapy, it was noticed that there was an improvement in the wound reduction with a significant process of tissue repair. Where as in the control group there was no reduction of wound size is seen. CONCLUSION: Group A shows more effectiveness in reducing wound size, considering to the low-level laser therapy seems to be an efficient method, viable, painless, and of low cost in tissue repair of ulcers in diabetic foot. The analgesic effect is significant for the reestablishment of these patients, preventing possible amputations and improving quality of life. Keywords: LOW- LEVEL LASER THERAPY, DIABETIC FOOT, DIABETIC FOOT ULCER

ABSTRACTThe popularity of the Copenhagen Adduction Exercise (CAE) has risen in recent years. This review aims to evaluate the available evidence on the isolated use of the CAE for both performance enhancement and injury prevention. This systematic review included prospective interventional studies investigating the effect of the CAE on strength and conditioning and injury prevention outcomes. 15 studies were included, comprising randomized controlled trials (n = 4), cluster‐randomized controlled trials (n = 6), and pre–post trials (n = 5). These studies assessed adduction and abduction strength, jump and sprint performance, core endurance, dynamic balance, adductor longus muscle thickness, and the seasonal prevalence of groin injuries. Meta‐analyses of within‐group changes and between‐group comparisons were performed using standardized mean differences (SMDs) and relative risk (RR). The implementation of the CAE yielded large effect sizes for adduction (within‐group SMD = 0.72, 95% CI = 0.41 to 1.0; between‐group SMD = 0.95, 95% CI = 0.18 to 1.7) and abduction (within‐group SMD = 0.92, 95% CI = 0.47 to 1.4; between‐group SMD = 0.94, 95% CI = 0.33 to 1.56) strength. Adduction strength adaptations were dependent on the repetitions performed (adherence‐adjusted repetitions: p = 0.02; adherence‐adjusted weekly repetitions: p = 0.0063). Dynamic balance can also be improved using the CAE (within‐group SMD = 3.9). The CAE showed no statistically significant effect on seasonal groin injury prevalence (RR = 0.83, 95% CI = 0.41 to 1.68). There were no additional benefits of the intervention for other performance metrics, and the quality of evidence underpinning all findings was rated as very low. The inclusion of the CAE can be recommended for adductor strength training, although current evidence does not support its use for reducing the risk of sustaining groin injuries.Registration Number:https://doi.org/10.17605/OSF.IO/CA7JW.

Shoulder injuries are a key injury for elite cricket players; however, the burden is not well understood. This study describes the incidence, prevalence, characteristics and management of medical attention shoulder injuries in elite female cricket players. Retrospective review of shoulder injuries sustained by elite Australian female cricket players between July 2015 and June 2023. A total of 409 medical attention shoulder injuries were recorded, with an average incidence of 12.9 per 100 players per season. Gradual onset injuries were most commonly experienced by pace bowlers (51%). Sudden onset injuries were most commonly sustained whilst fielding (69%). Four in five injuries were non-time-loss. Modified activities (e.g., throwing, diving and bowling) were typically required for between two weeks and six months. Players typically returned to full unrestricted match play between 1 and 8.5 months, longer for recurrent injuries (p = 0.007). Despite only one in five injuries resulting in a player being unavailable to play or train, impaired shoulder function may reduce the overall performance of the player and the team. Risk reduction strategies may be targeted to players (pace bowlers) and activities (diving and throwing) with a higher rate of shoulder injury. Further consideration may also be given to reducing the risk of exacerbations and recurrent injuries which may prolong recovery.

Abstract Background: Although pulmonary rehabilitation (PR) has demonstrated remarkable efficacy in improving exercise tolerance, physical function and alleviating perceived dyspnea in individuals with chronic respiratory conditions, there is little understanding on the delivery of PR research programs in the Latin American region. This review analyzed 1) the implementation of PR research in Latin America, 2) adherence to established ATS criteria and 3) the evaluation of PR program effectiveness in the region. Methods: The literature search was conducted in six databases (CINAHL, Medline, Embase, Scielo, Web of Science and Health and Medical Collection) up to January 2024, including studies published in English, Spanish, or Portuguese. This review was reported and summarized using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations extension for scoping reviews (PRISMA-ScR, 2022). The protocol was registered in OSF. Studies with adults from Latin America with any respiratory condition longer than three months, participating in any PR program were included. Results: Of the 1508 articles identified, 45 studies involving a total of 2067 individuals were analysed. The studies were conducted in Brazil (n=28), Colombia (n=9), Cuba (n=4), Chile (n=3) and Argentina (n=1). Most PR participants were individuals with COPD (86%). PR programs included aerobic exercise, resistance training, respiratory exercises and educational programs involving a multidisciplinary team. Quality of life, dyspnea, aerobic capacity and muscle strength were the main assessments included in the programs. Aerobic training was included in 39 studies (87%) and strength training in 32 studies (71%). Outcome measures included quality of life in 29 studies (64%), dyspnea in 40 studies (89%), aerobic capacity in 37 studies (82%) and muscle strength in 20 studies (44%). Twenty-six studies (58%) followed international recommendations for PR. Conclusion: A significant progress has been made in the implementation of pulmonary rehabilitation research programs in Latin America However, disparities remain, particularly in the exercise modalities, assessments, professional team and adherence to international guidelines.