2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T5b3,We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes.31:T772, Purpose of review We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Recent findings Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. Summary A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Physiotherapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Physiotherapy (modality). Clinician-written summaries and actionable practice insights. 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The pathway included multidisciplinary assessment, with 2-week digitally supported physiotherapy-led follow-up (n=101) and semi-structured interviews (n=20).","key_result":"90% of patients (129/143) did not return to a public ED within 90 days. Significant improvements in pain/discomfort and usual activities were seen at 2 weeks (both p<0.001, effect sizes r=−0.88 and r=−0.76 respectively), but anxiety/depression scores did not improve. 5 cases of missed serious pathology were identified (3 fragility fractures, 1 herpes zoster, 1 spinal metastasis).","limitations":"- No control group, so ED re-presentation rates cannot be directly compared to standard ED care.\n- Selection bias in qualitative interviews: only patients highly engaged with digital follow-up were interviewed, excluding non-users (e.g., older adults, non-English speakers) whose experiences may differ.\n- Some EQ-5D-5L items (self-care, mobility) were administered incorrectly and excluded; no primary care records were captured to identify missed diagnoses outside hospital.","practice_takeaway":"For patients with non-serious LBP triaged away from the ED, diversion to a multidisciplinary community hub with 2-week digital follow-up appears safe and acceptable, with 90% avoiding ED return within 3 months. Clinicians should be alert to older patients (all 6 who were admitted were >65 years), who may need enhanced support and closer follow-up."}},{"doi":"10.1016/j.rmed.2026.109041","pmid":"42462858","title":"Gaps in Physiotherapy Capacity to Provide Long COVID Rehabilitation Care","journal_title":"Respiratory Medicine","journal_issn":"0954-6111","published_at":"2026-07-16T00:00:00.000Z","url":"https://doi.org/10.1016/j.rmed.2026.109041","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-22T13:37:20.466Z","updated_at":"2026-07-22T13:37:20.466Z","tags":[{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"condition","value":"Long COVID","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"condition","value":"Post-COVID-19 Condition","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"modality","value":"Physiotherapy","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"modality","value":"Rehabilitation","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"sample_size","value":"n=139","value_numeric":139},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"study_design","value":"Cross-Sectional Survey","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"warning","value":"Findings reflect PTs in one Canadian province (British Columbia) and may not generalize to other healthcare systems or regions.","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"warning","value":"Response rate was approximately 6.6% (139/2113 contacted), which limits generalizability despite the sample being near the pre-specified target of n=150.","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109041","tag_type":"warning","value":"Self-reported confidence and expertise levels may not accurately reflect actual clinical competence.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional online survey of 139 registered physiotherapists (PTs) in British Columbia, Canada (March–August 2024), assessing their capacity, confidence, expertise, and training needs for Long COVID rehabilitation care.","key_result":"69% of PTs lacked confidence in assessing and managing Long COVID. Only 17% had high expertise in treating fatigue, and just 7% in dyspnea or chest pain. While 45% reported capacity to accommodate Long COVID patients, nearly half needed more training in Long COVID-specific patient education. Prior hands-on experience — not years of practice — was the strongest predictor of both capacity and lower training needs.","limitations":"- Low response rate (139/2113 contacted; ~6.6%), raising risk of selection bias toward PTs already interested in Long COVID.\n- Self-reported expertise and confidence are subject to response bias.\n- Item-level response rates varied widely (44–139), so some subgroup estimates carry wider uncertainty.","practice_takeaway":"Prioritize targeted continuing education for PTs in cardiorespiratory care, energy conservation/pacing for post-exertional malaise, and mental health integration — existing Canadian (CAN-PCC) and WHO guidelines already provide this content but need better dissemination. Interdisciplinary referral pathways and standardized Long COVID protocols are urgently needed to reduce fragmented care."}},{"doi":"10.1186/s12891-026-09873-z","pmid":"42067884","title":"Physiotherapy with integrated virtual reality for patients with severe chronic low back pain: cluster-randomized controlled trial (VARIETY)","journal_title":"BMC Musculoskeletal Disorders","journal_issn":"1471-2474","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.1186/s12891-026-09873-z","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:55.659Z","updated_at":"2026-05-08T13:23:55.659Z","tags":[{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"condition","value":"Chronic Low Back Pain","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"modality","value":"Physiotherapy","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"modality","value":"Virtual Reality","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"sample_size","value":"n=50","value_numeric":50},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"study_design","value":"Cluster Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"warning","value":"Historical controls were sourced from two external trials — introducing potential confounding from differences in patient selection, timing, and care context.","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"warning","value":"Level of evidence tagged as '2' reflects the RCT design, but the use of external controls and exploratory status functionally downgrades confidence in the findings.","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"warning","value":"No brand name or specific generic drug/device product name was reported for the VR platform used.","value_numeric":null},{"paper_doi":"10.1186/s12891-026-09873-z","tag_type":"warning","value":"The trial was severely underpowered (n=50 total, including 18 historical controls, vs. planned n=120); all effectiveness results are explicitly labeled exploratory by the authors.","value_numeric":null}],"summaries":{"what_studied":"A cluster-RCT evaluated 12 weeks of home-based VR (pain education, exercise, relaxation) integrated with usual physiotherapy vs. usual physiotherapy alone in Dutch adults with severe chronic low back pain (CLBP), with physical functioning as the primary outcome at 3 months.","key_result":"No statistically significant or clinically relevant between-group differences were found for any outcome. ODI mean difference at 3 months was -4.80 (95% CI: -17.78 to 8.18) vs. the VARIETY control and -8.80 (95% CI: -20.17 to 2.57) vs. the total control group. The intervention group showed 42% improvement in physical functioning from baseline vs. 26% in controls, but this comparison is exploratory given the underpowered sample.","limitations":"- Severely underpowered: only 25 intervention and 7 true controls enrolled vs. a planned 120, requiring supplementation with 18 historical controls from external trials.\n- Use of historical/external controls introduces confounding and limits causal inference.\n- Results are explicitly exploratory and cannot confirm or refute VR effectiveness.","practice_takeaway":"VR as an add-on to physiotherapy for severe CLBP is feasible and safe, but no effectiveness benefit was demonstrated in this underpowered trial. Clinicians should await results from adequately powered studies before routinely incorporating VR into CLBP physiotherapy."}},{"doi":"10.1097/qco.0000000000001182","pmid":"41518106","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-01-10T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001182","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1097/qco.0000000000001182","days":"7","issn":"0951-7375","rank":"8","field":"Clinical Medicine","score":"14","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/QCO.0000000000001182","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults.","journal":"Current opinion in infectious diseases","methods":"","results":"","abstract":"$30","keywords":["community-acquired pneumonia","interventions","outcomes","recovery"],"pubmed_id":"41518106","conclusions":"","publication_date":"2026-01-10T00:00:00"},"crossref":{"DOI":"10.1097/qco.0000000000001182","URL":"https://doi.org/10.1097/qco.0000000000001182","ISSN":["0951-7375","1473-6527"],"link":[{"URL":"https://journals.lww.com/10.1097/QCO.0000000000001182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults"],"author":[{"given":"Louise","family":"Lansbury","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Nottingham"},{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"}]},{"given":"Tricia","family":"McKeever","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Nottingham"},{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"}]},{"given":"Wei Shen","family":"Lim","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"},{"name":"Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK"}]}],"issued":{"date-parts":[[2025,12,30]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2026-01-10T12:00:10Z","timestamp":1768046410000,"date-parts":[[2026,1,10]]},"indexed":{"date-time":"2026-01-10T16:43:14Z","timestamp":1768063394818,"date-parts":[[2026,1,10]]},"license":[{"URL":"http://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000,"date-parts":[[2025,12,30]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/QCO.0000000000001182"}},"subtitle":[],"deposited":{"date-time":"2026-01-10T12:00:16Z","timestamp":1768046416000,"date-parts":[[2026,1,10]]},"issn-type":[{"type":"print","value":"0951-7375"},{"type":"electronic","value":"1473-6527"}],"published":{"date-parts":[[2025,12,30]]},"publisher":"Ovid Technologies (Wolters Kluwer 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Discharge communication and patient education reduced readmissions and improved adherence and satisfaction, guideline care bundles reduced 30-day mortality without changing length of stay or 30-day readmissions, and in severe CAP, corticosteroids probably reduce short-term mortality (possibly longer-term mortality and length of stay), while antiplatelets and statins may also reduce short-term mortality.","limitations":"Evidence spans heterogeneous studies and populations; few trials address individual micronutrient supplements, and core outcomes and long-term follow-up are inconsistently assessed.","practice_takeaway":"For adults hospitalized with CAP, consider early mobilization/respiratory physiotherapy and strong discharge education to reduce readmissions and length of stay, and implement guideline-based care bundles. In severe CAP, adjunctive corticosteroids likely improve short-term survival; benefits of antiplatelets and statins are suggestive but less certain."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Physiotherapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Physiotherapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Physiotherapy"}}}]]

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