Sharma S, et al. Hip Pelvis. 2023 Mar;35(1):1-5. https://doi.org/10.5371/hp.2023.35.1.1

Aim: To examine if a novel reactive balance training program (ReacStep) designed for clinical settings is acceptable to clinicians prescribing balance and mobility training.Methods: ReacStep consists of tether‐release reactive step training, volitional trip and slip training, and functional strength training. An open survey comprising 11‐point visual analog scale items (0 = strongly disagree to 10 = strongly agree) based on the Theoretical Framework of Acceptability was sent to clinicians working in balance and mobility training. Items evaluated the acceptability of ReacStep across seven domains (intervention coherence, perceived efficacy, self‐efficacy, ethicality, affective attitude, burden and opportunity cost).Results: Two hundred and seven clinicians (169 Physiotherapists, 22 Exercise Physiologists, 11 Occupational Therapists and five others) completed the survey. Respondents considered ReacStep to have good overall acceptability, intervention coherence, effectiveness, ethicality and self‐efficacy (mean acceptability scores >7). However, respondent's ratings of ReacStep's affective attitude, burden and opportunity cost were more variable (mean acceptability scores 2–8) due to concerns about client anxiety, the need for a safety harness and staffing and training requirements. Respondents considered that ReacStep would be more effective and safer to conduct in geriatrics clients compared with neurological clients, and that it would be more appropriate for rehabilitation and private practice settings compared to home settings.Conclusions: ReacStep was generally acceptable from the perspective of clinicians who prescribe balance and mobility training in various clinical settings, and was deemed more effective and safer for older clients without neurological conditions, and beneficial in outpatient rehabilitation and private practice settings.

Background: Lateral elbow tendinopathy is one of the most common chronic and degenerative diseases which significantly affects quality of life and the activities of daily living of a person. The following is a systematic review reporting a comparison between physical therapy intervention and corticosteroid injection for the treatment of lateral elbow tendinopathy. Method: PubMed, Web of Science, and Embase were searched using headings related to treatment options for Lateral elbow tendinopathy. The following keywords were used: lateral epicondylitis, physical therapy, and corticosteroid injection. Result: We descriptively analyzed and reviewed a total of 12 studies including a total of 1253 patients for lateral elbow tendinopathy. The physical therapy intervention included interventions like electrotherapy, manual therapy, and exercise. The studies included had an overall low to unknown risk of bias. Conclusion: Our review suggests corticosteroid injection provides beneficial short-term effects and physical therapy interventions provide intermediate to long-term effects, less additional treatment and low recurrence rate in patients with lateral elbow tendinopathy. Although high-quality randomized control trials are required in order to have a better understanding of both intervention types.

Falls are common among older adults and significantly impact their quality of life. Perturbation-based balance training (PBT) is a task-specific intervention designed to improve reactive balance. This systematic review evaluated the efficacy of PBT in reducing falls, injurious falls, and fall risk factors in older adults. PubMed, CINAHL, EMBASE, and Cochrane databases were searched from inception to June 2024. Randomised controlled trials (RCTs) assessing the effects of PBT on falls or fall risk factors, including reactive balance via laboratory-induced perturbations, were included. Two reviewers independently screened studies and extracted data. Meta-analyses were conducted using a random-effects model, and certainty of evidence was assessed using the GRADE approach. Twenty-five RCTs involving 2,659 participants were included. PBT significantly reduced fall rates by 23% (rate ratio [RR]⍰0.77, 95% CI 0.60–0.99; I ² =57%, low certainty) and injurious falls by 24% (RR⍰0.76, 95% CI 0.58–0.98; I ² =0%) compared to controls. PBT improved reactive balance (e.g., lab-induced falls) but had limited effects on other fall risk factors (e.g., gait). In the dosage subgroup analysis, only PBT programs for at least 6 hours reduced falls by 33%. PBT reduces falls and related injuries, likely through enhanced reactive balance rather than physical improvements. While many PBT programs are low doses (∼2 hours), higher doses (6+ hours) likely offer greater fall protection. Further high-quality trials using accessible PBT methods are needed to support scalable implementation.