The Evidence Compass: A Weekly Research Review

Welcome to our weekly literature review! An effort to stay at the cutting edge of physical therapy by integrating the latest evidence into our practice. Each week, we dive into the latest research shaping movement, health, and system-level innovation.

This week, we explored six new articles, from the domain of exercise for longevity to the complex mechanics of skeletal muscle. Here's a summary of the key takeaways and how they inform our approach to patient care and professional development.

Monday: Exercise Intensity vs. Volume for Longevity

The first article, from the European Journal of Preventive Cardiology, challenges the traditional "volume-over-intensity" approach to physical activity. Using accelerometer data from over 7,500 US adults, the study found that physical activity (PA) intensity is a more potent predictor of longevity than overall volume, especially for reducing cardiovascular disease (CVD) mortality risk.

Key Insight

The research suggests that current PA guidelines, which often focus on total weekly minutes, may need to be revised to emphasize intensity distribution and bout structure. Even short, intense bursts (5-15 minutes) were found to be more protective than sporadic, low-intensity accumulation. For physical therapists, this reinforces the importance of prescribing high-intensity interval training (HIIT) and other forms of vigorous activity to maximize long-term health benefits for our patients.

• APA Citation: Schwendinger, F., Infanger, D., Lichtenstein, E., Hinrichs, T., Knaier, R., Rowlands, A. V., & Schmidt-Trucksass, A. (2025). Intensity or volume: The role of physical activity in longevity. European Journal of Preventive Cardiology, 32(1), 10–19. https://doi.org/10.1093/eurjpc/zwae295

Tuesday: The Unseen Role of Chronic Stress in Women’s Heart Health

Our second review, published in Comprehensive Physiology, delved into a critical, yet often overlooked, topic: the link between chronic psychological stress and ischemic heart disease (IHD) in women. The review highlights that women are more susceptible to stress-related cardiovascular issues, but most of the foundational mechanistic research has been conducted on male models.

Key Insight

The paper reveals how chronic stress activates the HPA axis, leading to elevated cortisol and other stress hormones that drive inflammation and myocardial remodeling. This creates a vicious cycle of mental and cardiac decline. For physical therapists, this is a reminder to take a holistic, biopsychosocial approach to care. We must screen for and address chronic stress in our female patients, integrating mindfulness, breathing exercises, and other stress-reduction techniques into our treatment plans, especially in cardiovascular rehabilitation.

• APA Citation: Cairns, M., Marais, E., Joseph, D., & Essop, M. F. (2025). The role of chronic stress in the pathogenesis of ischemic heart disease in women. Comprehensive Physiology, 15(1), e70000. https://doi.org/10.1002/cph4.70000

Wednesday: Exercise and Inflammation in Centenarians

The third article, featured in Aging Cell, provides a powerful reminder that it's never too late to benefit from exercise. The study looked at a small group of centenarians (average age 101.2 years) and found that even a single 20-minute bout of moderate-intensity cycling could favorably modulate inflammatory and immune pathways.

Key Insight

This research challenges the assumption of biological rigidity in extreme aging. The participants showed remarkable transcriptomic plasticity, downregulating pro-inflammatory genes and upregulating neuroprotective ones. This confirms that functional exercise is a potent anti-inflammatory tool, regardless of age. It supports our mission to promote lifelong movement and gives us a strong evidence base to design safe, effective exercise programs for even our most fragile geriatric patients.

• APA Citation: Plaza‐Florido, A., Alcazar, J., Rodríguez‐Gonzalo, M., et al. (2025). Even at 100: Acute exercise modulates inflammatory pathways in centenarians. Aging Cell, 24(9), e13999. https://doi.org/10.1111/acel.13999

Thursday: Psychological Safety as a Clinical Imperative

Switching gears from clinical science to operational strategy, we reviewed a paper from Frontiers in Psychology on psychological safety (PS) in healthcare teams. This scoping review of 72 studies confirmed that PS, the shared belief that a team is safe for interpersonal risk-taking, is not a "soft skill" but a key driver of patient safety and team learning.

Key Insight

The review found that inclusive leadership and structured communication are pivotal for fostering PS. As physical therapy is a collaborative, interprofessional field, psychological safety is crucial for effective patient care. It allows us to ask questions, voice concerns, and admit mistakes without fear of judgment, leading to better outcomes. This reminds us to not only practice with our patients but also to foster a psychologically safe environment within our clinics and with our professional colleagues.

• APA Citation: Plaza-Flórido, A., Alcázar, J., Rodríguez-Gonzalo, M., et al. (2025). The role of psychological safety in healthcare teams: A scoping review. Frontiers in Psychology, 16, 1554062. https://doi.org/10.3389/fpsyg.2025.1554062

Friday: Multiscale Modeling of Skeletal Muscle

Finally, we explored a fascinating review in Frontiers in Physiology on multiscale modeling of skeletal muscle mechanics. This paper synthesizes how computational models can bridge the gap from microscopic sarcomeres to whole-muscle movement, providing a comprehensive understanding of muscle function and pathology.

Key Insight

Multiscale models can inform personalized rehabilitation protocols, surgical planning, and the development of digital twins for musculoskeletal care. This is a game-changer for physical therapy. It validates our role in trajectory-informed, value-based care by linking subjective patient outcomes to objective biomechanical data. As physical therapists, we are uniquely positioned to leverage these digital health tools to design more precise, effective, and data-driven treatment plans.

• APA Citation: Sharafi, B., & Blemker, S. S. (2025). Multiscale modeling of skeletal muscle mechanics: From sarcomeres to whole muscle. Frontiers in Physiology, 16, 1559594. https://doi.org/10.3389/fphys.2025.1559594

The Future Proof PT Conclusion

This week’s literature paints a clear picture: the future of physical therapy is holistic, data-driven, and patient-centered.

We must move beyond a "one-size-fits-all" approach to exercise, recognizing that intensity is a powerful driver of long-term health, even in the oldest populations. We must also embrace our role as behavioral health partners, acknowledging the profound impact of psychological stress on physical well-being. Finally, we need to lean into technological innovation, using new tools like multiscale modeling to deliver more precise and effective care.

By integrating these insights, we can continue to elevate our practice and truly live up to our name: Future Proof PT.