Musculoskeletal Care最新文献

{"title":"Exploring Barriers and Facilitators in Physiotherapy Rehabilitation for Patients With Knee Osteoarthritis: A Scoping Review.","authors":"Chandra Bathran, Asir John Samuel","doi":"10.1002/msc.70221","DOIUrl":"10.1002/msc.70221","url":null,"abstract":"<p><strong>Background and purpose: </strong>Evidence on barriers and facilitators to physiotherapy (PT) rehabilitation for patients with knee osteoarthritis (KOA) is limited. Hence, there is a definite need to identify the barriers and facilitators to PT rehabilitation for patients with KOA by reviewing the existing literature.</p><p><strong>Methods: </strong>Original articles on barriers and facilitators to PT rehabilitation for patients with KOA, published from 2016 to July 2025, were included. This scoping review followed Arksey and O'Malley's framework and the Joanna Briggs Institute (JBI) methodology. Search strategies were developed using PubMed, Scopus, ProQuest, and Web of Science and were limited to English. Data were extracted using a data extraction form and analysed thematically in NVivo 15.</p><p><strong>Results: </strong>Of the 469 articles identified, 20 were included that focused on the barriers and facilitators to influencing PT. Eight sub-themes were developed for the barriers theme, and seven for the facilitators theme. Barriers to PT experienced by patients with KOA include limited education, access, and time to access and adhere to PT rehabilitation, whereas facilitators include physiotherapists' follow-up and social support.</p><p><strong>Conclusions: </strong>Barriers and facilitators were identified, highlighting the importance of involving patients in treatment decision-making and adopting a patient-centred approach to address these barriers and enhance adherence, especially in low- and middle-income countries.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70221"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Identification and Management of Modifiable Risk Factors in Hip and Knee Osteoarthritis: A Quality Improvement Project in an NHS Orthopaedic Interface Service.","authors":"Rose Henning, Michael Henning, Justine McMillan, Gethin Lynch","doi":"10.1002/msc.70234","DOIUrl":"10.1002/msc.70234","url":null,"abstract":"<p><strong>Background: </strong>Hip and knee osteoarthritis are highly prevalent conditions associated with pain, disability and increasing demand on orthopaedic services. Best practice guidance emphasises early identification and optimisation of modifiable risk factors to improve outcomes following joint replacement, yet these are often inconsistently addressed in routine musculoskeletal care. This quality improvement project aimed to improve the consistency with which clinicians identified and acted on key modifiable risk factors during orthopaedic interface consultations.</p><p><strong>Methods: </strong>The project was conducted in an NHS Orthopaedic Interface Service using the Model for Improvement. A retrospective audit of 291 consultations demonstrated low rates of documented action despite a high prevalence of modifiable risk factors. Four domains were prioritised: excess body weight, smoking, diabetes optimisation and psychosocial factors. A bundle of low-burden interventions was introduced through sequential plan-do-study-act cycles. Prospective monthly sampling of 180 consultations over six months assessed change over time.</p><p><strong>Results: </strong>Across 180 prospective consultations, documented action increased from 30% to 78% among consultations where at least one targeted modifiable factor was present. Improvement was clearest for weight-related advice and signposting. Smoking, diabetes and psychosocial findings were limited by small denominators or variable documentation and were interpreted descriptively. The largest increase was observed following introduction of embedded workflow supports, although attribution to any single component is limited by the sequential QI design.</p><p><strong>Conclusion: </strong>A simple quality improvement bundle was associated with improved documentation of action on modifiable risk factors during routine osteoarthritis consultations, particularly for weight-related advice and signposting. Embedded documentation prompts may support more reliable care processes, but further work is needed to assess sustainability, patient-level outcomes and transferability to other settings.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70234"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13183992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of Structural Reasoning in Brazilian Physiotherapy: A Cross-Sectional Study on 'Text Neck' Beliefs.","authors":"Jorge Arrigoni, Marcelo de França Moreira, Ney Meziat-Filho, Igor M T Correia, Luciana C Lunkes","doi":"10.1002/msc.70220","DOIUrl":"10.1002/msc.70220","url":null,"abstract":"<p><strong>Background: </strong>The 'text neck' concept-that sustained cervical flexion during mobile device use causes mechanical overload, pain, and dysfunction-has gained popularity among physiotherapists despite limited empirical evidence. This belief may perpetuate outdated kinesiopathological reasoning that conflicts with biopsychosocial approaches.</p><p><strong>Purpose: </strong>To assess the prevalence of 'text neck' beliefs in a recruited sample of Brazilian physiotherapists and examine their association with kinesiopathological clinical reasoning.</p><p><strong>Methods: </strong>This cross-sectional observational study invited physiotherapists to complete an online questionnaire addressing clinical reasoning in both acute and chronic neck pain scenarios. The Chi-square (χ²) goodness-of-fit test was used to assess differences in category distributions, and the Chi-square test of independence was used to examine associations between categorical variables. Logistic regression models were developed to investigate the influence of educational level, professional specialisation in areas related to neck pain management, and time since graduation on the odds of employing kinesiopathological reasoning.</p><p><strong>Results: </strong>Most physiotherapists endorsed assessing and treating neck pain based on smartphone postural parameters and the kinesiopathological model (e.g., 73% for acute neck pain; 66% for chronic neck pain). Chi-square tests showed significant moderate associations between 'text neck' beliefs and kinesiopathological reasoning (Cramér's V = 0.31-0.40, p < 0.001). Higher educational level was associated with a 30% reduction in odds of employing kinesiopathological reasoning (OR = 0.70; 95% CI [0.56, 0.90], p = 0.003).</p><p><strong>Conclusions: </strong>Despite increasing endorsement of biopsychosocial models, a substantial proportion of physiotherapists in this sample reported employing 'text neck' concepts and kinesiopathological reasoning. Higher educational attainment was associated with reduced reliance on these approaches, highlighting the need for targeted educational reforms to promote evidence-based clinical reasoning.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70220"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activity-Based Functional Exercise for Disability in Systemic Sclerosis: Protocol for a Feasibility Randomised Controlled Trial.","authors":"Gabriela da Silva Santos, André Nunes Soares, Geisielly Maria Porto Soares, Thaís Ariadne Medeiros de Lima, Juliana Fernandes, Angela Luzia Branco Pinto Duarte, Angélica da Silva Tenório, Andrea Tavares Dantas","doi":"10.1002/msc.70217","DOIUrl":"10.1002/msc.70217","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic Sclerosis (SSc) is associated with substantial disability in affected patients. Although exercise interventions for SSc have been developed, most focus on isolated body segments rather than global disability. Thus, this study aims to assess the feasibility of a functional activity-based exercise programme designed to address disability in individuals with SSc.</p><p><strong>Methods: </strong>This feasibility study protocol is designed as a randomised controlled mixed-methods trial. It will include individuals with SSc aged 18-65 years and with a score ≥ 1 on the Scleroderma Health Assessment Questionnaire (SHAQ). Participants will be randomly allocated to either a control group, receiving an educational booklet on the disease, or an intervention group receiving the booklet plus a 10-week supervised functional exercise protocol (twice weekly). Feasibility outcomes include recruitment and retention rates, adherence, safety, and adverse events. Preliminary clinical outcomes will address disability level, physical function, fatigue, resilience, symptoms of anxiety and depression, and perceived change. Quantitative data will be analysed using descriptive and inferential statistics, while qualitative data will undergo thematic content analysis.</p><p><strong>Ethical approval: </strong>The study was approved by the Institutional Ethics Committee (Approval Number: 6.992.710).</p><p><strong>Results: </strong>The study is in its initial phase. The reference clinic has 219 registered patients, of whom 183 (83.6%) are preliminarily eligible. Recruitment and subsequent feasibility results are ongoing.</p><p><strong>Conclusion: </strong>This protocol proposes an innovative and low-cost approach, whose results will support refinements for a more rigorous clinical trial, despite potential logistical and disease-related limitations.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70217"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Physical Exercise on Pain in Patients With Lumbar Disc Herniation: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.","authors":"Diego Gama Linhares, Bruno Gama Linhares, Lilliany de Souza Cordeiro, Claudio Joaquim Borba-Pinheiro, Rodrigo Gomes de Souza Vale","doi":"10.1002/msc.70231","DOIUrl":"10.1002/msc.70231","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to analyse the effects of physical exercise on pain in patients with lumbar disc herniation, regardless of whether they had undergone surgery.</p><p><strong>Methods: </strong>A meta-analysis was conducted according to the PRISMA guidelines. Randomised controlled trials (RCTs) were selected based on the PICOS strategy, and methodological quality and risk of bias were assessed using the TESTEX scale and the RoB 2 tool, respectively. The GRADE tool was used to assess the quality of evidence. Electronic searches were performed in the PubMed, Scopus, Web of Science, Cochrane, and PEDro databases. Subgroup analyses were conducted in an attempt to explain heterogeneity.</p><p><strong>Results: </strong>A total of 864 studies were identified. After applying the eligibility criteria, 13 randomised controlled trials were included in the systematic review, with 12 studies included in the forest plot, comprising 18 analyses. Pain outcomes were assessed using different measurement instruments, and the meta-analysis demonstrated a significant reduction in pain favouring the exercise intervention, with a standardised mean difference of -0.68 (95% CI: -1.11 to -0.25; p = 0.002). However, substantial heterogeneity was observed among the included studies (I² = 89%; p < 0.0001). As this heterogeneity was not explained by subgroup analysis or meta-regression, a random-effects model was used for statistical adjustment.</p><p><strong>Conclusion: </strong>This meta-analysis concluded that physical exercise improves pain-related outcomes in adult patients. Notably, the forest plot demonstrated a significant mean difference. These findings suggest that physical exercise is associated with a better prognosis in the treatment of lumbar disc herniation.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70231"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Criteria and Outcome Measures for Cervicogenic Headache in Randomised Controlled Trials: An Updated Systematised Review With Age-Based Subgroup Analysis.","authors":"Sushmitha Iyer, Kalashree Hadya Ananda, Muhammed Rashid","doi":"10.1002/msc.70215","DOIUrl":"10.1002/msc.70215","url":null,"abstract":"<p><strong>Background: </strong>The overlap in signs and symptoms of CGH with other forms of headaches greatly complicates the process of an appropriate diagnosis, resulting in inaccurate diagnoses in approximately 50% of CGH cases.</p><p><strong>Objective: </strong>To identify and categorise the diagnostic criteria employed for CGH in randomised controlled trials published from 1997 to 2023 and to descriptively examine the outcome measures and physical examination methods employed, with reference to different age group applications.</p><p><strong>Methodology: </strong>The literature search for this systematised review was conducted from six different electronic databases using a specific search strategy and citation tracking. In total, 498 articles were screened by two reviewers based on preset inclusion and exclusion criteria using the PICO format, and disagreements were resolved by consensus; 59 RCTs were included in the review. Data were extracted on study characteristics, diagnostic criteria, outcome measures, and assessment methods. Due to methodological and clinical heterogeneity, a narrative qualitative synthesis was performed.</p><p><strong>Results: </strong>Fifty-nine RCTs involving 3454 participants were included. The mean age of participants ranged from 11.6 ± 2.3 years in paediatric samples to 54.5 ± 7.9 years in older adults. Cervicogenic Headache International Study Group (CHISG/Sjaastad) criteria were most commonly used (49%), followed by International Headache Society (IHS) criteria (39%) and International Classification of Headache Disorders, 2nd edition (ICHD-2) criteria (3%). The commonly employed outcome measures included pain intensity (VAS/NPRS), headache frequency and duration, cervical range of motion, and disability indices (e.g., NDI). Subgroup analysis revealed a lack of standardised diagnostic criteria in paediatric and adolescent studies.</p><p><strong>Conclusion: </strong>The included studies identified inconsistency in diagnostic criteria and outcome measures, particularly in younger populations. Despite the availability of established frameworks, their variable applications in the studies limit their comparability and clinical translation. This review highlights the urgent need for standardised diagnostic criteria for specific age and outcome coresets to strengthen future CGH research and clinical practice.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70215"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatricians' Knowledge, Skills, and Practices in Screening for Developmental Dysplasia of the Hip: A Nationwide Cross-Sectional Study.","authors":"Osama M Aldowekat, Abeer M Aldowikat, Raeda T Al-Ghananim, Yazan A Saleh, Taghleb T Al-Awad, Mahmmud S Alqawasmi, Raed I Seetan, Malak Smida, Moayed A Alqudah, Mohammad N Alswerki","doi":"10.1002/msc.70198","DOIUrl":"10.1002/msc.70198","url":null,"abstract":"<p><strong>Introduction: </strong>Developmental dysplasia of the hip (DDH) is a common condition that can be effectively treated if detected early. DDH screening remains institution-based with no clear guidelines at the national level in many countries, including Jordan and most of the MENA region. The aim of the study was to assess Jordanian pediatricians' DDH screening knowledge and skills, identify associated factors, and explore readiness for a national screening approach.</p><p><strong>Methods: </strong>A nationwide, cross-sectional, STROBE-compliant survey was administered (Aug-Sep 2025) to 255 Pediatricians. A 19-item questionnaire assessed aspects such as risk factors, age of screening, incidence in Jordan, physical signs, confidence in performing the Barlow and Ortolani manoeuvres, and management approaches, along with their 'composite knowledge score' score. CKS was graded using Bloom's cut-offs (high ≥ 80%, moderate 60%-79%, low < 60%). Factors associated with higher CKS were examined with the Welch two-sample t-test, ANOVA and Tukey post hoc tests.</p><p><strong>Results: </strong>Only 9% achieved high CKS scores, 49.4% moderate, and 41.6% low. DDH screening was routinely performed by 69.4% of participants, and 70.6% had access to hip ultrasound at their workplace. The mean overall CKS was 61.6 ± 14.6 and the mean CKS scores were 63.3 ± 14.25 for specialists and 57.7 ± 14.78 for residents; Participants with more experience, higher infant exposure, and greater confidence in performing the Barlow and Ortolani manoeuvres achieved higher scores.</p><p><strong>Conclusion: </strong>Our study revealed that pediatricians in Jordan generally lack adequate knowledge and skills in DDH screening, a gap consistent across location, sector, and experience level. Higher level of experience, greater exposure to infants and higher confidence in performing Barlow and Ortolani manoeuvres were associated with better proficiency. A national training programme coupled with national guidelines is needed to promote early detection and reduce late-presenting cases.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70198"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Management in Physiotherapy-Led Triage for Knee Osteoarthritis: A Mixed-Methods Service Evaluation.","authors":"Georgina E E Hulson, Melanie Ann Holden","doi":"10.1002/msc.70232","DOIUrl":"10.1002/msc.70232","url":null,"abstract":"<p><strong>Objective: </strong>To explore how weight is assessed and addressed for patients with knee osteoarthritis (KOA) by Advanced Practice Physiotherapists (APPs) in the Musculoskeletal Clinical Assessment and Triage Service (MCATS) at Mid Cheshire NHS Foundation Trust (MCHFT).</p><p><strong>Methods: </strong>A sequential mixed-methods service evaluation. Electronic patient records from all MCAT APPs (n = 8) between April and September 2023 were reviewed to identify care episodes for patients with KOA. Anonymised data on patient characteristics and care provision were extracted and analysed descriptively. APPs were invited to virtual semi-structured interviews exploring their knowledge of current guidelines, approaches to and confidence in, assessing and addressing weight. Interview transcripts were analysed thematically.</p><p><strong>Results: </strong>Of 167 patient records included in the medical record review, 28% (n = 47) had a recorded Body Mass Index (BMI) and 23% (n = 38) had a weight management discussion. Five APPs consented and were interviewed (n = 5). Findings confirmed that the assessment and management of weight were limited. Weight was typically addressed through brief dietary and exercise advice. Barriers to optimising weight management included limited confidence, knowledge, skills, and perceptions of scope of practice. Complex issues were raised with local BMI thresholds for surgical referral for joint replacement.</p><p><strong>Discussion: </strong>Weight is not routinely assessed or addressed in patients with KOA in MCATS at MCHFT.</p><p><strong>Conclusion: </strong>With appropriate training and improved knowledge of local resources, APPs could enhance weight management by optimising brief advice provision and signposting to relevant services.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70232"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Experiences of Multimodal Rehabilitation for Chronic Pain in Primary Care.","authors":"Charlotte Sylwander, Josefin Willhammar, Ingrid Larsson, Stefan Bergman","doi":"10.1002/msc.70241","DOIUrl":"10.1002/msc.70241","url":null,"abstract":"<p><strong>Objectives: </strong>To describe how patients with chronic pain experienced participation in a multimodal rehabilitation programme (MMR) in primary care.</p><p><strong>Methods: </strong>The study had a descriptive qualitative design with an inductive approach, including 10 participants (6 women and 4 men, aged 36-57). The MMR took place at a primary care centre in southern Sweden and consisted of face-to-face meetings twice a week for 6 to 7 weeks. The multidisciplinary team included a physiotherapist, an occupational therapist, a healthcare counsellor, and a physician. Individual in-person interviews were conducted using open-ended questions and analysed using qualitative content analysis.</p><p><strong>Results: </strong>The results illustrate participants' varied experiences of participation in MMR in primary care, described in three themes with six sub-themes: (1) knowing the pain (grasping the pain and voicing needs); (2) embracing pain (being recognised and empowered); and (3) building resilience (enhancing skillset and becoming proactive).</p><p><strong>Conclusions: </strong>MMR offered a structure to address chronic pain beyond symptoms, fostering better communication with healthcare professionals and promoting autonomy. It encouraged a shift towards a biopsychosocial understanding of pain and resilience building. Tailoring MMR to individual needs and previous experiences could further strengthen its impact on diverse groups of patients with chronic pain.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70241"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of an Autoimmune Protocol (AIP) Diet in Adults With Rheumatoid Arthritis: A Single Arm Crossover Pilot Feasibility Study.","authors":"Julianne J McNeill, Gael J Mearns, Rebecca Grainger, Caryn Zinn","doi":"10.1002/msc.70214","DOIUrl":"10.1002/msc.70214","url":null,"abstract":"<p><strong>Background: </strong>Individuals with rheumatoid arthritis (RA) often ask whether dietary changes or food exclusions can reduce symptoms. The Autoimmune Protocol (AIP) diet, an elimination-based approach, is popular on social media, with anecdotal reports of benefit, but lacks clinical evaluation in RA.</p><p><strong>Objectives: </strong>To assess the feasibility and effectiveness of an AIP diet on patient-reported outcomes (PROs) in adults with RA.</p><p><strong>Methods: </strong>In this single-arm, open-label pilot study, nine adults with RA followed their usual diet for 4 weeks and then an 8-week AIP diet in a free-living context. Weekly PRO measures included the Routine Assessment of Patient Index Data 3 (RAPID3) and RA Impact of Disease (RAID) as primary outcomes. Secondary outcomes included 3-day weighed food records and biometric measurements (weight and waist circumference) collected at baseline and every 4 weeks. Adherence and ease of implementation were recorded weekly.</p><p><strong>Results: </strong>Nine participants (7 females, 2 males, aged 40-63 years) completed the intervention. From baseline to end week 12, mean RAPID3 scores decreased from 2.73/10 (range 0.2-5.37) to 0.99 (0-2.5). Four participants demonstrated a clinically meaningful reduction and three others reached remission from low disease activity. Mean RAID scores decreased from 3.13/10 (0.1-6.35) to 1.02 (0-2.96). Fatigue, sleep and pain improved. Mean body mass index reduced from 26.3 kg/m² to 24.5 kg/m². The diet was feasible with high adherence.</p><p><strong>Conclusions: </strong>An 8-week AIP diet was associated with improvements in PROs in seven of nine participants. These pilot findings support further controlled trials to confirm efficacy and explore mechanisms as a potential adjunct therapy for RA.</p><p><strong>Trial registration: </strong>Number ACTRN12624001391561. https://www.anzctr.org.au/ACTRN12624001391561.aspx.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"24 2","pages":"e70214"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}