Musculoskeletal Science and Practice最新文献

{"title":"Limited association between central pain processing and clinical outcomes in non-specific chronic neck pain after a manual therapy intervention: A secondary analysis","authors":"Josu Zabala-Mata ,&nbsp;Jon Jatsu Azkue ,&nbsp;Joel E. Bialosky ,&nbsp;Estíbaliz López-Dominguez ,&nbsp;Diego Rada Fernandez de Jauregui ,&nbsp;Ion Lascurain-Aguirrebeña","doi":"10.1016/j.msksp.2025.103323","DOIUrl":"10.1016/j.msksp.2025.103323","url":null,"abstract":"<div><h3>Background</h3><div>Non-specific chronic neck pain (NSCNP) is a prevalent condition causing significant disability. While manual therapy is recommended, its clinical benefits are limited. The relationship between central pain processing and treatment outcomes in NSCNP remains unclear.</div></div><div><h3>Objectives</h3><div>To assess whether central pain processing measures could predict manual therapy outcomes in NSCNP patients.</div></div><div><h3>Design</h3><div>Pre-planned secondary analysis.</div></div><div><h3>Methods</h3><div>Sixty-three NSCNP patients underwent a four-week manual therapy regimen. Central pain processing mechanisms were assessed using Pressure Pain Threshold (PPT), Temporal Summation of Pain (TSP), and Conditioned Pain Modulation (CPM). Clinical outcomes were measured using the Neck Disability Index (NDI), pain intensity, and the Global Rating of Change Scale (GRoC). Univariate and multivariate regression models explored associations between baseline variables and treatment outcomes.</div></div><div><h3>Results</h3><div>Multivariate analysis identified baseline CPM and neck pain duration as significant predictors of treatment outcome based on GRoC. A weak negative association was found between CPM and GRoC (p &lt; 0.05), suggesting that patients with lower CPM response reported better perceived outcomes. Baseline NDI was inversely associated with changes in disability (p &lt; 0.01). Baseline pain intensity (p &lt; 0.01) and duration (p &lt; 0.05) were inversely related to pain reduction, while baseline CPM narrowly missed significance. No significant associations were found between TSP, PPT, and clinical outcomes.</div></div><div><h3>Conclusion</h3><div>The findings suggest a limited association between pre-treatment central pain processing status and manual therapy outcomes in NSCNP patients. The lower CPM response was modestly predictive of better outcomes, contrary to expectations. Routine use of QST measures to guide treatment decisions in this population is not supported by current data.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103323"},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between central sensitization and activity limitation in patients with knee osteoarthritis:The mediating role of pain catastrophizing","authors":"Nanyan Li ,&nbsp;Pingjuan Tan ,&nbsp;Guangyuan Dong ,&nbsp;Yun Lu ,&nbsp;Jingchun Zhang ,&nbsp;Qingzhao Liang ,&nbsp;Lei Shi","doi":"10.1016/j.msksp.2025.103318","DOIUrl":"10.1016/j.msksp.2025.103318","url":null,"abstract":"<div><h3>Background</h3><div>In patients with knee osteoarthritis, the most distressing symptom is activity limitation which exacerbates the global burden of the disease. Studies have shown that central sensitization has a negative effect on activity capabilities in patients with knee osteoarthritis. However, limited knowledge exists regarding the underlying mechanisms. Therefore, this study aimed to explore the mediating effect of pain catastrophizing on central sensitization and activity limitation among knee osteoarthritis patients.</div></div><div><h3>Objectives</h3><div>To explore the association between central sensitization and activity limitation by modelling three dimensions of pain catastrophizing as mediators among patients with knee osteoarthritis.</div></div><div><h3>Design</h3><div>This is a cross-sectional study.</div></div><div><h3>Methods</h3><div>A total of 392 patients were surveyed using the general demographic questionnaire, Animated Activity Questionnaire, Pain Catastrophizing Scale, and Central Sensitization Inventory. Multiple linear regression was used to determine covariates included in the mediating model. The mediating effect was tested using the SPSS PROCESS.</div></div><div><h3>Results</h3><div>Age, duration of KOA, and K-L grade were included as covariates. The mediating model revealed that central sensitization had a direct effect on activity limitation (c′ = −0.166; 95 % <em>CI</em> −0.271, −0.064). The relationship between central sensitization and activity limitation was primarily mediated by two indirect pathways: (1) rumination (a1b1 = −0.095; 95 % <em>CI</em> −0.176, −0.017) and (2) helplessness (a2b2 = −0.074; 95 % <em>CI</em> −0.137, −0.009). The indirect effect of the magnification dimension on activity limitation was not statistically significant (a3b3 = 0.002; 95 % <em>CI</em> −0.051, 0.054).</div></div><div><h3>Conclusions</h3><div>The study reveals rumination and helplessness in pain catastrophizing mainly mediate the relationship between central sensitization and activity limitation.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103318"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Move to improve - Prescribing physical activity and deprescribing paracetamol for people with low back pain: Findings from a hybrid type III feasibility study","authors":"Josielli Comachio ,&nbsp;Mark Halliday ,&nbsp;Paulo H. Ferreira ,&nbsp;Jillian Eyles ,&nbsp;Thomas G. Patterson ,&nbsp;David Roberts ,&nbsp;Emma Kwan‐Yee Ho ,&nbsp;Paula R. Beckenkamp","doi":"10.1016/j.msksp.2025.103313","DOIUrl":"10.1016/j.msksp.2025.103313","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of implementing a culturally adapted multimedia intervention in the waiting room of a public hospital physiotherapy outpatient service to guide the implementation of a large multicentre trial investigating the effects of a multimedia intervention to promote physical activity and reduce paracetamol use in people reporting low back pain (LBP).</div></div><div><h3>Methods</h3><div>A six-month (March to September 2024) hybrid type III feasibility study was conducted in an outpatient physiotherapy department of a public hospital in Sydney, Australia. The intervention included a brief video and booklet designed to engage patients and encourage informed management of LBP. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the evaluation. The educational materials were available in English, Arabic and Mandarin.</div></div><div><h3>Results</h3><div>The study revealed limited engagement, with only 11% of 688 potential people exposed to the intervention interacting with it. A total of 66 people completed the surveys (mostly English speakers), and six accepted to participate in a follow-up survey. Despite this low engagement, feedback from those who participated was positive. Satisfaction and usefulness ratings were high, with scores of 7.7–7.9 out of 10 for both video and booklet. Helpfulness was also rated positively, particularly for the video (8.6/10). Barriers to engagement included unfamiliarity with digital formats, video length, and the need for staff assistance in accessing the materials.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the intervention, as currently designed, is not feasible for effective implementation in its present form. While engagement with the multimedia intervention was limited, findings allowed for a comprehensive understanding of the barriers and contextual factors impacting patient interaction. Notably, the majority of feedback was positive, with high satisfaction and usefulness ratings. The results underscore the need for alternative implementation strategies and further refinement of the approach to improve engagement with culturally diverse populations experiencing LBP and optimise outcomes in future implementations.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103313"},"PeriodicalIF":2.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of neurodynamic tests in upper-limb entrapment neuropathies: A systematic review and meta-analysis","authors":"Daniel Albert-Lucena ,&nbsp;Marcos José Navarro-Santana ,&nbsp;María José Díaz-Arribas ,&nbsp;Gabriel Rabanal-Rodríguez ,&nbsp;Juan Antonio Valera-Calero ,&nbsp;César Fernández-de-las-Peñas ,&nbsp;Chad Cook ,&nbsp;Gustavo Plaza-Manzano","doi":"10.1016/j.msksp.2025.103317","DOIUrl":"10.1016/j.msksp.2025.103317","url":null,"abstract":"<div><h3>Background</h3><div>Upper-limb neurodynamic tests are commonly used to diagnose neuropathies in this area, including cervical radiculopathy and carpal tunnel syndrome, although their diagnostic accuracy remains uncertain across different conditions and criteria.</div></div><div><h3>Objective</h3><div>To assess the diagnostic accuracy of upper-limb neurodynamic tests and their variations and criteria for upper-limb entrapment neuropathies.</div></div><div><h3>Methods</h3><div>A systematic review with meta-analysis was conducted in different databases (for their inception in February 2025), including studies evaluating the diagnostic accuracy of these tests. Sensitivity, specificity, likelihood ratios (LR), diagnostic odds ratios, diagnostic accuracy and the area under the curve (AUC) were calculated using a bivariate and univariate meta-analysis. The quality of evidence was evaluated using the GRADE approach, and meta-regression was performed to examine the influence of diagnostic criteria.</div></div><div><h3>Results</h3><div>Twelve studies were included. Likelihood ratios for neuropathic pain conditions were LR+:1.65 and LR-:0.57, for cervical radiculopathy were LR+:2 and LR-:0.47, and for carpal tunnel syndrome were LR+:1.45 and LR-:0.66. The upper-limb neurodynamic test 2A showed the highest diagnostic accuracy (AUC: 0.76), with LR+:2.59 and LR-:0.42 for cervical radiculopathy, while test 3 had the highest specificity (0.92; LR+:7, LR-:0.48). Diagnostic accuracy for carpal tunnel syndrome was lower (AUC: 0.62). Meta-regression showed significant diagnostic criteria interaction, favoring structural differentiation maneuvers (p = 0.002).</div></div><div><h3>Conclusion</h3><div>Upper-limb neurodynamic tests show moderate sensitivity and low to moderate specificity for diagnosing upper-limb entrapment neuropathies, with diagnostic accuracy varying across conditions. The certainty of evidence ranges from very low to moderate, emphasizing the need for cautious clinical interpretation. Diagnostic reference criteria significantly influence test performance.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103317"},"PeriodicalIF":2.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of education on pain during and following acute exercise in people with knee osteoarthritis: A randomised controlled trial","authors":"Adrian Ram ,&nbsp;Alexandre Kovats ,&nbsp;Darryl Ser Foong Ho ,&nbsp;Laura Cooke ,&nbsp;G Pramod Ram ,&nbsp;Mitchell T. Gibbs ,&nbsp;John Booth ,&nbsp;Jeanette M. Thom ,&nbsp;Matthew D. Jones","doi":"10.1016/j.msksp.2025.103314","DOIUrl":"10.1016/j.msksp.2025.103314","url":null,"abstract":"<div><h3>Background</h3><div>Explicit education about exercise-induced hypoalgesia (EIH) reduces experimental pain after a single exercise session in pain-free individuals. However, the effect in people with chronic pain is unclear. This study aimed to determine the effect of EIH education on pain during and following exercise in people with knee osteoarthritis (OA).</div></div><div><h3>Methods</h3><div>All procedures were administered online. Participants were randomised to receive 15-min of explicit EIH education or 15-min of general education about knee OA. Participants then completed a questionnaire on their beliefs about exercise and pain, followed by a bout of home-based lower limb resistance exercise. Pain intensity (0–10) was assessed before, during and immediately after exercise.</div></div><div><h3>Results</h3><div>40 participants completed the study (67.3 ± 10.8 years old, 73 % female). Participants only somewhat agreed pain could be reduced following a single session of exercise and that the education changed what they thought about exercise and pain, but these beliefs were not significantly different between groups (p = 0.053 and p = 0.104, respectively). Pain was similar between groups (adjusted mean difference [95 % CI]) during exercise (0.51 [-0.72 to 1.74], p = 0.410) and following exercise (−0.75 [-1.62 to 1.11], p = 0.087. Compared to baseline, pain (mean difference [95 % CI]) was lower during exercise (−1.01 [-1.66 to −0.36], p = 0.003) and following exercise (−0.96 [-1.5 to −0.42], p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>A single exercise session reduces pain in people with knee OA, but this was not influenced by pre-exercise education about EIH. Further research is needed to understand if and how EIH can be modulated in people with knee OA.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103314"},"PeriodicalIF":2.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do clinical practice guidelines for low back pain include predatory journal or retracted publications? A meta-research study","authors":"Jodi L. Young ,&nbsp;Mark Shepherd ,&nbsp;Tanya Dickson ,&nbsp;Jessica Todd","doi":"10.1016/j.msksp.2025.103316","DOIUrl":"10.1016/j.msksp.2025.103316","url":null,"abstract":"<div><h3>Background</h3><div>Following clinical practice guidelines is widely recommended for treating many musculoskeletal diagnoses, including low back pain, but it is unknown if clinical practice guidelines for low back pain do.</div></div><div><h3>Objective</h3><div>Assess whether clinical practice guidelines for low back pain reference publications from predatory journals or include retracted publications.</div></div><div><h3>Design</h3><div>Meta-research.</div></div><div><h3>Methods</h3><div>Clinical practice guidelines focusing on the management of adults with low back pain published between January 2010–June 2024 were included. All referenced publications in each guideline were evaluated for predatory categorization using a systematic process that included assessing publisher/journal websites, the Directory of Open Access Journals, Beall's List and major literature databases. The Retraction Watch Database was used to assess retraction status.</div></div><div><h3>Results</h3><div>Nineteen clinical practice guidelines with 1617 unique publications met inclusion criteria. The majority of publications (1598/1617; 98.8 %) were categorized as ‘non-predatory.’ Fourteen publications (0.9 %) were categorized as ‘predatory,’ two (0.1 %) ‘presumed predatory,’ and three (0.2 %) were retracted. Four guidelines cited ‘predatory’ and/or ‘presumed predatory’ publications, and four guidelines cited the retracted publications.</div></div><div><h3>Conclusion</h3><div>Only 1.2 % of the cited publications included in clinical practice guidelines for the management of low back pain were deemed predatory or retracted, implying that guideline recommendations are unlikely to be influenced by their inclusion. There are currently no standard criteria for how to manage the inclusion of these publications in guidelines or systematic reviews. Future research should investigate the development of a valid and reliable checklist that allows authors to assess for and manage the presence of predatory or retracted publications.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103316"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What factors influence the community's use of physiotherapy services as first-line management for temporomandibular disorders? A qualitative study using the COM-B framework","authors":"Alana Dinsdale ,&nbsp;Joni Levine ,&nbsp;Shaun O'Leary ,&nbsp;Jaqueline Delaney ,&nbsp;Jeanne Read ,&nbsp;Susana Vuvan ,&nbsp;George Dimitroulis ,&nbsp;Rory Scanlan ,&nbsp;Roma Forbes","doi":"10.1016/j.msksp.2025.103315","DOIUrl":"10.1016/j.msksp.2025.103315","url":null,"abstract":"<div><h3>Background</h3><div>Physiotherapists play a unique role within the multidisciplinary management team for temporomandibular disorders (TMDs). However, historically they have been under-recognised and under-utilised in the care of individuals with TMD. To improve TMD management pathways and facilitate uptake of subsequent physiotherapy services, it is important to understand factors which underpin care-seeking behaviours of individuals with TMD in the community.</div></div><div><h3>Objectives</h3><div>To understand 1) what individuals with TMD perceive the role of physiotherapy to be in TMD management, 2) how these perceptions influence individuals' behaviour in seeking and receiving TMD care, 3) what other factors influence individuals’ behaviour in seeking and receiving TMD care from a physiotherapist.</div></div><div><h3>Design</h3><div>Qualitative, grounded in a relativist ontological and constructionist epistemological approach.</div></div><div><h3>Method</h3><div>Fourteen individuals with TMD (mean age = 37 years) were purposively recruited and interviewed using a semi-structured framework. Data were analysed deductively using the COM-B framework via a reflexive thematic analysis approach.</div></div><div><h3>Results</h3><div>Data were encapsulated into three themes: 1) motivation, 2) capability and 3) opportunity. Discord between participants’ perceptions about TMD and the role of physiotherapists was frequently observed, alongside challenges accessing physiotherapy services due to physical opportunity (e.g. time, financial, geographical, technological) and social opportunity (e.g. connections with and of healthcare practitioners) factors.</div></div><div><h3>Conclusion</h3><div>Various intrinsic and extrinsic factors influence individuals’ utilisation of physiotherapy services for TMD, including their knowledge about the condition and physiotherapy services available, their social connections, physical opportunity and their motivation to seek help. Promotion of physiotherapy services for TMD should consider these factors to optimise patient care.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103315"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting and incorporation of social risks in low back pain and exercise studies: A scoping review","authors":"Andrew Bernstetter ,&nbsp;Nicole H. Brown ,&nbsp;Brandon Fredhoff ,&nbsp;Daniel I. Rhon ,&nbsp;Chad Cook","doi":"10.1016/j.msksp.2025.103310","DOIUrl":"10.1016/j.msksp.2025.103310","url":null,"abstract":"<div><h3>Background</h3><div>Exercise is a common intervention for low back pain, but its effect sizes are small to modest. Social risk factors significantly influence health outcomes, yet their consideration in randomized controlled trials on exercise for low back pain is often neglected. Determining their relationship to outcomes may provide better insight into exercise effectiveness.</div></div><div><h3>Objectives</h3><div>To assess the reporting of social risk factors (SRFs) in randomized controlled trials (RCTs) of exercise interventions for low back pain (LBP) in adults and explore associations between SRFs and outcomes.</div></div><div><h3>Design</h3><div>Scoping Review.</div></div><div><h3>Methods</h3><div>The databases MEDLINE, CINAHL and Cochrane were searched for studies published between January 2014 to March 2025. RCTs were included if exercise was the primary intervention for LBP treatment and had a minimum follow-up of 12 weeks. A planned analysis of SRF and outcome associations was not conducted due to insufficient data.</div></div><div><h3>Results</h3><div>A total of 10,292 studies were identified and 157 studies included. Fewer than half (47.1 %) reported any SRFs at baseline. Socioeconomic position (42.7 %) was most frequently reported, followed by social relationships (17.8 %), race/ethnicity/cultural context (8.3 %), residential/community context (1.3 %), and gender (0.6 %). Four studies incorporated SRFs in their outcome analyses; one examined associations with outcomes and found no significant association.</div></div><div><h3>Conclusion</h3><div>SRFs are underreported in RCTs of exercise interventions for LBP and are rarely analyzed in relation to primary outcomes, limiting our understanding of their impact. Future trials should prioritize collecting and reporting SRFs at baseline and incorporating them in outcome analyses to assess their influence on outcomes.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103310"},"PeriodicalIF":2.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between education, practice, post-professional training and physical therapists’ attitudes and beliefs regarding low back pain management: A cross sectional survey study","authors":"Sarah Case-Morris ,&nbsp;Tzu-Chieh Liao ,&nbsp;Olivia Simon ,&nbsp;Daniel Whibley ,&nbsp;Jennifer Blackwood ,&nbsp;Danielle McCoy ,&nbsp;Lindsey Fox","doi":"10.1016/j.msksp.2025.103312","DOIUrl":"10.1016/j.msksp.2025.103312","url":null,"abstract":"<div><h3>Introduction</h3><div>Several recent initiatives have aimed to align physical therapists’ (PTs) understanding and management of low back pain (LBP) with the biopsychosocial model of health and illness.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to determine whether entry-level education, practice setting, experience, or post-professional training is associated with attitudes and beliefs of United States (US) PTs about LBP management, despite these initiatives.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was distributed to a sample of US PTs that included the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS). Linear regression was used to quantify the association between education, experience, post-professional training, and practice setting with PTs attitudes and beliefs.</div></div><div><h3>Results</h3><div>Of 412 respondents, those with a Bachelor's/Master's scored significantly higher on the PABS-Bio (β = 2.5, 95 % CI = 0.76–4.3, p = 0.005) and HC-PAIRS (β = 2.7, 95 % CI = 0.7–4.6, p = 0.006) and lower on the PABS-Psy (β = 1.7, 95 % CI = −2.7–0.7, p &lt; 0.001) compared to those with a DPT/tDPT. Those who did not undertake post-professional training scored higher on the PABS-Bio (β = 3.7, 95 % CI = 1.4–6.1, p = 0.002) and HC-PAIRS (β = 3.9, 95 % CI = 1.2–6.6, p = 0.005). Therapists licensed 20+ years and working in settings besides outpatient had stronger biomedical beliefs.</div></div><div><h3>Conclusion</h3><div>Highest degree, post-professional training, years licensed, and practice setting were all significantly associated with attitudes and beliefs of practicing PTs in the US regarding LBP management. This study highlights the need for further investigation into education for improving PTs’ attitudes and beliefs around LBP amidst diverse practice settings and experience.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103312"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beliefs and experiences of individuals with patellar tendinopathy following a rehabilitation program: A nested qualitative study","authors":"Diego Ruffino ,&nbsp;Igor Sancho ,&nbsp;Matías Alfonso ,&nbsp;Peter Malliaras","doi":"10.1016/j.msksp.2025.103311","DOIUrl":"10.1016/j.msksp.2025.103311","url":null,"abstract":"<div><h3>Objective</h3><div>to explore the perspectives, beliefs, and experiences of individuals with patellar tendinopathy (PT) following a rehabilitation program.</div></div><div><h3>Methods</h3><div>A qualitative study nested within a randomized trial was conducted to investigate the efficacy of two exercise programs in rehabilitation of PT. Eight individuals participated, with interviews video-recorded, transcribed verbatim, and analyzed using an inductive thematic analysis, following Braun and Clarke’s approach.</div></div><div><h3>Results</h3><div>Five themes were identified from the individuals’ responses: (1) motivations to seek treatment, (2) contrasting expectations about rehabilitation outcomes, (3) symptom responses to exercise therapy, (4) experiences with a gym-based exercise program, and (5) factors influencing treatment adherence.</div></div><div><h3>Conclusions</h3><div>The findings suggest that individuals with PT are primarily motivated by the hope of improving symptoms and function, as well as the condition's substantial impact on their ability to play sports and stay physically active. Participants identified key enablers of adherence and motivation during rehabilitation, including education and guidance from physiotherapists, the simplicity of the exercise program, supervision during sessions, and perceived short-term treatment effectiveness of treatment.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103311"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}