Musculoskeletal Science and Practice最新文献

{"title":"Muscle strength is a key predictor of physical function in advanced knee osteoarthritis","authors":"Mani Izadi ,&nbsp;Tiril Tøien ,&nbsp;Frank-David Øhrn ,&nbsp;Otto Schnell Husby ,&nbsp;Vigdis Kvitland Schnell Husby ,&nbsp;Siri Bjørgen Winther ,&nbsp;Ronan Sherman ,&nbsp;Mathias Forsberg Brobakken ,&nbsp;Eivind Wang ,&nbsp;Ole Kristian Berg","doi":"10.1016/j.msksp.2025.103339","DOIUrl":"10.1016/j.msksp.2025.103339","url":null,"abstract":"<div><div>Skeletal muscle strength of the lower limbs is negatively impacted in advanced knee osteoarthritis. However, its role in predicting physical function of these patients remains unclear. Therefore, we aimed to evaluate hierarchical linear regression associations between lower limbs' maximal muscle strength, rate of force development and physical function in 50 patients (age: 65 ± 8 years; 22 males and 28 females; and BMI: 31 ± 5 kg/m²) with advanced knee osteoarthritis. Results revealed that leg press maximal strength and leg extension maximum voluntary contraction were associated with sit-to-stand and stair climbing performance (all p &lt; 0.001) and accounted for variances of 29 % and 38 % in 30-s sit-to-stand and 37 % and 24 % in stair climbing performance, respectively. Leg press maximal strength and leg extension maximum voluntary contraction were also associated with Knee Injury and Osteoarthritis Outcome Score - Physical Function Short Form (KOOS-PS) (both <em>p</em> = 0.041), each accounting for 7 % of the variance. Similarly, rate of force development was associated with 30-s sit-to-stand (<em>p</em> &lt; 0.001) and stair climbing performance (<em>p</em> = 0.05), explaining 22 % and 6 % of additional variances, respectively. No association was observed between measures of muscle strength and 40 m fast-paced walking. The present study highlights maximal muscle strength, and in part rate of force development, as powerful predictors of physical function in patients with advanced knee osteoarthritis and may be used as simple, valuable measures when evaluating patients’ physical function.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103339"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891195","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":"Integrating physiotherapists, occupational therapists, and psychologists in the management of chronic and complex musculoskeletal pain in the municipality – a workshop study","authors":"Nielsen RB ,&nbsp;Johansen SK ,&nbsp;Andreasen J ,&nbsp;Palsson TS ,&nbsp;Carlsen A ,&nbsp;Rathleff MS","doi":"10.1016/j.msksp.2025.103336","DOIUrl":"10.1016/j.msksp.2025.103336","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal (MSK) pain is a major societal burden, costing up to 2 % of the EU's gross national product. Complex cases often involve comorbidities, increasing treatment challenges. Integrating physiotherapy, occupational therapy, and psychological support in primary care may improve patient outcomes. Aalborg Municipality, Denmark, is exploring interdisciplinary care models to enhance treatment for chronic MSK pain.</div></div><div><h3>Aim</h3><div>This study investigates physiotherapists', occupational therapists', and psychologists' perspectives on i) current management of chronic and complex MSK pain, ii) elements of ideal care, and iii) strategies for implementation.</div></div><div><h3>Method</h3><div>Using an action research approach, we conducted two workshops with 30 healthcare professionals. WS1 employed a future workshop design to explore solutions, while WS2 used an adapted affinity diagram to define patient characteristics. Data were analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Three main themes emerged: 1) Navigating a State of Limbo: Challenges Faced by Patients with Chronic MSK Pain, including difficulties in navigating treatment, emotional distress, and social relationships; 2) Navigating Healthcare: Receiving and Providing in a Frustrating System, highlighting systemic frustrations and limitations in care coordination; and 3) Optimizing Patient Care Pathways: Strategies for Enhanced Engagement, Integration and Collaboration, emphasizing improved collaboration, patient engagement, and support for transitions in care.</div></div><div><h3>Conclusion</h3><div>Findings highlight the importance of a person-centered, interdisciplinary approach to managing chronic MSK pain. Key strategies include early interventions, patient empowerment, and enhanced communication among professionals. Implementing a biopsychosocial model within healthcare systems is essential for improving patient outcomes and addressing complex needs.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103336"},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879187","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":"Structural brain alterations and clinical associations in individuals with chronic nonspecific neck pain","authors":"Rungtawan Chaikla ,&nbsp;Munlika Sremakaew ,&nbsp;Suwit Saekho ,&nbsp;Sureeporn Uthaikhup","doi":"10.1016/j.msksp.2025.103337","DOIUrl":"10.1016/j.msksp.2025.103337","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pain is associated with changes in brain structures. However, the specific morphological changes in chronic nonspecific neck pain (CNSNP) are still unclear.</div></div><div><h3>Objectives</h3><div>To investigate altered brain morphology in patients with CNSNP and its relationships with clinical characteristics of neck pain.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Thirty CNSNP and 30 controls underwent T1-weighted structural MRI to assess whole-brain vertex-wise cortical thickness and gray matter volume. Between-group differences were determined using cluster-wise correction for multiple comparisons and analyses of global structure and pain-related regions of interest (ROIs). Pain outcomes were neck pain duration, intensity, disability and pressure pain thresholds (PPTs) over the cervical spine.</div></div><div><h3>Results</h3><div>Overall, the cluster-wise analysis revealed increased cortical thickness and decreased gray matter volume in several brain regions such as the precuneus, supramarginal gyrus and parietal cortex in the neck pain group (CWP&lt;0.05). The global analysis showed that the neck pain group had increased total thickness and decreased total volume (p &lt; 0.05). The ROI analysis showed that the neck pain group exhibited increased thickness in the primary somatosensory cortex (S1), anterior cingulate cortex (ACC) and precuneus and decreased volume in the prefrontal cortex (PFC), S1, ACC and insula compared to controls (adjusted p-values&lt;0.05). Reduced insula volume correlated with greater neck disability (r = −0.53, adjusted p-value&lt;0.01). Increased PPTs correlated with greater S1 and precuneus thickness (r = 0.46−0.48, adjusted p-values&lt;0.05) and S1 volume (r = 0.53−0.58, adjusted p-values&lt;0.05).</div></div><div><h3>Conclusion</h3><div>Patients with CNSNP exhibited increased cortical thickness and decreased gray matter volume in brain regions involved in pain processing and emotional and cognitive responses.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103337"},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877009","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":"Increased central sensitivity is associated with greater shoulder disability in people with musculoskeletal shoulder symptoms: a cross-sectional study","authors":"Leanda McKenna,&nbsp;Tamara Lowry,&nbsp;Darren Beales","doi":"10.1016/j.msksp.2025.103334","DOIUrl":"10.1016/j.msksp.2025.103334","url":null,"abstract":"<div><h3>Background</h3><div>To fully comprehend shoulder pain and disability, a better understanding of the factors that may contribute to chronicity is required, i.e., increased central sensitivity.</div></div><div><h3>Objective</h3><div>To determine the association between increased central sensitivity and shoulder disability whilst accounting for confounding factors. To determine the prevalence of increased central sensitivity in those with musculoskeletal shoulder symptoms.</div></div><div><h3>Design</h3><div>Cross sectional design collecting data via an online survey. Participants with shoulder symptoms were recruited via social media and through flyer advertisement in Australia.</div></div><div><h3>Methods</h3><div>The Central Sensitivity Inventory and Shoulder Pain and Disability Index were used. Confounding factors included sex, age, socioeconomic status, obesity, psychological distress, sleep quality, physical activity, smoking, ethnicity, and the symptoms of neuropathic pain. The association between increased central sensitivity and shoulder disability was assessed by linear regression whilst adjusting for confounding factors. The percentage of participants with increased central sensitivity was calculated.</div></div><div><h3>Results</h3><div>In 249 participants with shoulder symptoms, increased central sensitivity was positively associated with greater shoulder disability, either as a categorical (coefficient 5.5, 95 % CI 0.1–11.0, <em>p</em> 0.046) or continuous variable (coefficient 0.2, 95 % CI 0.03–0.50, <em>p</em> 0.025) whilst adjusting for confounding factors. In the sample, 48.2 % of survey respondents met the threshold for having increased central sensitivity.</div></div><div><h3>Conclusion</h3><div>Increased central sensitivity was positively associated with greater disability even when accounting for multiple confounders in participants with musculoskeletal shoulder symptoms. These findings highlight the importance of considering increased central sensitivity in the clinical management of those with shoulder symptoms.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103334"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887910","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":"Effects of nonspecific chronic neck pain on balance, visuomotor reaction time and upper extremity explosive strength in young females","authors":"Meryem Buke,&nbsp;Serbay Sekeroz,&nbsp;Bahar Isyar,&nbsp;Medine Ortanc","doi":"10.1016/j.msksp.2025.103331","DOIUrl":"10.1016/j.msksp.2025.103331","url":null,"abstract":"<div><h3>Background</h3><div>The cervical region is highly enriched with sensory receptors, and chronic pain in this area can disrupt afferent signals, potentially affecting motor function and balance.</div></div><div><h3>Objective</h3><div>To examine the effects of nonspecific chronic neck pain on balance, visuomotor reaction time, and upper extremity explosive strength in young females. The secondary objective was to investigate the relationship between neck pain intensity and the evaluated parameters.</div></div><div><h3>Methods</h3><div>Forty-three participants (Neck Pain Group: 21 participants; Healthy Group: 22 participants) were included. Static balance was assessed with the One-Leg Standing Test (OLST), and dynamic balance with the Lower Quarter Y Balance Test (YBT). Visuomotor reaction time was measured using the FitLight Trainer™ system, consisting of 8 RGB Laser LEDs. The Seated Medicine Ball Throw Test was employed to assess upper extremity explosive strength.</div></div><div><h3>Results</h3><div>Participants in the neck pain group exhibited significantly lower scores on the eyes-closed OLST (p = 0.045) and the composite YBT (p = 0.028) for the dominant lower extremity. Visuomotor reaction time was significantly prolonged in the neck pain group (p = 0.032), while performance in the medicine ball throw test was significantly reduced (p = 0.030). Pain intensity was correlated with visuomotor reaction time (r = 0.454; p = 0.002) and the composite YBT score of the dominant lower extremity (r = −0.356; p = 0.019).</div></div><div><h3>Conclusion</h3><div>This study's findings indicate that chronic neck pain negatively impacts balance, visuomotor reaction time, and upper extremity explosive strength. Furthermore, a moderate correlation was observed between pain intensity and both visuomotor reaction time and dynamic balance, suggesting that greater pain intensity is associated with greater functional impairment.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103331"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833353","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":"Reasons for patient no-shows and drop-offs after initial evaluation in physical therapy outpatient care: a qualitative study","authors":"Andrew C. Thomas ,&nbsp;Sarah N. Shaver ,&nbsp;Jodi L. Young ,&nbsp;Chad E. Cook","doi":"10.1016/j.msksp.2025.103326","DOIUrl":"10.1016/j.msksp.2025.103326","url":null,"abstract":"<div><h3>Background</h3><div>No-shows and drop-offs by patients after their initial physical therapy evaluation can significantly impact clinics and therapists. To our knowledge, no previous studies have examined the patient's perspective of why they terminated their recommended plan of care after only attending their initial evaluation.</div></div><div><h3>Objective</h3><div>To gain insights regarding why patients do not follow through on a recommended physical therapy plan of care after the initial evaluation.</div></div><div><h3>Methods</h3><div>This qualitative study used semi-structured phone interviews with patients who received a physical therapy evaluation for a musculoskeletal condition within a large regional healthcare system. Participants were purposefully sampled if they attended their initial evaluation, did not attend a follow-up visit within 30 days, and had no future appointments scheduled. After data collection and transcription, coding and thematic analysis took place to establish primary and secondary themes.</div></div><div><h3>Results</h3><div>A total of 26 interviews were conducted, including 12 males and 14 females, with an average age of 51.04 (± 15.72) years. Five common themes emerged, including clinical improvement at an acceptable rate (23.1 %), access issues (26.9 %), did not see value or could do therapy on their own (23.1 %), other medical management was needed (15.4 %), and patient-provider relationship issues (11.5 %).</div></div><div><h3>Conclusion</h3><div>These findings highlight the patient's rationale for not following through on a physical therapist's recommended plan of care after an initial evaluation. They may help practice managers and clinicians to proactively address barriers, clinic access issues, and evaluation strategies to maximize the patient's follow-through on their plan of care.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103326"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816634","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 effect of tele-rehabilitation under a comprehensive exercise program on the function of patients with chronic ankle instability: A randomized controlled trial","authors":"Zhimo Yang,&nbsp;Shiya Yu,&nbsp;Wei Meng,&nbsp;Xixi Ma,&nbsp;Lin Yang","doi":"10.1016/j.msksp.2025.103327","DOIUrl":"10.1016/j.msksp.2025.103327","url":null,"abstract":"<div><h3>Design</h3><div>Single-blind randomized controlled trial.</div></div><div><h3>Objective</h3><div><u>To investigate</u> whether there is a difference in the therapeutic effect of remote exercise therapy and clinic-based exercise therapy on the recovery of motor function in patients with chronic ankle instability <u>(CAI)</u> under a comprehensive exercise program.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to either the control group (CG) or the tele-rehabilitation group (TRG). The CG underwent a 4-week clinic-based exercise rehabilitation program, while the TRG received guidance on using a tele-rehabilitation application followed by a 4-week tele-rehabilitation regimen. <u>The participants in both groups underwent exercise therapy under the same exercise prescription framework.</u> Outcome measures, including functionality, pain, strength, balance, and self-efficacy, were assessed at baseline, 4 weeks, and 8 weeks.</div></div><div><h3>Results</h3><div>A total of 48 participants completed the trial. At the 4-week mark, all outcomes demonstrated significant improvement compared to baseline, indicating that both treatment modalities utilizing the comprehensive exercise program enhanced the functionality of patients with <u>CAI.</u> By 8 weeks, functional improvements were sustained in both groups. Notably, among all outcomes, only the <u>Modified Gait Efficacy Scale (mGES)</u> revealed a significant group effect, with the CG exhibiting higher mGES than the TRG (P &lt; 0.001 at 4 weeks and P = 0.002 at 8 weeks).</div></div><div><h3>Conclusion</h3><div><u>The results suggest that, under a comprehensive exercise program, tele-rehabilitation can achieve outcomes comparable to clinic-based exercise therapy in enhancing motor function in patients with CAI, with only a slight disadvantage in improving self-efficacy compared to clinic-based therapy.</u></div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103327"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848314","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":"Stair climb muscle power is associated with gait speed, sit-to-stand performance, patient-reported outcomes and objective measures of mechanical muscle function in individuals with knee osteoarthritis – secondary analysis from an RCT","authors":"Brian Sørensen ,&nbsp;Per Aagaard ,&nbsp;Christian Couppé ,&nbsp;Charlotte Suetta ,&nbsp;Finn E. Johannsen ,&nbsp;S. Peter Magnusson","doi":"10.1016/j.msksp.2025.103332","DOIUrl":"10.1016/j.msksp.2025.103332","url":null,"abstract":"<div><h3>Background</h3><div>Mechanically measured leg extensor muscle power (LEP) predicts functional performance, patient-reported outcomes (PROMs) and mechanical muscle function in patients with knee osteoarthritis (OA). The stair climb test (SCT) have been used to assess LEP in clinical populations, but the relationship between SCT derived LEP and functional- and self-reported outcome measures in patients with knee-OA remains unknown.</div></div><div><h3>Objectives</h3><div>To investigate the relationship between LEP derived from SCT, and patient-reported outcomes (PROMs), functional performance, knee extensor muscle strength (MVIC), rate of force development (RFD) and Nottingham LEP in individuals with knee-OA.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Method</h3><div>SCT power was obtained in 96 knee-OA patients (age 56.9 ± 7.7 yr. males n = 47, females n = 49). The dependent variable was SCT power, while independent variables included 4 × 10 m fast-paced walk (4x10m-FWT), sit-to-stand (STS), STS power, KOOS, Oxford Knee Score (OKS), LEP, MVIC, and RFD.</div></div><div><h3>Results</h3><div>There were strong correlations (<em>r</em> = 0.72–0.80, <em>p</em> &lt; 0.01) between SCT power and 4x10m-FWT and STS. There were weak-to-moderate correlations (<em>r</em> = 0.22–0.42, <em>p</em> &lt; 0.05) between SCT power versus OKS and all KOOS subscales. Moderate correlations were observed between SCT power and Nottingham LEP, MVIC, and RFD (<em>r</em> = 0.53–0.64, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>SCT power correlates positively with functional performance, PROMs and mechanical lower limb muscle function in male and female individuals with knee-OA.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103332"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839304","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 effectiveness of conservative interventions on temporomandibular disorder-related kinesiophobia and pain catastrophizing: a systematic review","authors":"Alana Dinsdale,&nbsp;Cara Atkins,&nbsp;Laura Golds,&nbsp;Addison Gough,&nbsp;Kelcie Jessen,&nbsp;Roma Forbes","doi":"10.1016/j.msksp.2025.103328","DOIUrl":"10.1016/j.msksp.2025.103328","url":null,"abstract":"<div><h3>Background</h3><div>Temporomandibular disorders (TMD) are prevalent conditions that can significantly impact function and quality of life. Pain catastrophizing and kinesiophobia contribute to temporomandibular disorder-related disability.</div></div><div><h3>Aims</h3><div>Evaluate the effectiveness of conservative interventions on kinesiophobia and pain catastrophizing in adults with temporomandibular disorders.</div></div><div><h3>Methods</h3><div>PubMed, Embase, CINAHL and Cochrane Central were searched for peer-reviewed interventional studies evaluating the effect of non-pharmacological conservative interventions on kinesiophobia and pain catastrophizing in adults diagnosed with a temporomandibular disorder. Risk of bias was assessed using the Cochrane Risk of Bias (version 2) tool and data were synthesised narratively according to outcomes and interventions. Overall certainty of evidence was evaluated using a modified GRADE approach.</div></div><div><h3>Results</h3><div>Twelve studies were included, comprising 815 participants (mean age = 42.2 years, 85 % female, most with myofascial/pain-related temporomandibular disorders). Interventions included cognitive behavioural therapy, pain neuroscience education ± exercise, manual therapy, occlusal splinting and hypnosis. There was low to very low confidence that cognitive behavioural therapy, pain neuroscience education plus exercise, and manual therapy may reduce pain catastrophizing in individuals with temporomandibular disorders, and low to very low confidence that pain neuroscience education and manual therapy may improve kinesiophobia. There was very low confidence that hypnosis and occlusal splinting are ineffective at reducing pain catastrophizing levels compared to other conservative interventions.</div></div><div><h3>Conclusions</h3><div>Cognitive behavioural therapy, pain neuroscience education and manual therapy may be effective in reducing kinesiophobia and pain catastrophizing in adults with temporomandibular disorders. Further research is needed to improve the quality of this evidence.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103328"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829883","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":"“Go and get it checked”: Exploring the decision to attend the emergency department for low back pain","authors":"Holly Whitcomb ,&nbsp;Lisa C. Roberts ,&nbsp;Clare Ryan","doi":"10.1016/j.msksp.2025.103325","DOIUrl":"10.1016/j.msksp.2025.103325","url":null,"abstract":"<div><h3>Purpose and background</h3><div>Low back pain affects individuals and society, straining Emergency Departments (EDs) and prolonging wait times. While personal factors influence ED visits, third-party advice's role is underexplored. Limited guidance for healthcare professionals emphasises the need for effective back pain management to ease system strain and improve patient outcomes. This study examines motivations for ED visits due to low back pain.</div></div><div><h3>Methods and results</h3><div>This research utilised secondary analysis of qualitative data from a previous multisite study, adopting a subtle realist approach. From August to December 2021, 47 patients (26 M:21 F, aged 23–79) with back pain were sampled from four English EDs (2 Northern, 2 Southern) to capture diversity in sociodemographic and LBP characteristics. Eight patients had previously visited the ED for this back pain episode. During the pandemic, semi-structured interviews were conducted online, audio-recorded, transcribed, and analysed thematically.</div><div>Three key themes influenced decisions to attend ED: Healthcare professionals, trusted others, and individuals. Healthcare professionals often dictated choices, making participants feel powerless. Trusted others offered varying support, acting as allies. Individuals wrestled with anxiety about pain severity and uncertainty regarding LBP.</div></div><div><h3>Conclusion</h3><div>This study emphasises the need for healthcare professionals to offer clear guidance on when individuals and their caregivers should visit the ED for back pain. Findings show that pain-related worries significantly drive ED visits, misaligning with practice guidelines. Healthcare providers must consider these issues when creating strategies to manage low back pain patients and optimise ED resources.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103325"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865049","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}