Musculoskeletal Science and Practice最新文献

{"title":"Development of a patient decision aid in relation to imaging for rotator cuff tendinopathy: a mixed-methods study.","authors":"P Malliaras, T P Haines, F Burstein, D Connell, P Delir Haghighi, T Hoffmann, J Neil, P Nicklen, H Skouteris, R S Page, R Whale, I Harris, J R Zadro","doi":"10.1016/j.msksp.2025.103388","DOIUrl":"10.1016/j.msksp.2025.103388","url":null,"abstract":"<p><strong>Background: </strong>Unnecessary imaging for rotator cuff related shoulder pain is common and may be related to inadequate shared decision making.</p><p><strong>Objective: </strong>To develop and evaluate a patient decision aid (PDA) for people with rotator cuff-related shoulder pain to inform decision-making.</p><p><strong>Design: </strong>Mixed-methods study guided by the International Patient Decision Aids Standards.</p><p><strong>Methods: </strong>A multidisciplinary steering group guided this research. The PDA was developed iteratively, incorporating feedback from people with shoulder pain and health professionals through semi-structured interviews and acceptability questionnaires (1 = strongly disagree and 5 = strongly agree). Thematic analysis of qualitative data and descriptive analysis of quantitative data was undertaken.</p><p><strong>Results: </strong>Twenty health professionals and nineteen patients participated in interviews, while a separate cohort of 54 patients and 15 health professionals completed acceptability questionnaires. Most patients (74-98 %) rated the PDA as acceptable, though 37 % perceived it as biased against imaging. Health professionals (median agreement score 4/5) found the PDA useful but highlighted concerns about feasibility in time-constrained settings. Interview feedback emphasized clarity, contextualization of imaging findings, and alignment with clinical guidelines. When using the final version of the PDA in a clinical encounter, all five patients (100 %) reported that the information in the decision aid influenced their decision to have a scan, and four of the five health professionals (80 %) reported that they would use the decision aid in their practice.</p><p><strong>Conclusion: </strong>This decision aid appears to be an acceptable and useful tool for helping people with rotator cuff-related shoulder pain to make informed decisions about imaging. A randomized controlled trial evaluating whether this decision aid reduces people's intentions to have imaging and facilitate informed treatment choices is now needed.</p>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"103388"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805350","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":"Concurrent validity of the directional preference phenomenon compared to controlled lumbar discography: A supplementary analysis of a diagnostic accuracy study","authors":"Jean-Philippe Deneuville ,&nbsp;Mark Laslett ,&nbsp;Alexandra Cervantes ,&nbsp;Sylvain Peterlongo ,&nbsp;Amine Ounajim ,&nbsp;Romain Artico","doi":"10.1016/j.msksp.2025.103413","DOIUrl":"10.1016/j.msksp.2025.103413","url":null,"abstract":"<div><h3>Background</h3><div>Persistent low back pain (LBP) is a symptom with many potential causes. Centralisation phenomenon (CP) has emerged as promising diagnostic tools for identifying a subset of discogenic pain. CP represents a subgroup of patients demonstrating Directional Preference (DP) and to date the diagnosticaccuracy of DP has never been assessed. To bridge this gap, this study evaluates the diagnostic accuracy of DP for discogenic pain, compares its properties to CP, and explores the development of clinical diagnostic rules (CDRs) for patients with negative testing for DP, or inability to undergo repeated movement testing.</div></div><div><h3>Methods</h3><div>103 persistent low back pain patients were assessed by a physiotherapist to collect clinical data and determine DP status. Subsequently, a radiologist performed controlled discography to determine the discogenic pain status. Both the physiotherapist and the radiologist were blinded to each other's findings.</div></div><div><h3>Results</h3><div>DP demonstrated high diagnostic accuracy (specificity: 0.94; Positive Likelihood Ratio (LR⁺): 7.65) but low screening properties (sensitivity: 0.48; Negative Likelihood Ratio (LR⁻): 0.56). CP showed similar diagnostic properties (specificity: 0.94; LR⁺: 5.57). A CDR for untestable DP yielded low predictive power (Area Under the Curve (AUC): 0.57). Due to limited sample size and missing data, no valid CDR could be established to assist diagnostic decision when DP is negative.</div></div><div><h3>Conclusions</h3><div>DP is a valid diagnostic tool for mechanical discogenic pain but has limited screening utility. Further studies are needed to refine diagnostic approaches and explore subgroups, such as those with Modic changes/inflammation-driven discogenic pain.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103413"},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049162","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":"Exploring and comparing bracing protocols for acute isolated posterior cruciate ligament injuries: A scoping review of rationales and approaches","authors":"W.J. Sura ,&nbsp;B.S. Gill ,&nbsp;A. Walker","doi":"10.1016/j.msksp.2025.103412","DOIUrl":"10.1016/j.msksp.2025.103412","url":null,"abstract":"<div><h3>Background</h3><div>Posterior cruciate ligament (PCL) injuries often result in persistent knee laxity and functional deficits, highlighting the importance of treatment. Dynamic bracing is widely employed in non-operative management, yet standardised protocols remain undefined.</div></div><div><h3>Aim</h3><div>This scoping review maps existing literature on dynamic bracing for acute isolated PCL injuries and identifies evidence gaps to guide future research.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, CINAHL, and SportDiscus identified relevant studies published up to July 2024. The Population, Concept, and Context framework guided study selection. Eligible studies included articles reporting on non-operative management of acute PCL injuries using dynamic bracing protocols initiated within 12 weeks of injury.</div></div><div><h3>Results</h3><div>Of 1810 screened studies, 13 met inclusion criteria: seven primary research studies and six reviews. Bracing protocols varied significantly in type, duration, knee flexion angles, weight-bearing status, and activity restrictions. No studies compared different dynamic bracing protocols or directly evaluated their efficacy. Most studies lacked a clear rationale for protocol design, with only four citing prior studies. No recommendation can be made on a bracing protocol.</div></div><div><h3>Conclusion</h3><div>Evidence on dynamic bracing for acute PCL injuries is limited and inconsistent. Comparative studies are needed to establish standardised protocols and optimize non-operative PCL management.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103412"},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049159","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":"Brain structural and functional alterations in chronic non-specific low back pain: A case-control study","authors":"Huibiao Li ,&nbsp;Xiaonan Zhan ,&nbsp;Xin Zhao ,&nbsp;Jianhao Zhou ,&nbsp;Mengjiao Wu ,&nbsp;Cheng Fan ,&nbsp;Hong Liu ,&nbsp;Zheng Jiang","doi":"10.1016/j.msksp.2025.103410","DOIUrl":"10.1016/j.msksp.2025.103410","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between clinical symptoms and associated psychosocial factors of chronic non-specific low back pain (CNLBP) and changes in brain structure and function remains unclear. This study aims to identify changes in gray matter volume (GMV) in patients with CNLBP and to examine changes in resting-state functional connectivity (rsFC) in specific brain regions.</div></div><div><h3>Methods</h3><div>This study included 30 CNLBP patients and 30 healthy controls, who underwent clinical assessments and magnetic resonance imaging scans. Voxel-based morphometry analyzed GMV changes in CNLBP patients' brain regions, which were defined as regions of interest for whole-brain rsFC analysis. Partial correlation and mediation analyses elucidated the central nervous mechanisms of CNLBP.</div></div><div><h3>Results</h3><div>In CNLBP patients, pain severity is associated with anxiety (<em>P</em> = 0.042), depression (<em>P</em> &lt; 0.001), and pain catastrophizing (<em>P</em> &lt; 0.001), while disability is associated with anxiety (<em>P</em> = 0.002). Reduced GMV was observed in the left precentral gyrus, lingual gyrus, and right cerebellum_Crus1. Altered rsFC was found in the cerebellum-thalamus-precentral network (<em>P</em> &lt; 0.001) and limbic system (<em>P</em> &lt; 0.001). Partial correlation analysis revealed that these changes were associated with clinical symptoms of CNLBP (<em>P</em> &lt; 0.05). Mediation analysis revealed that the severity of BDI-II scores in CNLBP was indirectly mediated by rsFC in the precentral gyrus and cerebellum (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>This study found that the pain intensity and physical dysfunction in CNLBP patients are associated with psychosocial factors, such as anxiety, depression, and pain catastrophizing. In this context, widespread change in brain structure and function may contribute to a better understanding of CNLBP and its associated psychosocial factors.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103410"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049161","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":"Relative contribution of real/sham spinal manipulation performance, changes in cortisol levels, and patient expectations and fear behaviors in modulating short-term pain relief in people with neck pain: A secondary analysis of a randomized clinical trial","authors":"Juan Antonio Valera-Calero ,&nbsp;Jorge Buffet-García ,&nbsp;Magdalena Kocot-Kępska ,&nbsp;Dariusz Kosson ,&nbsp;Marcin Kołacz ,&nbsp;Gustavo Plaza-Manzano","doi":"10.1016/j.msksp.2025.103409","DOIUrl":"10.1016/j.msksp.2025.103409","url":null,"abstract":"<div><h3>Background</h3><div>Spinal manipulation (SM) is a widely practiced, hands-on, non-invasive manual therapy aimed at alleviating musculoskeletal pain and improving functional capacity. Although the clinical effects of this intervention are well known, most reviews conclude that the underlying mechanisms needs further investigation. Therefore, the aim of this study was to analyze the individual contribution of SM execution, expectations, fear behaviors and neuroendocrine changes on short-term pain intensity variance following the interventions.</div></div><div><h3>Design</h3><div>Experimental study.</div></div><div><h3>Methods</h3><div>A secondary analysis from a previous randomized clinical trial was conducted. Sixty-two patients were randomized for two factors: the intervention assigned (cervical manipulation and sham manipulation) and the induced expectations (positive, neutral and negative) during treatment. A linear regression analysis was conducted to calculate the individual contribution of the SM execution (sham/real), expectations conditioning (positive/negative/neutral), fear behaviors (fear/no fear) and neuroendocrine changes (salivary cortisol) on the variance of immediate pain intensity changes (pre-post intervention difference) following the single intervention.</div></div><div><h3>Results</h3><div>Changes in salivary cortisol (β = −0.027, p = 0.838) and fear (β = −0.192, p = 0.135) were not significant explanatory variables of pain intensity response (p &gt; 0.05). However, verbally-induced expectations (β = 0.722, p &lt; 0.001) and the manipulation execution (β = 0.207, p = 0.019) showed a significant positive association with pain intensity response, suggesting that positive expectations had a meaningful impact on reducing pain intensity and a real intervention may involve specific hypoalgesic responses.</div></div><div><h3>Conclusion</h3><div>Clinicians should consider that patients' expectations may influence clinical outcomes. Verbally expressing positive or neutral expectations may improve pain-related outcomes, whereas conveying negative expectations could diminish the treatment's effectiveness.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103409"},"PeriodicalIF":2.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057385","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":"Digital health self-management interventions for musicians with playing-related musculoskeletal disorders: A scoping review","authors":"N. Eleryan ,&nbsp;R. Hemming ,&nbsp;V. Sparkes ,&nbsp;L. Sheeran","doi":"10.1016/j.msksp.2025.103408","DOIUrl":"10.1016/j.msksp.2025.103408","url":null,"abstract":"<div><h3>Introduction</h3><div>Playing-related musculoskeletal disorders are common in musicians. Self-management interventions are recommended to improve the management of musculoskeletal disorders and support individuals to safely take responsibility for their own health. Digital health interventions are increasingly used to support self-management of musculoskeletal disorders. However, their use in musicians remains poorly understood.</div></div><div><h3>Aim</h3><div>The aim of this scoping review is to map the available evidence on digital health interventions for the self-management of playing-related musculoskeletal disorders in musicians. This includes summarising the key characteristics of current interventions including content, mode of delivery and theoretical underpinning, their effect on musicians’ ability to continue to play, and exploring any reported adverse effects, to inform future interventions.</div></div><div><h3>Methods</h3><div>The review followed the Joanna Briggs Institute scoping review framework and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.</div></div><div><h3>Results</h3><div>Nine studies were included. None of the interventions were underpinned by a theoretical framework. All interventions targeted student and orchestral musicians, involving exercise, health education, or both, and were delivered via pre-recorded videos (n = 4), websites (n = 3), and video conferencing (n = 2). Six interventions were home-based, one was conducted at a university, and two included a combination of home-based and workplace sessions. Exercise-based digital health interventions (n = 7) reported improvements in pain and physical outcomes.</div></div><div><h3>Conclusion</h3><div>The evidence on digital health interventions for musicians is limited, with studies targeting student and orchestral musicians and none applying theoretical frameworks. This highlights the need for broader and more rigorous self-management interventions for PRMSDs in musicians.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103408"},"PeriodicalIF":2.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020386","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":"Estimation of the minimal important change for Brief Pain Inventory in patients with persistent spinal pain","authors":"Jacob S. Gandløse ,&nbsp;Jonathan Vela ,&nbsp;Thorvaldur S. Palsson","doi":"10.1016/j.msksp.2025.103407","DOIUrl":"10.1016/j.msksp.2025.103407","url":null,"abstract":"<div><h3>Background</h3><div>The Brief Pain Inventory (BPI) is a widely used tool for assessing pain severity and interference, aligning with the bio-psycho-social model. It has been validated in various languages for patients with persistent spinal pain. However, the <em>Minimal Important Change</em> (MIC), which represents the smallest change perceived as meaningful by patients, has not yet been explored for this patient population.</div></div><div><h3>Objective</h3><div>This study aimed to estimate the MIC for the BPI-DK in patients with persistent spinal pain.</div></div><div><h3>Methods</h3><div>MIC was estimated using both anchor-based and distribution-based approaches. The anchor-based method was used to calculate mean changes in BPI-DK subscales for patients reporting improvement on the GROC scale. The distribution-based method estimated MIC as 1.96 times the standard error of measurement.</div></div><div><h3>Results</h3><div>A total of 135 patients completed both baseline and 3-month follow-up questionnaires. Statistically significant MIC scores were found across all subscales. The MIC ranged from 1.37 to 2.61 for <em>severity subscore</em>, 1.59 to 2.91 for <em>physical interference</em>, 1.08 to 3.11 for <em>affective interference</em>, and 1.38 to 2.72 for <em>overall interference subscore</em>, depending on the method used.</div></div><div><h3>Conclusion</h3><div>This study establishes the MIC for the BPI-DK in patients with persistent spinal pain. Differences between the anchor-based and distribution-based methods highlight the sensitivity of the approach, with distribution-based estimates suggesting changes beyond measurement uncertainty. A 2-point improvement is recommended as clinically meaningful for this population.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103407"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004452","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":"Physiotherapy students' perceptions of how the Cervical Framework influences their clinical reasoning: A qualitative single case study of a Canadian university","authors":"Chris Davis ,&nbsp;Katie Kowalski ,&nbsp;Tim Noblet ,&nbsp;Kaitlyn Maddigan ,&nbsp;Sitha Soung ,&nbsp;Andrew Hubbard ,&nbsp;Heather Gillis ,&nbsp;Paul Parikh ,&nbsp;Jackie Sadi ,&nbsp;Andrews Tawiah ,&nbsp;Christina Ziebart ,&nbsp;Alison Rushton","doi":"10.1016/j.msksp.2025.103405","DOIUrl":"10.1016/j.msksp.2025.103405","url":null,"abstract":"<div><h3>Background</h3><div>Neck pain and headaches are highly prevalent, often presenting a challenge for physiotherapists when considering differential diagnoses. For guidance, the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) created the International IFOMPT Cervical Framework. Its purpose is to improve clinical reasoning through various functional objectives and design principles. Although the Cervical Framework supports clinical reasoning among physiotherapy students, how this is achieved is unexplored.</div></div><div><h3>Objectives</h3><div>1. To explore physiotherapy students’ perceptions of how the Cervical Framework’s functional objectives influence their clinical reasoning.</div><div>2. To explore physiotherapy students’ perceptions of how the Cervical Framework’s design principles influence their clinical reasoning.</div></div><div><h3>Design</h3><div>Qualitative, constructivist, exploratory, single-case study.</div></div><div><h3>Method</h3><div>Semi-structured interviews of physiotherapy students enrolled in one of three educational programs at one university were conducted. Directed qualitative content analysis informed by the Cervical Frameworks’ functional objectives and design principles was used to interpret data.</div></div><div><h3>Findings</h3><div>From eighteen participants, meaningful data were found for all functional objectives, with particular value when informing clinical reasoning during assessment and improving understanding of risk. Students showed mixed perceived value in informing clinical reasoning during treatment and facilitating patient-centred practice. Physiotherapy students’ perceptions of the Cervical Framework align with most of its design principles, especially its informative, simple, and non-prescriptive nature. Students also perceived the Cervical Framework as long and this may have affected engagement.</div></div><div><h3>Conclusion</h3><div>Physiotherapy students in this case study perceive the Cervical Framework to influence their clinical reasoning by achieving its functional objectives and by successfully adhering to its design principles.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103405"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004451","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":"Cervical spine and vestibulo-ocular screening in elite female athletes with a history of concussion","authors":"Felix Leung ,&nbsp;Emma Warner ,&nbsp;Benjamin Currie ,&nbsp;Marguerite King ,&nbsp;Tim Oostenbroek ,&nbsp;Yanek Pearce ,&nbsp;George Stiles ,&nbsp;Daniel Brown ,&nbsp;M. Dilani Mendis ,&nbsp;Julie Hides","doi":"10.1016/j.msksp.2025.103406","DOIUrl":"10.1016/j.msksp.2025.103406","url":null,"abstract":"<div><h3>Background</h3><div>Female athletes are more susceptible to sports-related concussions and experience greater and prolonged symptomatology. Changes in the cervico-vestibular systems have been observed in the acute phase post-concussion, but it is unknown if residual impairments persist in the following 12 months.</div></div><div><h3>Objectives</h3><div>To determine if there was an association between baseline screening of the cervical spine, vestibular and oculomotor systems in female athletes with and without a history of concussion.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>94 elite and pre-elite female athletes participating in soccer, water polo and rugby-7s were recruited from the Queensland Academy of Sport, Australia. Athletes completed the Sport Concussion Assessment Tool (SCAT6), Vestibular/Ocular Motor Screening (VOMS), and assessment of the cervical spine (manual examination and joint proprioception). History of concussion (yes/no) in the last 12 months was self-reported.</div></div><div><h3>Results</h3><div>A history of headaches, findings on manual examination of the cervical spine (altered segmental mobility and tissue resistance) and symptom provocation on the VOMS were significantly different between groups for those with and without a history of concussion (all p &lt; 0.05). Unadjusted odds ratios were 4.2 (95 % CI: 1.3–13.4) for history of headaches, 3.8 (95 % CI: 1.2–11.8) for abnormal VOMS and 3.2 (95 % CI: 1.1–9.3) for increased tissue resistance on manual examination of the cervical spine, suggesting that players with these findings on clinical examination are more likely to have a history of concussion.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that athletes with a history of concussion should undergo manual assessment of the cervical spine and vestibulo-ocular system screening regardless of baseline self-reported symptom profile.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103406"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020346","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":"Are baseline clinical tests associated with the relative effectiveness of manual therapy and neck-specific exercise for people with chronic non-specific neck pain? Secondary analysis of a randomized controlled trial","authors":"Iker Villanueva-Ruiz ,&nbsp;Deborah Falla ,&nbsp;Marc Saez ,&nbsp;Maialen Araolaza-Arrieta ,&nbsp;Jon Jatsu Azkue ,&nbsp;Ane Arbillaga-Etxarri ,&nbsp;Ana Lersundi ,&nbsp;Ion Lascurain-Aguirrebeña","doi":"10.1016/j.msksp.2025.103393","DOIUrl":"10.1016/j.msksp.2025.103393","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether baseline clinical tests are associated with the relative effectiveness of manual therapy versus neck-specific exercise for people with chronic non-specific neck pain (NSNP).</div></div><div><h3>Design</h3><div>Pre-planned secondary analysis of a single-blind, parallel, randomized clinical trial with two treatment arms, adhering to CONSORT guidelines.</div></div><div><h3>Methods</h3><div>65 participants with NSNP were randomly allocated with a 1:1 allocation ratio to a programme of either manual therapy or neck-specific exercise. A battery of clinical tests was performed pre-treatment. The manual therapy group had four 30-min sessions, while the exercise group followed a four-week program with physiotherapist-led sessions and daily home exercises. Outcomes measured at baseline, two weeks, four weeks, and 12 weeks post-treatment included pain intensity, disability, patient-perceived improvement, quality of life, and kinesiophobia. Patients were categorized into either responders or non-responders according to pain intensity, disability and patient-perceived improvement.</div></div><div><h3>Results</h3><div>Patients with NSNP that reported bilateral pain, no blocking sensation and greater pain at end of range, showed side flexion or rotation range of movement asymmetry, and whose symptoms could be reproduced during the specific neck movements, were more likely to be classified as <em>responders</em> if they received manual therapy when compared to neck-specific exercise. Adjusted odds ratios (Prob &gt;0.95) varied considerably (range 7.01xe-14 to 0.32) depending on clinical tests and the follow up time point.</div></div><div><h3>Conclusion</h3><div>A battery of clinical tests showed significant associations with the relative effectiveness of manual therapy versus neck-specific exercise in patients with NSNP.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103393"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027542","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}