Musculoskeletal Science and Practice最新文献

{"title":"Assessing the knowledge of low back pain among physiotherapists in Spain: A cohort study with pre- and post-educational course evaluation","authors":"Julia Blasco-Abadía ,&nbsp;Pablo Bellosta-López ,&nbsp;Thorvaldur Skuli Palsson ,&nbsp;Steffan Wittrup McPhee Christensen ,&nbsp;Morten Hoegh ,&nbsp;Francesco Langella ,&nbsp;Pedro Berjano ,&nbsp;Priscila De Brito Silva ,&nbsp;Palle Schlott Jensen ,&nbsp;Víctor Doménech-García","doi":"10.1016/j.msksp.2024.103201","DOIUrl":"10.1016/j.msksp.2024.103201","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain (LBP) is the most prevalent musculoskeletal disorder worldwide and physiotherapists are among the primary healthcare professionals assessing and treating the condition. However, scientific knowledge regarding the management of LBP amongst physiotherapists is largely unknown.</div></div><div><h3>Objectives</h3><div>To evaluate the level of evidence-based knowledge among Spanish physiotherapists in LBP management and assess knowledge enhancement following the completion of an e-learning course.</div></div><div><h3>Design</h3><div>Single-arm cohort study with pre-post evaluation.</div></div><div><h3>Methods</h3><div>This single-arm pre-post study involved 1350 physiotherapists practicing in Spain. Initially, participants underwent a 22-question test on evidence-based LBP knowledge, covering socio-economic impact, characteristics of LBP, rehabilitation goals, psychosocial factors, and high- and low-value interventions. After completing the course, participants took a final test with the same 22 questions in randomized order.</div></div><div><h3>Results</h3><div>Out of the 1350 physiotherapists enrolled, 857 completed the course. The initial responses demonstrated that almost half of the participants considered medical imaging essential before starting physiotherapy treatment, perceived glucocorticoids as recommended for chronic low back pain, and considered ergonomic adjustments crucial for managing the condition. Individuals who completed their education more than 10 years ago showed a minor improvement in evidence-based knowledge compared to those who recently finished their university degree. Following the course, participants displayed improved knowledge, narrowing prior disparities in error percentages across questions.</div></div><div><h3>Conclusion</h3><div>Due to existing gaps in physiotherapists’ evidence-based knowledge of LBP, particularly among those who have worked longer time as physiotherapists, e-learning initiatives may be a feasible approach to support continuous training of physiotherapists.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103201"},"PeriodicalIF":2.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395562","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":"A 7-item Tampa Scale for Kinesiophobia in people with femoroacetabular impingement syndrome: evaluation of structural validity, hypothesis testing, internal consistency and minimally important change","authors":"Myles C. Murphy ,&nbsp;Ebonie K. Rio ,&nbsp;Mark J. Scholes ,&nbsp;Denise M. Jones ,&nbsp;Marcella Pazzinatto ,&nbsp;Richie TJ. Johnston ,&nbsp;Sally L. Coburn ,&nbsp;Joanne L. Kemp","doi":"10.1016/j.msksp.2024.103200","DOIUrl":"10.1016/j.msksp.2024.103200","url":null,"abstract":"<div><h3>Background</h3><div>The 17-item Tampa Scale for Kinesiophobia (TSK) is a commonly used patient-reported outcome measure (PROM) to assess kinesiophobia, but the measurement properties of the TSK in people with femoroacetabular impingement syndrome (FAIS) are unknown.</div></div><div><h3>Objectives</h3><div>1) Revise the existing TSK by removing items, as needed, with inadequate functioning to optimise the TSK for people with FAIS, and 2) evaluate construct validity (both structural validity and hypothesis testing), internal consistency, and minimal important change.</div></div><div><h3>Methods</h3><div>Cross-sectional cohort study including 153 young adults with FAIS. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate structural validity and the TSK was revised to remove items with poor function, improving CFA model fit. Hypothesis testing, internal consistency (Cronbach's α) and minimal important change (distribution-based method) were also evaluated.</div></div><div><h3>Results</h3><div>A 7-item version of the TSK provided the best CFA model fit with 10-items functioning poorly and needing to be removed. The 7-item TSK was uni-dimensional (single factor in EFA) and had adequate structural validity (Standardised Root Measure Square = 0.0771). The 7-item TSK had insufficient hypothesis testing with moderate correlations to 8/14 PROMs measuring different constructs. The 7-item TSK had adequate internal consistency (α = 0.783). The minimal important change of the 7-item TSK was 6.00 points (0–100 point scale).</div></div><div><h3>Conclusion</h3><div>We found that the ‘7-item TSK for FAIS’, had superior structural validity to the original 17-item scale, suggesting that it may be more appropriate for use in this population. Further studies should evaluate other measurement properties of the 7-item scale.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103200"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378599","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":"Sensorimotor control of functional joint stability: Scientific concepts, clinical considerations, and the articuloneuromuscular cascade paradigm in peripheral joint injury","authors":"Nicholas C. Clark","doi":"10.1016/j.msksp.2024.103198","DOIUrl":"10.1016/j.msksp.2024.103198","url":null,"abstract":"<div><div>Human movement depends on sensorimotor control. Sensorimotor control refers to central nervous system (CNS) control of joint stability, posture, and movement, all of which are effected via the sensorimotor system. Given the nervous, muscular, and skeletal systems function as an integrated “neuromusculoskeletal system” for the purpose of executing movement, musculoskeletal conditions can result in a cascade of impairments that affect negatively all three systems. The purpose of this article is to revisit concepts in joint stability, sensorimotor control of functional joint stability (FJS), joint instability, and sensorimotor impairments contributing to functional joint instability. This article differs from historical work because it updates previous models of joint injury and joint instability by incorporating more recent research on CNS factors, skeletal muscle factors, and tendon factors. The new ‘articuloneuromuscular cascade paradigm’ presented here offers a framework for facilitating further investigation into physiological and biomechanical consequences of joint injury and, in turn, how these follow on to affect physical activity (functional) capability. Here, the term ‘injury’ represents traumatic joint injury with a focus is on peripheral joint injury. Understanding the configuration of the sensorimotor system and the cascade of post-injury sensorimotor impairments is particularly important for clinicians reasoning rational interventions for patients with mechanical instability and functional instability. Concurrently, neurocognitive processing and neurocognitive performance are also addressed relative to feedforward neuromuscular control of FJS. This article offers itself as an educational resource and scientific asset to contribute to the ongoing research and applied practice journey for developing optimal peripheral joint injury rehabilitation strategies.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103198"},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373625","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":"Is Achilles tendon structure associated with functional ability and chronic ankle instability in military recruits?","authors":"Gali Dar ,&nbsp;Michal Shenhar ,&nbsp;Aharon S. Finestone ,&nbsp;Jeremy Witchalls ,&nbsp;Gordon Waddington ,&nbsp;Omer Paulman ,&nbsp;Dan Nemet ,&nbsp;Nili Steinberg","doi":"10.1016/j.msksp.2024.103197","DOIUrl":"10.1016/j.msksp.2024.103197","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the relationship between Achilles tendon (AT) structure, functional ability and chronic ankle instability (CAI) in military recruits.</div></div><div><h3>Methods</h3><div>Three hundred and sixty newly recruited infantry male soldiers recruited in April 2022 were assessed for AT structure by Ultrasound Tissue Characterization (UTC), for functional abilities (included proprioception ability, heel-raise test, dynamic postural balance, and hopping agility ability) and for CAI (recurrent sprains and a positive perceived instability).</div></div><div><h3>Results</h3><div>Soldiers that were identified with disorganized tendon had significantly lower heel-raise and agility scores compared to those with organized tendon structures (33.6 ± 18.1(n) vs. 49.9 ± 28.9(n), p &lt; 0.001; and 5.39 ± 2.12(n) vs. 6.16 ± 1.90(n), p = 0.002, respectively). The best discriminator between soldiers with organized vs. disorganized structure, was heel-raise test (AUC = 0.741). Moreover, soldiers with disorganized AT structure had a higher prevalence of CAI compared with those with organized tendon structures (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Recruits with disorganized tendon structures displayed reduced heel-raise score, agility ability and dynamic postural-balance and greater ankle instability. Inferior tendon quality at the onset of military service is an important physical indicator to consider when seeking to manage future injuries and potential for physical performance. Pre-recruitment screening of the AT structure, CAI, and functional abilities, especially in high-intensity infantry programs, needs to be considered.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103197"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376291","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":"Healthcare professionals’ experiences of delivering pain science education to adults from ethnically minoritised groups","authors":"J. Pun ,&nbsp;J. Franklin ,&nbsp;C.G. Ryan","doi":"10.1016/j.msksp.2024.103196","DOIUrl":"10.1016/j.msksp.2024.103196","url":null,"abstract":"<div><h3>Background</h3><div>Pain Science Education (PSE) seeks to increase patients understanding of their pain, to improve clinical outcomes. It has been primarily developed and tested within western cultures. There is a lack of research exploring its use with people from ethnically minoritised groups.</div></div><div><h3>Objective</h3><div>To explore Healthcare Professionals (HCPs) experiences of delivering PSE to people with persistent pain from ethnically minoritised groups.</div></div><div><h3>Methods</h3><div>In this qualitative study semi-structured interviews were carried out with a convenience sample of 14 HCPs who routinely deliver PSE to patients from ethnically minoritised groups. The interviews were analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>Three themes were identified: 1) <em>Biomedical model or disengagement</em>, 2) <em>Pain is a taboo topic</em>, and 3) <em>The importance of cultural competence</em>. Participants believed that people from ethnically minoritised groups disengaged with PSE sooner in comparison to non-ethnically minoritised groups and this was rooted in a strong biomedical understanding of pain and preference for biomedical treatments. Addressing patients’ beliefs was deemed difficult as participants felt that pain was considered a taboo amongst some ethnically minoritised groups and HCPs lacked sufficient training in cultural competency to confidently address their pain-related misconceptions.</div></div><div><h3>Conclusions</h3><div>Overall, HCPs found that many people from ethnically minoritised groups held strongly biomedical views and/or a cultural reluctance to discuss pain. These factors made pain discussions challenging leading to disengagement from PSE and a preference for passive care. Cultural competency training and access to culturally competent PSE resources may facilitate engagement with PSE for people from ethnically minoritised background.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103196"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402106","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 patients’ preferences and expectations match clinical guidelines? A survey of individuals seeking private primary care for a musculoskeletal disorder","authors":"Marc-Olivier Dubé ,&nbsp;Pierre Langevin ,&nbsp;Hugo Massé-Alarie ,&nbsp;Jean-Francois Esculier ,&nbsp;Anthony Lachance ,&nbsp;Jean-Sébastien Roy","doi":"10.1016/j.msksp.2024.103195","DOIUrl":"10.1016/j.msksp.2024.103195","url":null,"abstract":"<div><h3>Background</h3><div>Physiotherapists often inconsistently adhere to clinical practice guidelines (CPGs) when managing musculoskeletal disorders (MSKDs), potentially due to discrepancies between patient-valued interventions and guideline recommendations. Since patients’ expectations are important predictors of outcome, this disparity between CPGs recommendations and patient preferences could be problematic for the effective care of MSKDs.</div></div><div><h3>Objectives</h3><div>To assess patients’ expectations and preferences for the interventions used in their MSKD management and to establish correspondence rates between patients' preferences and recommendations from CPGs.</div></div><div><h3>Design</h3><div>Survey.</div></div><div><h3>Method</h3><div>This cross-sectional descriptive study included a survey on sociodemographics, preferences, and expectations towards interventions for their MSKD, acceptable cost of care, number of treatment sessions required, and their involvement in their MSKD management.</div></div><div><h3>Results</h3><div>One hundred and fifty participants (94 women and 56 men; mean age: 51 ± 17) responded to the survey. Eighty percent of respondents expected their involvement in their MSKD management to be equal to or superior than that of the physiotherapist. Sixty-nine percent of respondents expected to receive exercises, and 67% expected to receive education. Based on preference ratings, 95% of respondents chose recommended interventions, 57% chose interventions with uncertain levels of recommendation, and 48% chose interventions not recommended by CPGs.</div></div><div><h3>Conclusion</h3><div>Less than 70% of participants expected to receive education and exercises, the two most frequently recommended interventions by CPGs. On the other hand, the majority of respondents indicated that their involvement should be equal to or superior than that of the physiotherapist. This aligns with CPGs, which advocate for active and self-management strategies.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103195"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333105","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":"Effectiveness of conservative treatment in the management of post-traumatic elbow stiffness: A systematic review","authors":"Alberto Piacenza ,&nbsp;Andrea Zerilli ,&nbsp;Ilenia Viccari ,&nbsp;Greta Castelli","doi":"10.1016/j.msksp.2024.103194","DOIUrl":"10.1016/j.msksp.2024.103194","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic elbow stiffness is a common consequence following trauma or surgery, resulting in significant limb disability, with a negative impact on daily life. Although conservative treatment is the first-line approach, it is not yet known which is most suitable and effective.</div></div><div><h3>Objective</h3><div>To investigate the effectiveness of conservative treatments in patients with post-traumatic elbow stiffness.</div></div><div><h3>Method</h3><div>A protocol for this systematic review was published in PROSPERO (CRD42024517823). PRISMA standards were followed. An extensive systematic search was conducted in six databases (PubMed, CINHAL, Cochrane Library, Web of Science, Scopus, and PEDro), and the CENTRAL trial register. Two reviewers independently assessed, selected results, collected data, rated the risk of bias (RoB) of included studies with the Cochrane risk of bias tool, synthesized the available evidence, and rated it using GRADE methodology.</div></div><div><h3>Results</h3><div>Five studies were included in the review, although high variability in interventions and comparators precluded the synthesis of results into a meta-analysis. Large effect sizes were observed when conservative treatment was initiated immediately after immobilization, improving elbow functionality (SMD 3.07; 95%CI 1.91 to 4.23), and pain (SMD 1.83; 95%CI 0.91 to 2.76). Results indicate that Proprioceptive Neuromuscular Facilitation (SMD = −1.22; 95%CI [-1.90, −0.54]) and Graded Motor Imagery (SMD = −2.79; 95%CI [-3.59, −2.00]) were more effective than comparisons in recovering elbow functionality and pain reduction.</div></div><div><h3>Conclusion</h3><div>Although conservative treatment is recommended as a first-line approach, the best conservative treatment cannot be determined with certainty due to the low to very low confidence in the results.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103194"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333106","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 CROM-VAS Test: A novel and reliable clinical test to assess immediate pain relief following treatment for movement-evoked neck pain","authors":"Ivo J. Lutke Schipholt ,&nbsp;Gwendolyne G.M. Scholten-Peeters ,&nbsp;Sifra Logghe ,&nbsp;Meghan Koop ,&nbsp;Sietse Donders ,&nbsp;Martijn S. Stenneberg ,&nbsp;Michel W. Coppieters","doi":"10.1016/j.msksp.2024.103191","DOIUrl":"10.1016/j.msksp.2024.103191","url":null,"abstract":"<div><h3>Background</h3><div>The CROM-VAS Test is a novel method to quantify immediate hypoalgesic treatment effects for neck pain by measuring the reduction in pain intensity (using a VAS) at the same (sub)maximal neck position (using a CROM device) before and after treatment. It is a novel test designed to quantify immediate pain relief following treatment, without the potentially confounding effects of simultaneous improvements in function.</div></div><div><h3>Objectives</h3><div>(1) To describe the CROM-VAS Test, (2) To assess reliability and absolute agreement of the CROM-VAS Test, and (3) To evaluate its distinctiveness by comparing it to changes in pressure pain threshold (PPT) and baseline pain scores.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>The CROM-VAS Test was assessed in 58 people with non-specific neck pain treated with cervical mobilisation and cervicothoracic manipulation. Inter-rater reliability (intraclass correlation coefficient (ICC_1.1)) and absolute agreement (standard error of measurement (SEM), minimal detectable change (MDC) and Bland-Altman limits of agreement (LoA)) were determined.</div></div><div><h3>Results</h3><div>Reliability was high (ICC_1.1: 0.91 (95%CI: 0.85–0.95) for the CROM-VAS Test in the painful direction and 0.73 (95%CI: 0.54–0.85) in the non/least painful direction). Agreement was good (CROM-VAS Test (painful direction): SEM: 2.3 mm; MDC: 6.4 mm; LoA: 13.5 to 16.6 mm; CROM-VAS Test (non/least painful direction): SEM: 4.0 mm; MDC: 11.1 mm; LoA: 14.7 to 22.0 mm). Low or negative correlations were observed between CROM-VAS Test scores and changes in PPT and baseline neck pain scores.</div></div><div><h3>Conclusion</h3><div>The CROM-VAS Test has good clinimetric properties. It measures a distinct dimension of pain relief compared to PPTs and baseline pain scores.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103191"},"PeriodicalIF":2.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468781224002868/pdfft?md5=2382e791b5a2d03a9223df362822b2d9&pid=1-s2.0-S2468781224002868-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315934","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":"Influence of nationality on the trajectories of pain, disability and health related quality of life in neck and back patients – The Norwegian Neck and Back Registry","authors":"Janica S. Ignatius ,&nbsp;Cecilie Røe ,&nbsp;Paul B. Perrin ,&nbsp;Sigrid Skatteboe ,&nbsp;Jens I. Brox ,&nbsp;Maja Garnaas Kielland ,&nbsp;John Bjørneboe","doi":"10.1016/j.msksp.2024.103193","DOIUrl":"10.1016/j.msksp.2024.103193","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the current study was to examine differences in trajectories of pain, disability, and health related quality of life (HRQOL) between non-Norwegian and Norwegian patients with neck and back pain over 12 months.</div></div><div><h3>Methods</h3><div>The study is based on data from the Norwegian Neck and Back Registry (NNRR). The data include demographics and patient-reported outcome measures such as pain rating, the Oswestry Disability Index and HRQOL. Data were collected at baseline, 6 and 12 months after consultation for neck and back pain in specialist health care.</div></div><div><h3>Results</h3><div>A total of 5012 patients were included. We found a significant main effect of nationality. Non-Norwegian patients showed higher levels of pain and disability and lower HRQOL than Norwegian patients. Both patient groups exhibited an improvement in all three outcomes at 6- and 12-month follow-ups. The improvement was similar for pain with the greatest improvement taking place during the first 6 months and then slightly flattening out. For disability and HRQOL, we observed a differential effect over time as a function of nationality. Both groups reported an improvement the first 6 months, however, while the Norwegian patients continued their improvement to 12 months, non-Norwegian patients had increasing disability and lower HRQOL at 12 months.</div></div><div><h3>Conclusion</h3><div>Both patient groups improved over the 12-month period. Non-Norwegian patients showed an overall higher level of pain, disability and lower HRQOL compared to Norwegian patients, with a differential effect over time as a function of nationality for disability and HRQOL. Suggesting that future studies should focus on potential systemic barriers that may affect the recovery of neck and back patients based on nationality.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103193"},"PeriodicalIF":2.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395563","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":"Communicating safety-netting information in primary care physiotherapy consultations for people with low back pain","authors":"Christopher Horler ,&nbsp;Geraldine Leydon ,&nbsp;Lisa Roberts","doi":"10.1016/j.msksp.2024.103192","DOIUrl":"10.1016/j.msksp.2024.103192","url":null,"abstract":"<div><h3>Background</h3><div>Safety-netting involves communicating information to patients about diagnostic uncertainty, the likely time-course of their condition and how to appropriately seek help from a healthcare professional if their condition persists or worsens. Little is known about how physiotherapists communicate safety-netting information to people with low back pain (LBP).</div></div><div><h3>Objectives</h3><div>This research aimed to use a Safety-Netting Coding Tool (SaNCoT) to explore how physiotherapists communicate safety-netting information to people with LBP.</div></div><div><h3>Methods</h3><div>The SaNCoT was used to conduct a secondary analysis of audio-recordings and transcripts from 79 primary care physiotherapy consultations (41 initial and 38 follow-up) involving 12 physiotherapists and 41 patients with LBP in Southern England. Quantitative data from the SaNCoT were analysed descriptively.</div></div><div><h3>Findings</h3><div>The study found evidence of diagnostic uncertainty in 53 (67%) appointments and no examples of physiotherapists providing patients with specific information about their condition time-course. Eight patients were given safety-netting advice, but most (57.9%, n = 11) episodes of safety-netting advice did not include specific signs and symptoms for patients to monitor. Potential missed opportunities for safety-netting advice were identified in 19 appointments (24.1%) which tended to relate to the patient's associated leg symptoms but also included possible serious pathology.</div></div><div><h3>Conclusion</h3><div>The SaNCoT was successfully used to measure safety-netting communication within physiotherapy consultations and found missed opportunities for providing clear safety-netting advice. Physiotherapists can use the findings to reflect on how they can provide clear safety-netting information to patients with LBP to effectively support patients to self-manage and help them seek appropriate care if their condition deteriorates.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103192"},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246878122400287X/pdfft?md5=d0da9eb5f94103165312aae6e3822444&pid=1-s2.0-S246878122400287X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301852","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}