Musculoskeletal Science and Practice最新文献

{"title":"The construct validity of screening questions for kinesiophobia, pain catastrophizing, depression, and stress in patients with (sub-)acute non-traumatic neck pain","authors":"Tineke Pieterson ,&nbsp;Sophie Konings ,&nbsp;Rebecca Stellato ,&nbsp;Arjan Boshuijzen ,&nbsp;Martine J. Verwoerd","doi":"10.1016/j.msksp.2025.103324","DOIUrl":"10.1016/j.msksp.2025.103324","url":null,"abstract":"<div><h3>Background</h3><div>Neck pain is common and may transition from acute to chronic, often influenced by psychological factors like kinesiophobia, pain catastrophizing, depression, and stress. Early screening for these factors in patients with (sub-)acute neck pain is crucial to prevent chronicity.</div></div><div><h3>Objectives</h3><div>To examine the construct validity and internal consistency of screening questions for kinesiophobia, pain catastrophizing, depression, and stress in Dutch patients with (sub-)acute, non-traumatic neck pain.</div></div><div><h3>Design</h3><div>Cross sectional study.</div></div><div><h3>Method</h3><div>Hypotheses were formulated for convergent and divergent validity. <em>Screening questions were compared with established questionnaires: the Tampa Scale for Kinesiophobia (TSK-11) for kinesiophobia, the Pain Catastrophizing Scale (PCS-6) for pain catastrophizing, and the Depression, Anxiety, and Stress Scale (DASS-21) for depression and stress.</em> When strong convergent validity (r ≥ 0.7) was observed, internal consistency was assessed.</div></div><div><h3>Results</h3><div>Moderate correlations were observed for kinesiophobia (r = 0.526, TSK-11), depression (r = 0.660 DASS-21 depression), and stress (r = 0.506. DASS-21 distress). Pain catastrophizing showed a strong correlation with the PCS-6 (r = 0.771). Divergent validity was supported by correlations ≤0.5 with unrelated constructs for kinesiophobia, pain catastrophizing, and stress, but not for depression. Internal consistency for pain catastrophizing was 0.692. Scatterplots showed wide dispersion for kinesiophobia and stress. For pain catastrophizing, the scatterplot revealed that low screening scores were associated with high reference standard scores.</div></div><div><h3>Conclusions</h3><div>Investigating the complex constructs of kinesiophobia, pain catastrophizing, depression and stress with one or two questions cannot currently be recommended. Further research is needed to confirm the ability to screen for psychological constructs.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103324"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799402","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":"Correlation of absolute and relative limb differences in Y-balance test and asymmetry indices of CMJ, SJ and IMTP","authors":"Longji Li ,&nbsp;Tianfei Fan ,&nbsp;Kaifang Liao ,&nbsp;Lifeng Zhang","doi":"10.1016/j.msksp.2025.103320","DOIUrl":"10.1016/j.msksp.2025.103320","url":null,"abstract":"<div><h3>Objective</h3><div>Determine the relationship between Y-Balance Test (YBT) and force platform-based assessments, including squat jump (SJ), countermovement jump (CMJ), and isometric mid-thigh pull (IMTP), to evaluate lower limb stability and asymmetry.</div></div><div><h3>Method</h3><div>Sixty-one recruited active professional firefighters were assessed for YBT absolute limb differences (anterior, posteromedial, and posterolateral directions) using the YBT classic formula or a force platform built-in formula, and for asymmetry indices of CMJ, SJ and IMTP derived from the force platform.</div></div><div><h3>Results</h3><div>The absolute limb differences in YBT anterior (YBT-A) showed a moderate correlation (r &gt; 0.4) with asymmetry indices of SJ concentric peak force (SJ-CPF), IMTP peak force component (IMTP-PFC), and IMTP peak force (IMTP-PF). Subsequently, limb relative differences for YBT-A were calculated using the built-in formula of the force platform, which also showed a moderate correlation (r &gt; 0.4) with asymmetry indices of SJ-CPF, IMTP-PFC, and IMTP-PF. However, when considering either absolute or relative differences, YBT posteromedial asymmetry (YBT-PMA) or YBT posterolateral asymmetry (YBT-PLA) showed weak or negative correlations with asymmetry indices derived from the force platform.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that YBT anterior asymmetry (YBT-AA) calculated by using either the YBT classic formula or the built-in formula of the force platform, showed a moderate correlation with asymmetry indices derived from the force platform. This study provides clinicians and researchers with different test methods for assessing lower limb stability.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103320"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786042","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":"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":"Differences in non-weight-bearing and weight-bearing measures of lower leg muscle elasticity using shear wave elastography","authors":"David J. Kempfert ,&nbsp;Katy Mitchell ,&nbsp;Wayne Brewer ,&nbsp;Christina Bickley","doi":"10.1016/j.msksp.2025.103322","DOIUrl":"10.1016/j.msksp.2025.103322","url":null,"abstract":"<div><h3>Introduction</h3><div>Elasticity is a biomechanical property of muscle necessary for physical function and can be measured with shear wave elastography (SWE). SWE may be useful in diagnosing pathology, predicting injury, and monitoring rehabilitation. This would be beneficial for smaller muscles working synergistically to resist external loads during functional activities. Establishing clinical measures of elasticity in larger sample sizes is necessary prior to its use in assessing pathology and guiding intervention.</div></div><div><h3>Purpose</h3><div>The study's primary aim was to investigate differences in elasticity for the tibialis anterior (TA), tibialis posterior (TP), peroneal longus (PL), and peroneal brevis (PB) muscles. It was hypothesized that there would be a statistically-significant difference in muscle elasticity both within and between non-weight-bearing (NWB) and weight-bearing (WB) positions.</div></div><div><h3>Methods</h3><div>Same-day, repeated-measures, cross-sectional design incorporating 109 healthy, recreationally active adults. Elasticity (kPa) was measured in NWB and 90 % WB.</div></div><div><h3>Results</h3><div>There was a statistically-significant interaction between muscle (TA, TP, PL, PB) and position (NWB, WB). Utilizing pairwise simple effects with Bonferroni correction, there was a significant (<em>p</em> ≤ 0.001–0.007) difference within muscles for NWB measures. WB measures revealed a significant (<em>p</em> ≤ 0.001) difference within muscles, except the TA-PB (<em>p</em> = 1.000). A significant (<em>p</em> ≤ 0.001–0.018) difference was found between NWB and WB positions for the TA, TP, and PB but not the PL (<em>p</em> = 0.140).</div></div><div><h3>Conclusion</h3><div>The utility of SWE may help describe how the biomechanical property of elasticity differs between resting positions and functional states of muscle contraction. These findings may aid future clinical applications of SWE for injury prevention, rehabilitation, and physical performance.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103322"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792398","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":"Predicting pregnancy-related pelvic girdle pain using machine learning","authors":"Atefe Ashrafi ,&nbsp;Daniel Thomson ,&nbsp;Hadi Akbarzadeh Khorshidi ,&nbsp;Amir Marashi ,&nbsp;Darren Beales ,&nbsp;Dragana Ceprnja ,&nbsp;Amitabh Gupta","doi":"10.1016/j.msksp.2025.103321","DOIUrl":"10.1016/j.msksp.2025.103321","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy-related pelvic girdle pain (PPGP) is a common complication during gestation which negatively influences pregnant women's quality of life. There are numerous risk factors associated with PPGP, however, there is limited information about being able to predict the diagnosis of PPGP.</div></div><div><h3>Objective</h3><div>To compare machine learning (ML) and traditional predictive modelling to predict the clinical diagnosis of PPGP.</div></div><div><h3>Methods</h3><div>This study reanalysed data from 780 pregnant women attending a tertiary hospital. ML algorithms, including Logistic Regression (LR), Random Forest, Xtreme Gradient Boost (XGBoost), and K-Nearest Neighbors, were used to predict the clinical diagnosis of PPGP. Feature selection methods and cross-validation were employed to optimize model performance, with the Area Under the Receiver Operating Characteristic Curve (AUROC) as the primary outcome measure.</div></div><div><h3>Results</h3><div>The ML models, particularly XGBoost and LR, demonstrated high levels of predictive accuracy (AUROC = 0.70). Key predictive factors were a history of low back pain/pelvic girdle pain (LBP/PGP) in previous pregnancies, family history, gestational age, and a longer duration of standing during the day. The history of LBP/PGP in previous pregnancies emerged as the most significant predictor.</div></div><div><h3>Conclusions</h3><div>This study highlighted the potential of ML models to enhance the ability to predict PPGP and offers a more accurate and comprehensive approach to identifying women at risk of PPGP. The integration of ML techniques into clinical practice could improve early identification and inform preventative and intervention strategies, potentially reducing the impact of PPGP on pregnant women.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103321"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842747","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":"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":"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":"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":"Manual therapy and neck-specific exercise are equally effective for treating non-specific neck pain but only when exercise adherence is maximised: A randomised controlled trial","authors":"Villanueva-Ruiz Iker ,&nbsp;Falla Deborah ,&nbsp;Saez Marc ,&nbsp;Araolaza-Arrieta Maialen ,&nbsp;Azkue Jon Jatsu ,&nbsp;Arbillaga-Etxarri Ane ,&nbsp;Lersundi Ana ,&nbsp;Lascurain-Aguirrebeña Ion","doi":"10.1016/j.msksp.2025.103319","DOIUrl":"10.1016/j.msksp.2025.103319","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effectiveness of manual therapy versus a progressive, tailored neck-specific exercise program with high adherence for treating non-specific chronic neck pain (NSNP) and to examine the relationship between exercise adherence and treatment outcome.</div></div><div><h3>Design</h3><div>Single-blind, parallel, randomized clinical trial with two treatment arms, adhering to CONSORT guidelines.</div></div><div><h3>Methods</h3><div>65 NSNP participants were randomly allocated to manual therapy or exercise. They received four treatment sessions of either manual therapy or neck-specific exercise, once a week for four weeks. Outcomes measured at baseline, two weeks, four weeks, and 12 weeks post-treatment included pain intensity, disability, patient-perceived improvement, quality of life, kinesiophobia and the craniocervical flexion test (CCFT) performance. In addition to evaluating each individual outcome, patients were categorized into either <em>responders</em> or <em>non-responders</em> according to pain intensity, disability and patient-perceived improvement. Exercise adherence was recorded.</div></div><div><h3>Results</h3><div>There were no differences between groups in individual outcomes. Treatment outcome in the exercise group was associated with exercise adherence. Patients receiving manual therapy were more likely to be classified as responders than those receiving exercise at all measured time points (odds ratio, 2 weeks: 0.14; 95 % CI: 0.02–0.79; treatment completion: 0.31; 95 % CI: 0.12–0.82; 12 weeks after treatment completion: 0.19; 95 % CI: 0.05–0.65), however these differences were no longer present when only patients whose exercise adherence was ≥95 % were analysed. Exercise was more effective than manual therapy in improving CCFT performance but only if patients with ≥95 % adherence were considered.</div></div><div><h3>Conclusion</h3><div>A four-week intervention of manual therapy was more effective than exercise, however when exercise adherence was ≥95 %, the interventions were equally effective. Manual therapy may only be superior to specific-exercise when high exercise adherence cannot be assured.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"77 ","pages":"Article 103319"},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865048","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}