Musculoskeletal Science and Practice最新文献

{"title":"Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study","authors":"","doi":"10.1016/j.msksp.2024.103178","DOIUrl":"10.1016/j.msksp.2024.103178","url":null,"abstract":"<div><h3>Objective</h3><p>Investigate people's acceptance of specialist musculoskeletal care within a new care pathway for common musculoskeletal conditions (low back pain, neck pain/whiplash, knee osteoarthritis).</p></div><div><h3>Design</h3><p>Convergent parallel mixed methods design referencing the Theoretical Framework of Acceptability. The study included a subset of participants (n = 29) at-risk of poor outcomes from the intervention arm of the PAthway of CarE for common musculoskeletal conditions (PACE-MSK) trial. In the PACE-MSK arm, participants received specialist physiotherapist care as an adjunct to the care provided by their primary healthcare professional(s). One-to-one semi-structured interviews were conducted around 3-months after commencing in the trial. Quantitative data were collected at baseline and 3-month follow-up (health-related quality of life, pain self-efficacy, global perceived change, satisfaction).</p></div><div><h3>Results</h3><p>Five themes were identified (Expectations and beliefs shaped patient experience; Clinical expertise and competence influence acceptance; Person-centred care; Mechanisms facilitating beneficial responses to care; Gaps in care pathway implementation). There were positive individual changes in physical quality of life for 17/29 (59%) participants, mental health quality of life for 12/29 (41%), pain self-efficacy for 8/29 (28%) and global perceived change for 19/29 (66%). Management met expectations with the majority reporting high levels of satisfaction. Integrating the qualitative and quantitative data with the Theoretical Framework of Acceptability, there were complementary meta-inferences in the constructs of ‘ethicality’, ‘intervention coherence’, ‘self-efficacy’ and ‘affective attitude’. Divergence was identified in ‘perceived effectiveness’.</p></div><div><h3>Discussion</h3><p>In general, there was positive acceptance of the care pathway by participants. Specialist physiotherapists’ care was perceived as a positive addition to usual care.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246878122400273X/pdfft?md5=3b47a0364e59468e6a1d9565e9904831&pid=1-s2.0-S246878122400273X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173619","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":"Effects of therapeutic exercise on pain processing in people with chronic non-specific neck pain - A systematic review and meta-analysis","authors":"","doi":"10.1016/j.msksp.2024.103183","DOIUrl":"10.1016/j.msksp.2024.103183","url":null,"abstract":"<div><h3>Background</h3><p>Emerging evidence suggests that individuals with chronic non-specific neck pain may experience altered sensory processing, potentially contributing to the modest response to therapeutic exercise treatments.</p></div><div><h3>Objective</h3><p>This systematic review aims to explore the effect of therapeutic exercise on pain processing among patients with chronic non-specific neck pain.</p></div><div><h3>Methods</h3><p>A systematic search was conducted in multiple databases (PubMed, EMBASE, CINAHL, PEDro, SportDiscus, and Cochrane CENTRAL) from inception to June 2023. Inclusion criteria included randomized controlled trials (RCT) comparing therapeutic exercise to non-exercise treatments or no treatment. The screening and data extraction was conducted by two reviewers. The methodological quality was evaluated using the PEDro scale and the certainty of evidence using GRADE. The primary outcomes assessed were pressure pain threshold (PPT), temporal summation, and conditioned pain modulation.</p></div><div><h3>Results</h3><p>Thirteen trials included a total of 948 participants, with 586 in the exercise therapy group and 362 in the non-exercise group. The therapeutic exercise was not superior to non-exercise treatments for both local and PPT in the immediate (MD = 0.13, 95%CI = −0.18 to 0.43), and short-term follow-up (MD = 0.17, 95%CI = −0.27 to 0.61). In the medium term, therapeutic exercise demonstrated a small effect size in increasing local PPT (Kg/cm2) (MD = 0.64, 95%CI = 0.08 to 1.19) compared to non-exercise interventions. The certainty of evidence for these outcomes was very low.</p></div><div><h3>Conclusions</h3><p>There is very low certainty of evidence that therapeutic exercise is not superior than non-exercise treatment on pain processing in patients with chronic non-specific neck pain.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274553","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":"Online education and manual skill acquisition","authors":"","doi":"10.1016/j.msksp.2024.103181","DOIUrl":"10.1016/j.msksp.2024.103181","url":null,"abstract":"","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233871","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":"Cross-cultural Adaptation of the Avoidance of Daily Activities Photo Scale for Turkish patients with shoulder pain: Reliability and validity assessment according to the COSMIN guideline","authors":"","doi":"10.1016/j.msksp.2024.103180","DOIUrl":"10.1016/j.msksp.2024.103180","url":null,"abstract":"<div><h3>Context</h3><p>People with chronic or long-term pain may develop various psychosocial symptoms such as fear and avoidance of behavior due to pain. Reliable and valid quality of life tools must be available in Turkish to specifically assess avoidance of behavior in people with shoulder pain.</p></div><div><h3>Objectives</h3><p>This study aimed to translate and culturally adapt the Avoidance of Daily Activities Photo Scale for Patients with Shoulder Pain and to evaluate the psychometric properties of its Turkish version (ADAP-Tr) in patients with shoulder pain.</p></div><div><h3>Methods</h3><p>Translation, adaptation, and validation were performed according to the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidelines. The internal consistency, reliability, construct validity, and discriminant validity of the ADAP-Tr were tested. The Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Shoulder Pain and Disability Index (SPADI) were applied for validation purposes.</p></div><div><h3>Results</h3><p>The study included a total of 162 participants with shoulder pain. The internal consistency of the ADAP-Tr showed excellent reliability with a Cronbach's α of 0.94 and a test-retest assessment of 0.88 ICC (95% CI, 0.83-0.91). The standard error of measurement was 1.85 points, and the minimal detectable change was determined 5.12 points. There was a low to high correlation among the ADAP-Tr and PCS (r = 0.481, p &lt; .001), TSK (r = 0.448, p &lt; .001), and SPADI (r = 0.826, p &lt; .001) scores.</p></div><div><h3>Conclusions</h3><p>The ADAP-Tr was shown to be a valid and strong reliability tool to use in clinical and research settings as a shoulder-specific measurement tool.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163069","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":"Corrigendum to “Conference abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th–6th July” [Muscoskel. Sci. Pract. 72 (2024) 103127]","authors":"","doi":"10.1016/j.msksp.2024.103159","DOIUrl":"10.1016/j.msksp.2024.103159","url":null,"abstract":"","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468781224002546/pdfft?md5=59e7744af87db49662e2ce9383e67a6c&pid=1-s2.0-S2468781224002546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149924","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":"Can assessment of human assumed central sensitisation improve the predictive accuracy of the STarT Back screening tool in acute low back pain?","authors":"","doi":"10.1016/j.msksp.2024.103177","DOIUrl":"10.1016/j.msksp.2024.103177","url":null,"abstract":"<div><h3>Background</h3><p>The STarT Back Screening Tool (SBT) is recommended to provide risk-stratified care in low back pain (LBP), yet its predictive value is moderate for disability and low for pain severity. Assessment of human assumed central sensitisation (HACS) in conjunction with the SBT may improve its predictive accuracy.</p></div><div><h3>Objectives</h3><p>To examine whether assessment of HACS in acute LBP improves the predictive accuracy of the SBT for LBP recovery at six months in people with acute non-specific LBP.</p></div><div><h3>Design</h3><p>A prospective longitudinal study.</p></div><div><h3>Method</h3><p>Data were drawn from the UPWaRD study. One hundred and twenty people with acute non-specific LBP were recruited from the community. Baseline measures included SBT risk status, nociceptive flexor withdrawal reflex, pressure and heat pain thresholds and conditioned pain modulation. Primary outcome was the presence of LBP (pain numeric rating scale ≥1 and Roland Morris Disability Questionnaire score ≥3) at six-month follow-up. Regression coefficients were penalised using the least absolute shrinkage and selection operator technique to select predictor variables. Internal validation was performed using ten-fold cross-validation.</p></div><div><h3>Results/findings</h3><p>SBT risk status alone did not predict the presence of LBP at six months (area under receiver operating characteristic curve [AUC] = 0.58). Adding measures of HACS to the SBT did not improve discrimination for whether LBP was present at six months (AUC = 0.59).</p></div><div><h3>Conclusions</h3><p>This study confirmed the suboptimal predictive accuracy of the SBT, administered during acute LBP, for LBP recovery at six months. Assessment of HACS in acute LBP does not improve the predictive accuracy of the SBT.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163067","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 visual cues at different heights on sit-to-stand movements in people with and without low back pain","authors":"","doi":"10.1016/j.msksp.2024.103179","DOIUrl":"10.1016/j.msksp.2024.103179","url":null,"abstract":"<div><h3>Background</h3><p>Investigating movement strategies that can be utilized to avoid pain-provocation could enhance the management of low back pain episodes.</p></div><div><h3>Objective</h3><p>To assess the effect of visual cues at different heights on the kinematics of sit-to-stand movements, as well as perceived difficulty and pain levels.</p></div><div><h3>Design</h3><p>Cross-over design comparing individuals with low back pain to healthy controls.</p></div><div><h3>Methods</h3><p>26 asymptomatic controls and 15 individuals with chronic, recurrent low back pain performed 5 sets of 5 sit-to-stand movements. High, middle, and low visual cues were used during sets 2–4. Spinal sagittal plane range of motion, peak spinal flexion and extension angles, and trunk centre of mass velocity were obtained from kinematic data.</p></div><div><h3>Results</h3><p>The low cue led to significantly more head and lumbar spine flexion, while the high cue led to significantly more head and thoracic spine extension and increased thoracic spine range of motion. The low back pain group demonstrated a significantly lower vertical trunk centre of mass velocity than the control group during the high cue trials. There was a significant association between higher perceived difficulty scores and lower trunk centre of mass velocity for the low back pain group. Pain scores were not significantly different between cue conditions.</p></div><div><h3>Conclusion</h3><p>Visual cues can be used to temporarily change the spinal kinematics of sit-to-stand movements in people with and without low back pain. This could be helpful in clinical practice to encourage more, or less, movement in specific spinal regions, and avoid pain provocation to facilitate functional rehabilitation.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173618","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":"Pain neuroscience education is not superior to spinal physiology and ergonomics education within a short multidisciplinary rehabilitation program: A randomized controlled trial","authors":"","doi":"10.1016/j.msksp.2024.103176","DOIUrl":"10.1016/j.msksp.2024.103176","url":null,"abstract":"<div><h3>Introduction</h3><p>There is little evidence to suggest that one educational intervention is superior to another when associated with a rehabilitation program in the management of persistent low back pain. The objective of the present study was to compare pain neuroscience education with spine physiology and ergonomics education as part of a one-week multidisciplinary rehabilitation program.</p></div><div><h3>Method</h3><p>We conducted a randomized, controlled trial among patients having experienced persistent low back pain for at least 1 year. The patients participated in a one-week multidisciplinary rehabilitation program with an educational component. The members of the experimental and control groups received pain neuroscience education and spine physiology and ergonomics education, respectively. Outcomes were assessed before the program (day 0), immediately afterwards (day 5), and on day 90 after the start of the program. The primary outcome measure was functional disability on day 90.</p></div><div><h3>Results</h3><p>A total of 88 patients were randomized. On day 90, a statistically significant mean [95% confidence interval] decrease in the level of disability was observed in the experimental (PNE) group (−3.4 [-5.0 to −1.8]). The mean [95%CI] difference versus the control group (−1.7 [-4.0 to 0.5]) was not statistically significant (p = 0.12). There were no statistically significant intergroup differences in the secondary outcome measures.</p></div><div><h3>Conclusion</h3><p>There appears to be no advantage in replacing a conventional, non-neuroscientific educational program (based on spinal physiology and ergonomics) with a pain neuroscience education program as part of a one-week multidisciplinary rehabilitation program. Further research is needed to identify patients who will respond better to a pain neuroscience education module as part of a personalized care program.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163066","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":"Characteristics of patients seeking national health service (NHS) care for Achilles tendinopathy: A service evaluation of 573 patients","authors":"","doi":"10.1016/j.msksp.2024.103156","DOIUrl":"10.1016/j.msksp.2024.103156","url":null,"abstract":"<div><h3>Background</h3><p>Achilles tendinopathy is a common condition that is often still symptomatic 10 years after onset. Much of the available research has focussed on active populations, however our experience is patients seeking care in the UK's National Health Service (NHS) may be different.</p></div><div><h3>Objectives</h3><p>To determine the characteristics of patients receiving NHS care for Achilles tendinopathy (AT).</p><p>To describe the utilisation of resources and the effectiveness of AT management in the NHS.</p></div><div><h3>Methods</h3><p>A data extraction tool was developed and used to retrospectively extract the characteristics of 573 patients diagnosed with Achilles tendinopathy.</p></div><div><h3>Results</h3><p>NHS Achilles tendinopathy patients averaged 57 years old, had a Body Mass Index of 31, and 69% had at least one other long-term health condition. These included musculoskeletal complaints (59%), hypertension (30%), Chronic Obstructive Pulmonary Disease or asthma (17%), cardiovascular disease (13%) and diabetes (13%). Subsequently medication usage was higher than the general population and included drugs that have been linked to the pathogenesis of tendinopathy. On average, healthcare providers conducted 3.8 therapy sessions and 26% of patients had radiological investigations. Outcome measures were commonly absent with Visual Analog Scale (VAS) scores documented in 51% of records, and patient-reported outcome measures like VISA-A only appearing in 3% of cases. Reports on psychosocial factors were seldom documented.</p></div><div><h3>Conclusion</h3><p>Individuals diagnosed with Achilles tendinopathy through NHS services exhibit distinct characteristics that diverge considerably from those currently represented in the published research used to develop clinical guidelines. NHS Achilles tendinopathy patients have multiple long-term health conditions and higher medication usage.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173617","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":"A combined program of education plus exercise versus general advice for ankle osteoarthritis: A feasibility randomised controlled trial","authors":"","doi":"10.1016/j.msksp.2024.103169","DOIUrl":"10.1016/j.msksp.2024.103169","url":null,"abstract":"<div><h3>Background</h3><p>Unlike hip and knee OA, there is little evidence to guide the management of ankle osteoarthritis (OA) and there are no clinical guidelines for ankle OA. Regardless of the body region, guidelines for treating OA typically include education, weight loss and exercise as the key components of management. Such an intervention has not been investigated in people with ankle OA.</p></div><div><h3>Objectives</h3><p>To determine the feasibility of conducting a randomised controlled trial (RCT) that compares physiotherapist-delivered education plus exercise to physiotherapist-delivered general advice for people with ankle OA. Secondarily, to inform planning for future RCTs.</p></div><div><h3>Design</h3><p>A randomised parallel-group feasibility trial.</p></div><div><h3>Method</h3><p>Study participants were recruited, assessed for eligibility, and randomised using 1:1 concealed allocation to receive either physiotherapist-delivered education plus exercise, or physiotherapist-delivered general advice. Primary feasibility outcomes were evaluated based on predetermined feasibility criteria. Secondary participant-reported and physical outcomes were collected to inform the design of future RCTs.</p></div><div><h3>Results</h3><p>Thirty participants (67% (n = 20) women, mean (standard deviation) age: 66.1 (11.5) years) were randomised. Data for key feasibility outcomes met <em>a priori</em> feasibility criteria: consent rate (97%), participant adherence with their allocated intervention arm (71%), fidelity of the intervention (94%) and rate of completion of outcome measures at 3 months (87%).</p></div><div><h3>Conclusions</h3><p>This study demonstrates that it is feasible to run an adequately powered RCT comparing physiotherapist-delivered education plus exercise versus physiotherapist-delivered general advice for people with ankle OA. Study data will inform the planning of a full-scale RCT.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468781224002649/pdfft?md5=be5e6d2153320836e614de082f07d2a8&pid=1-s2.0-S2468781224002649-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146980","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}