Musculoskeletal Science and Practice最新文献

{"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}

{"title":"Identifying distinct scapular upward rotation patterns in individuals with upper trapezius–associated neck pain using unsupervised clustering approach","authors":"Hwa-Ik Yoo ,&nbsp;Ui-Jae Hwang ,&nbsp;Jun-Hee Kim ,&nbsp;Oh-Yun Kwon","doi":"10.1016/j.msksp.2025.103396","DOIUrl":"10.1016/j.msksp.2025.103396","url":null,"abstract":"<div><h3>Background</h3><div>Previous findings on scapular motion in upper trapezius (UT)-associated neck pain are inconsistent, and binary pain classification may overlook important movement characteristics.</div></div><div><h3>Objectives</h3><div>To identify distinct scapular upward rotation patterns in individuals with UT-associated neck pain using unsupervised clustering and to compare the resulting subgroups with healthy controls.</div></div><div><h3>Design</h3><div>Exploratory, cross-sectional design.</div></div><div><h3>Method</h3><div>Eighty-nine participants with UT-associated neck pain and 25 asymptomatic controls performed unilateral and bilateral scapular upward rotation. A smartphone camera recorded marker trajectories on the acromion process. Marker displacements along the <em>x</em>- and <em>y</em>-axes and the <em>y</em>/<em>x</em> ratio served as input features. K-means clustering was applied, and group differences were assessed.</div></div><div><h3>Results/Findings</h3><div>Cluster 1 showed restricted displacement and elevated <em>y</em>/<em>x</em> ratios; Cluster 2 displayed excessive displacement with normal <em>y</em>/<em>x</em> ratios. Control values lay between clusters, and pain intensity did not differ by cluster.</div></div><div><h3>Conclusions</h3><div>Smartphone-based clustering reveals hypomobile and hypermobile scapular phenotypes, supporting personalized assessment. This classification could potentially help clinicians who seek to assess how both excessive and restricted scapular motions may contribute to UT‐associated neck pain. Future studies should validate these clusters in larger samples and incorporate three-dimensional kinematics.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103396"},"PeriodicalIF":2.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916500","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":"What do we know about safety netting patients at risk of metastatic spinal cord compression? A scoping review","authors":"Philippa C. Hacking ,&nbsp;Gillian Yeowell ,&nbsp;Susan Greenhalgh","doi":"10.1016/j.msksp.2025.103397","DOIUrl":"10.1016/j.msksp.2025.103397","url":null,"abstract":"<div><h3>Background</h3><div>Metastatic spinal cord compression is a potentially devastating consequence of cancer. This oncological emergency requires early recognition and treatment to prevent irreversible spinal cord injury and paralysis. Provision of information to at risk patients has been recommended in the 2023 NICE Guidelines. However, it is unclear when, how and what information should be provided.</div></div><div><h3>Aim</h3><div>To investigate how healthcare professionals provide safety netting information to patients at risk of metastatic spinal cord compression.</div></div><div><h3>Methods</h3><div>This scoping review utilised the Arksey and O'Malley Framework and the recommendations by the Joanna Briggs Institute. Relevant literature was identified following a systematic search of three databases, with grey literature accessed through a targeted search of relevant websites. Following data charting, thematic analysis was used to identify salient themes across the dataset.</div></div><div><h3>Results</h3><div>A total of N = 197 records were identified. Following removal of duplicates, title and abstract screening, N = 24 records were screened and N = 9 were included for full analysis. Three key themes were identified: information format and dissemination, health education and raising awareness, and timeliness of safety netting.</div></div><div><h3>Implications</h3><div>All patients with or at risk of developing bony metastases should be provided with safety netting information about metastatic spinal cord compression. Generalist clinicians should be prepared to share this information to empower patients to present early with symptoms. Further research is needed to explore the information needs and perspectives of patients with or at risk of metastatic spinal cord compression.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103397"},"PeriodicalIF":2.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076610","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":"Exercise-based rehabilitation for ACL injuries: a systematic review and meta-analysis","authors":"Arianne P. Verhagen ,&nbsp;Anthony Nasser ,&nbsp;Luke Jenkins ,&nbsp;Andrew Paul Monk ,&nbsp;Bruno T. Saragiotto ,&nbsp;Peter Stubbs","doi":"10.1016/j.msksp.2025.103392","DOIUrl":"10.1016/j.msksp.2025.103392","url":null,"abstract":"<div><h3>Background</h3><div>Despite the lack of clear benefit of surgery for Anterior Cruciate Ligament (ACL) injury and the uncertain cost-effectiveness, the rates of surgery are increasing. Therefore, a better insight in the benefits of exercise is needed.</div></div><div><h3>Objective</h3><div>Evaluate the effectiveness of exercises in people with an ACL injury.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We searched 5 databases for randomized trials investigating exercise interventions for the management of ACL injuries. We assessed the methodological quality and completeness of exercise reporting and performed a meta-analysis using a random-effects model. The certainty of evidence was assessed using GRADE.</div></div><div><h3>Results</h3><div>We included 18 trials (n = 1433); four compared exercises with no treatment, eight compared various exercises, and six trials compared exercise to surgery. Single studies showed (very uncertain) benefit of Tai Chi and Pilates on pain or recovery compared to no treatment; the pooled evidence showed no differences on function (MD = −2.2; 95 %CI -6.5 to 2.1). Pooled evidence shows no differences (moderate certainty) between various exercises in function (SMD = −0.07; 95 %CI -0.4 to 0.3). Only one single study showed benefit of additional perturbation training on recovery (very uncertain). We found moderate certainty for no differences between exercise and surgery on pain (MD = −3.5; 95 %CI -7.9 to 1.0), and for a small benefit of surgery on function (MD = −4.3; 95 %CI: −6.7 to −1.8).</div></div><div><h3>Conclusion</h3><div>We found very uncertain benefit of exercise over no treatment, but no exercise was likely more beneficial than another. Compared to exercise, surgery shows no benefit on pain, but a small improvement in function.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103392"},"PeriodicalIF":2.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082541","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 person-centered hypothesis framework: Advancing clinical reasoning in musculoskeletal pain management","authors":"Mark H. Shepherd ,&nbsp;Amy McDevitt ,&nbsp;Damian Keter ,&nbsp;Nick Albers ,&nbsp;Derek Clewley ,&nbsp;Chad Cook","doi":"10.1016/j.msksp.2025.103395","DOIUrl":"10.1016/j.msksp.2025.103395","url":null,"abstract":"<div><h3>Introduction</h3><div>The Person-Centered Hypothesis (PCH) framework is a structured clinical reasoning model designed to enhance \"in action\" reasoning in person-centered care (PCC). The PCH integrates elements of the biopsychosocial model, pain phenotyping, and contextual factors, addressing gaps in real-time clinical decision-making.</div></div><div><h3>Purpose</h3><div>To describe the proposed PCH framework that synthesizes four domains: dominant pain phenotype(s), relevant clinical patterns, regional and co-existing contributors, and psychosocial and lifestyle influencing factors. This masterclass outlines the clinical use of the PCH framework, its ability to reduce cognitive load, and its alignment with precision medicine principles.</div></div><div><h3>Implications</h3><div>The PCH integrates with existing care models, offering clinicians a comprehensive and adaptable framework for managing musculoskeletal pain. By emphasizing reflective practice and prioritizing person-centered domains, the PCH helps clinicians navigate the complexities of diverse patient presentations and facilitates targeted evaluation and intervention strategies. While challenges in implementation exist, the PCH has the potential to improve patient outcomes and clinician confidence. Future research and educational initiatives are recommended to refine, validate, and assess the framework's effectiveness and support its adoption in clinical practice.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103395"},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906967","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 tactile grid localization accuracy between people with back pain compared to individuals without pain","authors":"Kory Zimney ,&nbsp;Tyler Turbak ,&nbsp;Eric Fjeldheim","doi":"10.1016/j.msksp.2025.103394","DOIUrl":"10.1016/j.msksp.2025.103394","url":null,"abstract":"<div><h3>Objectives</h3><div>The study aimed to investigate the grid localization test (GLT) between patients with lower back pain and those without back pain.</div></div><div><h3>Methods</h3><div>Individuals receiving physical therapy were tested before treatment with a GLT to the low back. Testing was performed in the prone position. Participants were oriented to the 12-box, 50 mm grid squares, arranged in three rows and four columns, with a single touch in the center of each square, and provided with the corresponding number for that square. Twenty random touch points were then applied with a single touch in the center of the square, and the participant's accuracy in reporting the correct number associated with the touched square was recorded.</div></div><div><h3>Results</h3><div>GLT was done on 26 individuals with lower back pain compared to 26 individuals without back pain. Those with back pain had a mean accuracy score of 52.41 %, compared to those without back pain, who averaged 76.18 % accuracy, adjusted for age as a covariate between groups. This was a significant difference (p &lt; 0.001) that demonstrated a large effect size (partial η² = 0.296). Interestingly, those with acute pain (&lt;3 months) scored (n = 14, mean = 48.9 %, SD = 21.2 %), similarly to those with chronic pain (&gt;3 months) (n = 12, mean = 49.2 %, SD = 20.3 %).</div></div><div><h3>Discussion</h3><div>When tested with GLT, individuals with low back pain exhibit poorer accuracy scores compared to those without pain. Future studies are needed to determine if treatment to improve accuracy scores has therapeutic benefits.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"Article 103394"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890112","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 individuals’ perspectives on participating in a feasibility trial assessing a combined program of education plus exercise versus general advice for ankle osteoarthritis","authors":"Nathalia Costa ,&nbsp;Bill Vicenzino ,&nbsp;Viana Vuvan ,&nbsp;Natalie J. Collins ,&nbsp;Melinda M. Franettovich Smith ,&nbsp;Zachary Southern ,&nbsp;Tim Duffy ,&nbsp;Alexander Downie ,&nbsp;David J. Hunter ,&nbsp;Michelle D. Smith","doi":"10.1016/j.msksp.2025.103391","DOIUrl":"10.1016/j.msksp.2025.103391","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of exercise and education in individuals with ankle osteoarthritis (OA) has not been investigated, and their perspectives on these interventions remain underexplored.</div></div><div><h3>Objective</h3><div>To understand the experiences of individuals with ankle OA on participating in a feasibility trial comparing general advice and education plus exercise and their views on such interventions.</div></div><div><h3>Design</h3><div>Descriptive qualitative study.</div></div><div><h3>Methods</h3><div>We invited adults with ankle OA who participated in a feasibility trial for an interview. Data were transcribed, de-identified and analysed using Reflexive Thematic Analysis.</div></div><div><h3>Results</h3><div>We interviewed twenty-two participants (age range 45–84 years, 14 females) and identified three themes: 1) The trial team made the trial a great experience, with some room for improvement (e.g., online weekly diaries, access to assessment results); 2) Both general advice and education plus exercise interventions can have a meaningful impact on participants' lives. For some who received general advice, the physiotherapy assessment and the advice received were catalysts for change, while exercise was expected and enjoyable for those who received education plus exercise. However, some thought the general advice and education did not add to their existing knowledge; 3) Lack of discipline and ‘life’ aspects (e.g., being a student, getting sick) can hinder participation.</div></div><div><h3>Conclusion</h3><div>Participants in a feasibility study comparing general advice and education plus exercise had a positive experience with the trial processes, research team, physiotherapists and exercise program. However, perspectives on general advice and education varied, and they had suggestions for improvement that should be considered in future ankle OA trials.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"Article 103391"},"PeriodicalIF":2.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867202","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":"Optimizing acute pain relief in severe knee Osteoarthritis: The influence of resistance exercise volume and psychosocial factors","authors":"Alberto Sánchez-Sabater ,&nbsp;Luis Suso-Martí ,&nbsp;Rodrigo Núñez-Cortés ,&nbsp;Rubén López-Bueno ,&nbsp;Carlos Cruz-Montecinos ,&nbsp;Joaquín Salazar-Méndez ,&nbsp;Vicente Orenga ,&nbsp;Lars Louis Andersen ,&nbsp;José Casaña ,&nbsp;Joaquín Calatayud","doi":"10.1016/j.msksp.2025.103390","DOIUrl":"10.1016/j.msksp.2025.103390","url":null,"abstract":"<div><h3>Background</h3><div>While exercise is a key part of knee osteoarthritis (OA) management, the optimal dose for acute pain relief remains unclear. We aimed to determine the optimal resistance exercise volume to induce exercise-induced hypoalgesia (EIH) in older adults with severe knee OA.</div></div><div><h3>Methods</h3><div>28 participants (11/17 women/men; mean age = 71.6 ± 5.2 years) with severe knee OA awaiting unilateral Total Knee Arthroplasty were recruited. They were randomised to four experimental conditions (cross-over design) conducted with a separation of 4 days. Knee extension exercises with elastic resistance were performed at single exercise sessions at 10 repetition maximum (RM) intensity, while varying the number of sets (control with no exercise, 4 sets, 8 sets, and 12 sets).</div></div><div><h3>Results</h3><div>Higher exercise volumes (12 and 8 sets) induced greater EIH 10 min post-exercise compared to lower volumes (4 sets) or no exercise, with significant differences favouring the 12-set exercise intervention (η² = 0.472, p &lt; 0.001). Pain intensity increased immediately post-exercise in all exercise interventions but returned to baseline after 10 min in the 4- and 12-set exercise interventions. PPT increased post-10 min in the 8- and 12-set exercise interventions for both the affected and contralateral limbs (p &lt; 0.05). PCS moderated the EIH response, reducing its effect in the 12-set (r = −0.436, p &lt; 0.05) and 8-set (r = −0.418, p &lt; 0.05) exercise intervention.</div></div><div><h3>Conclusions</h3><div>Greater resistance exercise volume appears to be associated with an initial increase in pain perception followed by a delayed hypoalgesic response in patients with severe knee OA. These exploratory findings suggest that higher-volume resistance exercise may be a valuable strategy for acute pain relief, although clinicians should balance short-term discomfort with long-term benefits, considering both physical and psychosocial factors, to improve pain-related outcomes aimed at reducing acute pain in this population. However, further research is needed to confirm these effects beyond a controlled, single-exercise acute intervention.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"Article 103390"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764191","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":"Effectiveness of an active behavioural physiotherapy intervention (ABPI) for chronic non-specific neck pain: an internal pilot cluster-randomised double-blind clinical trial","authors":"Taweewat Wiangkham ,&nbsp;Sureeporn Uthaikhup ,&nbsp;Alison Rushton","doi":"10.1016/j.msksp.2025.103389","DOIUrl":"10.1016/j.msksp.2025.103389","url":null,"abstract":"<div><h3>Background</h3><div>Chronic non-specific neck pain (CNSNP) causes pain and disability, contributing to a serious public health problem. An active behavioural physiotherapy intervention (ABPI) may be an effective intervention to manage patients with CNSNP based on our previous trial data. To date, a CNSNP population has not been investigated with an ABPI.</div></div><div><h3>Objectives</h3><div>To preliminarily evaluate the potential effectiveness and feasibility of the ABPI for the management of patients with CNSNP.</div></div><div><h3>Design</h3><div>An internal pilot cluster-randomised double-blind, parallel 2-arm (ABPI vs standard physiotherapy intervention: SPI) clinical trial across 4 Thai public hospitals.</div></div><div><h3>Methods</h3><div>Forty participants (20 each arm) were recruited and face-to-face assessed at baseline and 3-month follow-up post baseline using the neck disability index (NDI), numerical pain rating scale (NPRS), cervical range of motion, fear-avoidance beliefs questionnaire, central sensitisation inventory (CSI) and short form-36.</div></div><div><h3>Results</h3><div>The mean (standard deviation) age of participants was 38.1 (7.8) years. The ABPI demonstrated significant within group improvement in all outcome measures and the NDI, NPRS and CSI illustrated significant improvement for the SPI (p ≤ 0.05). For the comparison between groups, all outcome measures were significantly better in the ABPI arm compared to the SPI (p ≤ 0.05), except the CSI. Finally, the number of fully recovered participants (considering the NDI ≤ 4/50) was greater for the ABPI (15/20 participants, 75 %) than the SPI (7/20 participants, 35 %).</div></div><div><h3>Conclusion</h3><div>These promising findings from an internal pilot study support continued data collection to conduct the definitive phase III trial (n = 120) to evaluate the effectiveness of the ABPI for the CNSNP management.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"Article 103389"},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757353","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":"Physiotherapists’ beliefs of the working mechanisms of manual therapeutic techniques for spinal pain relief: a quantitative content analysis","authors":"J.P. Hendriks ,&nbsp;R.R. Reezigt ,&nbsp;M.F. Reneman","doi":"10.1016/j.msksp.2025.103387","DOIUrl":"10.1016/j.msksp.2025.103387","url":null,"abstract":"<div><h3>Background</h3><div>Manual therapeutic techniques (MTTs), including high velocity thrust manipulation (HVT) and spinal mobilization (MOB), are used to reduce spinal pain. Physiotherapists' beliefs on their working mechanisms to relieve pain are unknown.</div></div><div><h3>Objectives</h3><div>To explore the prevalence of physiotherapists’ beliefs regarding the working mechanisms of MTTs on pain relief and their associated factors.</div></div><div><h3>Design</h3><div>Quantitative content analysis.</div></div><div><h3>Method</h3><div>The results of the verbal and online survey were analyzed based on a theory-driven coding framework (categories and depth). Ordinal, linear, and nominal regression analyses were used to analyze the secondary aim.</div></div><div><h3>Results</h3><div>A total of 541 physiotherapists were included (survey, n = 383, 70.8 %; verbal surveys, n = 158, 29.2 %), resulting in 759 HVT and 713 MOB responses. Six categories were present: biomechanical (39.3 % HVT, 50.9 % MOB), neurophysiological (39.4 % HVT, 31.4 % MOB), immunological (2.0 % HVT, 1.1 % MOB), non-specific (13.4 % HVT, 14.2 % MOB), unknown (4.3 % HVT, 1.3 % MOB), and not categorizable (1.6 % HVT, 1.1 % MOB). Levels of depth were low (65.1 % HVT, 64.1 % MOB), moderate (17.3 % HVT, 19.0 % MOB), and high (17.4 % HVT, 16.8 % MOB). Having a Master degree, network participation and work experience were associated with the category of working mechanism, level of depth and number of working mechanisms.</div></div><div><h3>Conclusion</h3><div>The beliefs of physiotherapists in the Netherlands regarding the working mechanisms of MTTs for spinal-related pain reduction are mainly biomechanical and neurophysiological. The working mechanisms were dominantly explained in an unifactorial manner and with a low level of depth. Having a Master of Science degree was strongly associated with more evidence-consistent beliefs and deeper understanding.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"79 ","pages":"Article 103387"},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723750","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}