Musculoskeletal Science and Practice最新文献

{"title":"More neck pain, less spinal mobility, altered sitting posture: Sagittal spinal alignment and mobility in women with chronic neck pain","authors":"Nur Efsan Unal ,&nbsp;Sevtap Gunay Ucurum ,&nbsp;Muge Kirmizi ,&nbsp;Elif Umay Altas","doi":"10.1016/j.msksp.2024.103205","DOIUrl":"10.1016/j.msksp.2024.103205","url":null,"abstract":"<div><h3>Background</h3><div>Increasing evidence suggests that people with chronic neck pain (CNP) may display altered biomechanics beyond the cervical spine. However, whether spinal alignment and mobility are associated with neck pain is not clarified.</div></div><div><h3>Objectives</h3><div>To investigate whether there is a significant association between neck pain intensity and sagittal spinal alignment and mobility in people with CNP, and to examine whether sagittal spinal alignment and mobility differ according to pain intensity.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Method</h3><div>Forty-four women with CNP were included. The neck pain intensity at rest and during neck movements was assessed with the visual analogue scale (VAS). A skin-surface measurement device was used to assess sagittal alignment and mobility while sitting and standing. Linear regression analysis was used to assess associations. Participants were divided into two groups according to the pain intensity as group with mild pain (VAS≤4.4 cm) and group with moderate to severe pain (VAS&gt;4.4 cm) and compared using the analysis of covariance.</div></div><div><h3>Results</h3><div>Greater resting pain was associated with a more forward trunk during sitting (Beta = 0.433, p &lt; 0.05). Greater pain during neck movements was associated with increased lumbar lordosis during sitting (Beta = −0.376, p &lt; 0.05). Classified by pain intensity at rest, trunk mobility while sitting was lower and forward trunk inclination and sacral kyphosis while sitting were higher in those with moderate/severe pain (η²_p = 0.093–0.119, p &lt; 0.05). By pain intensity during neck movements, women with moderate/severe pain exhibited lower sacral mobility while sitting (η²_p = 0.129, p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Addressing the entire spine in the assessment and management of CNP may help reduce pain.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103205"},"PeriodicalIF":2.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442338","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":"Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force","authors":"David A. Sherman ,&nbsp;Justin Rush ,&nbsp;Neal R. Glaviano ,&nbsp;Grant E. Norte","doi":"10.1016/j.msksp.2024.103204","DOIUrl":"10.1016/j.msksp.2024.103204","url":null,"abstract":"<div><h3>Background</h3><div>Dysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement.</div></div><div><h3>Objectives</h3><div>To synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology.</div></div><div><h3>Design</h3><div>Commentary.</div></div><div><h3>Method</h3><div>We summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques.</div></div><div><h3>Results</h3><div>Adaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology.</div></div><div><h3>Conclusions</h3><div>Adaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103204"},"PeriodicalIF":2.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445249","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":"Neck muscle stiffness during craniocervical flexion under functional upper extremity conditions in patients with chronic non-specific neck pain: A shear-wave elastography study","authors":"Ebrahim Ramezani ,&nbsp;Meysam Velayati ,&nbsp;Mohammad Akbari ,&nbsp;Reza Salehi ,&nbsp;Holakoo Mohsenifar","doi":"10.1016/j.msksp.2024.103203","DOIUrl":"10.1016/j.msksp.2024.103203","url":null,"abstract":"<div><h3>Objective</h3><div>The primary objective of the present study was to examine the differences and patterns of change in the neck extensor (NE) muscle stiffness during the Cranio-cervical flexion (CCF) task under different functional conditions of the upper extremity between CNSNP participants and asymptomatic controls.</div></div><div><h3>Methods</h3><div>In the current case-control study, 25 participants with CNSNP and 25 asymptomatic controls were recruited. The stiffness of the superficial (i.e., upper trapezius, splenius capitis, and semispinalis capitis) and deep (i.e., semispinalis cervicis and multifidus) NE muscles was measured at prone resting, sitting resting, and during the CCF task in different functional conditions of upper extremity using shear wave elastography.</div></div><div><h3>Results</h3><div>The findings showed that there was a significant main effect of condition in all NE muscles (P &lt; 0.05), as well as a significant main effect of the group on the stiffness of superficial neck muscles (P &lt; 0.05), indicating higher muscle stiffness in participants with CNSNP compared to the control group. There was no significant group-by-condition interaction effect on the stiffness of NE muscles (P &gt; 0.05), except for the upper trapezius muscle (P = 0.00), indicating a different pattern of stiffness changes compared to the other muscles.</div></div><div><h3>Conclusions</h3><div>Individuals with CNSNP exhibited significantly greater stiffness in the superficial neck extensor muscles compared to healthy controls. Furthermore, the CCF task performed under functional upper extremity conditions, which includes bilateral shoulder scaption and shoulder abduction-external rotation while seated, resulted in increased stiffness of the NE muscles. Additionally, participants with CNSNP exhibited a higher magnitude of stiffness changes in the upper trapezius muscle across different conditions.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103203"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433763","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":"UK physiotherapists’ perceptions on providing face-to-face and virtual rehabilitation for patients with Greater Trochanteric Pain Syndrome (GTPS): A cross-sectional survey","authors":"Ben Foxcroft ,&nbsp;Christine Comer ,&nbsp;Anthony C. Redmond","doi":"10.1016/j.msksp.2024.103199","DOIUrl":"10.1016/j.msksp.2024.103199","url":null,"abstract":"<div><h3>Background</h3><div>Greater Trochanteric Pain Syndrome (GTPS) is a prevalent and debilitating cause of lateral hip pain. Physiotherapists often prescribe exercises and educate patients on self-management strategies. Virtual consultations have increased since COVID-19. Rehabilitating patients with GTPS virtually may offer benefits to patients and healthcare providers.</div></div><div><h3>Objectives</h3><div>Understand physiotherapists' perceived effectiveness of providing rehabilitation for people with GTPS virtually compared to face-to-face.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Methods</h3><div>An internet-based survey was distributed via Twitter (now X). The survey included participant characteristics and 5-point Likert scales to rate the perceived effectiveness (higher score is more effective) of each consult method to deliver treatments for GTPS. Descriptive and inferential statistics were calculated to compare effectiveness between consultation types.</div></div><div><h3>Results</h3><div>54 physiotherapists responded. Overall, physiotherapists felt they were more effective at managing patients face-to-face compared to virtually with median scores of 5 (IQR 4–5) to 3 (IQR 2–4) respectively (P &lt; 0.001). Physiotherapists rated themselves more effective at delivering exercise interventions and most educational components face-to-face compared to virtually. Coaching exercises and checking exercise technique received the lowest rating with virtual consults. Higher levels of post-graduate education and confidence in technology were associated with higher perceptions of virtual consults (P &lt; 0.05). There has been a significant increase in virtual practice since COVID-19 (P &lt; 0.001), despite few physiotherapists receiving training.</div></div><div><h3>Conclusion</h3><div>Physiotherapists rated themselves as more effective in treating patients with GTPS face-to-face compared to virtually in almost all aspects of rehabilitation. However, virtual consultations still scored highly in self-management support and specific aspects of exercise and education.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103199"},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402107","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":"Translation and psychometric properties of the Hebrew version of Patient Enablement Instrument for Back Pain (PEI-BP)","authors":"Aviya Levin ,&nbsp;Ruth Goldstein ,&nbsp;Jan Hartvigsen ,&nbsp;Henrik Hein Lauridsen ,&nbsp;Tamar Pincus ,&nbsp;Noa Ben Ami","doi":"10.1016/j.msksp.2024.103202","DOIUrl":"10.1016/j.msksp.2024.103202","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain (LBP) is a widespread cause of disability worldwide. Self-management is a significant factor impacting an individual's ability to cope with LBP. The Patient Enablement Instrument for Back Pain (PEI-BP) assesses the ability of people with LBP to self-manage their illness.</div></div><div><h3>Objective</h3><div>This study aimed to translate and culturally adapt the PEI-BP into Hebrew and evaluate the reliability, validity, and responsiveness.</div></div><div><h3>Design</h3><div>Cross-sectional study with a nested prospective sub‐sample.</div></div><div><h3>Methods</h3><div>The PEI-BP was translated and culturally adapted into Hebrew using recommended guidelines. We included 188 LBP patients. The psychometric properties of the PEI-BP were evaluated according to the COSMIN methodology. For construct validity, the Ronald Morris disability questionnaire, the Brief Illness Perception Questionnaire, the Fear-Avoidance Beliefs Questionnaire-physical activity, the 12-item Short‐Form Health Survey mental health, and the Numerical pain rating scale were included. To assess reliability, a sub-sample of participants (n = 50) completed the PEI-BP again after one week and after six weeks (n = 50) to evaluate responsiveness.</div></div><div><h3>Results</h3><div>The PEI-BP demonstrated good internal consistency (Cronbach's α = 0.821) and test-retest reliability (ICC = 0.77). For construct validity, four out of the five hypothesized correlations were confirmed. Responsiveness showed a Receiver Operating Characteristic curve area of 0.81 (95% CI 0.67–0.93); the minimal detectable change was 14.5. A potential significant ceiling but no floor effects were observed (17.5% and 6.4%, respectively).</div></div><div><h3>Conclusions</h3><div>The translation and validation of the PEI-BP suggest that it is a feasible, reliable, valid, and responsive instrument for evaluating 'patient enablement' with LBP in the Hebrew-speaking population.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103202"},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433764","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":"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}