Musculoskeletal Science and Practice最新文献

{"title":"ChatGPT is a comprehensive education tool for patients with patellar tendinopathy, but it currently lacks accuracy and readability","authors":"Jie Deng ,&nbsp;Lun Li ,&nbsp;Jelle J. Oosterhof ,&nbsp;Peter Malliaras ,&nbsp;Karin Grävare Silbernagel ,&nbsp;Stephan J. Breda ,&nbsp;Denise Eygendaal ,&nbsp;Edwin HG. Oei ,&nbsp;Robert-Jan de Vos","doi":"10.1016/j.msksp.2025.103275","DOIUrl":"10.1016/j.msksp.2025.103275","url":null,"abstract":"<div><h3>Background</h3><div>Generative artificial intelligence tools, such as ChatGPT, are becoming increasingly integrated into daily life, and patients might turn to this tool to seek medical information.</div></div><div><h3>Objective</h3><div>To evaluate the performance of ChatGPT-4 in responding to patient-centered queries for patellar tendinopathy (PT).</div></div><div><h3>Methods</h3><div>Forty-eight patient-centered queries were collected from online sources, PT patients, and experts and were then submitted to ChatGPT-4. Three board-certified experts independently assessed the accuracy and comprehensiveness of the responses. Readability was measured using the Flesch-Kincaid Grade Level (FKGL: higher scores indicate a higher grade reading level). The Patient Education Materials Assessment Tool (PEMAT) evaluated understandability, and actionability (0–100%, higher scores indicate information with clearer messages and more identifiable actions). Semantic Textual Similarity (STS score, 0–1; higher scores indicate higher similarity) assessed variation in the meaning of texts over two months (including ChatGPT-4o) and for different terminologies related to PT.</div></div><div><h3>Results</h3><div>Sixteen (33%) of the 48 responses were rated accurate, while 36 (75%) were rated comprehensive. Only 17% of treatment-related questions received accurate responses. Most responses were written at a college reading level (median and interquartile range [IQR] of FKGL score: 15.4 [14.4–16.6]). The median of PEMAT for understandability was 83% (IQR: 70%–92%), and for actionability, it was 60% (IQR: 40%–60%). The medians of STS scores in the meaning of texts over two months and across terminologies were all ≥ 0.9.</div></div><div><h3>Conclusions</h3><div>ChatGPT-4 provided generally comprehensive information in response to patient-centered queries but lacked accuracy and was difficult to read for individuals below a college reading level.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103275"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124144","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":"Determinants of sleep quality in individuals with musculoskeletal pain and its effects on fatigue, attention, cognition, and physical performance","authors":"Merve Kurt-Aydin ,&nbsp;Aslı Coksever ,&nbsp;Dilan Temam ,&nbsp;Nermin Eris ,&nbsp;Merve Keskin ,&nbsp;Derya Ozer Kaya","doi":"10.1016/j.msksp.2025.103273","DOIUrl":"10.1016/j.msksp.2025.103273","url":null,"abstract":"<div><h3>Purpose</h3><div>Sleep is a necessity to maintain many vital functions. Sleep disorders can result in negative consequences such as fatigue, drowsiness, and decreased neurocognitive performance. This study aimed to explore sleep quality determinants in individuals with musculoskeletal pain and assess its impact on fatigue, physical performance, attention, and cognition.</div></div><div><h3>Methods</h3><div>The study involved 65 patients aged 40–65 years. Sleep quality, pain severity, physical activity levels, anxiety and depression levels, rumination, fatigue levels, attention levels, cognitive levels and physical performance were evaluated with reliable scales.</div></div><div><h3>Results</h3><div>Pain intensity during activity (r:0.270, p &lt; 0.05), anxiety (r:0.521, p &lt; 0.05), depression (r:0.484, p &lt; 0.005), rumination (r:0.365, p &lt; 0.05), fatigue (r:0.380, p &lt; 0.05), attention (r:0.253, p &lt; 0.05), and cognition (r: 0.279, p &lt; 0.05) were found to be the factors associated with sleep quality. Anxiety and depression were identified as determinants of sleep quality (p &lt; 0.05). It was also seen that the group with poor sleep quality had higher fatigue scores (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Among those experiencing musculoskeletal pain, the quality of sleep is associated not only with pain intensity but also with anxiety, depression, rumination, fatigue, and attention. Anxiety and depression were found to be the main determinants of sleep quality, overshadowing the impact of pain intensity. A decline in sleep quality resulted in elevated fatigue scores. Recognizing the intricate web of connections between mental health and sleep underscores the importance of a holistic approach in managing musculoskeletal pain conditions.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103273"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138196","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":"Structural and dynamic characteristics in sonographic evaluation of the sciatic nerve in patients with probable neuropathic pain – A cross-sectional study","authors":"Maria Alice Mainenti Pagnez ,&nbsp;Rayssa de Vilhena Moreira ,&nbsp;Jessica Pinto Martins do Rio ,&nbsp;Leticia Amaral Corrêa ,&nbsp;Stephanie Mathieson ,&nbsp;Juliana Valentim Bittencourt ,&nbsp;Leandro Calazans Nogueira","doi":"10.1016/j.msksp.2025.103272","DOIUrl":"10.1016/j.msksp.2025.103272","url":null,"abstract":"<div><h3>Introduction</h3><div>Structural and dynamic alterations of peripheral nerves are commonly observed in patients with radiculopathy. The current study aimed to compare the cross-sectional area (CSA), echogenicity index (ECHO), and skin-to-nerve distance (SKN) of the sciatic nerve between the symptomatic and asymptomatic sides of patients with probable neuropathic pain under different levels of nerve tension.</div><div><strong>Methods</strong>: A cross-sectional study was conducted with 31 participants classified as having probable chronic neuropathic pain. The CSA, ECHO, and SKN of the sciatic nerve of both lower limbs were measured in the following positions: A) flexed knee and neutral ankle, B) extended knee and ankle plantarflexion, and C) extended knee and ankle dorsiflexion. Sonographic measurements of both lower limbs were compared using repeated measures analysis of variance.</div><div><strong>Results</strong>: The mean age of the sample was 44 years (SD 10; 77.4% females), and the mean pain intensity was 5.3 (SD 1.9) out of 10 on the Numeric Pain Rating Scale. No significant differences were found for CSA, ECHO, or SKN measurements between the symptomatic and asymptomatic sides for the three tested positions. Position C had a smaller CSA of the sciatic nerve on both sides compared to position A. Both sides exhibited the nerve being more superficial in position C compared to the other positions.</div><div><strong>Conclusion</strong>: Participants with probable chronic neuropathic pain had similar CSA, ECHO, and SKN of the sciatic nerve between the symptomatic and asymptomatic lower limbs. Increasing sciatic nerve tension (position C) reduced CSA and caused superficial nerve displacement on both sides.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103272"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138197","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":"Comparing the efficacy of two E-learning programs on physiotherapists' knowledge, attitudes, and confidence in musculoskeletal pain management: A randomized trial","authors":"Thaissa Rodrigues Coutinho ,&nbsp;Rafael Krasic Alaiti ,&nbsp;Bruno Tirotti Saragiotto ,&nbsp;Juliana Rezende ,&nbsp;Késia Oliveira ,&nbsp;Thayná Nunes ,&nbsp;Leandro Fukusawa ,&nbsp;Felipe J.J. Reis","doi":"10.1016/j.msksp.2025.103271","DOIUrl":"10.1016/j.msksp.2025.103271","url":null,"abstract":"<div><h3>Background</h3><div>Physiotherapists play a crucial role in managing patients with musculoskeletal pain. However, their training often lacks focus on pain management.</div></div><div><h3>Objectives</h3><div>This randomized controlled trial evaluated the effects of two e-learning programs on physiotherapists’ knowledge, attitudes, and confidence in musculoskeletal pain management.</div></div><div><h3>Methods</h3><div>Eligible participants had active professional registration, treated patients with musculoskeletal pain, and had internet access. Participants were randomized into two groups (video-based and booklet-based), with interventions lasting 5 weeks. Assessments were conducted at baseline, 6 weeks (T1), and 12 weeks (T2) using the Neurophysiology of Pain Questionnaire, a pain attitude survey, and self-reported confidence.</div></div><div><h3>Results</h3><div>A total of 211 physiotherapists were randomized (video = 106; booklet = 105). Both groups improved pain neurophysiology knowledge, with the booklet group scoring higher at T1 (adjusted mean difference = 1.25, 95%CI = 0.93 to 1.58) and T2 (adjusted mean difference = 1.30, 95%CI = 0.97 to 1.63). Attitudes varied: the booklet group improved in emotion (adjusted mean difference = −0.19, 95%CI = −0.35 to −0.03) and control (adjusted mean difference = −0.20, 95%CI = −0.37 to −0.03) at T2, while the video group improved in solicitude (adjusted mean difference = −0.37, 95% CI: 0.55 to −0.19) and disability at T1 and T2. No significant effects were found in the medical cure domain, and no interaction effects were observed in the physical harm domain. Confidence increased in both groups, with no between-group differences.</div></div><div><h3>Conclusion</h3><div>Both e-learning programs effectively enhanced physiotherapists’ knowledge, attitudes, and confidence in musculoskeletal pain management, demonstrating the value of e-learning for continuing education.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103271"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143331696","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":"Physical inactivity is the most important unhealthy lifestyle factor for pain severity in older adults with pain: A SHARE-based analysis of 27,528 cases from 28 countries","authors":"Rodrigo Núñez-Cortés ,&nbsp;Carlos Cruz-Montecinos ,&nbsp;Rubén López-Bueno ,&nbsp;Lars Louis Andersen ,&nbsp;Joaquín Calatayud","doi":"10.1016/j.msksp.2025.103270","DOIUrl":"10.1016/j.msksp.2025.103270","url":null,"abstract":"<div><h3>Background</h3><div>Limited knowledge exists on the association between lifestyle factors and pain severity in older adults.</div></div><div><h3>Objective</h3><div>To assess the associations between unhealthy lifestyle variables and pain severity in the European population of older adults with pain.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>Data were retrieved from the ninth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), a representative survey of individuals aged &gt;50 years living in 27 European countries and Israel. Associations between lifestyle factors (sleep, smoking, diet and physical inactivity) and pain severity (mild, moderate, severe) were assessed using multivariable multinomial regression adjusted for age, sex, geographic region, education, history of chronic disease and mutually adjusted for each lifestyle.</div></div><div><h3>Results</h3><div>27,528 cases were included (73.1 ± 9.76 years; 63.3% female). A significant association was observed between those who hardly ever or never engaged in activities that required a moderate level of energy and severe pain (OR: 4.35; 95% CI: 3.85 to 4.92). Sleep problems (OR: 1.83; 95% CI: 1.69 to 1.99), smoking (OR: 1.21; 95% CI: 1.13 to 1.34) and an inadequate diet (OR: 1.78: 95% CI: 1.22 to 2.61) were also significantly associated with severe pain, but with lower odds. Given the cross-sectional design, the bidirectionality of these relationships should be considered.</div></div><div><h3>Conclusion</h3><div>Physically inactive older adults were particularly more likely to experience severe pain, while other lifestyle factors were more weakly associated with pain. As these lifestyle factors are modifiable, the results may be useful in prioritising appropriate preventive measures to attenuate pain and ensure healthy ageing.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103270"},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069782","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":"Promoting longus colli muscle activation: Force direction in sitting matters","authors":"Janey Prodoehl ,&nbsp;Raj Pathak ,&nbsp;Jeremy Glavanovits ,&nbsp;James Chang ,&nbsp;Tyler Nault ,&nbsp;Stephanie Levine ,&nbsp;Emily Daly","doi":"10.1016/j.msksp.2025.103269","DOIUrl":"10.1016/j.msksp.2025.103269","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence to inform exercise prescription for deep neck flexor activation out of supine.</div></div><div><h3>Objective</h3><div>To compare activation of longus colli (LC) and sternocleidomastoid (SCM) from supine to sitting, and to compare the effect of craniocervical flexion (CCF) exercises in sitting on activation.</div></div><div><h3>Methods</h3><div>Twenty-four individuals without neck pain (mean age 28.8 years, 12 females) completed 7 isometric CCF exercises (1 supine CCF, 6 sitting with applied head resistance through an elastic band in straight or oblique planes from the contra- or ipsilateral sides) while muscle activation was captured using ultrasound imaging. A 2-way analysis of variance examined the effects of exercise and muscle on percent change activation using planned post-hoc comparisons and Cohen's D to establish effect sizes.</div></div><div><h3>Results</h3><div>Supine CCF was equivocal to sitting CCF with resistance for LC activation (<em>p</em> = 0.758). The LC muscle was most robustly activated by applying an ipsilateral oblique resistance force compared to a straight lateral force (<em>p</em> = 0.002, Cohen's d = −0.82). LC activation was higher when oblique resistance was applied from the ipsilateral than contralateral side (<em>p</em> = 0.002, Cohen's d = −0.84). SCM activation was higher resisting an ipsilateral lateral force compared to a contralateral force (<em>p</em> = 0.0006, Cohen's d = 1.06).</div></div><div><h3>Conclusions</h3><div>Craniocervical flexion in supine and sitting activate LC equally but in sitting, applying oblique resistance during lateral flexion with extension enhances LC activation most effectively. Care should be taken with straight laterally applied forces since this can promote unwanted SCM activation.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103269"},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043456","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":"Development of a patient decision aid for people with chronic low back pain and degenerative disc disease considering lumbar fusion: A mixed-methods study","authors":"Yesung Cho ,&nbsp;Marnee J. McKay ,&nbsp;Joshua R. Zadro ,&nbsp;Tammy Hoffmann ,&nbsp;Chris G. Maher ,&nbsp;Ian Harris ,&nbsp;Ralph Stanford ,&nbsp;Manuela L. Ferreira ,&nbsp;Rachelle Buchbinder ,&nbsp;Christopher S. Han ,&nbsp;Giovanni E. Ferreira","doi":"10.1016/j.msksp.2025.103261","DOIUrl":"10.1016/j.msksp.2025.103261","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and user-test a patient decision aid providing evidence-based information for people with chronic low back pain (LBP) and degenerative disc disease considering lumbar fusion.</div></div><div><h3>Design</h3><div>Convergent parallel mixed methods study.</div></div><div><h3>Setting</h3><div>A prototype patient decision aid was developed, guided by the International Patient Decision Aid Standards (IPDAS) criteria, a multidisciplinary steering committee, and insights from previous studies. Participants were recruited via social media and the authors’ collaborative networks to refine and evaluate the decision aid.</div></div><div><h3>Participants</h3><div>Individuals who underwent lumbar fusion for chronic LBP and health professionals who manage these patients were purposively sampled.</div></div><div><h3>Primary and secondary outcomes</h3><div>Semi-structured interviews and questionnaires were used to gather feedback and assess the decision aid's acceptability, usability, and preparedness for decision-making. Framework analysis was used for interview data and descriptive analysis for questionnaires.</div></div><div><h3>Results</h3><div>Sixteen clinicians (5 physiotherapists, 2 rheumatologists, 2 surgeons, 7 general practitioners) and seven patients participated, most rating the prototype's acceptability as ‘excellent’ or ‘good’. Usability (mean [SD], health professionals: 78 [16], patients: 72 [8]) and preparedness for decision-making (health professionals: 73 [14], patients: 72 [10]) also scored highly. However, some viewed the prototype as biased against lumbar fusion, and suggestions to include more personalised information were made.</div></div><div><h3>Conclusions</h3><div>This study showed that our prototype patient decision aid is acceptable, useful, and prepares patients to make informed decisions about spinal fusion for chronic LBP and degenerative disc disease. Future studies will assess the clinical impact of our decision aid and its optimal distribution timing.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103261"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016326","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":"Intra- and inter-rater reliability, standard error of measurement, and minimal detectable change of the cranio-cervical flexion test in individuals with non-specific chronic neck pain","authors":"Camila N. Broisler,&nbsp;Giovanna L.N.A. Gaban,&nbsp;Maria R.S. Vivaldini,&nbsp;Giovanna S. Nunes,&nbsp;Luiz F.A. Selistre","doi":"10.1016/j.msksp.2025.103258","DOIUrl":"10.1016/j.msksp.2025.103258","url":null,"abstract":"<div><h3>Background</h3><div>The cranio-cervical flexion test (CCFT) is used in clinical practice to measure the activation of deep cervical flexor muscles. However, the reliability of the test has not been conducted on an adequate sample size, specifically in individuals with non-specific chronic neck pain (CNP).</div></div><div><h3>Objective</h3><div>The aim of the present study is to investigate the intra- and inter-rater reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of the CCFT in individuals with non-specific CNP.</div></div><div><h3>Methods</h3><div>A cross-sectional study of reliability conducted at the UFSCar. Fifty-one individuals (17 men and 31 women) with non-specific CNP and aged over 18 years participated in this study. The CCFT was assessed with the Stabilizer pressure biofeedback device. Two raters conducted the test over two days, with a 5-7-days interval and a 10-min rest between raters. The activation score was determined by the level at which the participant kept activation for 10 s in a single stage (22, 24, 26, 28 and 30 mmHg). Appropriate statistical analysis was performed to calculate the intraclass correlation coefficient (ICC), SEM and MDC.</div></div><div><h3>Results</h3><div>Both intra-rater (ICC = 0.65; 95% CI = 0.46–0.78) and inter-rater reliability (ICC = 0.72; 95% CI = 0.55–0.83) were considered moderate. The SEM was 1.73 and 1.66 for intra-rater and inter-rater reliability, and the MDC was 4.81 to 4.60, respectively.</div></div><div><h3>Conclusion</h3><div>The results of the present study indicate that CCFT is a reliable test to evaluate the activation score in individuals with chronic neck pain.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103258"},"PeriodicalIF":2.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025817","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":"Guidelines to minimize risk when dry needling the rectus capitus posterior major muscle","authors":"Gary A. Kearns ,&nbsp;Micah Lierly ,&nbsp;Kerry K. Gilbert ,&nbsp;Jan Dommerholt","doi":"10.1016/j.msksp.2025.103260","DOIUrl":"10.1016/j.msksp.2025.103260","url":null,"abstract":"<div><h3>Background</h3><div>Headache disorders are prevalent often leading to disability. The rectus capitus posterior major muscle (RCPMaj) may contribute to headache symptoms via nociceptive convergence and myodural bridging.</div></div><div><h3>Objectives</h3><div>To establish guidelines for needle length and needle angle to mitigate risks during dry needling RCPMaj.</div></div><div><h3>Design</h3><div>Cadaveric investigation.</div></div><div><h3>Methods</h3><div>Twenty-five cadavers (mean age: 80.1 ± 13.2 years) were placed in prone. Depth measurements from the skin to the C2 spinous process were taken following midline incision. Dissection continued exposing the RCPMaj for three measures including: 1) posterior angle from the frontal plane, 2) lateral angle from midline, and 3) distance from the external occipital protuberance to the lateral most RCPMaj.</div></div><div><h3>Results</h3><div>Mean values for tissue thickness overlying C2 spinous process (37 ± 7.3 mm), RCPMaj posterior angle from the frontal plane (65.2° ±10°), RCPMaj lateral angle from midline (34.7° ±12.9°), and distance from the external occipital protuberance to the lateral most RCPMaj (30.6 mm ± 9.3 mm) were used to calculate a needle inclination of ≤45° and a needle length &lt;40 mm to reach the occipital portion of RCPMaj with an <em>a priori</em> insertion point of midway between the C2 spinous process and the C1 transverse process.</div></div><div><h3>Conclusion</h3><div>Inserting a dry needle &lt;40 mm in length midway between the C2 spinous process and the C1 transverse process with a cranial angle of ≤45° relative to the frontal plane would increase the likelihood of reaching the RCPMaj and mitigate penetrating deeper structures.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103260"},"PeriodicalIF":2.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016727","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 intensity and lower limb dynamic balance were related to the laterality judgment test of patients with patellofemoral pain","authors":"Luiza Ferreira Moreira ,&nbsp;Vanessa Knust Coelho ,&nbsp;Lucas Ferreira Mendonça ,&nbsp;Felipe J.J. Reis ,&nbsp;Gustavo Felicio Telles ,&nbsp;Leandro Alberto Calazans Nogueira","doi":"10.1016/j.msksp.2025.103259","DOIUrl":"10.1016/j.msksp.2025.103259","url":null,"abstract":"<div><h3>Introduction</h3><div>Laterality judgement evaluates the capacity to differentiate between the left and right sides of bodily parts. Cortical body representations are impaired in various musculoskeletal conditions, yet this remains unexplored in individuals with patellofemoral pain (PFP).</div></div><div><h3>Objective</h3><div>This study compared laterality judgement performance between individuals with PFP and asymptomatic controls. Additionally, we investigated the relationship between laterality judgement and self-reported disability, physical performance, and dynamic stability within the PFP group.</div></div><div><h3>Methods</h3><div>A secondary analysis encompassed 48 patients and 48 controls. Participants were examined for laterality judgement, pain intensity, knee disability, physical performance and lower limb dynamic balance. Statistical analyses included Student's t-test for group differences and linear regression to examine relationships between laterality judgement and other measurements.</div></div><div><h3>Results</h3><div>The sample comprised 60 males (62.5%) with a mean age of 31.3 years. The PFP group reported a mean pain duration of 37.6 months and moderate pain intensity (4/10). Laterality judgement accuracy and time were identical between the PFP group (78.3% and 2.1 s, respectively) and controls (80.8% and 2.2 s, respectively) (accuracy p = 0.50 and time p = 0.66). Lower limb dynamic and pain intensity were related to laterality judgement accuracy (β = 0.4, p &lt; 0.01) and time (β = 0.4, p = 0.03), respectively.</div></div><div><h3>Conclusion</h3><div>PFP and control groups demonstrated similar laterality judgement performance. In the PFP group, lower laterality judgement accuracy was related to dynamic balance and lower laterality judgement time was related to pain intensity. The physical performance and self-reported knee disability were not related to the knee laterality judgment of these patients.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"76 ","pages":"Article 103259"},"PeriodicalIF":2.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017011","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}