Musculoskeletal Science and Practice最新文献

{"title":"Pain neuroscience education is not superior to spinal physiology and ergonomics education within a short multidisciplinary rehabilitation program: A randomized controlled trial","authors":"Nicolas Adenis ,&nbsp;Valérie Wieczorek ,&nbsp;Sophie Corbinau ,&nbsp;Léa Mortain ,&nbsp;André Thevenon","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":"74 ","pages":"Article 103176"},"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":"Matt Kenyon ,&nbsp;Phil Driver ,&nbsp;Adrian Mallows ,&nbsp;Gareth Stephens ,&nbsp;Michael Bryant ,&nbsp;Marwan Al Dawoud ,&nbsp;Seth O'Neill","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":"74 ","pages":"Article 103156"},"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":"Michelle D. Smith ,&nbsp;Viana Vuvan ,&nbsp;Natalie J. Collins ,&nbsp;Melinda M. Franettovich Smith ,&nbsp;Nathalia Costa ,&nbsp;Zachary Southern ,&nbsp;Tim Duffy ,&nbsp;Alexander Downie ,&nbsp;David J. Hunter ,&nbsp;Bill Vicenzino","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":"74 ","pages":"Article 103169"},"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}

{"title":"The effect of kinesiotaping on edema: A systematic review and meta-analysis","authors":"Denise Alves de Almeida Alcantara ,&nbsp;Francielly Natanaelly Andrade dos Santos ,&nbsp;José Jamacy de Almeida Ferreira ,&nbsp;Marcos de Noronha ,&nbsp;Palloma Rodrigues de Andrade","doi":"10.1016/j.msksp.2024.103168","DOIUrl":"10.1016/j.msksp.2024.103168","url":null,"abstract":"<div><h3>Background</h3><p>Treatment for edema involves multiple approaches, with Kinesiotaping having recently emerged as an option for edema reduction.</p></div><div><h3>Objective</h3><p>To systematically summarize current evidence on the effects of Kinesiotaping on edema reduction on any type of edema.</p></div><div><h3>Methods</h3><p>A systematic review was performed including randomized clinical trials that compared the effects of Kinesiotaping to any other intervention or no intervention on edema. Screening, assessment of methodological quality (PEDro scale) of studies, and confidence of evidence (GRADE) were analyzed by two independent reviewers. A quantitative summary is presented through meta-analyses.</p></div><div><h3>Results</h3><p>A total of 3750 studies were identified, of which 70 were included in this review, and were organized by body region (face, upper limbs and lower limbs) and by treatment time (short and long term). It was observed that Kinesiotaping was superior to comparison groups in the short-term for face edema (Standardized mean difference [SMD] −1.07; 95%CI -1.48 to −0.65) and lower limbs (SMD -0.55; 95%CI -1.06 to −0.05). Also, Kinesiotaping was superior to comparison group in the long-term for lower limbs (SMD -0.72; 95%CI -1.25 to −0.18). Kinesiotaping was not superior to the comparison groups for upper limbs in both the short (SMD -0.05; 95%CI -0.89 to 0.80) and long-term (SMD -0.04; 95%CI -0.31 to 0.24) protocols.</p></div><div><h3>Conclusion</h3><p>Kinesiotaping seems to be an effective intervention to reduce acute edema around the face and potentially in the lower limbs in both short and long-term protocols, although the quality of evidence is very low. However, these positive results were not observed for the upper limbs.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103168"},"PeriodicalIF":2.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097895","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":"Influence of unilateral versus bilateral patellofemoral pain on physical activity, pain self-efficacy, and disability","authors":"Sungwan Kim ,&nbsp;L. Colby Mangum ,&nbsp;Neal R. Glaviano","doi":"10.1016/j.msksp.2024.103167","DOIUrl":"10.1016/j.msksp.2024.103167","url":null,"abstract":"<div><h3>Background</h3><p>Patellofemoral pain (PFP) affects physical and psychosocial health; however, it is unclear if unilateral and bilateral PFP induce similar levels of impairments.</p></div><div><h3>Objectives</h3><p>We aimed to compare physical activity (PA), pain self-efficacy, and disability between individuals with unilateral and bilateral PFP, and to compare these groups against pain-free controls.</p></div><div><h3>Design</h3><p>Cross-sectional case-control.</p></div><div><h3>Method</h3><p>Sixty-two individuals with PFP (25 unilateral and 37 bilateral) and 20 pain-free controls completed the PA assessment using an accelerometer by daily steps, light PA, and moderate-to-vigorous PA (MVPA). We also calculated variability in each PA variable. Pain self-efficacy and disability were measured using the Pain Self-Efficacy Questionnaire and Anterior Knee Pain Scale, respectively.</p></div><div><h3>Results</h3><p>Individuals with bilateral PFP took fewer daily steps compared to pain-free controls (9568.1 ± 3827.0 vs. 12,285.8 ± 2821.2 steps/day; <em>P</em> = 0.018, Cohen d = 0.79), whereas individuals with unilateral PFP did not (11,099.2 ± 3547.1 steps/day; <em>P</em> = 0.503, Cohen d = 0.37). Individuals with bilateral PFP showed greater variability in MVPA compared to individuals with unilateral PFP (42.9 ± 23.1 vs. 29.0 ± 15.9; <em>P</em> = 0.011, Cohen d = 0.91) and pain-free controls (42.9 ± 23.1 vs. 17.6 ± 6.1; <em>P</em> &lt; 0.001, Cohen d = 1.21). Individuals with unilateral and bilateral PFP similarly exhibited less time spent in MVPA, greater variability in daily steps, lower pain self-efficacy, and greater disability compared to pain-free controls (<em>P</em> &lt; 0.001, Cohen d = 1.14–3.89).</p></div><div><h3>Conclusions</h3><p>Versus pain-free controls, individuals with bilateral PFP displayed greater variability in MVPA than individuals with unilateral PFP. However, it is important to note that unilateral PFP influenced time spent in MVPA, variability in daily steps, pain self-efficacy, and disability at similar levels to bilateral PFP.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"73 ","pages":"Article 103167"},"PeriodicalIF":2.2,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044207","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 adding dry needling of the upper trapezius muscle to the usual physiotherapy for managing chronic neck pain: A randomized controlled trial with a 7-week follow-up","authors":"Slwa Sami Alattar ,&nbsp;Hosam Alzahrani","doi":"10.1016/j.msksp.2024.103155","DOIUrl":"10.1016/j.msksp.2024.103155","url":null,"abstract":"<div><h3>Background</h3><p>Myofascial pain syndrome (MPS) is a chronic condition caused by sensitive pressure regions within the muscles known as myofascial trigger points (MTrPs).</p></div><div><h3>Objective</h3><p>The purpose of this randomized controlled trial (RCT) was to assess the effectiveness of adding dry needling (DN) to activate MTrPs in the upper trapezius muscle compared with usual physiotherapy among individuals with chronic neck pain.</p></div><div><h3>Methods</h3><p>Thirty participants were recruited from a private clinic in Saudi Arabia. Their mean age was 29.7 ± 4.4 years. The subjects were randomized into two groups: the experimental group (application of DN to the MTrPs coupled with usual physiotherapy (n = 15)) and the control group (usual physiotherapy alone (n = 15)). The primary outcomes were pain (assessed using the visual analog scale) and disability (Neck Disability Index), and the secondary outcomes were neck active range of motion (AROM; assessed using cervical ROM) and depression (Beck's Depression Inventory).</p></div><div><h3>Results</h3><p>Significant between-group difference in pain intensity was observed immediately post-intervention. Participants in the experimental group had significantly higher pain (mean difference = 1.27, 95% confidence interval [CI] 0.20, 2.33, p = 0.022, Cohen's d = 0.889) than those in the control group. There was no significant difference between both groups in pain intensity during the follow-up. There were no between-group differences in disability immediately post-intervention. However, there was a between-group difference in disability at follow-up; participants in the experimental group had significantly lower disability (mean difference = −3.13, 95%CI -5.07, −1.20, p = 0.003, Cohen's d = 1.211) than those in the control group. Immediately post-intervention, the experimental group showed greater flexion AROM compared to the control group, with no differences in other AROM measures. At follow-up, the experimental group exhibited significantly higher neck AROM in extension, flexion, right and left side bending, and lower depression, while no differences were observed in right- and left-rotation AROMs between groups.</p></div><div><h3>Conclusions</h3><p>The addition of DN to standard physiotherapy effectively improved disability, AROM (extension, flexion, and side bending), and depression among patients with chronic neck pain.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103155"},"PeriodicalIF":2.2,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097758","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":"Factors associated with patient-reported mouth opening activity limitations in individuals with persistent intra-articular temporomandibular disorders: A cross-sectional study exploring physical and self-reported outcomes","authors":"Alana Dinsdale,&nbsp;Lucy Thomas,&nbsp;Roma Forbes,&nbsp;Julia Treleaven","doi":"10.1016/j.msksp.2024.103166","DOIUrl":"10.1016/j.msksp.2024.103166","url":null,"abstract":"<div><h3>Background</h3><p>Individuals living with intra-articular temporomandibular disorders (IA-TMDs) often report limitations with mouth opening activities. While clinical measures such as active range of motion (AROM) and movement quality are often used to assess mouth opening function, it is unclear if and how these relate to patient-reported limitations and whether other factors such as kinesiophobia influence mouth opening activities in those with IA-TMDs.</p></div><div><h3>Objectives</h3><p>Compare clinical measures of mouth opening function in those with IA-TMDs to asymptomatic controls. In those with an IA/TMD, explore relationships between patient-reported mouth opening limitations, and mouth opening function and kinesiophobia.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Method</h3><p>Clinical mouth opening function (AROM, movement quality, pain on movement/10, stiffness on movement/10) was compared between groups (n = 30 IA-TMD, n = 30 controls). Within the IA-TMD group, correlations between patient-reported mouth opening limitations (Patient specific functional scale), kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders) and clinical measures of mouth opening function were explored.</p></div><div><h3>Results</h3><p>Impairments in AROM (-4 mm, p = 0.04, d = 0.5), movement quality (p &lt; 0.01, φ = 0.6), pain on movement (p &lt; 0.01, d = 0.8) and stiffness on movement (p &lt; 0.01, d = 1.6) were observed in the IA-TMD group compared to controls. Patient-reported mouth opening limitations and kinesiophobia were significantly correlated (r = −0.48, p &lt; 0.01); no correlation was found between patient-reported limitations and clinical mouth opening measures (r &lt; 0.3, p &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Mouth opening function is impaired in IA-TMD. However, kinesiophobia appears more related to patient-reported mouth opening limitations than clinical impairments. Consideration of clinical, kinesiophobia and patient-reported limitation measures are necessary to direct management of IA-TMD in those presenting for care.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"73 ","pages":"Article 103166"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468781224002613/pdfft?md5=93ea4322e40debe62801320fc79709ff&pid=1-s2.0-S2468781224002613-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012266","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":"Pain intensity scales: A cross-sectional study on the preferences and knowledge of physiotherapists and participants with musculoskeletal pain","authors":"Amanda Dutra da Silva Ranzatto ,&nbsp;Thais Cristina Chaves ,&nbsp;Marcella Nobre Martins ,&nbsp;Diogo Pereira Motta ,&nbsp;Leandro Calazans Nogueira ,&nbsp;Ney Meziat-Filho ,&nbsp;Felipe J.J. Reis","doi":"10.1016/j.msksp.2024.103162","DOIUrl":"10.1016/j.msksp.2024.103162","url":null,"abstract":"<div><h3>Background</h3><p>Subjective pain intensity can be measured using instruments like the Faces Pain Scale-Revised (FPS-R), Verbal Rating Scale (VRS), Numerical Pain Rating Scale (NPRS), and Visual Analogue Scale (VAS). However, information on physiotherapists' and patients' knowledge and preference for these tools is scarce.</p></div><div><h3>Objective</h3><p>We investigated the knowledge and preference of physiotherapists and participants with musculoskeletal pain (MP) regarding the pain intensity measurement scales.</p></div><div><h3>Methods</h3><p>This cross-sectional study consisted of physiotherapists and participants with MP. Physiotherapists were recruited via social media for an online open survey, gathering sociodemographic, professional data, and their knowledge and preferences for pain intensity scales. Participants over 18 with MP, participated in interviews focusing on their familiarity and preferences for pain intensity scales. Data was analyzed descriptively, and Chi-squared test evaluated scale preferences.</p></div><div><h3>Results</h3><p>We included 352 physiotherapists (mean experience = 10.5 years) and 94 participants with MP. Of the physiotherapists, 94.3% were familiar with pain scales, but 30.4% struggled to differentiate them. The NPRS was the most used (56.3%) and preferred scale (52.4%). Among participants with MP, unfamiliarity was noted with all scales. After instruction, 46% preferred FPS-R, with preference varying by income and education levels (p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>We found a knowledge gap among physiotherapists in identifying pain intensity scales, with a preference for the NPRS among those familiar with the scales. Participants with MP had limited familiarity with these scales. After instructions, these participants preferred the FPS-R, particularly those with lower income and education levels.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"73 ","pages":"Article 103162"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011904","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 the role of therapeutic alliance and biobehavioural synchrony in musculoskeletal care: Insights from a qualitative study","authors":"Aurora Arrigoni MSc ,&nbsp;Giacomo Rossettini PT, PhD ,&nbsp;Alvisa Palese PhD ,&nbsp;Mick Thacker PhD ,&nbsp;Jorge E. Esteves PhD, MA, BSc, DO","doi":"10.1016/j.msksp.2024.103164","DOIUrl":"10.1016/j.msksp.2024.103164","url":null,"abstract":"<div><h3>Background</h3><p>Person-centred care underscores the therapeutic alliance (TA) as fundamental, fostering positive treatment outcomes through collaborative patient-clinician interactions. Biobehavioural synchrony within the TA, essential for effective care, reflects an adaptive process where organisms align responses during interactions. Enactivism and active inference provide profound insights into human perception, reshaping musculoskeletal care understanding. Touch and verbal communication, integral to the TA, foster synchrony and alignment of personal beliefs.</p></div><div><h3>Aim</h3><p>This study aimed to identify the tools used by manual therapists in musculoskeletal care to establish a TA with patients. Furthermore, it endeavours to evaluate the alignment of these strategies with current literature and their correlation with biobehavioural synchrony, enactivism, and the role of touch in active inference.</p></div><div><h3>Methods</h3><p>The methodology followed rigorous qualitative research principles, particularly Grounded Theory and interpretative-constructivist principles, conducting eleven semi-structured interviews with open-ended questions.</p></div><div><h3>Results</h3><p>The core category identified in the study is elucidated as follows: \"<em>Interwoven Connection: The Fabric of Therapeutic Synchrony</em>.\" The interviews unveiled three main categories, each comprising sub-categories: (1) Creating a meaningful dialogue; (2) Promoting active patient participation; (3) Synchronisation.</p></div><div><h3>Conclusion</h3><p>Fostering meaningful dialogue, patient involvement, and therapeutic synchrony is crucial for a robust therapeutic alliance in musculoskeletal care. This underscores the importance of establishing a deep connection between clinicians and patients, central to effective person-centred care. Clinicians must prioritise two-way communication, empathy, and patient collaboration in defining personalised goals. Emphasizing touch and seeking patient feedback are also pivotal. Further research is needed to explore these elements and their impact.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"73 ","pages":"Article 103164"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990542","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 and validation of the Italian version of the pain attitudes and beliefs scale-musculoskeletal (PABS-MSK) among physiotherapists working with patients with musculoskeletal chronic pain","authors":"Katiuscia Bartucci ,&nbsp;Alberto Catalano ,&nbsp;Francesco Morello ,&nbsp;Paolo Leone ,&nbsp;Fulvio Ricceri ,&nbsp;Sara Carletto","doi":"10.1016/j.msksp.2024.103161","DOIUrl":"10.1016/j.msksp.2024.103161","url":null,"abstract":"<div><h3>Background</h3><p>Due to their high prevalence, long-term disability, work absenteeism, and low productivity capacity they often lead to, nociplastic and chronic pain are a major public health and social concern. Although high-level literature recommends the Biopsychosocial model, the traditional Biomedical approach is still very diffuse in clinical practise. It is recognized that the beliefs and attitudes of clinicians have an impact on those of patients. The Exploratory Factor Analysis (EFA) was used to validate the Italian version of the PABS-MSK questionnaire.</p></div><div><h3>Objectives</h3><p>The aim of this study was to translate the original PABS-MSK items into Italian and then assess the construct validity of the new Italian version of the PABS-MSK questionnaire, addressed to physiotherapists, to gain knowledge about physiotherapists’ attitudes and beliefs toward the management of chronic musculoskeletal pain and to correlate them with individual characteristics.</p></div><div><h3>Methods</h3><p>An EFA was performed to validate the modified-Italian-PABS-MSK questionnaire. Furthermore, multivariable regression models were implemented to assess any statistically significant differences in the total score of the two dimensions for sociodemographic and occupational characteristics.</p></div><div><h3>Results</h3><p>The sample consisted of 563 subjects who are members of the order of physiotherapists.</p><p>The Parallel Analysis suggested extracting two factors, and the EFA showed that the first scale (which we called Biopsychosocial) had higher factor loadings values, while two items (7 and 19) did not adequately represent the other scale (Biomedical).</p><p>Moreover, the regression models showed that younger and freelance clinicians are more prone to adhere to the Biopsychosocial model.</p></div><div><h3>Conclusions</h3><p>The modified-Italian-PABS-MSK questionnaire appears to measure two factors related to the Biopsychosocial and Biomedical beliefs of physiotherapists in the management of chronic musculoskeletal pain. The results suggest that professional training based on the evidence and recommendations of international guidelines is necessary to improve the adherence of physiotherapists to the Biopsychosocial model. However, additional studies are needed to further validate the scales, and assess the test-retest reliability, responsiveness, and construct validity.</p></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103161"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246878122400256X/pdfft?md5=5815f17b7322a8ba44f665ca71d93d5e&pid=1-s2.0-S246878122400256X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097757","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}