BMC Musculoskeletal Disorders最新文献

{"title":"Co-development of an evidence-informed, theoretically driven exercise programme for people with chronic non-specific neck pain (the EPIC-Neck programme - \"Exercise Prescription Improved through Co-design\").","authors":"Jonathan Price, Alison Rushton, Natalie Ives, Kate Jolly, Colin Greaves","doi":"10.1186/s12891-025-08918-z","DOIUrl":"10.1186/s12891-025-08918-z","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend neck exercise as a key intervention for chronic non-specific neck pain, yet current exercise programmes show modest effects and poor patient engagement. This study aimed to co-develop a neck exercise programme that maximizes effectiveness and engagement.</p><p><strong>Methods: </strong>Intervention Mapping steps 1-4 were employed with input from a diverse patient group (n = 17). In Step 1, outcomes/changes that the intervention aims to improve were synthesized from literature and patient workshops. To maximise engagement, Step 2 identified target behaviours (performance objectives), and their determinants from clinical guidelines, literature, and patient workshops. In Step 3, change techniques for each determinant were selected using the Theory and Techniques Tool and patient workshops. Techniques were organized into a logic model and framed within a \"best fit\" existing behaviour change theory to guide clinical practice. To maximise effectiveness, Step 2 identified exercise objectives from systematic reviews and expert consensus, describing the mechanisms through which exercise affects outcomes. Step 3 identified the most effective exercises and tailoring strategies to optimise exercise objectives. Resources to support delivery in clinical practice were co-developed with patients and physiotherapists in Step 4.</p><p><strong>Results: </strong>The EPIC-Neck intervention aims to improve outcomes including pain, disability, function, sleep, mental well-being and relationship impact, based on individual patient needs. A biopsychosocial exercise prescription framework informs exercise tailoring to optimize neuromuscular function, pain self-efficacy, night pain, cognitive control, social support; and reduce catastrophic thinking/fear avoidance, depending on a patients desired outcome. Patients need to achieve four performance objectives to manage neck pain effectively with exercise: (1) performing specific neck exercises, (2) independently adapting and progressing their neck exercises, (3) using specific neck exercises during flare-ups, and (4) initiating general exercise. To maximise engagement, a facilitation guide was developed based on the Process Model of Lifestyle Behaviour Change. The guide addresses 35 determinants using 24 change techniques, including goal setting, motivation enhancement, social support, action planning, self-monitoring, problem-solving support, shared decision-making, and patient-centred communication.</p><p><strong>Conclusion: </strong>This study co-developed an evidence-informed, theoretically driven exercise programme designed to enhance both effectiveness and patient engagement. Future work will assess its feasibility and acceptability to patients and physiotherapists, and in the long-term establish its clinical and cost-effectiveness.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"689"},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667171","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":"Ankle morphometry based on CT in Chinese population.","authors":"Chen Zhuang, Zechen Yan, Wenhuan Chen, Yu Pan, Xiangke Wu, Fan Wu, Weijie Guo, Wenxuan Guo, Wenzhan Tu","doi":"10.1186/s12891-025-08959-4","DOIUrl":"10.1186/s12891-025-08959-4","url":null,"abstract":"<p><strong>Background: </strong>Total ankle arthroplasty (TAA) is a surgical intervention for end-stage ankle arthritis. However, existing ankle prostheses continue to exhibit certain limitations, and there remains a need to develop prostheses that better conform to the ankle's anatomic characteristics. The objective of this study was to evaluate ankle morphometric data to establish an anatomical foundation for designing improved ankle prostheses.</p><p><strong>Methods: </strong>50 CT scans of ankle joints were included. 3D reconstruction was conducted using Mimics 19.0 and 3-matic 11.0, followed by meshing with Hypermesh software. The evaluated parameters included Tibial Plafond Width (TiW). Additionally, the study measured the Distance from the Lowest Point of the Lateral Malleolus to the Superior Tibial Plafond Tangent (DLA), among a total of 27 anatomical ankle joint parameters.</p><p><strong>Result: </strong>The 27 groups of CT measurement data followed a normal distribution. Statistically significant differences were observed in 18 of the 27 measurement groups (TiW, DMA, MaIW, TaW, MTiTh, APG, TiAL, TaAL, Th, TBL, TBH, TaW(a, p, c), TiW(a, p, c) and TBB) when comparing males (n = 23) and females (n = 27), with all measured values in males being larger than those in females. When comparing left and right ankles, no statistically significant differences were found in any other measurements, except for male Medial Dorsoventral dimension (MDV) (p = 0.027).</p><p><strong>Conclusion: </strong>The ankle joint parameters in the Chinese population exhibit sex-related differences, bilateral asymmetries, and regional variations when compared to populations from other geographic areas. Therefore, prosthesis design should comprehensively consider factors such as gender, ethnicity, and side-specific anatomical differences to ensure optimal anatomical compatibility.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"692"},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667170","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 from english into Urdu of a clinical decision tool to screen older women with back pain for osteoporotic-related vertebral fragility fractures.","authors":"Tanzeela Y Khalid, Huzaifa Adamali, Najma Zahoor, Sarah Drew, Emma M Clark","doi":"10.1186/s12891-025-08837-z","DOIUrl":"10.1186/s12891-025-08837-z","url":null,"abstract":"<p><strong>Background: </strong>Vertebral fractures associated with osteoporosis are common in individuals over 65, yet most cases go undiagnosed. This is concerning as those with vertebral fractures are at an increased risk of future fractures. To address this gap in healthcare, and facilitate diagnosis, so that bone-protective medications can be initiated, we developed and validated a clinical decision tool called 'Vfrac'. Vfrac assists healthcare professionals in determining whether an older person with back pain requires a spinal radiograph to diagnose vertebral fractures. However, because Vfrac was developed in English, it remains inaccessible to non-English speakers. Given the high prevalence of vertebral fractures in South Asians, our study aimed to translate Vfrac from English to Urdu using a cross-cultural adaptation approach based on a standardised framework.</p><p><strong>Methods: </strong>Vfrac was translated into Urdu by five independent translators who were provided with information about the tool's purpose and its components. Five different translators then back-translated the Urdu versions into English. A group of bilingual healthcare professionals and members of the public who spoke both English and Urdu reviewed and discussed the translations in reference to the original English questionnaire. The group selected the translations that best conveyed the intended meaning of each question, producing a final Urdu version of Vfrac. A bilingual healthcare professional conducted a final review and audio-recorded the Urdu Vfrac for accessibility.</p><p><strong>Results: </strong>The group of bilingual adults consisted of two healthcare professionals and three lay members, of whom four were female, and all aged 25 to 69 years. The final translated version of Vfrac written in Urdu was produced, ensuring it accurately reflected the original English version's meaning. To improve accessibility, an audio-recorded version was also created.</p><p><strong>Conclusions: </strong>This study successfully adapted an English language clinical checklist, Vfrac, into Urdu through a structured cross-cultural adaptation process. To enhance accessibility and address healthcare disparities we strongly recommend incorporating audio-recordings alongside written translations.</p><p><strong>Study registration: </strong>This study received ethical approval by the Faculty of Health Sciences Research Ethics Committee (FREC Ethics Ref: 13801) on the 27th of April 2023.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"691"},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667174","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":"Age- and sex-related changes in children with and without generalized joint hypermobility: a two-year follow-up study.","authors":"Oluwakemi Adebukola Ituen, Jacques Duysens, Gillian Ferguson, Bouwien Smits-Engelsman","doi":"10.1186/s12891-025-08684-y","DOIUrl":"10.1186/s12891-025-08684-y","url":null,"abstract":"<p><strong>Background: </strong>Joint hypermobility provides flexibility and is known to enhance motor performance but can also give rise to musculoskeletal complaints. There is evidence that young people are more flexible than older individuals, and females are more flexible than males. However, information about age- and sex-related changes in the range of motion (ROM) over time is scarce.</p><p><strong>Method: </strong>This study followed 126 children over two years; their ROM was measured three times with one year between measurements. The Beighton scoring system and goniometry were used to classify the children into normal mobile, mobile and hypermobile groups. The study included 56 males and 70 females. Mean age was 7.58 (6-9years), 8.58 (7-10years), and 9.60 (8-11years) years at time points 1, 2, and 3, respectively.</p><p><strong>Results: </strong>Joint hypermobility based on a Beighton score of 7-9 decreased from 25 to 13% to 6% in the last year. This was caused by a reduction of elbow and knee movement range but not by changes in finger joints or hamstring length. The pattern of decrease was very similar for boys and girls. Four children with hypermobility showed a large increase in ROM (> 10 degrees), of which 2 showed an increase in ROM at the elbow. Of the 53 children classified with normal mobility at measurement one 15 (28.3%) had one hypermobile joint (localized joint hypermobility).</p><p><strong>Conclusion: </strong>Children between 6 and 11 years of age get less flexible over 2 years. Mobility changes with age are comparable in boys and girls. Children who are not classified as generalized hypermobile can still have localized hypermobility. An increase in joint mobility is exceptional and may be a warning sign.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"693"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717525","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 effectiveness of Valsalva Maneuver-Assisted percutaneous vertebroplasty in reducing cement leakage in osteoporotic vertebral compression fractures.","authors":"Yongjie Wang, Xueming Chen, Qian Lu, Libin Cui, Xiangyu Li, Chao Kong, Shibao Lu","doi":"10.1186/s12891-025-08840-4","DOIUrl":"10.1186/s12891-025-08840-4","url":null,"abstract":"<p><strong>Objectives: </strong>Percutaneous vertebroplasty (PVP) is a highly practical treatment of osteoporotic vertebral compression fractures (OVCFs). However, cement leakage (CL) after PVP remains a challenging problem. There is a lack of effective methods to reduce CL. The objective of this study is to evaluate the effectiveness and safety of Valsalva maneuver-assisted percutaneous vertebroplasty (V-PVP) compared to conventional PVP in treating OVCFs.</p><p><strong>Methods: </strong>302 patients were enrolled in this study. Patients were divided into the V-PVP group and the conventional PVP group according to whether they received the Valsalva maneuver intraoperatively. Postoperative CT was performed to determine CL which can be classified as no leakage, cortical leakage, venous leakage, and cortical & venous leakage. CL rate and visual analog scale (VAS), performed before surgery, 1 day, and 6 months after surgery, Operation time, cement volume, pulmonary embolism rate, and hospital stay were compared between the two groups. The age, gender, BMI, BMD, fracture segment (thoracic, thoracolumbar, lumbar), fracture type (mild, moderate), cortical disrupture and cement volume of the two groups were also recorded, Multinomial Logistic regression analysis of all factors was conducted to analyze the relationship between all factors and CL.</p><p><strong>Results: </strong>A total of 302 patients were enrolled (150 V-PVP and 152 PVP). The V-PVP group had significantly lower overall CL rates (36.7% vs. 77.6%), lower pulmonary embolism rates (1.3% vs. 17.1%), and shorter hospital stays. Pain relief was significantly better in the V-PVP group at 1 day and 6 months post-surgery (P < 0.01). Logistic regression analysis identified male gender and absence of cortical disruption as protective factors against cortical leakage, while Genant grade 2 was a risk factor. Male gender and V-PVP treatment were protective against venous leakage, whereas thoracic fractures and higher BMD were risk factors. No significant differences were found in operation time or cement volume between the groups.</p><p><strong>Conclusion: </strong>V-PVP is a more effective and safer option than conventional PVP for treating OVCFs, particularly in reducing cement leakage and pulmonary embolism rates. Future prospective studies with larger sample sizes are warranted to validate these findings.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"688"},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648597","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":"Conditional GAN performs better than orthopedic surgeon in virtual reduction of femoral neck fracture.","authors":"Keyang Zhao, Yihan Mei, Xiaoling Wang, Weihui Ma, Wei Shen","doi":"10.1186/s12891-025-08921-4","DOIUrl":"10.1186/s12891-025-08921-4","url":null,"abstract":"<p><strong>Objective: </strong>Satisfied reduction of fracture is hard to achieve. The purpose of this study is to develop a virtual fracture reduction technique using conditional GAN (Generative Adversarial Network), and evaluate its performance in simulating and guiding reduction of femoral neck fracture, which is hard to reduce. We compared its reduction quality with manual reduction performed by orthopedic surgeons. It is a pilot study for augmented reality assisted femoral neck fracture surgery.</p><p><strong>Methods: </strong>To establish the gold standard of reduction, we invited an orthopedic surgeon to perform virtual reduction registration with reference to the healthy proximal femur. The invited orthopedic surgeon also performed manual reduction by Mimics software to represent the capability of human doctor. Then we trained conditional GAN models on our dataset, which consisted 208 images from 208 different patients. For displaced femoral neck fractures, it is not easy to measure the accurate angles, like Pauwels angle, of the fracture line. However, the fracture lines would be clearer after reduction. We compared the results of manual reduction, conditional GAN models and registration by Pauwels angle, Garden index and satisfied reduction rate. We tried different number of downsampling (α) to optimize the performance of conditional GAN models.</p><p><strong>Results: </strong>There were 208 pre-surgical CT scans from 208 patients included in our study (age 69.755 ± 13.728, including 88 men). The Pauwles angles of conditional GAN model(α = 0) was 38.519°, which was significantly more stable than manual reduction (44.647°, p < 0.001). The Garden indices of conditional GAN model(α = 0) was 176.726°, which was also significantly more stable than manual reduction (163.590°, p = 0.002). The satisfied reduction rate of conditional GAN model(α = 0) was 88.372%, significantly higher than manual reduction (53.488%, p < 0.001). The Pauwels angles, Garden indices and satisfied reduction rate of conditional GAN model(α = 0) showed no difference to registration.</p><p><strong>Conclusion: </strong>Conditional GAN model(α = 0) can achieve better performance in the virtual reduction of femoral neck fracture than orthopedic surgeon.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"687"},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648596","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":"Comparison of clinical outcomes of trochanteric femoral nail advanced system (TFNA) with and without cement augmentation for geriatric unstable trochanteric fractures: a single-center retrospective cohort study.","authors":"Yutaro Kuwahara, Genta Takemoto, Hiroshi Fukuoka, So Mitsuya, Ken-Ichi Yamauchi","doi":"10.1186/s12891-025-08901-8","DOIUrl":"10.1186/s12891-025-08901-8","url":null,"abstract":"<p><strong>Introduction: </strong>Unstable trochanteric fractures (AO types A2 or A3) are reported to be risk factors for mechanical failure such as screw cut-out. This study aimed to compare the incidence of implant related complications and functional outcomes between cement augmentation and non-augmentation.</p><p><strong>Methods: </strong>Patients at a single institution aged > 60 years who underwent fixation using the trochanteric femoral nail advanced system (TFNA) with or without cement augmentation from 2020 to 2023 were retrospectively analyzed. We evaluated reduction quality and screw position on immediate postoperative radiographs, the occurrence of screw cut-out, and Parker's mobility score (PMS) as functional outcomes.</p><p><strong>Results: </strong>We evaluated 140 patients in the non-augmentation group and 93 patients in the augmentation group. The mean follow-up period was 13.6 ± 5.7 months. The mean age was 86.0 ± 8.1 years in the non-augmentation and 85.2 ± 8.3 years in the cement augmentation group. Patient demographics, including fracture type, were similar in both groups. The screw cut-out rate was seven out of 140 patients (5.0%) in the non-augmentation group, whereas no patients in the augmentation group experienced screw cut-out, and the difference was significant (p = 0.044). All cases which occurred screw cut-out were associated with postoperative poor reduction quality and screw malposition. The mean PMS at the last follow-up was 4.0 ± 3.0 in the non-augmentation group and 4.7 ± 2.7 in the augmentation group, and the difference was not significant (p = 0.187).</p><p><strong>Conclusions: </strong>Cement augmentation showed a significant lower screw cut-out rate compared with non-augmentation. This technique could be a more favorable option for osteoporotic unstable trochanteric fractures.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"683"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641781","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":"Direct anterior approach versus posterior approach in total hip arthroplasty after ONFH with failed vascularized iliac crest bone grafting for hip preservation: a retrospective comparative study.","authors":"Kun Chu, Yuchuan Wang, Bo Liu, Zihang Li, Zhaolong Wang, Junheng Zhang, Yongqiang Fan, Binquan Zhang, Huijie Li","doi":"10.1186/s12891-025-08418-0","DOIUrl":"10.1186/s12891-025-08418-0","url":null,"abstract":"<p><strong>Background: </strong>Hip preservation surgery with vascularized iliac bone flap transplantation is currently an important method for treating patients with early-stage femoral head necrosis and collapse. However, if hip preservation fails, total hip arthroplasty (THA) is the only treatment option. This study aimed to compare the clinical efficacy and complications of direct anterior (DAA) and posterior (PA) approaches for subsequent THA in patients with failed hip preservation.</p><p><strong>Methods: </strong>The data of patients who initially underwent vascularized iliac crest bone grafting for hip preservation, and subsequently progressed to end-stage hip osteonecrosis which required THA from January 2013 to March 2020 were retrospectively analysed. These patients were divided into two groups (group DAA; group PA). Baseline information of the included patients was collected. Surgical time, blood loss, and perioperative complications were compared between the two groups. Visual analog scale (VAS) results were recorded for all patients at 1, 3,and 6 months postoperatively to assess the severity of pain. Harris hip scores (HHS) were evaluated at 3, 6, and 12 months postoperatively to assess hip joint function recovery. Radiographic measurements were used to evaluate prosthesis placement.</p><p><strong>Results: </strong>The study included 62 patients (62 hips), with 28 patients (28 hips) in the DAA group and 34 patients (34 hips) in the PA group. The two groups were well-balanced in terms of basic characteristics (p > 0.05). Perioperative outcomes comparison revealed that in subsequent THA surgeries, PA was associated with significantly longer surgical time and greater intraoperative blood loss than DAA (p < 0.05). Patients who received THA in the direct anterior approach experienced less pain The direct anterior approach demonstrated superior pain relief within the first month and third month postoperatively compared to the posterior approach (p < 0.05). Furthermore, at the 3-month follow-up, patients receiving DAA had significantly higher HHS scores than those undergoing PA, suggesting enhanced joint function recovery benefits from DAA (79.54 ± 7.91 vs. 76.62 ± 7.76, p = 0.000).</p><p><strong>Conclusion: </strong>In cases where vascularized iliac crest bone grafting for hip preservation fails, subsequent THA performed via DAA appears to result in shorter surgical time and less intraoperative blood loss compared to PA. However, compared with PA, DAA seems to have a higher risk of complications, so surgeons need to be extra cautious during surgery.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"686"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641834","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":"Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial.","authors":"Chun-Ya Xia, Hao-Zhi Niu, Xin-Wen Zhang, Si-Yan Cai, Ying-Jie Fan, Tian-Pei Xie, Peng-Xia Dong, Xiao-Tong Zu, Ze-Lin Su, Xing-Sheng Lu, Yong-Gang Hao, Min Su","doi":"10.1186/s12891-025-08924-1","DOIUrl":"10.1186/s12891-025-08924-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of wearable transcutaneous electrical nerve stimulation (TENS) combined with transcranial direct current stimulation (tDCS) in the middle-aged person with mild knee osteoarthritis (KOA).</p><p><strong>Design: </strong>Double-blind, randomized clinical trial.</p><p><strong>Setting: </strong>A general hospital.</p><p><strong>Subjects: </strong>Participants aged 60-70 with mild KOA (Kellgren-Lawrence grade 1-2).</p><p><strong>Interventions: </strong>The experimental group received TENS + tDCS, and the control group received TENS + sham tDCS for four weeks from Monday through Friday.</p><p><strong>Main measures: </strong>The primary outcome was Brief Pain Inventory (BPI). The secondary outcomes included participants' Visual Analog Scale (VAS), step length, cadence, 6-minute walking test (6MWT), active knee range of motion (ROM), and quadriceps strength. The indexes were assessed one week before treatment (T0), two weeks after treatment commencement (T1), four weeks after treatment commencement (T2), one month after treatment cessation (T3), and two months after treatment cessation (T4).</p><p><strong>Results: </strong>A total of 110 participants (55 per group) completed the intervention and follow-up. Repeated-measures ANOVA indicated that tDCS significantly improved the efficacy of TENS in alleviating pain and enhancing walking ability among patients with mild KOA. Statistically significant differences in BPI scores were observed between the experimental and control groups at T1 (2.16 vs. 2.45, P = 0.038), T2 (1.17 vs. 1.73, P < 0.001), and T3 (2.17 vs. 2.41, P = 0.021). However, no significant difference was detected at T4 (2.50 vs. 2.63, P = 0.293).</p><p><strong>Conclusion: </strong>The four-week combined intervention demonstrated that tDCS potentiated the therapeutic efficacy of TENS in managing mild KOA. The combined protocol exhibited superiority over TENS monotherapy, with sustained benefits observed up to one-month post-intervention.</p><p><strong>Trial registration: </strong>This research has been registered in chictr.org.cn (registration number: ChiCTR2200064735) on 15 October 2022, https://www.chictr.org.cn/showproj.html?proj=182561 .</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"684"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641837","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":"Evaluation of Artificial Intelligence-based diagnosis for facial fractures, advantages compared with conventional imaging diagnosis: a systematic review and meta-analysis.","authors":"Jiangyi Ju, Zhen Qu, Han Qing, Yunxia Ding, Lihua Peng","doi":"10.1186/s12891-025-08842-2","DOIUrl":"10.1186/s12891-025-08842-2","url":null,"abstract":"<p><strong>Background: </strong>Currently, the application of convolutional neural networks (CNNs) in artificial intelligence (AI) for medical imaging diagnosis has emerged as a highly promising tool. In particular, AI-assisted diagnosis holds significant potential for orthopedic and emergency department physicians by improving diagnostic efficiency and enhancing the overall patient experience. This systematic review and meta-analysis has the objective of assessing the application of AI in diagnosing facial fractures and evaluating its diagnostic performance.</p><p><strong>Methods: </strong>This study adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PRISMA-Diagnostic Test Accuracy (PRISMA-DTA). A comprehensive literature search was conducted in the PubMed, Cochrane Library, and Web of Science databases to identify original articles published up to December 2024. The risk of bias and applicability of the included studies were assessed using the QUADAS-2 tool. The results were analyzed using a Summary Receiver Operating Characteristic (SROC) curve.</p><p><strong>Results: </strong>A total of 16 studies were included in the analysis, with contingency tables extracted from 11 of them. The pooled sensitivity was 0.889 (95% CI: 0.844-0.922), and the pooled specificity was 0.888 (95% CI: 0.834-0.926). The area under the Summary Receiver Operating Characteristic (SROC) curve was 0.911. In the subgroup analysis of nasal and mandibular fractures, the pooled sensitivity for nasal fractures was 0.851 (95% CI: 0.806-0.887), and the pooled specificity was 0.883 (95% CI: 0.862-0.902). For mandibular fractures, the pooled sensitivity was 0.905 (95% CI: 0.836-0.947), and the pooled specificity was 0.895 (95% CI: 0.824-0.940).</p><p><strong>Conclusions: </strong>AI can be developed as an auxiliary tool to assist clinicians in diagnosing facial fractures. The results demonstrate high overall sensitivity and specificity, along with a robust performance reflected by the high area under the SROC curve.</p><p><strong>Clinical trial number: </strong>This study has been prospectively registered on Prospero, ID:CRD42024618650, Creat Date:10 Dec 2024. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618650 .</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"682"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641835","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}