Musculoskeletal Care最新文献

Background: Chronic neck pain (CNP) significantly impacts individuals' quality of life and functional capacity. Cervical stabilisation exercises (CSEs), targeting deep cervical muscles and improving postural alignment, have emerged as a promising intervention. This systematic review evaluates the efficacy of CSEs in managing CNP.

Objective: To determine the effectiveness of CSEs in alleviating pain, improving function, and enhancing quality of life in individuals with CNP.

Methods: A systematic review of the literature was conducted following PRISMA guidelines. Searches were performed across PubMed, Scopus, and the PEDro. Eligible studies included randomised controlled trials (RCTs) published within the past 10 years. Methodological quality was assessed using the PEDro scale.

Results: Twelve studies met the inclusion criteria, with most rated as moderate to high quality. Findings demonstrated that CSEs significantly reduce pain (as measured by VAS and NRS), improve functional capacity (e.g., Neck Disability Index), and correct postural abnormalities such as forward head posture. Multimodal interventions combining CSEs with manual therapy, thermotherapy, or dynamic exercises yielded superior outcomes compared with CSEs alone. Intervention duration of 6-8 weeks was most effective. Variability in outcomes was attributed to differences in population characteristics and methodological quality.

Conclusion: CSEs are an effective, evidence-based intervention for managing CNP. Tailored programs, particularly those integrating multimodal approaches, enhance therapeutic outcomes. Future research should focus on long-term effects and subpopulation-specific benefits to optimise clinical implementation.

Objective: Knee osteoarthritis is a primary cause of disability across the world and current standard care fails to address all biopsychosocial contributions to pain. The current review aims to evaluate randomised controlled trials examining the effect of adding cognitive behavioural therapy or pain coping skills training to standard care on pain and function outcomes for individuals with knee osteoarthritis.

Data sources: Systematic searches were conducted of CINAHL, EMBASE (OVID), Medline (EBSCO) and PsycINFO databases until July 2024 with no date restrictions.

Methods: This systematic review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Risk of bias was assessed using the Risk of bias 2 tool. Meta-analysis using a random-effects model was carried out using the ​Statistical Package for the Social Sciences, and effect sizes from standardised mean differences were calculated using Cohen's d statistic. Heterogeneity was assessed using I-squared and Tau-squared tests.

Results: Four randomised controlled trials met eligibility criteria (n = 628, mean age 62.91), demonstrating a low risk of bias. The addition of cognitive behavioural therapy or pain coping skills training to standard care for knee osteoarthritis produced statistically significant changes in standardised mean differences (p < 0.001), showing small to medium effect sizes in pain (0.488) and function (0.340) between 3- and 6-month time points. Heterogeneity measured by I^-squared and Tau-squared was low for pain and function.

Conclusion: Adding psychological interventions to standard care for knee osteoarthritis improves outcomes in both pain and function. These findings support the integration of psychological interventions into clinical practice.

Objective: To investigate the relation of radiographic knee osteoarthritis (RKOA) and type 2 diabetes mellitus (T2DM) to physical activity, pain, physical function, and quality of life.

Methods: Data on physical activity (light and moderate-vigorous physical activity minutes/day, steps/day, sedentary time percent of wear time), pain, physical function (Western Ontario and McMaster Index, walking speed during 20-m walk) and quality of life (SF-12) from the Osteoarthritis Initiative at the 48-month visit were included. Participants (n = 1788) were categorised into no RKOA or T2DM, RKOA-alone, T2DM-alone, and RKOA and T2DM. Multivariable regression models, adjusted for age, sex, and BMI, assessed the relationship of disease status to outcomes.

Results: Compared to RKOA-alone, RKOA and T2DM were associated with lower moderate-vigorous physical activity (Coefficient: 4 min/day, 95% CI: [-7, -1]) and steps/day (-817 steps/day [-1291, -343]) and higher sedentary time percent (1.3%/day [-0.2, 2.8]). No significant differences were found in light physical activity (-11 min/day [-25, 2]). The RKOA and T2DM groups reported greater pain (1.0 [0.4, 1.6]) and functional limitations (3 [1, 5]), slower walking speed (-0.09 m/s [-0.12, -0.05]), and worse quality of life (-3.2 [-4.8, -1.6]). T2DM-alone was also associated with lower physical activity and worse quality of life than RKOA-alone.

Conclusions: The comorbidity of RKOA and T2DM and T2DM-alone were associated with lower physical activity and worse quality of life than RKOA-alone. Management should address both conditions concurrently rather than in isolation.

Background: Osteoarthritis (OA) and inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondylarthritis (axSpA), are leading causes of disability worldwide, significantly impacting health and quality of life. Sleep issues are highly prevalent in these populations, exacerbating pain, fatigue, and disease activity. However, there is a dearth of evidence regarding how sleep disorders should be assessed.

Objective: The main objectives are to identify, describe, and synthesise which types of sleep dimensions are evaluated, what measurement tools are employed to measure them in individuals with OA and IA, and provide an overview of the impact of sleep issues in OA and IA.

Methods: This systematic scoping review will follow the Joanna Briggs Institute methodological framework and be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Systematic Scoping Reviews. The search strategy will involve PubMed, Embase, Cochrane Central, PsycINFO, and CINAHL, along with grey literature sources. Articles will be selected based on predefined eligibility criteria, and data will be synthesised narratively.

Anticipated outcomes: This systematic scoping review will synthesise the current literature on studies that collect and report sleep assessment as a primary or secondary outcome in people with OA and IA. It will clarify which sleep dimensions are assessed and how they are measured, provide an updated overview to inform clinical practice regarding sleep assessment and impact in OA and IA, and identify key research gaps.

Dissemination: The findings will be disseminated through research publications, including peer-reviewed articles and conference abstract(s)/presentation(s).

Objectives: This scoping review will explore and map the extent and type of literature related to physiotherapy capabilities in the health care of adult patients at increased risk of osteoporotic fractures and identify gaps in the literature.

Background: With an ageing population, osteoporosis and fractures and their associated costs are increasing. Unfortunately, many people with, or at increased risk of, osteoporotic fractures remain undiagnosed and untreated. The scope of physiotherapy has expanded over recent years with enhanced, advanced and consultant roles. This presents opportunities for physiotherapists to help reduce the osteoporosis care gap. Clarifying capabilities is important to ensure successful implementation of new roles and development of holistically competent practitioners.

Eligibility criteria: Literature will be included if it relates to capabilities of qualified physiotherapists involved in the health care of adult patients (aged 18 and over) at increased risk of osteoporotic fractures in any clinical setting. All published and non-published literature to include research studies, editorials, and grey literature will be considered.

Methods: A scoping review will be carried out in accordance with JBI guidelines. Peer-reviewed databases including MEDLINE, EMBASE, EMCARE, CINAHL, SCOPUS, Cochrane, PEDro and ProQuest will be searched for literature between 2003 and 2025, alongside a comprehensive search for grey literature (including reports and government publications) from additional sources to ensure a broad representation of available evidence. Source selection will use the PRISMA-ScR flow chart against agreed eligibility criteria. Data extraction will be mapped out in tabular and/or diagrammatic format with a supporting narrative synthesis.

Trial registration: https://doi.org/10.17605/OSF.IO/47UYE.

Background: Patient education is a cornerstone of care for individuals with non-specific low back pain (LBP). However, little is known about whether accessible patient education materials (PEMs) meet people's information needs.

Methods: We conducted a scoping review following the JBI methodology and reported results according to PRISMA-ScR. We systematically reviewed three databases: Ovid MEDLINE, Scopus, and CINAHL. The search strategy was iteratively developed and peer-reviewed using the PRESS checklist. Eligible studies had to provide full access to the PEM designed for people with LBP. Study selection and data extraction were performed independently and in duplicate. Five reviewers conducted a consensus-based analysis by independently matching PEM content to eight categories of information needs derived from previous research.

Results: Of 9617 citations identified, 23 studies met inclusion criteria, yielding 41 unique PEMs. We excluded many citations (67.3%) because the PEM used in the study was missing. Most PEMs were in English (95%) and took the form of posters, booklets, or leaflets. Only eight PEMs (19.5%) reported readability assessment. Stakeholder involvement was reported in eight studies. Among PEMs with stakeholder input, characteristics from the PROGRESS + framework were rarely disclosed. Only one PEM addressed all eight identified information needs. The most frequently covered information needs were treatment options (65.9%) and imaging (61.0%), while information on prognosis and flare management was scarce (17.1%).

Conclusion: Accessible PEMs for non-specific LBP rarely meet the full spectrum of patient information needs. Improving stakeholder involvement and readability assessment is essential to enhance the usefulness and equity of educational resources.

Background: Total Knee Arthroplasty (TKA) is a widely accepted intervention for end-stage knee osteoarthritis, significantly improving pain relief and overall function. However, many patients continue to report dissatisfaction with the results, especially in low- and middle-income countries (LMICs), where various contextual challenges may influence recovery outcomes.

Objective: This study aimed to explore experiences, satisfaction and quality of life in patients following physiotherapy after TKA through repeated interviews.

Methods: A phenomenological qualitative design was employed. Seven patients' who had completed postoperative physiotherapy were recruited through purposive sampling. In-depth interviews were conducted one and 3 months after surgery. The interviews were transcribed verbatim and analysed using reflexive thematic analysis to identify key patient satisfaction and recovery themes.

Results: Fourteen interviews identified four key themes: (1) Pain and recovery, (2) Functional ability, (3) Satisfaction with care, and (4) Psychological aspects. While patients' experienced improvements in pain and mobility, many continued to deal with discomfort and limitations. Cultural norms, home environments, and individual expectations influenced their perspectives on recovery. Strong family support and positive interactions with therapists also contributed to higher satisfaction levels.

Conclusions: Patients expressed mixed feelings about their pain relief and functional abilities, which impacted their overall quality of life. Although the initial recovery phase was largely positive, many patients' experienced increased pain and dissatisfaction by the third month. It was found that psychological, social, and environmental factors and clinical outcomes influence the recovery process.

Background: Rheumatoid Arthritis (RA) is a chronic musculoskeletal disorder that is a leading cause of disability worldwide, with early diagnosis and pharmacological treatment being critical to alleviate disease progression. However, the marginalised populations face significant barriers in accessing timely medical care, which contributes to functional impairment, and reduced quality of life (QoL). Despite this, little is understood about how intersecting marginalities influence access to musculoskeletal care, particularly in low-resource settings.

Purpose: To explore care-seeking pathways, underlying factors, and access constraints among the socioeconomically marginalised women living with RA in rural Kashmir.

Methods: Constructivist grounded theory approach of Cathy Charmaz was employed to obtain an in-depth comprehension of the phenomenon under study. Purposive and theoretical sampling strategies were employed to recruit 18 women diagnosed with RA from rural Kashmir. Data were collected through semi-structured interviews and analysed using the constant comparative method, which is well viewed to be the hallmark of the grounded theory approach.

Findings: Participants sought care from a pluralistic healthcare system involving a variety of untrained, and trained providers, and kept on changing from one provider to another without any restrictive access protocols. Their care-seeking trajectories usually began with self-medication, home-based remedies, traditional healers, spiritual intervention and local medicates. Conventional medical care was considered as the last resort, undertaken following a prolonged delay, and only when all other options proved ineffective. These care-seeking choices were largely influenced by illness/treatment perception, cultural norms, accessibility, affordability and organizational dynamics.

Conclusion: The delayed transition to formal healthcare highlights the need for strengthening health(care) awareness, affordability, and rural health infrastructure to ensure timely, equitable and culturally sensitive care for the vulnerable.

Background: Low back pain (LBP) is a prevalent musculoskeletal condition often associated with lumbar instability, resulting from structural and functional spinal deficits. This instability leads to pain, reduced function, and diminished quality of life. Physiotherapy aims to restore stability, enhance strength, and improve neuromuscular control. This systematic review examines the effectiveness of physiotherapy in managing lumbar instability and its symptoms.

Research questions: Do physiotherapy interventions reduce pain in individuals with lumbar instability? Do they improve functional abilities and neuromuscular control? What is the role of adjunct techniques such as respiratory resistance training and neurodynamic interventions?

Objectives: To assess the effectiveness of physiotherapy in reducing pain, improving function, and enhancing muscle activation in individuals with lumbar instability.

Design: Systematic review (PROSPERO ID: CRD42025610915).

Methods: Studies involving patients with lumbar instability were identified through searches on PubMed and Google Scholar using the terms: (PHYSIOTHERAPY MANAGEMENT) AND (LUMBAR INSTABILITY). Outcomes assessed included spinal stability, strength, pain, and quality of life.

Results: Seventeen studies met the inclusion criteria. Lumbar stabilisation exercises, alone or combined with techniques such as respiratory resistance, whole-body vibration, or neurodynamic approaches, effectively reduced pain and improved function. Individualised and progressive programs showed greater benefits in muscle activation and overall well-being.

Conclusion: Physiotherapy, particularly lumbar stabilisation exercises, is effective in managing lumbar instability. Adjunct techniques enhance outcomes, supporting the use of tailored, evidence-based interventions.

Objective: To systematically review the evidence on the effectiveness of Isostretching on pain, physical function and quality of life in individuals with Low Back Pain (LBP).

Data sources: We searched the following databases until November 11, 2024: PubMed, Embase, Cochrane CENTRAL, CINAHL, PEDro, Virtual Health Library Regional Portal, Scopus, Web of Science, SportDiscus and Rehabilitation and Sports Medicine. PRISMA-S was used to strengthen the reporting quality of our search strategy.

Methods: This review followed the PRISMA checklist. Randomized clinical trials that investigated the effects of Isostretching against any control intervention in individuals with non-specific LBP were eligible. Literature screening and data extraction were performed independently by the authors. The PEDro scale, the GRADE approach and the TIDier checklist were used to assess the risk of bias, quality of the evidence and reporting quality of the intervention, respectively. Results were analysed and synthesised narratively.

Results: Five articles were included (pooled n = 155). Only adults (76% female) between 19 and 60 years were included. The PEDro score ranged from 2-8 points (mean of 5.6). Very-low quality evidence suggests that isostretching may reduce pain and improve functional capacity in the short term when compared with no intervention. Also, very-low quality evidence suggests that isostretching is not superior to any active intervention to reduce pain and improve functional capacity and quality of life. The mean number of reported TIDier items was 6.4.

Conclusion: This review supports Isostretching to reduce pain and improve physical function and quality of life in patients with non-specific LBP.