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Correction to Clinical efficacy of JAK inhibitors on enthesitis in spondyloarthropathy: A scoping literature review. 更正:JAK抑制剂对脊柱关节病的临床疗效:范围性文献综述。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-08 DOI: 10.1002/msc.1819
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引用次数: 0
Barriers and facilitators of evidence-based physiotherapy practice in Iran: A qualitative study. 伊朗循证物理治疗实践的障碍和促进因素:一项定性研究。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-10-11 DOI: 10.1002/msc.1831
Shabnam ShahAli, Mehrnaz Kajbafvala, Sadaf Fetanat, Fahimeh Karshenas, Marzieh Farshbaf, Fatma Hegazy, Saeed Shahabi

Background: To facilitate evidence-based practice (EBP) in physiotherapy in Iran and guide future improvements, it is crucial to identify what barriers and facilitators exist in the current system from the physiotherapist's perspective. Therefore, the purpose of this study was to explore the barriers and facilitators of EBP in physiotherapy in Iran.

Methods: This qualitative study was conducted using a phenomenological approach from January to July 2023 in Iran. The sampling process started with a purposive approach, and then an attempt was made to identify and interview more potential samples with the snowball approach. Thematic analysis was used to analyse the collected qualitative data.

Results: 44 individuals, including 37 physiotherapists and seven faculty members, participated in this study. Several barriers and facilitators to evidence-based physiotherapy practice in Iran were found and then put into three themes: (1) individual factors, (2) practice environment factors, and (3) extra-organisational factors. The most common barriers were time/workload pressures, financial incentives, lack of motivation, weakness in English, managers' pressures, inadequate awareness among patients, infrastructure limitations, poor economic situation, Internet restrictions, inappropriateness of the educational curriculum, difficult access to scientific research, and lack of insurance coverage for up-to-date therapies.

Conclusions: Although most of the participants had a very positive view of physiotherapy based on scientific evidence, various obstacles have prevented this approach from being well implemented in Iran. Therefore, it is necessary to move towards minimising the existing barriers at the individual, practice environment, and extra-organisational levels by adopting effective multilateral policies.

背景:为了促进伊朗物理治疗的循证实践(EBP)并指导未来的改进,从理疗师的角度确定当前系统中存在哪些障碍和促进因素至关重要。因此,本研究旨在探讨伊朗物理治疗中EBP的障碍和促进因素。方法:本研究于2023年1月至7月在伊朗采用现象学方法进行。抽样过程从有目的的方法开始,然后尝试用滚雪球方法识别和采访更多潜在的样本。专题分析用于分析所收集的定性数据。结果:包括37名物理治疗师和7名教员在内的44人参与了本研究。发现了伊朗循证理疗实践的几个障碍和促进因素,然后将其分为三个主题:(1)个人因素,(2)实践环境因素,以及(3)组织外因素。最常见的障碍是时间/工作量压力、经济激励、缺乏动力、英语薄弱、管理人员的压力、患者意识不足、基础设施限制、经济状况不佳、互联网限制、教育课程不合适、难以获得科学研究,以及缺乏最新疗法的保险。结论:尽管大多数参与者根据科学证据对理疗持非常积极的看法,但各种障碍阻碍了这种方法在伊朗的良好实施。因此,有必要通过采取有效的多边政策,尽量减少个人、实践环境和组织外层面的现有障碍。
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引用次数: 0
A mixed methods approach to investigating physical activity in people with obesity participating in a chronic care programme awaiting total knee or hip arthroplasty. 一种混合方法来调查参与等待全膝或髋关节置换术的慢性护理计划的肥胖患者的身体活动。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-29 DOI: 10.1002/msc.1825
Natalie Pavlovic, Bernadette Brady, Robert Boland, Ian A Harris, Victoria M Flood, Furkan Genel, Manxin Gao, Justine M Naylor

Aims: To describe patient-reported physical activity and step count trajectory and explore perceived barriers and enablers to physical activity amongst people with obesity participating in a chronic care programme whilst awaiting arthroplasty.

Design: Convergent parallel mixed-method study.

Method: A patient cohort derived from a longitudinal sample of adults with end-stage osteoarthritis and obesity from a chronic care programme whilst awaiting primary total knee or hip arthroplasty (n = 97) was studied. Physical activity was measured at baseline (entry to the wait list) and before surgery (9-12 months waiting time) using the Lower Extremity Activity Scale (LEAS) and activity monitors (activPAL™). A subset of participants completed in-depth semi-structured interviews 6 months after being waitlisted to explore perceived barriers and enablers to physical activity. Themes were inductively derived and then interpreted through the COM-B model.

Results: Baseline LEAS and activPAL™ data were available from 97 and 63 participants, respectively. The proportion of community ambulant individuals reduced from 43% (95% CI 33%-53%) at baseline to 17% (95% CI 9%-28%) pre-surgery. Paired activPAL™ data (n = 31) for step count, upright time, and stepping time remained unchanged. Twenty-five participants were interviewed. Five themes underpinning physical activity were mapped to the COM-B model components of capability (physical capability), opportunity (accessibility and social norms), and motivation (self-efficacy and beliefs and physical activity).

Conclusions: Participation in a chronic care programme did not improve physical activity levels for people with obesity awaiting arthroplasty. Programs cognisant of the COM-B model components may be required to address the natural trajectory of declining physical activity levels while awaiting arthroplasty.

目的:描述患者报告的身体活动和步数轨迹,并探讨在等待关节成形术期间参与慢性护理计划的肥胖患者中身体活动的障碍和促成因素。设计:收敛并行混合方法研究。方法:对一个患者队列进行研究,该队列来自一个长期护理计划中患有终末期骨关节炎和肥胖的成年人的纵向样本,同时等待初级全膝或髋关节置换术(n=97)。使用下肢活动量表(LEAS)和活动监测器(activPAL™). 一部分参与者在被列入候补名单6个月后完成了深入的半结构化访谈,以探索身体活动的障碍和促成因素。对主题进行归纳推导,然后通过COM-B模型进行解释。结果:基线LEAS和activPAL™ 数据分别来自97名和63名参与者。社区流浪者的比例从基线时的43%(95%CI 33%-53%)降至手术前的17%(95%CI 9%-28%)。成对的activPAL™ 步数、直立时间和步进时间的数据(n=31)保持不变。对25名参与者进行了访谈。支撑身体活动的五个主题被映射到COM-B模型的组成部分,即能力(身体能力)、机会(可达性和社会规范)和动机(自我效能和信念以及身体活动)。结论:参与慢性护理计划并不能提高等待关节成形术的肥胖患者的身体活动水平。可能需要了解COM-B模型组件的程序来解决在等待关节成形术时身体活动水平下降的自然轨迹。
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引用次数: 0
Lived experience of people with painful hallux valgus: A descriptive qualitative study. 拇外翻疼痛患者的生活经历:一项描述性定性研究。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-23 DOI: 10.1002/msc.1822
Matthew Cotchett, Cassandra Bramston, Shan Bergin, Hylton B Menz, Rebecca Jessup

Objective: Hallux valgus has a detrimental impact on health-related quality of life. Education is crucial for the management of all musculoskeletal conditions, although no previous research has evaluated the sources and quality of education accessed by patients with hallux valgus. Therefore, we aimed to evaluate the perceptions and attitudes of individuals with hallux valgus, including their educational experiences.

Methods: A qualitative descriptive design was employed to gather data from individuals diagnosed with painful hallux valgus. Semi-structured interviews explored the perceptions, attitudes and educational experiences of participants. Interviews were recorded, transcribed verbatim, and analysed using the Framework Method. Respondent validation was used to ensure the rigour of the study findings.

Results: Ten participants were interviewed, ages 26-72. Data analysis revealed five themes including the impact of hallux valgus, coping with hallux valgus, cause of hallux valgus, health professional support and education received. Hallux valgus was associated with a negative impact on health-related quality of life. Participants described a lack of high quality, accurate and reliable educational resources, and a variable experience with health professionals, which was often characterised by a lack of engagement and commitment and an overemphasis of referrals for specialist opinion.

Conclusion: Hallux valgus has a negative influence on well-being, including physical, mental, and social impacts. Health professionals should be responsive to patient needs and strive to implement person-centred care when indicated. There is also a need for the development of high-quality educational resources to help people with hallux valgus make informed decisions about their condition.

目的:外翻对健康相关的生活质量有不利影响。教育对于管理所有肌肉骨骼疾病至关重要,尽管之前没有任何研究评估拇外翻患者接受教育的来源和质量。因此,我们旨在评估拇外翻患者的认知和态度,包括他们的教育经历。方法:采用定性描述性设计收集被诊断为拇外翻疼痛的个体的数据。半结构化访谈探讨了参与者的看法、态度和教育经历。访谈记录下来,逐字逐句转录,并使用框架方法进行分析。受访者验证用于确保研究结果的严谨性。结果:10名参与者接受了访谈,年龄为26-72岁。数据分析揭示了五个主题,包括拇外翻的影响、应对拇外翻、拇外翻原因、健康专业支持和接受的教育。Hallux外翻与健康相关的生活质量的负面影响相关。参与者描述了缺乏高质量、准确可靠的教育资源,以及与卫生专业人员相处的经历参差不齐,其特点往往是缺乏参与和承诺,过于强调转诊专家意见。结论:外翻对幸福感有负面影响,包括身体、心理和社会影响。卫生专业人员应响应患者的需求,并在需要时努力实施以人为本的护理。还需要开发高质量的教育资源,帮助拇外翻患者对自己的病情做出明智的决定。
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引用次数: 0
Qualitative assessment of the impact of restricting number of drug treatments for rheumatoid arthritis: Experience of prescribers and patients. 限制类风湿性关节炎药物治疗次数影响的定性评估:处方医生和患者的经验。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1002/msc.1838
David Walker, Sandra Robinson

Introduction: In 2020, almost half of all Clinical Commissioning Groups in England were restricting the number of higher cost drugs (HCDs) that could be prescribed for Rheumatoid Arthritis (RA) before an Individual Funding Request was required. We were interested in qualitatively exploring the experiences of prescribers affected by these restrictions and the experiences of patients who required four or more of these drugs.

Methods: Semi-structured interviews were conducted with five prescribers in restricted areas and six patients from our own service who had received four or more HCDs. The interviews were analysed thematically.

Results: Prescribers reported feeling distressed and frustrated by the unsatisfactory service they were constrained to provide. Some prescribers continued partially effective treatments in order not to run out of options. They did not find Individual Funding Requests or the Blueteq High Cost Drug (HCD) System helpful in the management of these patients. The Blueteq HCD System is an electronic platform that allows health managers to monitor the prescribing of high-cost medicines and manage the complexities associated with their use. Patients expressed severe distress at the prospect of running out of options and anxiety around the process of gaining approval for their next treatment.

Conclusions: Restricting drugs for RA by the number which can be prescribed results in persistence with partially effective treatments, which is unsatisfactory for prescribers and patients, further it does not save money. Patients need to travel in their journey with RA and be able to try the next drug even though they know that it may not work.

引言:2020年,在需要个人资金申请之前,英格兰几乎一半的临床调试小组都在限制治疗类风湿性关节炎(RA)的高成本药物(HCD)的数量。我们感兴趣的是定性地探索受这些限制影响的处方医生的经历,以及需要四种或四种以上这些药物的患者的经历。方法:对五名限制区的处方医生和六名接受过四次或四次以上HCD的患者进行半结构化访谈。访谈按主题进行了分析。结果:处方医生报告说,他们对被迫提供的不令人满意的服务感到痛苦和沮丧。一些开处方的人继续进行部分有效的治疗,以免失去选择。他们没有发现个人资助申请或Blueteq高成本药物(HCD)系统对这些患者的管理有帮助。Blueteq HCD系统是一个电子平台,允许卫生管理人员监控高成本药物的处方,并管理与使用相关的复杂性。患者对下一次治疗获得批准的过程中可能会失去选择和焦虑表示严重的痛苦。结论:通过处方数量限制治疗RA的药物会导致部分有效治疗的持续性,这对处方医生和患者来说是不令人满意的,而且也不能节省资金。RA患者需要在旅途中旅行,并能够尝试下一种药物,即使他们知道它可能不起作用。
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引用次数: 0
Foot-related impairment in children with juvenile idiopathic arthritis. 幼年特发性关节炎患儿与足部有关的损伤。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-07-05 DOI: 10.1002/msc.1794
Hanene Lassoued Ferjani, Ines Cherif, Lobna Ben Ammar, Dorra Ben Nessib, Dhia Kaffel, Kaouther Maatallah, Wafa Hamdi

Aim: Foot involvement is present in approximately 60%-90% of children with Juvenile idiopathic arthritis (JIA). It is a major cause of disability, which can lead to deterioration in daily activities and quality of life. However, it is often overlooked and can compromise patient management.

Purpose: Our objective was to describe the ankle and foot involvement in JIA and to appraise the functional impact of this damage on the child's performance and quality of life by using validated scores.

Methods: The cross-sectional study included patients with JIA. Functional impairment was assessed through the Juvenile Arthritis Functionality Scale (JAFS) and the Oxford Ankle and Foot Questionnaire for children.

Results: Twenty-three patients aged 12.75 ± 3.9 and with 41 months of disease duration. After completing the Oxford score, the physical domain appeared to be the most altered. A long delay in diagnosis was associated with an alteration in the emotional domain of the Oxford score. Higher disease activity was significantly associated with impairment in both the physical activity and the footwear domains of the Oxford score. As regards clinical examination data, the presence of foot pain as well as the presence of tendinopathy were associated with an alteration of all Oxford score domains. The presence of flat feet significantly affected all domains of the Oxford score. The JAFS was reported to affect the child's performance ability and was associated with impairment in physical activity, school and play, and emotional domains.

Conclusion: Ankle and foot involvement was common in our study. Functional ability was most impaired in the lower limbs. High disease activity, foot and ankle pain, tenosynovitis, and flat feet were associated with poorer quality of life and higher functional impact.

目的:约有 60%-90% 的幼年特发性关节炎(JIA)患儿的足部受累。足部受累是致残的主要原因,可导致日常活动能力和生活质量下降。目的:我们的目的是描述 JIA 中踝关节和足部受累的情况,并通过使用有效的评分来评估这种损伤对患儿表现和生活质量的功能影响:这项横断面研究包括JIA患者。通过青少年关节炎功能量表(JAFS)和儿童牛津踝足问卷对功能障碍进行评估:23名患者的年龄为(12.75±3.9)岁,病程为41个月。在完成牛津评分后,身体领域的变化似乎最大。诊断延误时间过长与牛津评分中情感领域的改变有关。较高的疾病活动度与牛津评分中身体活动和鞋类领域的损伤有明显关联。在临床检查数据方面,足部疼痛和肌腱病变的存在与牛津评分所有领域的改变有关。扁平足的存在会明显影响牛津评分的所有项目。据报告,JAFS会影响儿童的表现能力,并与体育活动、学校和游戏以及情感方面的障碍有关:结论:在我们的研究中,踝关节和足部受累很常见。结论:在我们的研究中,踝关节和足部受累很常见,下肢功能受损最严重。高疾病活动度、足踝疼痛、腱鞘炎和扁平足与较差的生活质量和较高的功能影响有关。
{"title":"Foot-related impairment in children with juvenile idiopathic arthritis.","authors":"Hanene Lassoued Ferjani, Ines Cherif, Lobna Ben Ammar, Dorra Ben Nessib, Dhia Kaffel, Kaouther Maatallah, Wafa Hamdi","doi":"10.1002/msc.1794","DOIUrl":"10.1002/msc.1794","url":null,"abstract":"<p><strong>Aim: </strong>Foot involvement is present in approximately 60%-90% of children with Juvenile idiopathic arthritis (JIA). It is a major cause of disability, which can lead to deterioration in daily activities and quality of life. However, it is often overlooked and can compromise patient management.</p><p><strong>Purpose: </strong>Our objective was to describe the ankle and foot involvement in JIA and to appraise the functional impact of this damage on the child's performance and quality of life by using validated scores.</p><p><strong>Methods: </strong>The cross-sectional study included patients with JIA. Functional impairment was assessed through the Juvenile Arthritis Functionality Scale (JAFS) and the Oxford Ankle and Foot Questionnaire for children.</p><p><strong>Results: </strong>Twenty-three patients aged 12.75 ± 3.9 and with 41 months of disease duration. After completing the Oxford score, the physical domain appeared to be the most altered. A long delay in diagnosis was associated with an alteration in the emotional domain of the Oxford score. Higher disease activity was significantly associated with impairment in both the physical activity and the footwear domains of the Oxford score. As regards clinical examination data, the presence of foot pain as well as the presence of tendinopathy were associated with an alteration of all Oxford score domains. The presence of flat feet significantly affected all domains of the Oxford score. The JAFS was reported to affect the child's performance ability and was associated with impairment in physical activity, school and play, and emotional domains.</p><p><strong>Conclusion: </strong>Ankle and foot involvement was common in our study. Functional ability was most impaired in the lower limbs. High disease activity, foot and ankle pain, tenosynovitis, and flat feet were associated with poorer quality of life and higher functional impact.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":" ","pages":"1135-1141"},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of fatigue on people with Fibromyalgia Syndrome: A survey. 疲劳对纤维肌痛综合征患者的影响:一项调查。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-07-21 DOI: 10.1002/msc.1799
Martina McToal, Rachel Christina McVeigh, Joseph G McVeigh

Introduction: Fibromyalgia syndrome (FMS) is a common pain syndrome associated with fatigue and anxiety. The aim of this survey was to determine the impact of fatigue on the quality of life (QoL) of people with FMS and to explore the relationships between fatigue, pain, and anxiety.

Methods: A postal survey was conducted among support groups. Demographic data were collected and participants were asked to complete the Multi-dimensional Assessment of Fatigue Scale (MAF) and two visual analog scales (VAS) measuring pain and anxiety. Data were analysed using descriptive statistics, and relationships between variables were explored using Pearson's correlation coefficient and Fisher's Exact Probability Test. Ethical approval was granted from Ulster University's research ethics committee.

Results: A response rate of 52.5% was achieved (105/200). Fatigue was found to severely impact the QoL of those with FMS. From the MAF, a mean Global Fatigue Index score of 40.7 (range 1 = no fatigue-50 = severe fatigue) was calculated. Fatigue was significantly associated with both pain (r = 0.674) and anxiety (r = 0.546) (both p values < 0.0001), and no significant relationship was found between the duration of FMS and fatigue (r = 0.106; p = 0.320).

Conclusion: Fatigue has a major impact on the QoL of patients with FMS. There is a strong relationship between fatigue and other variables such as pain and anxiety. However, there is no relationship between the time since diagnosis and fatigue experienced. Fatigue management should feature highly in any treatment programme for those with FMS.

简介:纤维肌痛综合征(FMS)是一种常见的与疲劳和焦虑相关的疼痛综合征。本调查的目的是确定疲劳对FMS患者生活质量(QoL)的影响,并探讨疲劳、疼痛和焦虑之间的关系。方法:在支持团体中进行邮寄调查。收集人口统计学数据,要求参与者完成疲劳多维评估量表(MAF)和两个测量疼痛和焦虑的视觉模拟量表(VAS)。使用描述性统计分析数据,并使用Pearson相关系数和Fisher精确概率检验探索变量之间的关系。阿尔斯特大学的研究伦理委员会授予了伦理批准。结果:有效率为52.5%(105/200)。疲劳严重影响FMS患者的生活质量。根据MAF,计算出平均全球疲劳指数得分40.7(范围1=无疲劳-50=严重疲劳)。疲劳与疼痛(r=0.674)和焦虑(r=0.546)显著相关(两个p值)结论:疲劳对FMS患者的生活质量有很大影响。疲劳与疼痛和焦虑等其他变量之间有很强的关系。然而,自诊断以来的时间与经历的疲劳之间没有关系。疲劳管理应在FMS患者的任何治疗方案中占有重要地位。
{"title":"The impact of fatigue on people with Fibromyalgia Syndrome: A survey.","authors":"Martina McToal, Rachel Christina McVeigh, Joseph G McVeigh","doi":"10.1002/msc.1799","DOIUrl":"10.1002/msc.1799","url":null,"abstract":"<p><strong>Introduction: </strong>Fibromyalgia syndrome (FMS) is a common pain syndrome associated with fatigue and anxiety. The aim of this survey was to determine the impact of fatigue on the quality of life (QoL) of people with FMS and to explore the relationships between fatigue, pain, and anxiety.</p><p><strong>Methods: </strong>A postal survey was conducted among support groups. Demographic data were collected and participants were asked to complete the Multi-dimensional Assessment of Fatigue Scale (MAF) and two visual analog scales (VAS) measuring pain and anxiety. Data were analysed using descriptive statistics, and relationships between variables were explored using Pearson's correlation coefficient and Fisher's Exact Probability Test. Ethical approval was granted from Ulster University's research ethics committee.</p><p><strong>Results: </strong>A response rate of 52.5% was achieved (105/200). Fatigue was found to severely impact the QoL of those with FMS. From the MAF, a mean Global Fatigue Index score of 40.7 (range 1 = no fatigue-50 = severe fatigue) was calculated. Fatigue was significantly associated with both pain (r = 0.674) and anxiety (r = 0.546) (both p values < 0.0001), and no significant relationship was found between the duration of FMS and fatigue (r = 0.106; p = 0.320).</p><p><strong>Conclusion: </strong>Fatigue has a major impact on the QoL of patients with FMS. There is a strong relationship between fatigue and other variables such as pain and anxiety. However, there is no relationship between the time since diagnosis and fatigue experienced. Fatigue management should feature highly in any treatment programme for those with FMS.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":" ","pages":"1175-1181"},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sitting may increase risk for radiographic incidence and progression of knee osteoarthritis over 2 years: Data from a large cohort study. 一项大型队列研究的数据显示,久坐可能会增加2年以上膝骨关节炎的影像学发病率和进展风险。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-05-30 DOI: 10.1002/msc.1786
Dana Voinier, Tuhina Neogi, Hiral Master, Louise M Thoma, Meredith Brunette, Jason Jakiela, Joshua J Stefanik, Daniel K White

Objectives: To examine the association of leisure-time sitting with radiographic incidence and progression of knee osteoarthritis (OA) over 2 years, and to determine whether worktime sitting modifies this association.

Methods: We included adults with or at high risk for knee OA who enroled in the Osteoarthritis Initiative (OAI). Participants reported leisure-time sitting (≤4 vs. >4 h/day) and worktime sitting (frequent vs. infrequent) at enrolment, and had bilateral knee radiographs at enrolment and 2 years later. Our outcome, radiographic knee OA incidence/progression (yes/no), was defined as any increase in Kellgren-Lawrence grade over 2 years. We examined the association of leisure-time sitting (≤4 vs. >4 h/day) with risk of radiographic knee OA incidence/progression using binary linear regression, adjusting for potential confounders. We stratified by worktime sitting (frequent vs. infrequent) and repeated our analysis.

Results: We included 4254 adults (mean age 61 years; 58% women; mean body mass index 29 kg/m2 ) who contributed a total of 8127 knees. Adults with >4 h/day of leisure-time sitting had 25% higher risk (adjusted risk ratio [RR] 1.25, 95% confidence interval [95% CI] 1.08-1.50) for radiographic knee OA incidence/progression compared with adults with ≤4 h/day of leisure-time sitting (referent group). Importantly, this association was intensified (RR 1.60, 95% CI 1.19-2.33) among adults with frequent worktime sitting, but was attenuated (RR 1.11, 95% CI 0.89-1.39) among adults with infrequent worktime sitting.

Conclusions: Higher leisure-time sitting (>4 h/day) may be associated with greater risk for radiographic knee OA incidence/progression over 2 years. Furthermore, this association was intensified among adults who also reported frequent worktime sitting.

目的:研究休闲时间久坐与2年以上膝骨关节炎(OA)的放射学发病率和进展之间的关系,并确定工作时间久坐是否改变了这种关系。方法:我们纳入了参加骨关节炎倡议(OAI)的患有或有膝关节OA高风险的成年人。参与者在入组时报告了休闲时间坐着(≤4小时/天vs >4小时/天)和工作时间坐着(频繁vs不频繁),并在入组时和2年后进行了双侧膝关节x线片检查。我们的结果,膝关节OA的放射学发病率/进展(是/否),被定义为2年内kelgren - lawrence分级的任何增加。我们使用二元线性回归检查了休闲时间坐着(≤4小时vs >4小时/天)与膝关节OA放射学发病率/进展风险的关系,并调整了潜在的混杂因素。我们根据工作时间坐着(频繁与不频繁)进行了分层,并重复了我们的分析。结果:我们纳入了4254名成人(平均年龄61岁;58%的女性;平均身体质量指数29 kg/m2)者共贡献8127个膝关节。与休闲时间坐着≤4小时/天的成年人(参照组)相比,休闲时间坐着>4小时/天的成年人膝关节炎的放射学发病率/进展风险增加25%(调整风险比[RR] 1.25, 95%可信区间[95% CI] 1.08-1.50)。重要的是,在工作时间经常坐着的成年人中,这种关联增强(RR 1.60, 95% CI 1.19-2.33),但在工作时间不经常坐着的成年人中,这种关联减弱(RR 1.11, 95% CI 0.89-1.39)。结论:休闲时间久坐(>4小时/天)可能与2年内膝关节骨性关节炎发病率/进展的更高风险相关。此外,这种关联在工作时间经常坐着的成年人中更为明显。
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引用次数: 0
Goal setting in physiotherapy-led adult musculoskeletal care: A scoping review. 以物理治疗为主导的成人肌肉骨骼护理中的目标设定:范围综述。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-08-28 DOI: 10.1002/msc.1803
Jonathan Gayton, Aastha Monga

Introduction: Goal setting is a key part of rehabilitation across various fields of physiotherapy. It is less clear what evidence exists to underpin its effectiveness and to practically guide its use within musculoskeletal physiotherapy.

Objectives: This scoping review provides an overview of current research regarding goal setting in adult physiotherapy-led musculoskeletal care with three aims: 1) to identify and analyse any gaps in the literature, 2) to identify relevant features of goal setting theory and 3) to make recommendations for future research. The principal research question was what does the literature tell us about the role of goal setting for adults over the age of 18 with musculoskeletal pain accessing outpatient physiotherapy services?

Inclusion criteria: The population, concept and context framework was used to define the inclusion criteria. Key definitions were adults over the age of 18 with musculoskeletal conditions, goal setting, and physiotherapy-led interventions.

Methods: This scoping review followed the guidance set out by the Joanna Briggs Institute Manual for Evidence Synthesis. Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, MEDLINE, American Psychological Association PsycInfo and the Cochrane Database of Systematic Reviews, Protocols and Trials were searched using pre-defined search criteria. Data were extracted from screened full-text articles and presented in basic statistical and narrative form.

Results: 41 articles were included in the review. Several broad themes and research methods were identified. The nature of the studies suggested that the clinical application of goal setting is complex and the depth of understanding is limited. Most studies suggested that goal setting is feasible and has a positive impact on outcomes. A common finding was a lack of clear definitions regarding goal setting terminology and approaches. Study samples were generally defined by biomedical categories, suggesting a pathoanatomical approach to researching a cognitive construct. Theoretical underpinning was lacking in many studies. No frameworks guiding goal setting in physiotherapy-led musculoskeletal rehabilitation have been identified.

Conclusions: Goal setting is a popular tool within musculoskeletal outpatient physiotherapy. Further research is required to clarify its efficacy and provide guidance on its role and application in clinical practice.

介绍:目标设定是物理治疗各个领域中康复治疗的关键部分。目前尚不清楚有哪些证据可以证明其有效性,并实际指导其在肌肉骨骼物理治疗中的应用:本范围界定综述概述了当前在以物理治疗为主导的成人肌肉骨骼治疗中有关目标设定的研究,其目的有三个:1) 识别并分析文献中的任何空白,2) 识别目标设定理论的相关特征,3) 为未来研究提出建议。主要的研究问题是:对于18岁以上患有肌肉骨骼疼痛并在门诊接受物理治疗服务的成年人来说,目标设定的作用从文献中可以看出什么?采用人群、概念和背景框架来定义纳入标准。关键定义包括:18 岁以上患有肌肉骨骼疾病的成年人、目标设定以及物理治疗主导的干预措施:本次范围界定审查遵循了乔安娜-布里格斯研究所的《证据综合手册》。采用预先定义的检索标准,对联合与补充医学数据库、护理与联合健康文献全文累积索引、MEDLINE、美国心理学会 PsycInfo 和 Cochrane 系统性综述、协议与试验数据库进行了检索。从筛选出的全文文章中提取数据,并以基本统计和叙述的形式呈现:结果:41 篇文章被纳入综述。确定了几个广泛的主题和研究方法。研究的性质表明,目标设定的临床应用是复杂的,理解的深度也是有限的。大多数研究表明,目标设定是可行的,并对结果产生积极影响。一个共同的发现是缺乏关于目标设定术语和方法的明确定义。研究样本一般按照生物医学类别进行定义,这表明研究认知结构时采用了病理解剖学方法。许多研究缺乏理论依据。在物理治疗主导的肌肉骨骼康复中,尚未发现指导目标设定的框架:结论:目标设定是肌肉骨骼门诊物理治疗中的一种常用工具。需要进一步研究以明确其功效,并为其在临床实践中的作用和应用提供指导。
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引用次数: 0
Perspectives on chronic musculoskeletal pain management among healthcare professionals in Bhutan: A qualitative study. 不丹医护人员对慢性肌肉骨骼疼痛管理的看法:定性研究。
IF 1.3 Q3 RHEUMATOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-14 DOI: 10.1002/msc.1821
Monu Tamang, Nidup Dorji, Kuenzang Wangdi, Zimba Letho, Karma Lhaki, Thinley Dorji

Introduction: Musculoskeletal pain disorders continue to be one of the leading causes of disability worldwide. Best practice care recommends patient-centred biopsychosocial models of care. Little is known about the chronic musculoskeletal pain management in low- and middle-income countries.

Objectives: To explore the management of chronic musculoskeletal pain by healthcare professionals in Bhutan.

Methods: This study employed a qualitative design involving 19 Bhutanese healthcare professionals managing chronic musculoskeletal pain in Bhutan. We collected data using a semi-structured interview guide. Thematic analysis was done manually.

Results: Healthcare professionals reported that patients rely on a combination of home remedies and seek help from local healers and hospitals for chronic musculoskeletal pain management. While healthcare professionals understand chronic musculoskeletal pain as multi-dimensional phenomenon, the primary focus was on identifying and treating structural anomalies. Time constraints, inadequate knowledge and skills, lack of confidence, facilities and expertise were reported as barriers to the effective management of chronic musculoskeletal pain. They proposed a need for clinical guidelines, relevant skills training and creating awareness of chronic musculoskeletal pain.

Conclusion: The management of chronic musculoskeletal pain in Bhutan is focused on identifying and treating physical abnormalities. Healthcare professionals consider psychosocial dimensions important but lack any form of actionable interventions in this domain.

导言:肌肉骨骼疼痛疾病仍然是导致全球残疾的主要原因之一。最佳护理实践建议采用以患者为中心的生物-心理-社会护理模式。在低收入和中等收入国家,人们对慢性肌肉骨骼疼痛的管理知之甚少:探讨不丹医护人员对慢性肌肉骨骼疼痛的管理:本研究采用定性设计,涉及 19 名在不丹管理慢性肌肉骨骼疼痛的不丹医护人员。我们使用半结构化访谈指南收集数据。结果:医护人员报告说,患者依赖的是 "治疗",而不是 "护理":医护人员报告称,患者在治疗慢性肌肉骨骼疼痛时,既依赖家庭疗法,也寻求当地医护人员和医院的帮助。虽然医护人员认为慢性肌肉骨骼疼痛是一种多维现象,但他们主要关注的是识别和治疗结构异常。据报告,时间限制、知识和技能不足、缺乏信心、设施和专业知识是有效治疗慢性肌肉骨骼疼痛的障碍。他们认为有必要制定临床指南、开展相关技能培训并提高人们对慢性肌肉骨骼疼痛的认识:结论:在不丹,慢性肌肉骨骼疼痛的管理重点在于识别和治疗身体异常。医疗保健专业人员认为社会心理层面非常重要,但在这一领域缺乏任何形式的可行干预措施。
{"title":"Perspectives on chronic musculoskeletal pain management among healthcare professionals in Bhutan: A qualitative study.","authors":"Monu Tamang, Nidup Dorji, Kuenzang Wangdi, Zimba Letho, Karma Lhaki, Thinley Dorji","doi":"10.1002/msc.1821","DOIUrl":"10.1002/msc.1821","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal pain disorders continue to be one of the leading causes of disability worldwide. Best practice care recommends patient-centred biopsychosocial models of care. Little is known about the chronic musculoskeletal pain management in low- and middle-income countries.</p><p><strong>Objectives: </strong>To explore the management of chronic musculoskeletal pain by healthcare professionals in Bhutan.</p><p><strong>Methods: </strong>This study employed a qualitative design involving 19 Bhutanese healthcare professionals managing chronic musculoskeletal pain in Bhutan. We collected data using a semi-structured interview guide. Thematic analysis was done manually.</p><p><strong>Results: </strong>Healthcare professionals reported that patients rely on a combination of home remedies and seek help from local healers and hospitals for chronic musculoskeletal pain management. While healthcare professionals understand chronic musculoskeletal pain as multi-dimensional phenomenon, the primary focus was on identifying and treating structural anomalies. Time constraints, inadequate knowledge and skills, lack of confidence, facilities and expertise were reported as barriers to the effective management of chronic musculoskeletal pain. They proposed a need for clinical guidelines, relevant skills training and creating awareness of chronic musculoskeletal pain.</p><p><strong>Conclusion: </strong>The management of chronic musculoskeletal pain in Bhutan is focused on identifying and treating physical abnormalities. Healthcare professionals consider psychosocial dimensions important but lack any form of actionable interventions in this domain.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":" ","pages":"1401-1411"},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10230517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Musculoskeletal Care
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