Journal of Orthopaedic & Sports Physical Therapy最新文献

Letter to the Editor-in-Chief in response to JOSPT article "Heel Pain - Plantar Fasciitis: Revision 2023" by Koc et al. J Orthop Sports Phys Ther 2025;55(1):72-73. doi:10.2519/jospt.2025.0202.

SYNOPSIS: To improve the potential for sustained success when implementing injury prevention programs, researchers must focus on patient and public involvement and engagement. Creating lasting equitable relationships between researchers and knowledge users (ie, improving patient and public involvement and engagement) takes time and purposeful investment. Researchers must prioritize, embrace, and integrate patient and public involvement and engagement as a dynamic and continuous social process, unique to each community setting; it is not a one-off checkbox. Recognizing that knowledge users across disciplines and settings are not passive scientific consumers, but active knowledge creators, begins the process of developing equitable partnerships. In this editorial, we highlight the importance of (1) equity in sport and orthopaedic medicine, (2) prioritizing patient and public involvement and engagement at all stages of the research process, and (3) focusing on a knowledge user-centered perspective when designing, analyzing, implementing, and subsequently evaluating musculoskeletal injury prevention programs. J Orthop Sports Phys Ther 2024;54(12):1-5. doi:10.2519/jospt.2024.12668.

Letter to the Editor-in-Chief in response to JOSPT article "Which Portion of Physiotherapy Treatments' Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-analysis of Randomized Placebo-Controlled Trials" by Ezzatvar et al J Orthop Sports Phys Ther 2024;54(12):1-2. doi:10.2519/jospt.2024.0201.

OBJECTIVE: To summarize the effectiveness of eHealth interventions for improving pain, physical disability, psychological factors, and the quality of life for people with spine pain. DESIGN: Overview of systematic reviews. LITERATURE SEARCH: CINAHL, Embase, PubMed, and SPORTDiscus e-databases were searched. STUDY SELECTION CRITERIA: Systematic reviews with meta-analysis of randomized clinical trials evaluating any type of eHealth were included. DATA SYNTHESIS: AMSTAR 2 was used to assess the methodological quality of included reviews. The degree of overlap between reviews was calculated. RESULTS: Sixteen systematic reviews were included. Of them, 13 reviews were exclusively focused on back pain or low back pain. Exercise and psychological interventions were the primary contents of eHealth interventions. In general, eHealth interventions based on physical exercise may improve the quality of life of people with low back pain. eHealth interventions based on cognitive behavioral therapy may reduce pain catastrophizing and fear-avoidance beliefs for physical activity for people with low back pain. eHealth interventions based on multidisciplinary approaches including physical exercise may reduce low back pain. Few systematic reviews used the GRADE system to evaluate the certainty of evidence, and few specified the content of eHealth interventions. CONCLUSION: eHealth interventions may improve the quality of life, pain catastrophizing, and fear-avoidance beliefs for people with low back pain. It is unclear, based on available systematic reviews, how clinicians should deliver eHealth interventions for people with spine pain (eg, neck pain or low back pain). J Orthop Sports Phys Ther 2024;54(12):1-18. Epub 4 November 2024. doi:10.2519/jospt.2024.12844.

Author response to the JOSPT Letter to the Editor-in-Chief "Comment on "Which Portion of Physiotherapy Treatments' Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-Analysis of Randomized Placebo-Controlled Trials" by Ezzatvar et al" J Orthop Sports Phys Ther 2024;54(12):1-2. doi:10.2519/jospt.2024.0201-R.

The Academy of Orthopaedic Physical Therapy (AOPT) has an ongoing effort to create evidence-based clinical practice guidelines (CPG) for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The 2024 Achilles Pain, Stiffness, and Muscle Power Deficit: Midportion Achilles Tendinopathy Clinical Practice Guideline (CPG) is a revision of the 2018 CPG and represents the third CPG from AOPT on this topic. The goals of the revision were to provide a concise summary of the contemporary evidence and to develop new recommendations or revise previously published recommendations to support evidence-based practice. This current CPG covers prevalence, pathoanatomical features, risk factors, clinical course, diagnosis, examination, imaging, and physical therapy interventions for the management of midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2024;54(12):CPG1-CPG32. Epub 27 November 2024. doi:10.2519/jospt.2024.0302.

OBJECTIVES: To (1) estimate the economic cost of disabling musculoskeletal pain in children and adolescents from a health care and societal perspective, (2) identify the characteristics of children and adolescents with higher costs, and (3) estimate the economic cost of children's pain to Brazil. DESIGN: Prospective cohort study. METHODS: We recruited children and adolescents with disabling musculoskeletal pain from public and private schools. The economic cost associated with disabling musculoskeletal pain was reported by parents each month for 1 year. The cost categories were health care, lost productivity, and patient/family costs. The sum of the categories resulted in the societal costs. Costs were reported using means, standard errors, medians, interquartile ranges, confidence intervals, and sum for each cost category. We compared participant characteristics between groups with low and high costs, and estimated the health and social cost of children's pain to the Brazilian federal budget. RESULTS: We included 237 children and adolescents with mean age of 11.8 years (standard deviation, 2.9). Total annual health care costs were $29.58 and $103.13 for health insurance/public health care and out-of-pocket, respectively, per child. Total annual societal costs were $177.62 per child. Individuals in low socioeconomic class E (with a monthly income of up to R$403.00) reported that heavy backpack weight, practice of fewer days of sports, and more negative psychosomatic symptoms were associated with higher health care costs. The annual costs to Brazil from the societal perspective was $1 001 329 553. CONCLUSION: Disabling musculoskeletal pain in children and adolescents in Brazil imposes a serious economic burden of up to $1 billion on the federal budget. J Orthop Sports Phys Ther 2024;54(12):1-10. Epub 4 November 2024. doi:10.2519/jospt.2024.12735.

OBJECTIVE: To examine whether there was a racial disparity among Medicare beneficiaries in the likelihood of using outpatient physical therapy (PT) services following a hip fracture. METHODS: Our retrospective descriptive cohort study analyzed administrative claims data for 51 781 Medicare beneficiaries post hip fracture. We examined the association between race and PT use within the first 6 months post fracture using hierarchical logistic regression, adjusting for demographics, medical complexity, and socioeconomic factors. We used Poisson regression to examine the association between race and the number of PT visits. RESULTS: Only 31% of beneficiaries used outpatient PT after hip fracture with significant racial disparities. After controlling for demographics, medical complexity, and socioeconomic factors, Black beneficiaries had 42% lower odds of using PT (adjusted odds ratio [aOR], 0.58; 95% confidence interval [CI]: 0.51, 0.66) compared to White beneficiaries. Among PT users, Black beneficiaries received fewer visits than White beneficiaries (rate ratio [RR], 0.85; 95% CI: 0.82, 0.88) with this disparity persisting after adjustments (RR, 0.88; 95% CI: 0.85, 0.91). CONCLUSION: Even after adjusting for demographic, medical, and socioeconomic factors, Black beneficiaries were less likely to use outpatient PT following hip fractures. Conditional on an initial PT evaluation, Black beneficiaries received fewer sessions. J Orthop Sports Phys Ther 2024;54(12):1-7. Epub 9 October 2024. 10.2519/jospt.2024.12641.

OBJECTIVES: To (1) summarize pooled prevalence and incidence rates of concussion by type of sport and (2) synthesize the differences in prevalence or incidence rates of concussion by type of sports in terms of sex, age, type of session, and level of competition. DESIGN: An overview of systematic reviews with meta-analysis. LITERATURE SEARCH: CINAHL, Embase, Epistemonikos, PubMed, Scopus, SPORTDiscus, and the Cochrane Library databases were searched. STUDY SELECTION CRITERIA: Systematic reviews with meta-analyses reporting pooled incidence or prevalence of sport-related concussion. DATA SYNTHESIS: AMSTAR 2 was used to assess the methodological quality of reviews. Overlap between reviews was calculated. RESULTS: Ten systematic reviews with meta-analysis were included, all evaluating incidence rates of concussion. There were no meta-analyses of concussion prevalence. Concussions seem to have a higher incidence in rugby, snowboarding, ice hockey, and American football. In reviews that explored sex-based differences across subgroups, there was a higher incidence rate of concussion in baseball-softball, basketball, and soccer in females compared to males. There were no age subgroups analyzed. The incidence of concussions was higher during games compared to practice in American football, ice hockey, rugby, and soccer. Amateur rugby had higher concussion rates compared to professional rugby. CONCLUSIONS: Rugby, snowboarding, ice hockey, and American football had the highest incidence rate of concussion when no other differences (eg, type of session) were considered. However, important methodological flaws were detected, such as the lack of use of the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system and subgroups for specific factors (eg, age groups). J Orthop Sports Phys Ther 2024;54(11):1-9. Epub 15 October 2024. doi:10.2519/jospt.2024.12677.

OBJECTIVES: To identify baseline characteristics that modified the effect of a 12-week quadriceps-focused (QE) vs hip muscle-focused (HE) exercise program on symptoms and physical function, through changes at baseline in the Anterior Knee Pain Scale (AKPS) in patients with PFP. DESIGN: A secondary analysis of a 26-week randomized trial involving 200 participants with patellofemoral pain. METHODS: Participants were randomly assigned to a QE or HE program with a duration of 12 weeks. The primary outcome was change from baseline in the AKPS at week 12 and week 26. Subgroups were predefined and based on baseline information: presence of low back, hip, ankle, or bilateral knee pain; body mass index (BMI); sex; age; education; occupation; hypermobility; quadriceps strength; dynamic knee alignment; midfoot mobility; exercise self-efficacy; pain self-efficacy; pain catastrophizing; neuropathic pain; pain duration; and pain severity. RESULTS: Participants with pain catastrophizing seemed to benefit from HE with a subgroup difference in treatment effect of 8.3 AKPS points at week 12 (95%CI 1.6 to 15.0). At week 26, participants with a baseline BMI above 25 seemed to benefit from HE with a subgroup difference in treatment effect of 11.1 (95%CI 4.8 to 17.4), and participants with severe knee pain at baseline seemed to benefit from QE with a subgroup difference of -9.1 (95% CI: -15.7, -2.6). CONCLUSION: Hip-focused exercises may provide more benefits than quadriceps-focused exercises among patients with patellofemoral pain and pain catastrophizing or overweight. Quadriceps-focused exercises may provide more benefits than hip-focused exercises for patients with severe knee pain. J Orthop Sports Phys Ther 2024;54(11):1-11. Epub 09 September 2024. doi:10.2519/jospt.2024.12503.