Musculoskeletal Science and Practice最新文献_第2页

Health-seeking behaviour in adults with musculoskeletal conditions: A scoping review 成人肌肉骨骼疾病患者的健康寻求行为：范围综述

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2026-01-14 DOI: 10.1016/j.msksp.2026.103499

Susan Greenhalgh , Melika Ghorbankhani , Gillian Yeowell

Background

Musculoskeletal conditions, such as osteoarthritis and low back pain, are among the leading causes of disability worldwide. Individuals often delay or avoid seeking healthcare due to personal, social, and systemic factors. Existing research on health-seeking behaviour is fragmented and lacks synthesis across diverse contexts and populations.

Objective

This scoping review systematically maps the literature on health-seeking behaviour in adults with musculoskeletal conditions, highlighting knowledge gaps and generating insights for future research, clinical practice, and policy.

Methods

A scoping review was conducted following the Joanna Briggs Institute methodology. Six electronic databases and relevant grey literature sources were systematically searched. Eligible studies focusing on adults with musculoskeletal conditions were screened and analysed using narrative synthesis. Findings were organised into thematic tables and illustrated through a conceptual framework.

Results

Twenty-three studies published between 2004 and 2025 were included, representing a diverse range of geographic and socioeconomic contexts. Five key themes were identified: Clinical and Functional Need; Socioeconomic and Environmental Context; Cultural and Social Context; Healthcare System and Provider Experiences; and Use of Alternative and Digital Care Options.

Conclusion

This review identifies five key themes connecting clinical, socioeconomic, cultural, and systemic factors in adults with musculoskeletal conditions. Highlighting patient agency, it informs research, policy, and practice aimed at delivering more equitable and responsive musculoskeletal care.

骨关节炎和腰痛等肌肉骨骼疾病是全球致残的主要原因之一。由于个人、社会和系统因素，个人经常延迟或避免寻求医疗保健。关于求医行为的现有研究是零散的，缺乏对不同背景和人群的综合。目的：本综述系统地绘制了有关成人肌肉骨骼疾病患者寻求健康行为的文献，突出了知识差距，并为未来的研究、临床实践和政策提供了见解。方法根据乔安娜布里格斯研究所的方法进行范围审查。系统检索6个电子数据库和相关灰色文献来源。针对成人肌肉骨骼疾病的合格研究进行筛选，并使用叙事综合方法进行分析。调查结果被组织成专题表格，并通过概念框架加以说明。结果纳入了2004年至2025年间发表的23项研究，代表了不同的地理和社会经济背景。确定了五个关键主题：临床和功能需求；社会经济和环境背景；文化和社会背景；医疗保健系统和提供者经验；以及替代性和数字化护理方案的使用。结论：本综述确定了与成人肌肉骨骼疾病相关的临床、社会经济、文化和系统因素的五个关键主题。强调患者代理，它为研究、政策和实践提供信息，旨在提供更公平和反应灵敏的肌肉骨骼护理。

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引用次数: 0

The representation of individuals from ethnically minoritised groups in pain science education randomised controlled trials: a scoping review 疼痛科学教育随机对照试验中少数民族个体的代表性：范围审查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2025-12-08 DOI: 10.1016/j.msksp.2025.103466

J. Pun , J. Franklin , S. Browne , J. Mankelow , A. Mardon , J. Watson , H.B. Leake , C.G. Ryan

Background

Pain science education seeks to improve an individual's understanding of their pain, and thus improve outcomes. It has been primarily developed and tested within western cultures. The extent and nature of ethnically minoritised group involvement in pain science education trials is unknown.

Objective

This scoping review aimed to investigate the level of representation of people from ethnically minoritised groups in pain science education randomised controlled trials.

Methods

This scoping review follows Joanna Briggs Institute guidelines and is reported in line with PRISMA-SCR guidelines. The following search engines were reviewed: CINAHL, EMBASE, MEDLINE, AMED and APA PSYCArticles. Eligible studies were randomised controlled trials involving people with chronic pain who had received pain science education as a focused intervention. The two stage study selection process and data extraction were completed by independent reviewers. Data is presented to quantify ethnically minoritised representation.

Results

Sixty-two studies were included in the review, totaling 4685 participants. Nineteen studies reported on ethnicity, ten included no participants from minoritised groups, whilst nine included ethnically minoritised participants ranging from 3 to 29 %.

Conclusion

Overall, this review identified that participant ethnicity is not commonly reported in pain science education randomised controlled trials, which highlights an urgent need for better reporting. Where data on ethnicity was reported, ethnically minoritised groups were largely under-represented, raising questions about the generalisability of existing evidence, and underscoring the need for more inclusive and representative research practices in pain science education trials.

疼痛科学教育旨在提高个人对疼痛的理解，从而改善治疗效果。它主要是在西方文化中发展和测试的。少数民族群体参与疼痛科学教育试验的程度和性质尚不清楚。目的本综述旨在调查少数民族在疼痛科学教育随机对照试验中的代表性水平。方法本综述遵循乔安娜布里格斯研究所的指南，并根据PRISMA-SCR指南进行报道。本文综述了以下几个搜索引擎：CINAHL、EMBASE、MEDLINE、AMED和APA PSYCArticles。符合条件的研究是随机对照试验，涉及接受疼痛科学教育作为重点干预的慢性疼痛患者。两个阶段的研究选择过程和数据提取由独立审稿人完成。提供数据是为了量化少数民族的代表性。结果纳入62项研究，共4685名受试者。19项研究报告了种族，10项研究没有少数民族参与者，而9项研究包括少数民族参与者，范围从3%到29% %。结论：总体而言，本综述发现疼痛科学教育随机对照试验中参与者种族的报道并不普遍，这表明迫切需要更好的报道。在种族数据报告中，少数族裔群体的代表性不足，这引发了对现有证据的普遍性的质疑，并强调了在疼痛科学教育试验中需要更具包容性和代表性的研究实践。

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引用次数: 0

Association between pain catastrophizing and sarcopenia in patients with knee osteoarthritis: A cross-sectional study 膝关节骨关节炎患者疼痛突变与肌肉减少症之间的关系：一项横断面研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.msksp.2026.103506

Qingzhao Liang , Guangyuan Dong , Nanyan Li , Mengchao He , Shiqi Gong , Lei Shi

Background

Sarcopenia and pain catastrophizing(PC) are prevalent physiological and psychological comorbidities in knee osteoarthritis(KOA). They may collectively burden patients' quality of life. Nevertheless, their potential association remains inadequately explored.

Objectives

To explore the association between PC and sarcopenia in KOA patients, adjusting for demographic, lifestyle, and disease-related covariates (e.g., sex, BMI, affected site, disease duration, physical activity and other relevant factors.) To examine whether this association varies across subgroups defined by age and sedentary behavior.

Design

Cross-sectional study.

Methods

This study recruited 390 KOA patients aged ≥45 years from orthopedic surgery departments. PC was assessed using the PC scale. Sarcopenia was defined by concurrent low muscle mass and muscle strength, measured via bioelectrical impedance analysis and electronic handgrip dynamometry. Logistic regression was used to describe the relationship between PC and sarcopenia, adjusting for covariates.

Results

Among the patients, 24.9 % were diagnosed with sarcopenia and 21.5 % with PC, with 10.3 % had both. Adjusted analyses showed PC was independently associated with sarcopenia (OR = 1.036; 95 % CI: 1.012, 1.061; P = 0.003). Subgroup analyses revealed stronger associations in patients aged 60–69 years (aOR = 1.036; 95 % CI: 1.001, 1.073; P = 0.045), those aged ≥70 years (aOR = 1.095; 95 % CI: 1.050, 1.143; P < 0.001), and individuals with prolonged sedentary time (aOR = 1.051; 95 % CI: 1.016, 1.086; P = 0.004).

Conclusions

PC was significantly associated with higher odds of sarcopenia in KOA patients, and this association was stronger in older individuals and those with prolonged sedentary behavior. Comprehensive management of elderly KOA patients should address both psychological and physical comorbidities.

背景：骨骼肌减少症和疼痛灾难性化（PC）是膝关节骨性关节炎（KOA）常见的生理和心理合并症。它们可能共同加重患者的生活质量。然而，它们之间的潜在联系仍未得到充分探讨。目的：在调整人口统计学、生活方式和疾病相关协变量（如性别、BMI、发病部位、病程、体力活动等相关因素）后，探讨KOA患者PC与肌肉减少症之间的关系。为了检验这种关联是否在年龄和久坐行为定义的亚组中有所不同。设计：横断面研究。方法：本研究从骨科招募年龄≥45岁的KOA患者390例。PC采用PC量表进行评估。肌肉减少症的定义是肌肉质量和肌肉力量同时降低，通过生物电阻抗分析和电子握力测量来测量。逻辑回归用于描述PC和肌肉减少症之间的关系，调整协变量。结果：24.9%的患者被诊断为肌肉减少症，21.5%的患者被诊断为PC， 10.3%的患者两者兼有。校正分析显示PC与肌肉减少症独立相关（OR = 1.036; 95% CI: 1.012, 1.061; P = 0.003）。亚组分析显示60-69岁患者（aOR = 1.036; 95% CI: 1.001, 1.073; P = 0.045）和≥70岁患者（aOR = 1.095; 95% CI: 1.050, 1.143； P）的相关性更强。结论：PC与KOA患者中较高的肌少症发生率显著相关，且这种相关性在老年人和久坐行为者中更强。老年KOA患者的综合管理应兼顾心理和生理合并症。

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引用次数: 0

Psychosocial assessment in musculoskeletal care: A survey of UK physiotherapists 社会心理评估在肌肉骨骼护理：英国物理治疗师的调查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2025-12-30 DOI: 10.1016/j.msksp.2025.103485

Michael Henning , Shea Palmer , Nicola Walsh

Background

Psychosocial factors strongly influence musculoskeletal (MSK) outcomes, yet their systematic assessment remains inconsistent in physiotherapy practice. Although validated psychosocial assessment tools exist, little is known about how UK MSK physiotherapists use them.

Objective

To explore UK physiotherapists’ perceptions, practices, and confidence regarding psychosocial assessment, and to identify key challenges and facilitators.

Design

Cross-sectional online survey.

Methods

An anonymous online questionnaire was distributed via professional networks and social media to qualified UK-based MSK physiotherapists. Questions focused on demographics, perceptions, practices, and challenges/facilitators regarding psychosocial assessment. Quantitative data were analysed descriptively and using non-parametric statistics; free-text responses were examined narratively.

Results

373 physiotherapists responded, from a range of roles and experience levels. Most rated psychosocial factors as highly important and reported they often influenced treatment planning. Assessment relied mainly on clinical judgement and explicit questioning, while formal tool use was uncommon. Confidence in identifying and interpreting psychosocial factors showed moderate positive associations with screening tool use and weak or no associations with years of clinical experience. The most cited challenges to use of validated tools were time constraints, and training, whereas concise tools, electronic integration, and evidence of patient benefit were viewed as key facilitators.

Conclusions

UK MSK physiotherapists recognise the importance of psychosocial assessment, but its application in routine practice remains inconsistent and largely informal. Confidence appears to be more closely related to exposure to psychosocial screening tools than to years of clinical experience. These findings highlight the need for approaches that support consistent psychosocial assessment within routine MSK care.

背景：心理社会因素强烈影响肌肉骨骼（MSK）结果，但其系统评估在物理治疗实践中仍不一致。虽然存在有效的心理社会评估工具，但人们对英国MSK物理治疗师如何使用它们知之甚少。目的探讨英国物理治疗师对心理社会评估的看法、实践和信心，并确定主要挑战和促进因素。横断面在线调查。方法通过专业网络和社交媒体向英国合格的MSK物理治疗师发放匿名在线问卷。问题集中在人口统计，观念，实践和挑战/促进有关社会心理评估。定量数据进行描述性和非参数统计分析；以叙述的方式检查自由文本回答。结果373名物理治疗师从不同的角色和经验水平作出回应。大多数人认为社会心理因素非常重要，并报告说它们经常影响治疗计划。评估主要依靠临床判断和明确提问，而正式工具的使用并不常见。识别和解释心理社会因素的信心与筛查工具的使用有中度正相关，与临床经验的年数有微弱关联或无关联。使用经过验证的工具面临的最大挑战是时间限制和培训，而简洁的工具、电子集成和患者受益的证据被视为关键的促进因素。结论suk MSK物理治疗师认识到心理社会评估的重要性，但其在日常实践中的应用仍然不一致，而且很大程度上是非正式的。信心似乎与接触社会心理筛查工具的关系比与多年临床经验的关系更密切。这些发现强调了在常规MSK护理中支持一致的心理社会评估方法的必要性。

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引用次数: 0

Effectiveness of a corticosteroid injection versus exercise therapy for shoulder pain in general practice (SIX-Shoulder Study): A randomized controlled trial 一般情况下，皮质类固醇注射与运动疗法治疗肩痛的有效性（六肩研究）：一项随机对照试验

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2026-01-08 DOI: 10.1016/j.msksp.2026.103497

A.H.C. Versloot , D. Schiphof , R.P.G. Ottenheijm , D.A. van der Windt , M. de Graaf , J.M. van Ochten , P.J.E. Bindels , B.W. Koes , J. Runhaar

Background

Guidelines recommend a corticosteroid injection or exercise therapy for shoulder pain in primary care, but long-term comparative studies are lacking.

Objective

To examine the effectiveness of a corticosteroid injection versus physiotherapist-led exercise therapy over 12 months in patients with shoulder pain presenting in primary care.

Design

A pragmatic randomized controlled trial.

Methods

Patients with a new episode of shoulder pain were included and randomly allocated to a corticosteroid injection or 12 sessions of physiotherapist-led exercise therapy. Questionnaires were administered at baseline, 6 weeks, 3, 6, 9 and 12 months. The primary outcome was pain and function measured with the Shoulder Pain and Disability Index (SPADI) over 12 months.

Results

99 patients were included in the injection group and 101 in the exercise therapy group. Side effects were reported in 25 % of the exercise therapy group and 7 % of the injection group. At 12 months follow-up, the exercise therapy group showed a statistically significantly greater improvement of SPADI-score (mean difference = 8·5, 95 % CI = 1·2 to 15·8) compared to the injection group. This was also seen at 6 months (mean difference = 9·6, 95 % CI = 2·3 to 16·9) and 9 months (mean difference = 7·9, 95 % CI = 0·4 to 15·4). The injection group showed a statistically significantly greater improvement of SPADI-score at 6 weeks (mean difference = −7·7, 95 % CI = −14·9 to −0·6).

Conclusion

There is an indication that treatment with exercise therapy gives statistically significant better SPADI-scores over 12 months follow-up. However, wide confidence intervals indicate uncertainty in the effect estimates.

Registration

The Netherlands Trial Registry (NL-OMON52854)

背景：指南推荐在初级保健中使用皮质类固醇注射或运动治疗肩痛，但缺乏长期的比较研究。目的探讨皮质类固醇注射与物理治疗师主导的运动治疗在12个月内对在初级保健中出现肩痛的患者的有效性。设计一项实用随机对照试验。方法纳入新发肩痛患者，随机分配皮质类固醇注射组或12期物理治疗师主导的运动治疗组。在基线、6周、3、6、9和12个月时进行问卷调查。主要终点是12个月内用肩痛和残疾指数（SPADI）测量疼痛和功能。结果注射组99例，运动治疗组101例。运动治疗组和注射组的副作用发生率分别为25%和7%。随访12个月时，运动治疗组spadi评分较注射组改善有统计学意义（平均差异为8.5,95% CI = 1.2 ~ 15.8）。6个月时（平均差值= 9.6,95% CI = 2.3 ~ 16.9）和9个月时（平均差值= 7.9,95% CI = 0.4 ~ 15.4）也出现这种情况。注射组6周spadi评分改善有统计学意义（平均差异= - 7.7,95% CI = - 14.9 ~ - 0.6）。结论经12个月随访，运动疗法能显著改善spadi评分。然而，较宽的置信区间表明效应估计存在不确定性。荷兰试验注册中心（NL-OMON52854）

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引用次数: 0

Occupational risks, musculoskeletal disorders, and quality of work life: An age-based analysis 职业风险、肌肉骨骼疾病和工作生活质量：基于年龄的分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1016/j.msksp.2026.103513

Jonatan Magno Norte da Silva , Rafaela de Sá Teixeira , Lucas Gomes Miranda Bispo , Italo Rodeghiero Neto , Alexandre Henrique Silva Lisboa , Vitor William Batista Martins

Background

Work-related musculoskeletal disorders (WMSDs) are a prevalent issue, associated with a complex interaction of occupational risk factors that can be linked to lower quality of work life (QWL). While these relationships are well-established, it remains unclear how age-based differences mediate them, as younger and older workers may respond differently to various workplace hazards. Understanding these age-specific pathways is crucial for developing targeted interventions.

Objective

This study aimed to investigate the relationships between occupational risk factors, WMSDs, and QWL across different age groups to identify key differences and inform ergonomic practice.

Methods

A sample of 312 workers, divided into young (under 45 years) and older (45 years and above) groups, was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to test hypotheses linking biomechanical, psychosocial, and organizational risk factors to WMSDs and QWL.

Results

Significant differences were observed between age groups. Tight deadlines were associated with occupational stress (OS) only in older workers, whereas WMSDs were significantly associated with lower QWL only among younger workers. Physical job demands and OS were associated with WMSDs in both groups, and OS was related to their QWL. The findings indicate that worker age significantly influences how occupational risks are associated with WMSDs and QWL, and that these associations are not uniform.

Conclusion

This study validated a model that examined the relationships among occupational risk factors, WMSDs, and QWL across age groups. The model demonstrated robust psychometric properties, enabling the identification of significant differences between young and older workers.

背景：与工作相关的肌肉骨骼疾病（WMSDs）是一个普遍存在的问题，与职业风险因素的复杂相互作用有关，这些因素可能与较低的工作生活质量（QWL）有关。虽然这些关系已经确立，但目前尚不清楚年龄差异是如何调节它们的，因为年轻和年长的员工对各种工作场所危害的反应可能不同。了解这些特定年龄的途径对于制定有针对性的干预措施至关重要。目的：本研究旨在探讨不同年龄组职业危险因素、WMSDs和QWL之间的关系，找出关键差异，为人体工程学实践提供依据。方法：采用偏最小二乘结构方程模型（PLS-SEM）对312名工人进行分析，将其分为45岁以下的年轻组和45岁以上的老年组，以检验生物力学、社会心理和组织风险因素与wmsd和QWL之间的关系。结果：不同年龄组间差异有统计学意义。只有在老年员工中，紧迫的截止日期与职业压力（OS）相关，而只有在年轻员工中，WMSDs与较低的QWL显著相关。两组的体力工作需求和工作满意度与wmsd相关，工作满意度与QWL相关。研究结果表明，工人年龄显著影响职业风险与WMSDs和QWL的关系，但这些关系并不统一。结论：本研究验证了职业危险因素、WMSDs和QWL在不同年龄组之间关系的模型。该模型显示了强大的心理测量特性，能够识别年轻和年长工人之间的显著差异。

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引用次数: 0

Pressure pain sensitivity is more strongly associated with musculoskeletal pain among women and those with chronic diseases: results from a large population-based birth cohort study 在妇女和慢性病患者中，压力疼痛敏感性与肌肉骨骼疼痛的相关性更强：来自一项大型人口出生队列研究的结果

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-04-01 Epub Date: 2026-01-27 DOI: 10.1016/j.msksp.2026.103503

Eveliina Heikkala , Jaro Karppinen

Objective

Individuals affected by chronic pain often have greater pain sensitivity compared to pain-free subjects, but there is a lack of population-based evidence in this regard. The factors playing a role in this relationship are rarely examined. The aims were to evaluate 1) whether pressure pain sensitivity is associated with a) the presence of musculoskeletal (MSK) pain and b) worse pain and 2) whether sex and the presence of chronic diseases moderate these associations.

Methods

This population-based Northern Finland Birth Cohort 1966 study obtained data on pain frequency (daily, nondaily, and absent), number of pain sites (range 1–8), bothersomeness of pain (Numerical Rating Scale [NRS]-11), and intensity (NRS-11) from 5178 participants (43 % males) aged 46 born in 1966. Measured pressure pain threshold (PPT) and pressure pain tolerance (PPTol) were dichotomized as the lowest quartile vs. the other quartiles (the reference). Logistic and linear regressions with adjustments were utilized.

Results

Lower PPT and PPTol were associated with daily MSK pain only among females (adjusted odds ratio 1.26, 95 % confidence interval 1.00–1.58 for PPT; 1.29, 1.02–1.61 for PPTol). A positive relationship with bothersomeness of pain among individuals with daily or nondaily MSK pain was observed only among females. After stratification by chronic diseases, the associations between PPT/PPTol and daily MSK pain remained significant only among females with chronic diseases.

Conclusions

The associations between pressure pain sensitivity and MSK pain varied according to sex and presence of chronic diseases. However, clinical relevance of our findings can be questioned.

受慢性疼痛影响的个体通常比无疼痛的受试者具有更大的疼痛敏感性，但在这方面缺乏基于人群的证据。在这种关系中起作用的因素很少被研究。目的是评估1)压痛敏感性是否与a)肌肉骨骼（MSK）疼痛的存在和b)更严重的疼痛有关，以及2)性别和慢性疾病的存在是否会缓和这些关联。方法：这项以人群为基础的1966年芬兰北部出生队列研究获得了5178名1966年出生的46岁参与者（43%男性）的疼痛频率（日常、非日常和无疼痛）、疼痛部位数量（范围1-8）、疼痛的恼人程度（数值评定量表[NRS]-11）和强度（NRS-11）的数据。测量压力疼痛阈值（PPT）和压力疼痛耐受性（PPTol）被分为最低四分位数与其他四分位数（参考）。采用逻辑回归和线性回归进行调整。结果较低的PPT和PPTol仅在女性中与每日MSK疼痛相关（调整后的比值比为1.26，PPT的95%可信区间为1.00-1.58；PPTol的校正后比值比为1.29,1.02-1.61）。在每日或非每日MSK疼痛的个体中，仅在女性中观察到与疼痛的烦恼性呈正相关。在慢性疾病分层后，PPT/PPTol与每日MSK疼痛之间的关联仅在患有慢性疾病的女性中保持显著。结论压力疼痛敏感性与MSK疼痛的关系因性别和慢性疾病的存在而异。然而，我们的研究结果的临床相关性可能会受到质疑。

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引用次数: 0

Evaluation of temporomandibular joint and masticatory muscles in fibromyalgia: A cross-sectional ultrasonographic study. 纤维肌痛的颞下颌关节和咀嚼肌的评价：横断面超声研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-03-18 DOI: 10.1016/j.msksp.2026.103548

Ömer Kuzu, Merve Çakır, Furkan Çakır, Ayşe Merve Ata, Berke Aras

Objective: Temporomandibular joint (TMJ) and masticatory muscles, which are likely to be affected in patients with fibromyalgia (FM), have not been objectively evaluated together previously. The aim of this study was to compare sonographic measurements of TMJ and masticatory muscle thickness between FM patients and healthy controls, and to evaluate the relationship between these parameters and clinical features.

Methods: The study included 38 patients with FM and 38 healthy controls. The thickness of the masticatory muscles (masseter and temporalis) and TMJ disc space were evaluated bilaterally using ultrasonography, and the mean values of both sides were used for analysis. The severity of FM was assessed using the Fibromyalgia Impact Questionnaire (FIQ), anxiety with the Beck Anxiety Inventory, depression with the Beck Depression Inventory, sleep quality with the Pittsburgh Sleep Quality Index, and the presence and severity of temporomandibular disorder with the Fonseca Anamnestic Index.

Results: Both at rest and during maximal jaw clenching, the mean sonographic thickness of the masseter and temporalis muscles was significantly thicker in the FM group compared to the control group (all p < 0.05). The mean sonographic thickness of the closed-mouth TMJ disc space was also significantly thicker in the FM group (p < 0.05). In addition, there was a positive correlation between the masseter muscle thickness at rest and FIQ.

Conclusion: This study showed that the masticatory muscles and TMJ disc space of patients with FM were thicker compared to healthy controls, and increased masseter muscle thickness was associated with poorer quality of life.

目的：颞下颌关节（TMJ）和咀嚼肌是纤维肌痛（FM）患者最容易受到影响的两个部位，但目前尚未对这两个部位进行客观评价。本研究的目的是比较FM患者和健康对照者的TMJ和咀嚼肌厚度的超声测量，并评估这些参数与临床特征的关系。方法：选取38例FM患者和38例健康对照。采用超声检查双侧咀嚼肌（咬肌和颞肌）厚度及颞下颌关节间隙，取双侧平均值进行分析。使用纤维肌痛影响问卷（FIQ）评估FM的严重程度，使用Beck焦虑量表评估焦虑，使用Beck抑郁量表评估抑郁，使用匹兹堡睡眠质量指数评估睡眠质量，使用Fonseca记忆指数评估颞下颌障碍的存在和严重程度。结果：在休息和最大咬合时，FM组的咬肌和颞肌的平均声像图厚度明显比对照组厚（均p）。结论：FM患者的咀嚼肌和TMJ椎间盘间隙较健康对照组厚，咬肌厚度的增加与生活质量的下降有关。

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引用次数: 0

Patient expectations and therapist perceptions in low back pain care: A cross-sectional survey. 患者期望和治疗师对腰痛护理的看法：一项横断面调查。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-03-18 DOI: 10.1016/j.msksp.2026.103547

Dylan J Gibson, John H Hollman, Stephanie M Dang, Zach C Fellows, Jason C Schad, Ben E Zuercher, Darren Q Calley

Background: Low back pain is one of the most common conditions managed by physical therapists. Positive patient expectations have been associated with improved clinical outcomes; however, limited research has examined how physical therapists perceive patients' expectations at the initial consultation.

Objective: To explore patients' expectations at their initial physical therapy evaluation and compare them with physical therapists' perceptions of those expectations.

Methods: A cross-sectional survey was conducted at a large medical center in the United States. Patients and physical therapists completed an identical 10-question, 5-point Likert scale assessing expectations for initial care. Patients completed the survey prior to their first visit; therapists responded electronically. Mann-Whitney U tests were used to compare group differences.

Results: 144 patients and 22 physical therapists completed the survey. Patients most frequently rated provision of a home exercise program as "very" or "extremely important" (93%). Physical therapists assigned relatively greater importance to examination, diagnosis, and prognosis. Statistically significant differences (Bonferroni-adjusted p ≤ 0.001) reflected differing emphases between groups.

Conclusion: Patients and physical therapists assigned varying levels of importance to several components of initial low back pain care. Physical therapists tended to place relatively greater importance on examination-related elements, whereas patients emphasized receiving a home exercise program. These findings suggest that patient priorities and therapist perceptions may not always align during initial consultations. Therapists may consider directly asking patients about their expectations during the initial consultation to clarify what individuals hope to gain from the clinical encounter.

背景：腰痛是物理治疗师治疗的最常见的疾病之一。积极的患者期望与改善的临床结果相关；然而，有限的研究调查了物理治疗师如何在最初的咨询中感知患者的期望。目的：探讨患者在初始物理治疗评估时的期望，并与物理治疗师对这些期望的感知进行比较。方法：在美国一家大型医疗中心进行横断面调查。患者和理疗师完成了一份相同的10题5分李克特量表，评估对初始治疗的期望。患者在第一次就诊前完成调查；治疗师以电子方式回应。采用Mann-Whitney U检验比较组间差异。结果：144名患者和22名物理治疗师完成了调查。患者通常认为提供家庭锻炼计划“非常”或“极其重要”（93%）。物理治疗师相对更重视检查、诊断和预后。统计学上的显著差异（Bonferroni-adjusted p≤0.001）反映了组间不同的侧重点。结论：患者和物理治疗师对最初腰痛护理的几个组成部分的重视程度不同。物理治疗师倾向于相对更重视与检查相关的因素，而患者则强调接受家庭锻炼计划。这些发现表明，在最初的咨询中，患者的优先事项和治疗师的看法可能并不总是一致的。治疗师可以考虑在最初的咨询中直接询问患者的期望，以澄清个人希望从临床接触中获得什么。

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引用次数: 0

Optimizing management of neck pain though the pain and disability drivers management model for neck pain: A feasibility trial. 通过颈部疼痛和残疾驱动管理模型优化颈部疼痛管理：可行性试验。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-03-17 DOI: 10.1016/j.msksp.2026.103545

Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Yannick Tousignant-Laflamme

Background: Neck pain represents a major burden. Guideline-based interventions demonstrated modest clinical benefits. The added value of subgrouping tools remains limited, potentially reflecting an incomplete assessment of key factors. The Pain and Disability Drivers Management model for neck pain (PDDM-Np) was adapted to address this gap, but its feasibility and acceptability remain unknown.

Objectives: To evaluate the feasibility and acceptability of implementing PDDM-Np and its impact on clinical decision-making.

Design: Prospective feasibility study.

Method: Physiotherapists were eligible if they completed the PDDM-Np workshop and agreed to use its clinical decision support system (CDSS). Adult patients consulting for a new episode of neck pain were consecutively recruited. Clinicians attended a workshop on PDDM-Np, and used the CDSS, which generated a dashboard to guide management. Primary outcomes were feasibility and acceptability. Secondary exploratory outcomes included clinician-reported changes in clinical decision-making and patient-reported outcomes.

Results: Seventeen clinicians and 50 patients were enrolled. Clinician recruitment exceeded target, while patient enrollment was below projections. The follow-up rate was 78%. The CDSS was acceptable to clinicians and patients. One-third of clinicians reported an additional workload burden. Based on results, the decision was to perform a definitive study with minor protocol changes. All clinicians reported at least minor modifications in their decision-making process. Six weeks after baseline, 94% of patients reported clinical improvements.

Conclusions: Implementing PDDM-Np in private practice is feasible and acceptable, although it is associated with added burden. After minor adjustments, a definitive study can be conducted to evaluate the effectiveness and implementation of PDDM-Np.

背景：颈部疼痛是一个主要的负担。基于指南的干预显示出适度的临床益处。子分组工具的附加价值仍然有限，潜在地反映了对关键因素的不完整评估。颈部疼痛和残疾驱动因素管理模型（PDDM-Np）被用于解决这一差距，但其可行性和可接受性尚不清楚。目的：评价实施PDDM-Np的可行性和可接受性及其对临床决策的影响。设计：前瞻性可行性研究。方法：完成PDDM-Np工作坊并同意使用其临床决策支持系统（CDSS）的物理治疗师均符合资格。连续招募新发作颈部疼痛咨询的成年患者。临床医生参加了一个关于PDDM-Np的研讨会，并使用了CDSS，它生成了一个仪表板来指导管理。主要结局是可行性和可接受性。次要探索性结果包括临床医生报告的临床决策改变和患者报告的结果。结果：17名临床医生和50名患者入组。临床医生招募超过目标，而患者招募低于预期。随访率为78%。临床医生和患者均可接受CDSS。三分之一的临床医生报告了额外的工作量负担。根据结果，决定进行一项确定的研究，并对方案进行轻微修改。所有临床医生都报告说，他们的决策过程至少有轻微的改变。基线后6周，94%的患者报告临床改善。结论：在私人执业中实施PDDM-Np是可行和可接受的，尽管它会增加负担。经过微小的调整，可以进行明确的研究来评估PDDM-Np的有效性和实施。

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引用次数: 0