Musculoskeletal Science and Practice最新文献_第2页

Identifying reliable, valid and feasible outcome measures for adults aged 50 years or older with hip or knee osteoarthritis participating in supervised exercise programs: a scoping review 确定50岁及以上髋关节或膝关节骨关节炎患者参加监督锻炼项目的可靠、有效和可行的结果测量：一项范围审查。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-02 DOI: 10.1016/j.msksp.2026.103511

Nikole Watson , Rosmary Martinez Rueda , Hayley Legg , Catherine Boden , Brenna Bath

Objective

To identify reliable, valid, and feasible outcome measures that could be used to assess outcomes of participating in supervised exercise programs for adults aged 50 years or older with hip or knee osteoarthritis (OA).

Methods

A scoping review was conducted in accordance with Joanna Briggs Institute and PRISMA-ScR guidelines. Six databases were searched on July 18, 2024. Eligible studies were systematic, literature, or integrative reviews evaluating at least one psychometric property (reliability, validity, or feasibility) of outcome measures for adults aged ≥50 years with hip or knee OA, including those awaiting or having undergone total joint arthroplasty.

Results

Sixteen reviews were included, identifying 102 outcome measures (35 self-report, 67 performance-based). Nine reviews used the COSMIN methodology, while others applied alternative or narrative frameworks. Commonly supported measures included the WOMAC, KOOS, HOOS, LEFS, 6-Minute Walk Test, 40-m fast-paced walk, and Timed Up and Go, which showed strong reliability (ICC ≥0.80) and construct validity. Feasibility was discussed narratively in 13 reviews; none used formal criteria. Only three mentioned exercise, and none evaluated measures in supervised programs.

Conclusion

Multiple outcome measures demonstrated acceptable reliability and validity for adults with hip or knee OA, but feasibility data were limited, and no tools were validated in the context of supervised exercise. Consequently, no measure fulfilled all three psychometric criteria for this setting. Future research should include structured feasibility assessments and evaluate measures within exercise-based interventions.

目的：确定可靠、有效和可行的结果测量方法，用于评估50岁或以上髋关节或膝关节骨关节炎（OA）患者参加监督运动项目的结果。方法：根据乔安娜布里格斯研究所和PRISMA-ScR指南进行范围审查。2024年7月18日，对六个数据库进行了搜索。符合条件的研究是系统、文献或综合评价，评估≥50岁髋关节或膝关节OA成人（包括等待或已接受全关节置换术的患者）结果测量的至少一项心理测量特性（信度、效度或可行性）。结果：纳入16篇综述，确定102项结果测量（35项自我报告，67项基于绩效）。九篇评论使用了COSMIN方法，而其他评论则采用了替代或叙述框架。常用的测试包括WOMAC、oos、HOOS、LEFS、6分钟步行测试、40米快节奏步行和Timed Up and Go，这些测试具有较强的信度（ICC≥0.80）和结构效度。13篇综述对可行性进行了论述；没有一个使用正式的标准。只有三个提到了锻炼，没有一个评估了监督项目中的措施。结论：对于成年髋关节或膝关节OA患者，多个结果测量显示出可接受的信度和效度，但可行性数据有限，并且没有工具在监督运动的背景下得到验证。因此，没有一种测量方法能满足这一设置的所有三个心理测量标准。未来的研究应包括结构化的可行性评估和评估运动干预措施。

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引用次数: 0

Pain and the immune system. 疼痛和免疫系统。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-31 DOI: 10.1016/j.msksp.2025.103484

Paul W Hodges, Nathan T Fiore, Linda R Watkins, David M Klyne, Michel W Coppieters, Peter M Grace

Although classically considered from a neuro-centric vantage point, is now well known that pain involves interaction between the immune and nervous systems. Neuro-immune interactions occur all along the pain axis from the tissues to the peripheral neurons, the dorsal root ganglia, the spinal cord and supraspinal centres. Immune cells from mast cells, macrophages, T cells and B cells, to the Schwann cells of neurons, and the glia cells in the spinal cord and brain, release diverse inflammatory mediators including cytokines and chemokines. Fundamental mechanisms underlying pain enhancement by immune cells are diverse and differ between nociceptive, neuropathic and nociplastic pain conditions. The involvement of the immune system in pain provides enormous potential for interventions to address pain by targeting these mechanisms. These interventions include pharmacological and genetic treatments, as well as non-pharmacological treatments with the potential to impact systemic and CNS immune activity, such as exercise, diet and treatments targeting psychosocial and behavioural features (e.g., sleep and stress). Logically, treatment efficacy should depend on matching the treatment to the relevant neuro-immune mechanism. The aim of this review is to provide a foundation to understand the relevance of neuro-immune interactions to the development and persistence of chronic pain, and its implications for treatment. We provide an overview of the role of neuroinflammation in pain, evidence that this contributes to human pain conditions, and how this can guide matching the right treatments to the right person.

尽管传统上认为疼痛是神经中枢的优势，但现在众所周知，疼痛涉及免疫系统和神经系统之间的相互作用。从组织到周围神经元、背根神经节、脊髓和棘上中枢，整个疼痛轴都发生神经免疫相互作用。免疫细胞从肥大细胞、巨噬细胞、T细胞和B细胞，到神经元的雪旺细胞，以及脊髓和大脑的胶质细胞，释放多种炎症介质，包括细胞因子和趋化因子。免疫细胞增强疼痛的基本机制是多种多样的，并且在伤害性、神经性和伤害性疼痛条件下有所不同。免疫系统在疼痛中的参与为通过针对这些机制来解决疼痛的干预提供了巨大的潜力。这些干预措施包括药理学和遗传治疗，以及可能影响全身和中枢神经系统免疫活动的非药理学治疗，如运动、饮食和针对心理社会和行为特征（如睡眠和压力）的治疗。从逻辑上讲，治疗效果应该取决于治疗是否与相关的神经免疫机制相匹配。本综述的目的是为理解神经免疫相互作用与慢性疼痛的发展和持续的相关性及其对治疗的影响提供基础。我们概述了神经炎症在疼痛中的作用，证据表明这有助于人类疼痛状况，以及如何指导正确的治疗方法与正确的人匹配。

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引用次数: 0

Neuroinflammation: The dawn of a new era in clinical reasoning? 神经炎症：临床推理新时代的曙光？

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-31 DOI: 10.1016/j.msksp.2026.103510

A L Pool-Goudzwaard, C Ridehalgh

引用次数: 0

Neuroinflammation in the nerve roots and dorsal root ganglion decreases following 6 weeks of neural tissue management: PET/CT imaging findings in a patient with painful cervical radiculopathy. 神经组织管理6周后，神经根和背根神经节的神经炎症减少：疼痛性颈神经根病患者的PET/CT影像学表现。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-31 DOI: 10.1016/j.msksp.2026.103502

Ivo J Lutke Schipholt, Michel W Coppieters, Meghan A Koop, Ronald Boellaard, Elsmarieke van de Giessen, Carmen Vleggeert-Lankamp, Paul R Depauw, Bart N M van Berckel, Adriaan A Lammerstma, Maqsood Yaqub, Gwendolyne G M Scholten-Peeters

Background: There is increasing interest in uncovering working mechanisms of physiotherapy interventions. Advanced medical imaging enables in-vivo visualisation and quantification of neuroinflammation. This case report reveals for the first time how neuroinflammation in the nervous system may change following neural tissue management.

Case description: A 56-year-old man presented with a 9-month history of left C7 painful radiculopathy. He reported arm and neck pain, and numbness in the C7 dermatome. Elbow extension strength was reduced. The neurodynamic test (median nerve) was positive. MRI confirmed nerve root compression due to disc herniation C6/C7. Dynamic [¹¹C]DPA713 PET/CT imaging revealed neuroinflammation at the neuroforamen and spinal cord. While being on the surgical waitlist, he received six weeks of neural tissue management, which included 12 sessions of nerve and joint mobilisation, and a home program of neurodynamic exercises.

Outcome: At 6-weeks follow-up, arm and neck pain intensity had markedly reduced, which was maintained at 6 months. These improvements coincided with a substantial decrease in neuroinflammation at the affected neuroforamen (PET/CT: V_T: from 12.96 to 6.21). No meaningful decrease was observed in the spinal cord (V_T: from 6.43 to 5.38).

Discussion: Following six weeks of neural tissue management, in vivo measures of neuroinflammation reduced substantially at the affected nerve roots and dorsal root ganglion, which coincided with decreased neck and arm pain.

Conclusion: Changes in neuroinflammation exceeding the smallest detectable difference can be measured following neural tissue management in a patient with painful cervical radiculopathy. A randomised trial to validate these findings is warranted.

背景：人们对揭示物理治疗干预的工作机制越来越感兴趣。先进的医学成像技术使体内神经炎症的可视化和量化成为可能。本病例报告首次揭示了神经系统中的神经炎症如何在神经组织管理后发生变化。病例描述：一名56岁男性，有9个月的左C7疼痛性神经根病病史。他报告手臂和颈部疼痛，C7皮节麻木。肘部伸展强度降低。神经动力学试验（正中神经）阳性。MRI证实C6/C7椎间盘突出导致神经根受压。动态[11C]DPA713 PET/CT成像显示神经孔和脊髓神经炎症。在手术等待名单上，他接受了六周的神经组织管理，包括12次神经和关节活动，以及一个家庭神经动力学练习项目。结果：在6周的随访中，手臂和颈部疼痛强度明显减轻，并维持到6个月。这些改善与受影响神经孔的神经炎症的显著减少相吻合（PET/CT: VT：从12.96降至6.21）。脊髓无明显下降（VT：从6.43降至5.38）。讨论：经过六周的神经组织管理，体内受影响神经根和背根神经节的神经炎症显著减少，同时颈部和手臂疼痛减轻。结论：疼痛性颈神经根病患者在神经组织管理后，神经炎症的变化可超过最小可检测的差异。有必要进行随机试验来验证这些发现。

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引用次数: 0

Effectiveness of adding manual therapy to exercise for pain and disability in chronic non-specific low back pain: A systematic review and meta-analysis 慢性非特异性腰痛患者在运动中加入手工疗法治疗疼痛和残疾的有效性：一项系统综述和荟萃分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-30 DOI: 10.1016/j.msksp.2026.103508

Emmanuele C.S. dos Santos , Aline T. dos Santos , Natalia A. da Silva , Saul R. Carneiro , Érika P. Rampazo , Maurício O. Magalhães

Introduction

Manual therapy and therapeutic exercise are both recommended for chronic non-specific low back pain, the additional benefit of combining them is uncertain.

Objective

To systematically review the effects of adding manual therapy to therapeutic exercise compared to exercise alone on pain intensity and functional disability in adults with chronic non-specific low back pain.

Methods

A systematic review and meta-analysis of randomized controlled trials included adults aged 18–65 years with chronic non-specific low back pain (≥12 weeks). Interventions combined joint-based manual therapy (spinal mobilization and/or manipulation) with therapeutic exercise involving stretching, strengthening, motor control, and endurance training. Main outcomes were pain intensity and functional disability at short-, medium-, and long-term follow-up. PubMed, PEDro, Cochrane Library, CINAHL, and Web of Science were searched up to February 2025. Evidence certainty was rated using GRADE.

Results

Five trials (n = 260) were included. Low-quality evidence indicated no significant short-term pain reduction with manual therapy plus exercise versus exercise alone (SMD = −0.87, 95 % CI: −1.87 to 0.12, I² = 90 %). Moderate-to low-certainty evidence showed greater improvement in disability with combined therapy at short- (SMD = −0.73, 95 % CI: −1.05 to −0.42, I² = 0 %) and long-term follow-up (SMD = −1.13, 95 % CI: −2.06 to −0.19, I² = 80 %).

Conclusion

Manual therapy combined with therapeutic exercise does not appear to provide substantial additional short-term improvements in pain intensity when compared to exercise alone. However, significant benefits were identified for functional disability in both short- and long-term outcomes

Prospero registration

CRD42023413778.

手工疗法和治疗性运动均推荐用于慢性非特异性腰痛，两者结合的额外益处尚不确定。目的：系统回顾与单纯运动相比，在治疗性运动中加入手工疗法对成人慢性非特异性腰痛疼痛强度和功能障碍的影响。方法：对18-65岁慢性非特异性腰痛（≥12周）的成人随机对照试验进行系统评价和荟萃分析。干预措施结合以关节为基础的手工疗法（脊柱活动和/或操纵）和治疗性运动，包括伸展、强化、运动控制和耐力训练。在短期、中期和长期随访中，主要结局是疼痛强度和功能障碍。PubMed, PEDro, Cochrane Library， CINAHL和Web of Science被检索到2025年2月。证据确定性采用GRADE评分。结果：纳入5项试验（n = 260）。低质量证据表明，与单纯运动相比，手工治疗加运动没有显著的短期疼痛减轻（SMD = -0.87, 95% CI: -1.87至0.12,I2 = 90%）。中至低确定性证据显示，短期（SMD = -0.73, 95% CI: -1.05至-0.42,I2 = 0%）和长期随访（SMD = -1.13, 95% CI: -2.06至-0.19,I2 = 80%）联合治疗对残疾的改善更大。结论：与单独运动相比，手工疗法结合治疗性运动似乎没有提供实质性的额外的疼痛强度短期改善。然而，在短期和长期结果中，功能性残疾都有显著的益处。

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引用次数: 0

Corrigendum to "The person-centered hypothesis framework: Advancing clinical reasoning in musculoskeletal pain management" [Musculoskelet. Sci. Pract. 80C (2025) 103395]. “以人为中心的假设框架：推进肌肉骨骼疼痛管理的临床推理”的更正[肌肉骨骼]。科学。惯例。80C(2025) 103395]。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-29 DOI: 10.1016/j.msksp.2026.103504

Mark H Shepherd, Amy McDevitt, Damian Keter, Nick Albers, Derek Clewley, Chad Cook

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 : 2026-01-29 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

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 : 2026-01-27 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

The additional effects of dual-task training with core stability exercises versus general exercises on disability and pain in people with nonspecific chronic low back pain: A randomized controlled trial 双任务训练加核心稳定性锻炼与一般锻炼对非特异性慢性腰痛患者残疾和疼痛的额外影响：一项随机对照试验。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-16 DOI: 10.1016/j.msksp.2026.103501

Zeinab Raoufi , Abbas Tabatabaei , Mehdi Dadgoo , Esmaeil Ebrahimi Takamjani , Reza Salehi , Mohammad Ali Sanjari

Background

Non-specific chronic low back pain (NSCLBP) is a prevalent musculoskeletal condition associated with disability, pain, and reduced quality of life. Core stability exercises combined with dual-task training may improve clinical outcomes; however, evidence is limited. This study compared the effectiveness of core stability exercises with dual-task training (CSD) versus general exercises with dual-task training (GED) on disability, pain, quality of life, fear-avoidance beliefs, and kinesiophobia in individuals with NSCLBP.

Methods

47 participants with NSCLBP (40.27 ± 7.69 years) were randomized into CSD (n = 24) or GED (n = 23) groups. Both groups completed 16 supervised sessions. The primary outcome was disability (Oswestry Disability Index, ODI) assessed at baseline, post-intervention (5 weeks), and 18-week follow-up. Secondary outcomes included pain intensity (Visual Analog Scale, VAS) assessed at same time points, quality of life (Short Form-12 Health Survey: Mental Component Summary [MCS-12], Physical Component Summary [PCS-12]), fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire for physical activity [FABQ-P] and work [FABQ-W]), and kinesiophobia (Tampa Scale for Kinesiophobia [TSK]) assessed at baseline and post-intervention.

Results

The CSD group showed greater improvement in ODI post-intervention (d = 0.78, p = 0.012) and at follow-up (d = 0.97, p = 0.002). Both groups improved over time in all outcomes, with CSD superior for VAS (post-intervention and follow-up), MCS-12, PCS-12, FABQ-P, FABQ-W, and TSK post-intervention (p < 0.05).

Conclusion

Core stability exercises combined with cognitive dual-task training appear to be more effective than general exercises combined with the same dual-task training in improving both physical and psychological outcomes in individuals with NSCLBP.

Clinical trial registration number

NCT05832918.

Trial registration

This trial was registered at https://www.clinicaltrials.gov/(Identifier: NCT05832918) on March 31, 2023.

背景：非特异性慢性腰痛（NSCLBP）是一种常见的肌肉骨骼疾病，与残疾、疼痛和生活质量下降有关。核心稳定性训练结合双任务训练可以改善临床结果；然而，证据有限。本研究比较了核心稳定性训练加双任务训练（CSD）与一般训练加双任务训练（GED）对NSCLBP患者的残疾、疼痛、生活质量、恐惧回避信念和运动恐惧症的效果。方法：47例NSCLBP患者（40.27±7.69年）随机分为CSD组（n = 24）和GED组（n = 23）。两组都完成了16个有监督的疗程。主要终点是在基线、干预后（5周）和18周随访时评估的残疾（Oswestry残疾指数，ODI）。次要结果包括在同一时间点评估疼痛强度（视觉模拟量表，VAS），生活质量（短表格-12健康调查：心理成分摘要[MCS-12]，身体成分摘要[PCS-12]），恐惧-回避信念（恐惧-回避信念体力活动问卷[FABQ-P]和工作问卷[FABQ-W]），以及运动恐惧症（运动恐惧症坦帕量表[TSK]）在基线和干预后评估。结果：CSD组在干预后（d = 0.78, p = 0.012）和随访时（d = 0.97, p = 0.002） ODI有较大改善。随着时间的推移，两组的所有结果都有所改善，干预后VAS（干预后和随访）、MCS-12、PCS-12、FABQ-P、FABQ-W和TSK的CSD优于干预后的CSD (p结论：核心稳定性锻炼结合认知双任务训练在改善NSCLBP患者的生理和心理结果方面似乎比普通锻炼结合相同的双任务训练更有效。临床试验注册号：NCT05832918。试验注册：该试验于2023年3月31日在https://www.Clinicaltrials: gov/（标识符：NCT05832918）注册。

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引用次数: 0

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 : 2026-01-14 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