Pub Date : 2026-01-31DOI: 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.
{"title":"Pain and the immune system.","authors":"Paul W Hodges, Nathan T Fiore, Linda R Watkins, David M Klyne, Michel W Coppieters, Peter M Grace","doi":"10.1016/j.msksp.2025.103484","DOIUrl":"https://doi.org/10.1016/j.msksp.2025.103484","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":" ","pages":"103484"},"PeriodicalIF":2.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-31DOI: 10.1016/j.msksp.2026.103510
A L Pool-Goudzwaard, C Ridehalgh
{"title":"Neuroinflammation: The dawn of a new era in clinical reasoning?","authors":"A L Pool-Goudzwaard, C Ridehalgh","doi":"10.1016/j.msksp.2026.103510","DOIUrl":"https://doi.org/10.1016/j.msksp.2026.103510","url":null,"abstract":"","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":" ","pages":"103510"},"PeriodicalIF":2.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-31DOI: 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: VT: from 12.96 to 6.21). No meaningful decrease was observed in the spinal cord (VT: 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.
{"title":"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.","authors":"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","doi":"10.1016/j.msksp.2026.103502","DOIUrl":"https://doi.org/10.1016/j.msksp.2026.103502","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case description: </strong>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 [<sup>11</sup>C]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.</p><p><strong>Outcome: </strong>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<sub>T</sub>: from 12.96 to 6.21). No meaningful decrease was observed in the spinal cord (V<sub>T</sub>: from 6.43 to 5.38).</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":" ","pages":"103502"},"PeriodicalIF":2.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 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
{"title":"Effectiveness of adding manual therapy to exercise for pain and disability in chronic non-specific low back pain: A systematic review and meta-analysis","authors":"Emmanuele C.S. dos Santos , Aline T. dos Santos , Natalia A. da Silva , Saul R. Carneiro , Érika P. Rampazo , Maurício O. Magalhães","doi":"10.1016/j.msksp.2026.103508","DOIUrl":"10.1016/j.msksp.2026.103508","url":null,"abstract":"<div><h3>Introduction</h3><div>Manual therapy and therapeutic exercise are both recommended for chronic non-specific low back pain, the additional benefit of combining them is uncertain.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, I<sup>2</sup> = 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, I<sup>2</sup> = 0 %) and long-term follow-up (SMD = −1.13, 95 % CI: −2.06 to −0.19, I<sup>2</sup> = 80 %).</div></div><div><h3>Conclusion</h3><div>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</div></div><div><h3>Prospero registration</h3><div>CRD42023413778.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103508"},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-29DOI: 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.
{"title":"Association between pain catastrophizing and sarcopenia in patients with knee osteoarthritis: A cross-sectional study","authors":"Qingzhao Liang , Guangyuan Dong , Nanyan Li , Mengchao He , Shiqi Gong , Lei Shi","doi":"10.1016/j.msksp.2026.103506","DOIUrl":"10.1016/j.msksp.2026.103506","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> = 0.003). Subgroup analyses revealed stronger associations in patients aged 60–69 years (aOR = 1.036; 95 % CI: 1.001, 1.073; <em>P</em> = 0.045), those aged ≥70 years (aOR = 1.095; 95 % CI: 1.050, 1.143; <em>P</em> < 0.001), and individuals with prolonged sedentary time (aOR = 1.051; 95 % CI: 1.016, 1.086; <em>P</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103506"},"PeriodicalIF":2.2,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-27DOI: 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.
{"title":"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","authors":"Eveliina Heikkala , Jaro Karppinen","doi":"10.1016/j.msksp.2026.103503","DOIUrl":"10.1016/j.msksp.2026.103503","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103503"},"PeriodicalIF":2.2,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 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。
{"title":"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","authors":"Zeinab Raoufi , Abbas Tabatabaei , Mehdi Dadgoo , Esmaeil Ebrahimi Takamjani , Reza Salehi , Mohammad Ali Sanjari","doi":"10.1016/j.msksp.2026.103501","DOIUrl":"10.1016/j.msksp.2026.103501","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Clinical trial registration number</h3><div>NCT05832918.</div></div><div><h3>Trial registration</h3><div>This trial was registered at <span><span>https://www.clinicaltrials.gov/</span><svg><path></path></svg></span>(Identifier: NCT05832918) on March 31, 2023.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103501"},"PeriodicalIF":2.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 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.
{"title":"Health-seeking behaviour in adults with musculoskeletal conditions: A scoping review","authors":"Susan Greenhalgh , Melika Ghorbankhani , Gillian Yeowell","doi":"10.1016/j.msksp.2026.103499","DOIUrl":"10.1016/j.msksp.2026.103499","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103499"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.msksp.2026.103500
Bradley Furlong , Holly Etchegary , Andrea Pike , Mona Frey , Kris Aubrey-Bassler , Simon Davidson , Amanda Hall
Introduction
Patients lack knowledge and have unhelpful beliefs about low back pain, which are associated with worse outcomes. Education may improve knowledge and modify beliefs and is recommended as a first-line low back pain treatment. However, low back pain guidelines are vague in their education recommendations and patients report rarely receiving education in from their family doctor. Those receiving education often report unclear and inconsistent information across resources that do not address their needs. Patient education materials can be used to facilitate the provision of credible, clear and consistent information to address patients’ needs, but no tool has been developed to assess if they contain information patients want to know, or information providers want patients to know.
Objectives
To (i) identify a list of items describing information that patients want to know about and that educators want patients to know about related to low back pain and (ii) organize them into a checklist with a coding scheme for future pilot testing.
Methods
We reviewed the literature to inform working definitions of patients' information needs (what patients want to know more about) and education needs (what experts identified patients lack knowledge about). Using these definitions, we found two recent systematic reviews investigating patients' information needs, attitudes, and beliefs about low back pain. We used the constant comparative method to conduct a content analysis of the data from these reviews into codes and categories relating to patients’ needs, from which we generated items. Patient partners and clinician researchers assessed face validity. A clinician researcher pre-tested the checklist to minimize measurement error.
Results
We developed a checklist comprising 21 items about prognosis, diagnosis, treatment, causes, aetiology, prevention, functional anatomy, activities of daily living, and pain neuroscience education. A small group of patients and clinician researchers judged the checklist to have acceptable face validity.
Conclusion
We developed a novel checklist comprising 21 distinct patient information and education needs about low back pain. It is intended to assess whether patient education materials about low back pain contain information about these needs, but its development is preliminary in nature and further validation is required.
{"title":"Does your patient education material for low back pain meet patients’ information and education needs? Preliminary development of a new checklist","authors":"Bradley Furlong , Holly Etchegary , Andrea Pike , Mona Frey , Kris Aubrey-Bassler , Simon Davidson , Amanda Hall","doi":"10.1016/j.msksp.2026.103500","DOIUrl":"10.1016/j.msksp.2026.103500","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients lack knowledge and have unhelpful beliefs about low back pain, which are associated with worse outcomes. Education may improve knowledge and modify beliefs and is recommended as a first-line low back pain treatment. However, low back pain guidelines are vague in their education recommendations and patients report rarely receiving education in from their family doctor. Those receiving education often report unclear and inconsistent information across resources that do not address their needs. Patient education materials can be used to facilitate the provision of credible, clear and consistent information to address patients’ needs, but no tool has been developed to assess if they contain information patients want to know, or information providers want patients to know.</div></div><div><h3>Objectives</h3><div>To (i) identify a list of items describing information that patients want to know about and that educators want patients to know about related to low back pain and (ii) organize them into a checklist with a coding scheme for future pilot testing.</div></div><div><h3>Methods</h3><div>We reviewed the literature to inform working definitions of patients' information needs (what patients want to know more about) and education needs (what experts identified patients lack knowledge about). Using these definitions, we found two recent systematic reviews investigating patients' information needs, attitudes, and beliefs about low back pain. We used the constant comparative method to conduct a content analysis of the data from these reviews into codes and categories relating to patients’ needs, from which we generated items. Patient partners and clinician researchers assessed face validity. A clinician researcher pre-tested the checklist to minimize measurement error.</div></div><div><h3>Results</h3><div>We developed a checklist comprising 21 items about prognosis, diagnosis, treatment, causes, aetiology, prevention, functional anatomy, activities of daily living, and pain neuroscience education. A small group of patients and clinician researchers judged the checklist to have acceptable face validity.</div></div><div><h3>Conclusion</h3><div>We developed a novel checklist comprising 21 distinct patient information and education needs about low back pain. It is intended to assess whether patient education materials about low back pain contain information about these needs, but its development is preliminary in nature and further validation is required.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"82 ","pages":"Article 103500"},"PeriodicalIF":2.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号