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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 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
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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 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 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 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 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。
{"title":"Health-seeking behaviour in adults with musculoskeletal conditions: A scoping review","authors":"Susan Greenhalgh ,&nbsp;Melika Ghorbankhani ,&nbsp;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}
引用次数: 0
Does your patient education material for low back pain meet patients’ information and education needs? Preliminary development of a new checklist 你们关于腰痛的患者教育材料是否满足患者的信息和教育需求?初步制定新的检查清单
IF 2.2 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 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.
患者缺乏对腰痛的认识,对腰痛有不利的看法,这与较差的结果有关。教育可以提高知识和改变信念,建议作为治疗腰痛的一线方法。然而,腰痛指南在教育建议上是模糊的,患者报告很少从他们的家庭医生那里接受教育。那些接受教育的人经常报告不明确和不一致的信息,这些信息不符合他们的需求。患者教育材料可用于促进提供可靠、清晰和一致的信息,以满足患者的需求,但尚未开发出工具来评估这些材料是否包含患者想知道的信息,或信息提供者希望患者知道的信息。目的(i)确定一个项目列表,描述患者想要了解的信息,以及教育者希望患者了解的与腰痛相关的信息;(ii)将它们组织成一个清单,并为未来的试点测试提供编码方案。方法回顾文献,了解患者信息需求(患者希望了解更多)和教育需求(专家认为患者缺乏哪些知识)的工作定义。使用这些定义,我们发现了最近的两篇系统综述,调查了患者对腰痛的信息需求、态度和信念。我们使用持续比较法对这些综述的数据进行内容分析,将其纳入与患者需求相关的代码和类别,并从中生成条目。患者伴侣和临床研究人员评估了面部效度。临床研究人员预先测试了检查表,以尽量减少测量误差。结果我们编制了一份包含预后、诊断、治疗、病因、病因学、预防、功能解剖学、日常生活活动、疼痛神经科学教育等21项内容的检查表。一小群患者和临床研究人员判断该检查表具有可接受的面部效度。结论:我们编制了一份新的检查表,包括21种不同的患者信息和关于腰痛的教育需求。该研究旨在评估患者关于腰痛的教育材料是否包含这些需求的信息,但其发展是初步的,需要进一步的验证。
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引用次数: 0
Does physical activity provide additional benefit in individuals with rotator cuff related shoulder pain? 体育锻炼对肩袖相关肩痛患者是否有额外的益处?
IF 2.2 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-09 DOI: 10.1016/j.msksp.2026.103498
Ümmü Öztürk , Derya Çelik

Background

Rotator cuff-related shoulder pain (RCRSP) causes pain, functional loss and reduced quality of life. Although physical activity has been shown to reduce pain and improve overall well-being, its additional effect has not yet been investigated specifically in individuals with RCRSP.

Objectives

To investigate the effect of adding physical activity to supervised exercise on pain, function, quality of life, and satisfaction in individuals with RCRSP.

Design

Randomized controlled trial.

Methods

42 participants were randomly assigned into two groups. The Physical Activity Group (n = 21) received moderate-intensity walking exercise in addition to supervised exercise and the Control Group (n = 21) received only supervised exercise for 6 weeks. The outcome measures were Numeric Pain Rating Scale(NPRS), The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment(ASES), The shortened Disabilities of the Arm, Shoulder and Hand Questionnaire(Quick DASH), Rotator Cuff Quality of Life (RCQOL), Western-Ontario Rotator Cuff Index(WORC) and Global Rating of Change scales(GROC) scores.

Results

Between-group differences in outcomes at follow-up were analyzed using one-way ANCOVA. There was a significant difference between the two groups in post-intervention scores on the NPRS-activity (Mean difference [MD]: −0.9 [95 % Confidence interval: −1.5,−0.3]; p = 0.003), NPRS-night (MD:−0.8 [−1.5,−0.1]; p = 0.02), ASES (MD:8.1 [2.5,13.7]; p = 0.01), Quick DASH (MD:−7.6 [−13.2,−1.9]; p = 0.01), and RC-QOL (MD:6.5 [0.2,12.9]; p = 0.04), favoring the Physical Activity Group. In contrast, no significant between-group differences were found in WORC-Emotions (MD:−5 [−13.2,3.2]; p = 0.23) or GROC(χ2 = 0.79; p > 0.05).

Conclusions

Adding physical activity to supervised exercise may significantly improve pain, function, quality of life, and satisfaction in individuals with RCRSP.
肩袖相关性肩痛(RCRSP)会导致疼痛、功能丧失和生活质量下降。尽管体育活动已被证明可以减轻疼痛并改善整体健康状况,但其额外效果尚未对RCRSP患者进行专门研究。目的探讨在监督运动的基础上增加体力活动对RCRSP患者疼痛、功能、生活质量和满意度的影响。设计随机对照试验。方法42例受试者随机分为两组。体育活动组(n = 21)在有监督的锻炼基础上进行中等强度的步行锻炼,对照组(n = 21)只进行有监督的锻炼,为期6周。结局指标为数值疼痛评定量表(NPRS)、美国肩关节外科医生标准化肩关节评定量表(ASES)、手臂、肩膀和手的短残疾问卷(Quick DASH)、肩袖生活质量(RCQOL)、西安大略肩袖指数(WORC)和全球变化评定量表(GROC)评分。结果组间随访结果差异采用单因素方差分析。干预后两组在NPRS-activity(平均差值[MD]:−0.9[95%可信区间:−1.5,−0.3];p = 0.003)、NPRS-night (MD:−0.8[−1.5,−0.1];p = 0.02)、as (MD:8.1 [2.5,13.7]; p = 0.01)、Quick DASH (MD:−7.6[−13.2,−1.9];p = 0.01)和RC-QOL (MD:6.5 [0.2,12.9]; p = 0.04)得分上均有显著差异,均有利于运动组。相比之下,WORC-Emotions (MD: - 5 [- 13.2,3.2]; p = 0.23)或GROC(χ2 = 0.79; p > 0.05)组间无显著差异。结论在有监督的运动中增加体力活动可以显著改善RCRSP患者的疼痛、功能、生活质量和满意度。
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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 Pub 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
Patterns in anticipatory postural adjustment onset timing across multiple trunk muscles: Psychological correlates and participant clustering along the low back pain continuum 跨多个躯干肌肉的预期姿势调整的开始时间模式:心理相关因素和参与者聚类沿腰痛连续体。
IF 2.2 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-07 DOI: 10.1016/j.msksp.2026.103496
Jaap Wijnen , Sophie Van Oosterwijck , Evy Dhondt , Michiel Brandt , Lieven Danneels , Thomas Matheve , Jessica Van Oosterwijck

Background

Feedforward activation of trunk muscles is crucial for spinal control and can be quantified by assessing anticipatory postural adjustments (APA). Few studies have examined time-dependent changes in APA onset times across the low back pain (LBP) continuum and their association with psychological factors.

Objectives

1) Investigate variations in APA onset times along the LBP continuum; 2) identify participant clusters based on APA onset timing patterns across trunk muscles; 3) compare these clusters on psychological factors.

Method

This cross-sectional study assessed APA onset times of trunk muscles using surface electromyography in 30 pain-free, 20 recurrent LBP (in remission), and 28 chronic LBP participants. Fear of movement, pain vigilance/awareness, and pain-related worry were evaluated using self-reported measures. Mixed linear models compared APA onset times between groups, while K-means clustering identified participant subgroups with similar APA onset timing patterns. Between-cluster differences in psychological factors were analyzed using one-way ANOVAs and Kruskal-Wallis tests.

Results

No significant group-by-muscle interaction was found (p = 0.362), nor between-group differences in APA onset timing (p = 0.832). Cluster analysis identified three subgroups, independent of LBP-status, characterized by a pattern of early, similar, or delayed APA onsets across trunk muscles. Pain vigilance/awareness scores differed between clusters (p = 0.029), with highest scores in the delayed APA cluster, while differences in other psychological factors were nonsignificant despite moderate/large effect sizes.

Conclusions

APA onset times did not progressively differ along the LBP-continuum. A pattern of delayed APA onset timing across trunk muscles was associated with higher levels of pain vigilance/awareness.
背景:躯干肌肉的前馈激活对脊柱控制至关重要,可以通过评估预期体位调整(APA)来量化。很少有研究考察了腰痛(LBP)连续体中APA发作时间的时间依赖性变化及其与心理因素的关系。目的:1)研究沿腰痛连续体APA发病时间的变化;2)根据主干肌肉的APA发病时间模式识别参与者群;3)心理因素的比较。方法:本横断面研究使用表面肌电图评估了30名无痛、20名复发性下腰痛(缓解)和28名慢性下腰痛参与者的主干肌APA发作时间。运动恐惧、疼痛警觉/意识和疼痛相关担忧采用自我报告的方法进行评估。混合线性模型比较各组之间的APA发病时间,而k均值聚类则确定具有相似APA发病时间模式的参与者亚组。心理因素聚类间差异采用单因素方差分析和Kruskal-Wallis检验进行分析。结果:各组间无明显肌间相互作用(p = 0.362), APA发病时间组间无显著差异(p = 0.832)。聚类分析确定了三个独立于lbp状态的亚组,其特征是跨躯干肌肉的早期、相似或延迟的APA发病模式。疼痛警觉/意识得分在组间存在差异(p = 0.029),延迟APA组得分最高,而其他心理因素的差异不显著,尽管有中等/大的效应量。结论:APA的发病时间在lbp连续体上没有进行性差异。跨躯干肌肉的延迟APA发作时间模式与更高水平的疼痛警觉性/意识相关。
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引用次数: 0
Response to the Comment on “ChatGPT is a comprehensive education tool for patients with patellar tendinopathy, but it currently lacks accuracy and readability” 对“ChatGPT是髌骨肌腱病变患者的综合教育工具,但目前缺乏准确性和可读性”评论的回复
IF 2.2 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-06 DOI: 10.1016/j.msksp.2025.103461
Jie Deng , Lun Li , Edwin HG Oei , Robert-Jan de Vos
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引用次数: 0
期刊
Musculoskeletal Science and Practice
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