Musculoskeletal Science and Practice最新文献_第3页

A comparative analysis of lumbar paraspinal muscle morphology between two movement system impairment subgroups of chronic nonspecific low back pain 慢性非特异性腰背痛两个运动系统损伤亚组腰椎旁肌肉形态的比较分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103208

Fereshteh Rezazadeh , Shahin Goharpey , Nahid pirayeh , Mohammad Jafar Shaterzadeh Yazdi , Amin Behdarvandan , Saeed Hesam

Background

Based on the kinesiopathologic model, the Movement System Impairment (MSI) classification of LBP has shown that repetitive movements could contribute to pathoanatomic tissue changes. However, these changes have not been evaluated in different MSI classification subgroups of patients with LBP.

Objective

This study compared the grades of fatty infiltration as one of the muscle's pathologic changes in the lower lumbar paraspinal and psoas muscles between the two subgroups of patients diagnosed with MSI syndromes having opposite movement direction impairments.

Design

Observational cross-sectional study.

Method

Forty-five participants with chronic LBP were enrolled in the study, with 23 patients in the lumbar flexion-rotation (FlexRot) subgroup and 22 in the lumbar extension-rotation (ExtRot) subgroup of MSI. Magnetic resonance imaging (MRI) and the Goutallier Classification System (GCS) were used for fatty grading of lumbar paraspinal and psoas muscles. After the reliability of this grading scale was evaluated, the results were compared between the two subgroups.

Results

The Mann–Whitney U Test showed significantly higher fat infiltration of lower lumbar multifidus and erector spinae muscles in the lumbar ExtRot subgroup, with no significant difference between the two subgroups in terms of psoas muscles (P ≤ 0.05). Inter-rater reliability of GCS was acceptable to excellent, and intra-rater reliability was good to excellent.

Conclusion

The fatty infiltration grade of lumbar paraspinal muscles in L4-L5 and L5-S1 levels are significantly different between the two LBP subgroups of MSI that have two opposite movement direction impairments. The lumbar paraspinal muscles, which contribute to extension, have a higher grade of fat in the ExtRot subgroup, whose symptoms are aggravated by lumbar extension.

背景：根据运动病理模型，腰椎间盘突出症的运动系统损伤（MSI）分类表明，重复运动可能导致病理组织变化。然而，这些变化尚未在不同的 MSI 分类亚组枸杞痛患者中进行评估：本研究比较了被诊断为 MSI 综合征且运动方向相反的两个亚组患者的下腰椎旁肌和腰大肌中作为肌肉病理变化之一的脂肪浸润程度：观察性横断面研究：45名慢性腰痛患者参加了研究，其中23名患者属于腰部屈曲-旋转（FlexRot）亚组，22名患者属于腰部伸展-旋转（ExtRot）亚组。磁共振成像（MRI）和 Goutallier 分类系统（GCS）用于腰椎旁和腰肌的脂肪分级。在对该分级表的可靠性进行评估后，对两个亚组的结果进行了比较：曼-惠特尼U检验显示，腰椎外展肌亚组的下腰部多裂肌和竖脊肌的脂肪浸润率明显更高，而腰大肌的脂肪浸润率在两亚组间无明显差异（P≤0.05）。GCS的评分者间信度为可接受到优秀，评分者内部信度为良好到优秀：结论：腰椎间盘突出症的两个亚组之间，L4-L5 和 L5-S1 水平腰椎旁肌肉的脂肪浸润等级存在显著差异。在 ExtRot 亚组中，腰椎伸展时腰椎旁肌肉的脂肪等级更高，因为腰椎伸展会加重其症状。

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引用次数: 0

The effect of a neuromuscular-cognitive training program on postural stability, hop performance, and agility in Division-I Women's Tennis athletes: A pilot study 神经肌肉-认知训练计划对一级女子网球运动员姿势稳定性、跳跃表现和敏捷性的影响：试点研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103214

Ke’La H. Porter , Lina Ochoa , Danielle M. Torp , Matthew C. Hoch

Background

Situational awareness and cognitive function are often discounted in sports training programs, potentially limiting their effectiveness.

Objective

This research aimed to examine the effect of a six-week neuromuscular-cognitive training program on postural stability, hop performance, and agility with and without perceptual-cognitive challenge in a tennis team.

Design

Double baseline, quasi-experimental pretest-posttest.

Methods

Ten collegiate female tennis athletes volunteered to participate in this study. Participants completed two baseline testing sessions, a six-week training program, and a post-test session one week after the training program. Participants completed the neuromuscular-cognitive training twice a week for six weeks. The training integrated cognitive load (e.g., working memory and inhibitory control) during exercise (e.g., balance and shuffling). At each data collection session, subjects completed a single-limb stance on a force plate with and without an upper extremity reaction test, single-leg hop, single-leg memory hop, reactive agility, and a lower extremity reaction task. Pre-to post-intervention changes were analyzed using t-tests with corresponding Hedge's g effect sizes. Results were considered significant when p ≤ 0.05 and Hedge's g effect sizes were moderate to strong.

Results

Statistically significant improvements were identified for single and dual-task anteroposterior mean center of pressure velocity (g = −0.684–0.803), single-task time-to-boundary mediolateral mean minima (g = 0.921), and single and dual-task time-to-boundary anteroposterior mean minima (0.708–0.830). Additionally, significant improvements were identified in the upper extremity reaction task during the dual-task static balance (g = −0.795).

Conclusion

Neuromuscular-cognitive training may be beneficial in improving postural stability outcomes; however, more research is needed to develop this type of training further.

背景：在运动训练计划中，情境意识和认知功能往往被忽视，这可能会限制其有效性：本研究旨在考察为期六周的神经肌肉-认知训练计划对网球队的姿势稳定性、跳跃表现和敏捷性的影响，以及是否存在感知-认知挑战：设计：双基线、准实验性前测-后测：方法：10 名大学网球女运动员自愿参加本研究。参加者完成了两次基线测试、为期六周的训练计划以及训练计划结束一周后的后测。参与者每周完成两次神经肌肉-认知训练，为期六周。训练将认知负荷（如工作记忆和抑制控制）与运动（如平衡和洗牌）结合起来。在每次数据收集过程中，受试者都要在测力板上完成单肢站立，同时进行或不进行上肢反应测试、单腿跳跃、单腿记忆跳跃、反应敏捷和下肢反应任务。采用 t 检验和相应的 Hedge's g 效果大小分析干预前和干预后的变化。当 p≤0.05 和 Hedge's g 效应量为中等至强时，结果被认为是有意义的：单任务和双任务的前胸平均压力中心速度（g = -0.684-0.803）、单任务到边界内外侧平均最小值的时间（g = 0.921）以及单任务和双任务到边界前胸平均最小值的时间（0.708-0.830）均有统计学意义的改善。此外，在双任务静态平衡（g = -0.795）中，上肢反应任务也有明显改善：结论：神经肌肉-认知训练可能有助于改善姿势稳定性结果；然而，还需要更多的研究来进一步发展这种类型的训练。

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引用次数: 0

The general public as well as physiotherapists evaluate spinal flexion as dangerous regardless of their own low back pain history 一般人和物理治疗师都认为脊柱弯曲是危险的，不管他们自己是否有腰痛病史。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103216

Tomas Kavka , Tomas Nedoma , Zuzana Blahova

Background

Maladaptive fear of movement in individuals with low back pain may be associated with worse clinical outcomes.

Objective

To explore beliefs about the perceived dangers regarding different spinal postures within the Czech Republic.

Design

Exploratory cross-sectional study including physiotherapists and members of the general public.

Methods

Self-reported perceived safety/danger of “straight” and “flexed” spinal postures regarding 1) sitting, 2) lifting of light and 3) heavy object from the floor based on three pairs of photographs was measured using numeric rating scales (0–10, safe to dangerous) without any given context and in the context of low back pain. The sum of differences between the ratings of flexed and straight postures were used to calculate Bending Safety Beliefs Thermometer (BSB_Thermometer) total score potentially ranging -60‒60 (higher values indicates evaluation of flexed spinal postures as more dangerous in comparison to straight postures).

Results

760 participants were included in the analysis. The mean BSB_Thermometer total score was 31.1 (SD 16.1) and higher scores were positively associated with being women (b = 14.8, 95% CI [9.9–19.8]); non-medical profession (b = 24.7, 95% CI [15.2–34.2]); age (b = 0.38, 95% CI [0.16–0.6]; and their interactions. There was no significant association with current low back pain status or history of low back pain.

Conclusions

On average, participants evaluated “flexed” spinal postures as significantly more dangerous when compared with “straight” spinal postures, with only subgroups of physiotherapists scoring lower than the general public. Clinically, these beliefs could be targeted by individualized education, exposure-based interventions and public campaigns; however, further research is required.

背景：腰背痛患者对运动的适应性恐惧可能与更差的临床疗效有关：腰背痛患者对运动的适应性恐惧可能与更差的临床结果有关：目的：探讨捷克共和国国内对不同脊柱姿势危险性的看法：设计：探索性横断面研究，包括物理治疗师和普通公众：方法：根据三对照片，使用数字评分量表（0-10 分，从安全到危险），在没有任何特定背景的情况下以及在腰背痛的背景下，测量 "直 "和 "屈 "脊柱姿势对 1）坐姿、2）从地板上提起轻物和 3）重物的安全性/危险性的自我感知。弯曲姿势和直立姿势的评分差异之和被用来计算弯曲安全信念温度计（BSBThermometer）的总分，潜在范围为-60-60（数值越高，表明脊柱弯曲姿势与直立姿势相比越危险）：共有 760 名参与者参与分析。BSBThermometer 总分的平均值为 31.1（标准差为 16.1），得分越高与女性（b = 14.8，95% CI [9.9-19.8]）、非医疗职业（b = 24.7，95% CI [15.2-34.2]）、年龄（b = 0.38，95% CI [0.16-0.6]）及其交互作用呈正相关。与当前腰背痛状况或腰背痛病史无明显关联：平均而言，与 "直 "脊柱姿势相比，参与者认为 "屈 "脊柱姿势更危险，只有物理治疗师亚群的得分低于普通大众。在临床上，可以通过个性化教育、基于暴露的干预措施和公共宣传活动来纠正这些观念；但是，还需要进一步的研究。

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引用次数: 0

The association between neuropathic pain features and central sensitization with acute headache associated to a whiplash injury 神经病理性疼痛特征和中枢敏感性与鞭打伤引起的急性头痛之间的关联。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103212

Ernesto Anarte-Lazo , Marco Barbero , Carlos Bernal-Utrera , Cleofas Rodriguez-Blanco , Deborah Falla

Background

Headache is one of the most common symptoms after a whiplash injury, although the pathophysiology remains under discussion. This study aimed to evaluate differences in neuropathic pain and central sensitization features between those who present with whiplash-associated headache (WAH) soon after a whiplash injury and those who do not.

Methods

This case-control study evaluated differences on the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Pain Detect Questionnaire (PDQ) and the Central Sensitization Inventory (CSI) between those who present with WAH in the acute phase after a whiplash injury (n = 46) and those who do not (n = 36). Moreover, the association of these variables in addition to neck pain intensity and the Neck Disability Index (NDI) score, with the presence of WAH was examined through logistic regression.

Results

While differences between groups were found for both neuropathic and central sensitization features, only the presence of neuropathic pain features was associated with the presence of headache, with 27 scores for the S-LANSS and 23 for the PDQ from 46 people with headache (58.6% and 50.0%, respectively). The NDI and the S-LANSS partially explained (R² = 0.68) the presence of WAH according to a logistic regression model.

Conclusion

Significant differences were found between people with whiplash with and without WAH when the S-LANSS, the PDQ and the CSI were assessed. S-LANSS and NDI were the variables most associated with the presence of WAH. These findings suggest that neuropathic pain features may be associated with the presence of acute WAH.

背景：头痛是鞭打伤后最常见的症状之一，但其病理生理学仍在讨论之中。本研究旨在评估在鞭打伤后不久出现鞭打相关性头痛（WAH）的患者与未出现鞭打相关性头痛的患者在神经病理性疼痛和中枢敏化特征方面的差异：这项病例对照研究评估了在鞭打伤后急性期出现 WAH 的患者（46 人）与未出现 WAH 的患者（36 人）在自编利兹神经病理性症状和体征评估（S-LANSS）、疼痛检测问卷（PDQ）和中枢敏感性量表（CSI）上的差异。此外，还通过逻辑回归分析了这些变量与颈部疼痛强度和颈部残疾指数（NDI）得分之间的关系：虽然在神经病理性和中枢敏感性特征方面发现了组间差异，但只有神经病理性疼痛特征与头痛存在相关，46 名头痛患者中有 27 人在 S-LANSS 中得分，23 人在 PDQ 中得分（分别占 58.6% 和 50.0%）。根据逻辑回归模型，NDI和S-LANSS可以部分解释（R2 = 0.68）是否存在WAH：结论：在对 S-LANSS、PDQ 和 CSI 进行评估时，发现有 WAH 和无 WAH 的鞭打患者之间存在显著差异。S-LANSS 和 NDI 是与 WAH 存在最相关的变量。这些研究结果表明，神经性疼痛特征可能与急性 WAH 的存在有关。

{"title":"The association between neuropathic pain features and central sensitization with acute headache associated to a whiplash injury","authors":"Ernesto Anarte-Lazo , Marco Barbero , Carlos Bernal-Utrera , Cleofas Rodriguez-Blanco , Deborah Falla","doi":"10.1016/j.msksp.2024.103212","DOIUrl":"10.1016/j.msksp.2024.103212","url":null,"abstract":"<div><h3>Background</h3><div>Headache is one of the most common symptoms after a whiplash injury, although the pathophysiology remains under discussion. This study aimed to evaluate differences in neuropathic pain and central sensitization features between those who present with whiplash-associated headache (WAH) soon after a whiplash injury and those who do not.</div></div><div><h3>Methods</h3><div>This case-control study evaluated differences on the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Pain Detect Questionnaire (PDQ) and the Central Sensitization Inventory (CSI) between those who present with WAH in the acute phase after a whiplash injury (n = 46) and those who do not (n = 36). Moreover, the association of these variables in addition to neck pain intensity and the Neck Disability Index (NDI) score, with the presence of WAH was examined through logistic regression.</div></div><div><h3>Results</h3><div>While differences between groups were found for both neuropathic and central sensitization features, only the presence of neuropathic pain features was associated with the presence of headache, with 27 scores for the S-LANSS and 23 for the PDQ from 46 people with headache (58.6% and 50.0%, respectively). The NDI and the S-LANSS partially explained (R<sup>2</sup> = 0.68) the presence of WAH according to a logistic regression model.</div></div><div><h3>Conclusion</h3><div>Significant differences were found between people with whiplash with and without WAH when the S-LANSS, the PDQ and the CSI were assessed. S-LANSS and NDI were the variables most associated with the presence of WAH. These findings suggest that neuropathic pain features may be associated with the presence of acute WAH.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"74 ","pages":"Article 103212"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632727","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

French translation and transcultural adaptation of the shoulder pain and disability index (SPADI) 肩部疼痛和残疾指数 (SPADI) 的法语翻译和跨文化改编。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103209

Thomas Lathiere , Noemie Chantriaux , David Beard , Nicolas Pinsault , Leo Druart

Background

A French version of the Shoulder Pain and Disability Index (SPADI) is currently unavailable for clinical and research use in French-speaking countries.

Objectives

To translate and transculturally adapt the Shoulder Pain And Disability Index (SPADI) from English to French language.

Design

Translation and transcultural adaptation of a Patient-Reported Outcome Measure.

Methods

Following international guidelines for translating and adapting PROMs, we carried out a seven-step process involving 15 contributors. The forward translation was performed by five independent native French speakers, while five independent native English speakers conducted the blinded back-translation. A bilingual expert committee synthesized the translations, and three healthcare professionals participated in the pre-test phase. Ten patients were involved in pre-testing to evaluate the pre-final version.

Results

A final French version of the SPADI was achieved after making seven adjustments across the 18 items, instructions, and examples on the Likert scale. Changes were implemented only if at least 20% of the pre-test participants suggested modifications to enhance readability or coherence. Face validity was assessed by the expert committee.

Conclusion

The French version of the SPADI is now available, enabling condition-specific self-assessment and quantitative follow-up of shoulder pain and function in both clinical practice and research. Although psychometric properties of this version are yet to be assessed, future studies are expected to confirm the preservation of the original tool's validity and reliability.

背景：目前，法语国家还没有用于临床和研究的法文版肩部疼痛和残疾指数（SPADI）：目前，法语国家还没有用于临床和研究的法语版肩关节疼痛和残疾指数（SPADI）：将肩部疼痛和残疾指数（SPADI）从英语翻译成法语，并进行跨文化改编：设计：对患者报告的结果测量进行翻译和跨文化改编：根据患者报告结果量表翻译和改编的国际指南，我们进行了七步流程，共有 15 位参与者参与。正译由五位独立的母语为法语的人员完成，反译则由五位独立的母语为英语的人员进行盲译。一个双语专家委员会对译文进行了综合，三名医护人员参与了预试阶段。10名患者参与了预试，以评估最终版本：在对 18 个项目、说明和李克特量表示例进行了 7 次调整后，最终完成了 SPADI 的法文版。只有在至少 20% 的预测试参与者提出修改建议以提高可读性或连贯性的情况下，才会进行修改。专家委员会对表面效度进行了评估：SPADI法文版现已面世，可在临床实践和研究中根据具体情况对肩部疼痛和功能进行自我评估和定量随访。尽管该版本的心理测量学特性还有待评估，但未来的研究有望证实其保留了原始工具的有效性和可靠性。

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引用次数: 0

An observational study: Correlation between self-perceived readiness and physical performance in healthy individuals 观察研究：健康人的自我感觉准备状态与身体表现之间的相关性。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103217

Lina Ochoa , Ke’La H. Porter , Bridget M. Walsh , Danielle Torp , Nicholas R. Heebner , Matthew C. Hoch

Introduction

In complex environments, individuals need to anticipate and react to stimuli by integrating complex systems and skills. Identifying the perceptual-cognitive, physical, and health characteristics that afford effective performance is necessary for developing training and readiness strategies. Measuring readiness by establishing a relationship between the Acute Readiness Monitoring Scale (ARMS) and performance during perceptual-cognitive tasks is essential. Therefore, this study aimed to determine the relationship between self-perceived readiness, physical performance, and perceptual-cognitive performance in healthy young adults.

Materials and methods

Cross-sectional design with healthy and physically active young adults (n = 35). Participants completed a measure of self-perceived readiness (the ARMS), physical performance (i.e., Vertical Jump (VJ) and Ballistic Push-Up), and perceptual-cognitive exercises (i.e., Single Leg Memory Hop (SLMH), Reactive VJ, Reactive Ballistic Push-Up, Reactive Agility Run Decide, and Upper and Lower Extremity Reaction Tests). Data was analyzed using Pearson's r (r) correlation to identify associations.

Results

Statistically significant moderate correlations were detected between ARMS Total and VJ (Peak Power Normalized and Flight Time) (r = 0.434, p = 0.010) and (r = 0.420, p = 0.013), and SLMH Distance Normalized (r = 0.409, p = 0.016). Moderate negative correlations between the ARMS Total and Reactive VJ Reaction Time (r = −0.473, p = 0.005).

Conclusion

The ARMS can be an effective tool for measuring acute self-perceived readiness. This suggests that individuals who work in dynamic environments may benefit from training that targets perceptual-cognitive skills. Although moderate, self-perceived readiness was associated with better resilience, health, and performance exercises. Results highlight the importance of protocols targeting populations who work in complex environments for increased performance.

引言在复杂的环境中，个人需要通过整合复杂的系统和技能来预测刺激并做出反应。要制定训练和准备策略，就必须确定能够有效发挥能力的感知认知、身体和健康特征。通过建立急性准备状态监测量表（ARMS）与感知认知任务中的表现之间的关系来衡量准备状态至关重要。因此，本研究旨在确定健康年轻人的自我感觉准备状态、体能表现和感知认知表现之间的关系：横断面设计，对象为健康且身体活跃的年轻人（n = 35）。参与者完成了自我认知准备度量（ARMS）、体能表现（即立定跳远（VJ）和弹道推举）和感知认知练习（即单腿记忆跳跃（SLMH）、反应性立定跳远、反应性弹道推举、反应性敏捷跑决定和上下肢反应测试）。数据分析采用皮尔逊 r（r）相关性来确定相关性：结果：ARMS 总分与 VJ（峰值功率归一化和飞行时间）（r = 0.434，p = 0.010）和（r = 0.420，p = 0.013）以及 SLMH 距离归一化（r = 0.409，p = 0.016）之间存在统计学意义上的中度相关性。结论：ARMS 总分与反应性 VJ 反应时间之间存在中度负相关（r = -0.473，p = 0.005）：结论：ARMS 是测量急性自我认知准备状态的有效工具。这表明，在动态环境中工作的人可能会从针对感知-认知技能的培训中受益。虽然自我感觉准备程度不高，但却与更好的复原力、健康和表现练习有关。研究结果凸显了针对在复杂环境中工作的人群制定方案以提高绩效的重要性。

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引用次数: 0

Good vibes for the brain - Placebo versus real vibration in patients with chronic neck pain: A randomized cross-over study 对大脑有益的振动--慢性颈痛患者服用安慰剂与实际振动的对比：随机交叉研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-11-01 DOI: 10.1016/j.msksp.2024.103210

Sandra Preiss , Wolfgang Taube , Sandra Helmstädter , Larissa Bentz , Konstantin Beinert

Background

Neck muscle vibration decreases pain and improves sensorimotor impairments in patients with chronic neck pain. However, the impact of placebo on these effects are still unclear.

Objective

The aim was to evaluate the effect of neck muscle vibration compared to placebo neck muscle vibration in patients with chronic neck pain.

Methods

Twenty-three people with chronic neck pain participated in this double-blinded, randomized crossover study. After baseline assessment at day 1, patients received either neck muscle vibration or placebo neck muscle vibration at day 2. At day 3, patients underwent the other treatment. The primary outcomes assessed at each day were active cervical joint position sense acuity, resting pain, and pressure pain threshold.

Results

Cervical joint position sense revealed a significant time effect (F1, 22 = 4.366, p = 0.016, η2 = 0.902). Post-hoc testing revealed significant increases in cervical joint position sense after neck muscle vibration (p = 0.023; d = 0.602) but not after placebo vibration. Resting pain (F1, 22 = 7.550, p = 0.003, η2 = 0.418) displayed significant time effects for neck muscle vibration and placebo vibration. Pressure pain threshold demonstrated a significant time to condition effect (F1, 22 = 6.146; p = 0.008, η2 = 0.369). Post-hoc tests revealed that only neck muscle vibration significantly increased pressure pain threshold (p = 0.043, d = 0.516).

Conclusion

The study demonstrates the efficacy of neck muscle vibration to decrease neck pain and improve cervical joint position sense in patients with chronic neck pain. Nevertheless, the influence of placebo effects should not be underestimated as they may contribute to these effects, indicated by similar decreases in resting pain.

背景：颈部肌肉振动可减轻慢性颈痛患者的疼痛并改善其感觉运动障碍。然而，安慰剂对这些效果的影响仍不清楚：目的：评估颈部肌肉振动与安慰剂颈部肌肉振动对慢性颈痛患者的影响：23名慢性颈部疼痛患者参加了这项双盲随机交叉研究。在第 1 天进行基线评估后，患者在第 2 天接受颈部肌肉振动或安慰剂颈部肌肉振动。第 3 天，患者接受另一种治疗。每天评估的主要结果是活动颈椎关节位置感敏锐度、静息痛和压痛阈值：结果：颈椎关节位置感显示出显著的时间效应（F1，22 = 4.366，P = 0.016，η2 = 0.902）。事后检验显示，颈部肌肉振动后颈椎关节位置感明显增强（p = 0.023; d = 0.602），而安慰剂振动后则没有。静息痛（F1，22 = 7.550，p = 0.003，η2 = 0.418）对颈部肌肉振动和安慰剂振动有显著的时间效应。压痛阈值显示出显著的时间条件效应（F1，22 = 6.146；p = 0.008，η2 = 0.369）。事后检验显示，只有颈部肌肉振动能显著提高压痛阈值（p = 0.043，d = 0.516）：研究表明，颈部肌肉振动对减轻慢性颈痛患者的颈部疼痛和改善颈椎关节位置感有一定疗效。尽管如此，安慰剂效应的影响也不容低估，因为安慰剂效应可能会促进这些效果的产生，静息疼痛的类似减轻就说明了这一点。

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引用次数: 0

Act now - serious pathology of the spine is affected by health inequalities 立即行动--脊柱的严重病变受到健康不平等的影响

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-10-23 DOI: 10.1016/j.msksp.2024.103207

Sue Greenhalgh , Laura M. Finucane , Christopher Mercer , Gill Yeowell

Early diagnosis of serious spinal pathology is the key to optimise patient outcomes, yet early diagnosis can be adversely affected by health inequalities. In this paper we consider the impact of health inequalities on the incidence and outcome for serious spinal musculoskeletal (MSK) pathologies. Health inequalities can be experienced by people grouped around a range of factors. These include socio-economic factors, the environmental conditions in which people live, protected characteristics such as ethnicity, and socially excluded groups such as people who are homeless. These factors can affect people's exposure to health risks and their opportunities to lead healthy lives. A person's behaviour is a key determinant of their health status. ‘Risky’ health behaviours include smoking, poor diet, harmful alcohol consumption and lack of exercise, and are more common in these groups. Importantly, socio-economic factors combined with health behaviours influence the health inequalities a person may experience. The most significant social and economic factors influencing poor MSK health are poverty, education, employment, environment, and food ethos. These determinants of health not only predispose people living in deprivation to having benign MSK conditions at a younger age and with worse outcomes, they are also risk factors of more serious MSK pathologies.

严重脊柱病变的早期诊断是优化患者预后的关键，然而早期诊断可能会受到健康不平等的不利影响。在本文中，我们将探讨健康不平等对严重脊柱肌肉骨骼（MSK）病变的发病率和治疗效果的影响。围绕一系列因素，人们可能会经历健康不平等。这些因素包括社会经济因素、人们生活的环境条件、种族等受保护特征以及无家可归者等被社会排斥的群体。这些因素会影响人们面临的健康风险和过上健康生活的机会。一个人的行为是决定其健康状况的关键因素。高危 "健康行为包括吸烟、不良饮食、酗酒和缺乏锻炼，在这些群体中更为常见。重要的是，社会经济因素与健康行为相结合，会影响一个人可能经历的健康不平等。贫困、教育、就业、环境和饮食风气是影响 MSK 健康状况最重要的社会和经济因素。这些健康决定因素不仅使生活在贫困中的人更容易在年轻时患上良性的 MSK 病症，并导致更坏的结果，而且也是更严重的 MSK 病症的风险因素。

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引用次数: 0

Italian versions of the optimal screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and the Örebro Musculoskeletal pain screening questionnaire (ÖMPQ-21) and their short forms, in patients with low back pain: Cross-cultural adaptation, reliability and validity 针对腰背痛患者的意大利语版 "转诊和结果黄旗预测最佳筛查"（OSPRO-YF）和Örebro 肌肉骨骼疼痛筛查问卷（ÖMPQ-21）及其简表：跨文化适应性、可靠性和有效性

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-10-21 DOI: 10.1016/j.msksp.2024.103206

Francesca Bonetti , Domenico Angilecchia , Alessandro Agostini , Paolo Marighetto , Silvia Minnucci , Gloria Giglioni , Leonardo Pellicciari , Alessandro Chiarotto

Background

Low back pain (LBP) is a leading cause of disability worldwide. Early detection of prognostic factors using the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) or the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPQ-21) can predict improvement in pain and disability for patients with nonspecific LBP.

Objectives

To translate and cross-culturally adapt the OSPRO-YF and the ÖMPQ-21 with their short versions into the Italian language and to test their measurement properties in patients with LBP.

Design

Clinimetric study.

Methods

OSPRO-YF and ÖMPQ-21 were translated and administered to LBP patients with questionnaires on pain intensity, disability, pain self-efficacy, and pain catastrophizing. We evaluated test-retest reliability, measurement error, and construct validity.

Results

Eighty-three patients with LBP were included. No floor or ceiling effects were reported. Test-retest reliability of the OSPRO-YF, the ÖMPQ-21, and their short forms were excellent. The measurement error analysis revealed a Standard Error of Measurement (SEM) of 6.7 points, a Minimal Detectable Change (MDC) of 18.6 points for ÖMPQ-21, a SEM of 2.3 points, and a MDC of 6.4 points for OSPRO-YF. The construct validity of the OSPRO-YF and ÖMPQ-21 and its 10-item short version was satisfactory and moderate. OSPRO-YF performed better than ÖMPQ-21 on all three measurement properties.

Conclusion

OSPRO-YF, ÖMPQ-21, and their short versions are reliable and valid for identifying ‘yellow flags’ in Italian patients with LBP, with the former generally performing better than the latter. Further research is needed to confirm their ability to predict outcomes in patients with LBP.

背景腰背痛（LBP）是导致全球残疾的主要原因。使用 "转诊和结果预测最佳筛查黄旗"（OSPRO-YF）或 "Örebro 肌肉骨骼疼痛筛查问卷"（ÖMPQ-21）对预后因素进行早期检测，可预测非特异性腰背痛患者的疼痛和残疾改善情况。方法将OSPRO-YF和ÖMPQ-21翻译成意大利语并对其进行跨文化改编，同时对其在枸杞痛患者中的测量特性进行测试。我们评估了重测信度、测量误差和结构效度。无最低或最高效应报告。OSPRO-YF、ÖMPQ-21及其简表的重测信度非常好。测量误差分析显示，ÖMPQ-21的测量标准误差（SEM）为6.7点，最小可检测变化（MDC）为18.6点，OSPRO-YF的测量标准误差（SEM）为2.3点，最小可检测变化（MDC）为6.4点。OSPRO-YF和ÖMPQ-21及其10项短文本的构建效度令人满意，属于中等水平。结论OSPRO-YF、ÖMPQ-21及其简易版在识别意大利腰背痛患者的 "黄旗 "方面可靠有效，前者的表现普遍优于后者。需要进一步的研究来证实它们预测腰椎间盘突出症患者预后的能力。

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引用次数: 0

More neck pain, less spinal mobility, altered sitting posture: Sagittal spinal alignment and mobility in women with chronic neck pain 颈部疼痛加剧，脊柱活动度降低，坐姿改变：慢性颈部疼痛女性的脊柱矢状排列和活动度

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-10-15 DOI: 10.1016/j.msksp.2024.103205

Nur Efsan Unal , Sevtap Gunay Ucurum , Muge Kirmizi , Elif Umay Altas

Background

Increasing evidence suggests that people with chronic neck pain (CNP) may display altered biomechanics beyond the cervical spine. However, whether spinal alignment and mobility are associated with neck pain is not clarified.

Objectives

To investigate whether there is a significant association between neck pain intensity and sagittal spinal alignment and mobility in people with CNP, and to examine whether sagittal spinal alignment and mobility differ according to pain intensity.

Design

A cross-sectional study.

Method

Forty-four women with CNP were included. The neck pain intensity at rest and during neck movements was assessed with the visual analogue scale (VAS). A skin-surface measurement device was used to assess sagittal alignment and mobility while sitting and standing. Linear regression analysis was used to assess associations. Participants were divided into two groups according to the pain intensity as group with mild pain (VAS≤4.4 cm) and group with moderate to severe pain (VAS>4.4 cm) and compared using the analysis of covariance.

Results

Greater resting pain was associated with a more forward trunk during sitting (Beta = 0.433, p < 0.05). Greater pain during neck movements was associated with increased lumbar lordosis during sitting (Beta = −0.376, p < 0.05). Classified by pain intensity at rest, trunk mobility while sitting was lower and forward trunk inclination and sacral kyphosis while sitting were higher in those with moderate/severe pain (η²_p = 0.093–0.119, p < 0.05). By pain intensity during neck movements, women with moderate/severe pain exhibited lower sacral mobility while sitting (η²_p = 0.129, p < 0.05).

Conclusions

Addressing the entire spine in the assessment and management of CNP may help reduce pain.

背景越来越多的证据表明，慢性颈痛（CNP）患者可能会表现出颈椎以外的生物力学改变。目的研究慢性颈部疼痛患者的颈部疼痛强度与脊柱矢状排列和活动度之间是否存在显著关联，并探讨脊柱矢状排列和活动度是否随疼痛强度而有所不同。采用视觉模拟量表（VAS）评估休息时和颈部活动时的颈部疼痛强度。使用皮肤表面测量仪评估坐姿和站姿时的矢状排列和活动度。线性回归分析用于评估相关性。根据疼痛强度将参与者分为两组，即轻度疼痛组（VAS≤4.4 cm）和中度至重度疼痛组（VAS>4.4 cm），并使用协方差分析进行比较。颈部运动时疼痛加剧与坐姿时腰部前凸增加有关（Beta = -0.376，p < 0.05）。按静止时的疼痛强度分类，中度/重度疼痛者坐位时的躯干活动度较低，坐位时的躯干前倾和骶骨后凸较高（η2p = 0.093-0.119, p <0.05）。根据颈部活动时的疼痛强度，中度/重度疼痛的女性坐着时骶骨活动度较低（η2p = 0.129，p < 0.05）。

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引用次数: 0