Musculoskeletal Science and Practice最新文献

Introduction: Accessing health services in rural Australia is challenging and innovative solutions to meet residents' needs are required. Research into eHealth is crucial as it offers potential solutions to these challenges. The study aimed to assess participants' satisfaction and experience with an eHealth physiotherapy intervention at improving physical function for low back pain and knee osteoarthritis in rural Australia.

Methods: Telephone surveys collected data on participant satisfaction and experiences. Satisfaction was rated on a scale of 0-10, and the data was presented descriptively and compared between groups (eHealth and usual care) using Mann-Whitney U tests. Participant experiences with the pilot trial were gathered using open-ended questions, categorised and presented descriptively.

Results: 75/156 (48%) participants responded to the satisfaction survey. Overall satisfaction was significantly higher for the eHealth group, median = 9 [IQR: 8-10] compared with the usual care group, median = 8 [IQR: 5-9] (p = 0.025). Satisfaction was also significantly higher in the eHealth group for all secondary measures in the study, including accessibility to healthcare practitioner (p = 0.001), time to contact physiotherapist (p = 0.011), cost of intervention (p < 0.001) and distance travelled (p < 0.001). For the pilot experiences, inconvenient aspects such as completing forms/administration and travel were significantly higher in the usual care group, while difficulties with exercises, were significantly higher in the eHealth group (p = 0.005).

Conclusions: An eHealth intervention for physiotherapy is acceptable to patients with knee osteoarthritis and low back pain in rural Australia. Future telehealth interventions should pay special attention to participant's exercise workload and motivation.

Background: There are a variety of different treatments for patients living with subacromial pain syndrome (SAPS). All treatments have small to moderate effect sizes, and it is challenging when healthcare practitioners and patients need to decide on which treatment options to choose. The aim of this study was to explore and understand the decisional needs of patients with SAPS, to inform and support the decision-making process.

Methods: A qualitative research study, using semi-structured individual interviews with patients with SAPS. The interview guide was informed by the Ottawa Decision Support Framework (ODSF), previous research related to treatment decision-making, other decisional needs assessment studies, and inputs from patients with SAPS and healthcare practitioners. Data were analysed by using reflexive thematic text analysis and ODSF. The analysis was conducted in NVivo 12.

Results: We invited 22 participants of which 17 (age 22-71 years) took part in the study. We found three main themes related to individual decisional needs in the context of decision-making: 1) The necessity of certainty and adequate information as fundamental prerequisites for effective decision-making, 2) The importance of person-centered care to achieve a desirable decision, and 3) The need for a supportive environment to facilitate adaptation and acceptance of the decision.

Conclusion: The decision-making process faced by patients with SAPS is complex and involves several decisional needs. Our findings highlight the importance of healthcare professionals identifying and addressing patients' decisional needs in consultations with patients with SAPS.

Introduction: Functional tests are used to establish the functional capacity of women with Greater Trochanteric Pain Syndrome (GTPS). However, the validity, reliability, or possibility of discriminating this dysfunction have not been established.

Objectives: To compare functional capacity, establish the properties of functional test measurements, and present the best test to discriminate between women with and without GTPS.

Methods: A total of 46 women were evaluated (23 with GTPS/23 asymptomatic). On the first day, two evaluators analyzed the muscle strength of the quadriceps and lateral hip complex and performance in the 30-s sit to stand test (STS30), stair ascent test (SAT), stair descent test (SDT), and Timed Up and Go test (TUG). On the second day, evaluator 1 repeated the assessment. The results were established by the intraclass correlation coefficient, Spearman's correlation test, and discriminant analysis.

Results: The GTPS group showed worse results in the VISA-G (P < 0.001), SAT (P = 0.009), SDT (P = 0.033), and TUG (P = 0.039). Intra-evaluator reliability ranged from moderate to excellent and inter-examiner reliability from good to excellent in this sample. Validity could not be established. Only SAT and TUG tests differentiated the participants with GDTS from the asymptomatic group.

Conclusion: Women with GTPS present worse functional capacity compared to asymptomatic women. The functional tests used were reliable, but not valid. The SAT and TUG, when used for functional performance diagnosis, were able to discriminate between individuals with GTPS and asymptomatic group over 40 years of age.

Background: An updated systematic review of cervical musculoskeletal dysfunction in migraine and tension-type headache is needed. Influencing factors (pain hypersensitivity with cervical musculoskeletal testing, active trigger points and tenderness) have not been investigated.

Objectives: To i) update evidence for cervical musculoskeletal impairments in migraine and tension-type headache ii) report on accompanying pain associated with testing, active trigger points and tenderness in headache; iii) determine relationships between these sensitivity features and cervical musculoskeletal impairments in headache.

Methods: Five databases were searched for observational studies. Quality of studies was assessed with JBI Critical Appraisal. Meta-analysis was performed using random effect models. Certainty of the evidence was assessed using GRADE.

Results: Seventy-seven studies were included comprising 2551 participants. New findings in migraine were increased forward head posture in standing (MD = -2.51°[-4.94°, -0.09°]), reduced flexion/rotation range (MD = -9.47°[-15.78°, -3.16°]), reduced flexor strength (Std. MD = -0.34[-0.57, -0.10]) and endurance (MD = -14.37[-28.15, -0.58]), and reduced extensor strength (Std. MD = -0.34[-0.60, -0.08]) in migraine. Tension-type headache had reduced extensor strength (Std. MD = -0.45[-0.85, -0.04]). Certainty was very low for all findings due to heterogeneity and small effect size. Active trigger points and tenderness were common, particularly, in chronic headache. A negative relationship between cervical musculoskeletal performance and active trigger points and tenderness was found in 2 from 77 studies (r < - 0.47).

Conclusions: Several cervical musculoskeletal impairments are present in migraine and tension-type headache with very low certainty. Caution is needed since few studies considered factors that would influence testing.