Musculoskeletal Science and Practice最新文献_第3页

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

Musculoskeletal Science and Practice

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

Musculoskeletal Science and Practice

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

Musculoskeletal Science and Practice

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

Musculoskeletal Science and Practice

Pub Date : 2026-01-06 DOI: 10.1016/j.msksp.2025.103461

Jie Deng , Lun Li , Edwin HG Oei , Robert-Jan de Vos

引用次数: 0

Comment on “ChatGPT is a comprehensive education tool for patients with patellar tendinopathy, but it currently lacks accuracy and readability” 点评“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”。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-06 DOI: 10.1016/j.msksp.2025.103460

Ismail Sivri , Emre Kaygin , Serap Colak , Tuncay Colak

引用次数: 0

Development of The COMBINED approach: Integrating a brief behaviour change intervention supported by a physiotherapist for people with rotator cuff disorders 联合方法的发展：在物理治疗师的支持下，对肩袖疾病患者进行简短的行为改变干预

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-02 DOI: 10.1016/j.msksp.2026.103493

Julie Bury , Chris Littlewood , Clare Jinks , Gemma Mansell , Kristina Curtis , Gillian Yeowell

Background

Modifiable lifestyle factors (smoking, inactivity, overweight) could contribute to the onset and persistence of rotator cuff disorders, yet physiotherapy practice rarely addresses them. Brief interventions (BIs) can support behaviour change but are not routinely embedded in musculoskeletal care.

Objectives

To develop The COMBINED approach: a physiotherapist-supported intervention integrating BI's targeting modifiable health behaviours into routine consultations for people with rotator cuff disorders; and to explore how physiotherapists can be supported to deliver it.

Materials and methods

A theory-, evidence-, and pragmatic-based development process incorporated stakeholder co-design, behavioural theory, and evidence across three workstreams: (1) narrative review of BIs targeting smoking, inactivity, and weight management; (2) four co-design workshops with 26 stakeholders (physiotherapists, patients, experts) to select and adapt a BI and identify key intervention features; (3) theoretical modelling using COM-B, TDF, and BCTTv1 to map barriers/facilitators, select behaviour change techniques, and develop prototype components.

Findings

Fourteen BIs were identified; Moving Medicine had greatest utility. Barriers included time constraints, limited skills and confidence, and fear of offending patients, contrasting with patients’ acceptability of lifestyle conversations. Recommendations included embedding the BI into routine care, scripts, infographics, patient resources, and training. Twelve TDF domains and 20 BCTs informed prototype development comprising: (1) patient-level intervention: a BI (adapted from Moving Medicine) embedded in routine consultations with tailored resources; (2) clinician-level implementation toolkit.

Conclusion

The COMBINED approach is the first formally developed intervention supporting integration of BI's within routine consultations for people with rotator cuff disorders and is now ready for feasibility testing.

背景：可改变的生活方式因素（吸烟、缺乏运动、超重）可能导致肩袖疾病的发生和持续，但物理治疗实践很少解决这些问题。短期干预（BIs）可以支持行为改变，但不常规嵌入肌肉骨骼护理。目的：开发联合方法：一种物理治疗师支持的干预措施，将BI针对可改变的健康行为纳入肩袖疾病患者的常规咨询；并探索如何支持物理治疗师提供治疗。材料和方法基于理论、证据和实用的开发过程将利益相关者共同设计、行为理论和证据纳入三个工作流程：(1)针对吸烟、不运动和体重管理的BIs的叙述性回顾；(2)与26名利益相关者（物理治疗师、患者、专家）共同设计4次研讨会，以选择和调整BI并确定关键干预特征；(3)利用COM-B、TDF和BCTTv1进行理论建模，绘制障碍/促进因素，选择行为改变技术，并开发原型组件。发现14个BIs；移动医学的效用最大。障碍包括时间限制，有限的技能和信心，以及害怕冒犯患者，与患者可接受的生活方式对话形成对比。建议包括将BI嵌入常规护理、脚本、信息图表、患者资源和培训中。12个TDF领域和20个bct知情原型开发包括：(1)患者层面的干预：BI（改编自移动医学）嵌入到常规咨询中，并提供定制资源；(2)临床层面实施工具包。联合方法是第一个正式开发的干预措施，支持将BI整合到肩袖疾病患者的常规会诊中，现在已准备好进行可行性测试。

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引用次数: 0

Masterclass- Axial and peripheral Spondyloarthritis: Screening, suspicion and referral in musculoskeletal clinical practice. 大师班-轴型和外周型脊柱炎：肌肉骨骼临床实践中的筛查、怀疑和转诊。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-01-02 DOI: 10.1016/j.msksp.2025.103474

Carol McCrum, Hannah Chambers

Introduction: Spondyloarthritis is an umbrella term for a group of inflammatory diseases that can present as back pain, joint pain and swelling, or tendon problems. Although as common as rheumatoid arthritis, awareness and screening questioning for axial and peripheral spondyloarthritis in musculoskeletal clinical practice is not yet core clinical practice and likely to be contributing to delays in diagnosis.

Purpose: The masterclass aims to increase awareness of the clinical features and risk factors that raise suspicion that persistent back, joint or tendon problems may be axial or peripheral spondyloarthritis. Guidance is provided on the updated inflammatory screening questioning important within musculoskeletal assessments, and for developing clinical knowledge and skills to support assessment for spondylarthritis, suspicion and referral to rheumatology. Clinical assessments need to question and examine for signs, symptoms and risk factors for both axial and peripheral spondyloarthritis. This involves screening for clinical features of inflammatory back pain, enthesitis, dactylitis, joint pain and swelling; prolonged morning stiffness; risk factors of psoriasis or family history of psoriasis, inflammatory bowel disease (IBD) -Crohn's disease and ulcerative colitis, uveitis, and family history of inflammatory arthritis. Referral criteria support clinical reasoning on levels of suspicion and when to refer to rheumatology.

Implications: Spondyloarthritis has been under-recognised in musculoskeletal assessments, which can have significant consequences for disease progression, complications and quality of life. Musculoskeletal clinicians play a crucial role in screening and supporting early recognition and intervention, which can significantly improve outcomes and reduce the impact of spondyloarthritis.

简介：脊椎关节炎是一组炎性疾病的总称，可以表现为背部疼痛，关节疼痛和肿胀，或肌腱问题。虽然与类风湿关节炎一样常见，但在肌肉骨骼临床实践中，对轴型和外周型脊柱炎的认识和筛查问题尚未成为核心临床实践，并可能导致诊断延误。目的：该大师班旨在提高对临床特征和危险因素的认识，这些特征和危险因素使人们怀疑持续的背部、关节或肌腱问题可能是轴性或周围性脊柱炎。提供了关于在肌肉骨骼评估中重要的最新炎症筛查问题的指导，以及发展临床知识和技能以支持脊柱炎评估、怀疑和风湿病转诊。临床评估需要询问和检查轴型和外周型脊柱炎的体征、症状和危险因素。这包括筛查炎症性背痛、鼻炎、指突炎、关节疼痛和肿胀的临床特征；晨僵延长；牛皮癣的危险因素或牛皮癣家族史，炎症性肠病(IBD) -克罗恩病和溃疡性结肠炎，葡萄膜炎，以及炎症性关节炎家族史。转诊标准支持对怀疑程度和何时转诊风湿病的临床推理。意义：脊柱关节炎在肌肉骨骼评估中被低估，这可能对疾病进展、并发症和生活质量产生重大影响。肌肉骨骼临床医生在筛查和支持早期识别和干预方面发挥着至关重要的作用，这可以显着改善结果并减少脊椎关节炎的影响。

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引用次数: 0

Psychosocial assessment in musculoskeletal care: A survey of UK physiotherapists 社会心理评估在肌肉骨骼护理：英国物理治疗师的调查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-30 DOI: 10.1016/j.msksp.2025.103485

Michael Henning , Shea Palmer , Nicola Walsh

Background

Psychosocial factors strongly influence musculoskeletal (MSK) outcomes, yet their systematic assessment remains inconsistent in physiotherapy practice. Although validated psychosocial assessment tools exist, little is known about how UK MSK physiotherapists use them.

Objective

To explore UK physiotherapists’ perceptions, practices, and confidence regarding psychosocial assessment, and to identify key challenges and facilitators.

Design

Cross-sectional online survey.

Methods

An anonymous online questionnaire was distributed via professional networks and social media to qualified UK-based MSK physiotherapists. Questions focused on demographics, perceptions, practices, and challenges/facilitators regarding psychosocial assessment. Quantitative data were analysed descriptively and using non-parametric statistics; free-text responses were examined narratively.

Results

373 physiotherapists responded, from a range of roles and experience levels. Most rated psychosocial factors as highly important and reported they often influenced treatment planning. Assessment relied mainly on clinical judgement and explicit questioning, while formal tool use was uncommon. Confidence in identifying and interpreting psychosocial factors showed moderate positive associations with screening tool use and weak or no associations with years of clinical experience. The most cited challenges to use of validated tools were time constraints, and training, whereas concise tools, electronic integration, and evidence of patient benefit were viewed as key facilitators.

Conclusions

UK MSK physiotherapists recognise the importance of psychosocial assessment, but its application in routine practice remains inconsistent and largely informal. Confidence appears to be more closely related to exposure to psychosocial screening tools than to years of clinical experience. These findings highlight the need for approaches that support consistent psychosocial assessment within routine MSK care.

背景：心理社会因素强烈影响肌肉骨骼（MSK）结果，但其系统评估在物理治疗实践中仍不一致。虽然存在有效的心理社会评估工具，但人们对英国MSK物理治疗师如何使用它们知之甚少。目的探讨英国物理治疗师对心理社会评估的看法、实践和信心，并确定主要挑战和促进因素。横断面在线调查。方法通过专业网络和社交媒体向英国合格的MSK物理治疗师发放匿名在线问卷。问题集中在人口统计，观念，实践和挑战/促进有关社会心理评估。定量数据进行描述性和非参数统计分析；以叙述的方式检查自由文本回答。结果373名物理治疗师从不同的角色和经验水平作出回应。大多数人认为社会心理因素非常重要，并报告说它们经常影响治疗计划。评估主要依靠临床判断和明确提问，而正式工具的使用并不常见。识别和解释心理社会因素的信心与筛查工具的使用有中度正相关，与临床经验的年数有微弱关联或无关联。使用经过验证的工具面临的最大挑战是时间限制和培训，而简洁的工具、电子集成和患者受益的证据被视为关键的促进因素。结论suk MSK物理治疗师认识到心理社会评估的重要性，但其在日常实践中的应用仍然不一致，而且很大程度上是非正式的。信心似乎与接触社会心理筛查工具的关系比与多年临床经验的关系更密切。这些发现强调了在常规MSK护理中支持一致的心理社会评估方法的必要性。

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引用次数: 0

Diagnostic labels used by health professionals for patellofemoral pain: A cross-sectional online survey. 卫生专业人员对髌股疼痛的诊断标签：一项横断面在线调查。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-30 DOI: 10.1016/j.msksp.2025.103481

Zixin Zhang, Giovanni E Ferreira, Evangelos Pappas, Christopher G Maher, Joshua R Zadro

Objectives: To explore what diagnostic labels are commonly used by health professionals in managing patellofemoral pain (PFP), to investigate management preferences for PFP, and whether imaging findings, patient characteristics, and clinicians' expertise influence the diagnostic labels used by health professionals for PFP.

Method: We conducted an online cross-sectional survey of health professionals with experience in managing knee pain to explore what diagnostic labels health professionals use for PFP. Demographic and outcome data were summarised using descriptive statistics. Logistic regression analyses were performed to explore whether years of experience and clinicians' expertise influence the use of diagnostic labels.

Results: 156 participants provided data for our primary outcome (use of diagnostic labels) and 139 completed the survey. The most used diagnostic labels for PFP were 'patellofemoral pain' (83 %), 'anterior knee pain and/or syndrome' (54 %), and 'patellofemoral pain syndrome' (44 %). The most common management strategies for PFP included exercise therapy (98 %), patient education (85 %), manual therapy (63 %), and patellar taping (58 %). Around one-third of health professionals would modify their diagnosis of PFP if imaging found a meniscal tear (37 %) or inflamed bursa/fat pad (38 %). Health professionals with self-reported excellent/good diagnostic skills or who had more years of experience were less likely to change their label based on imaging findings.

Conclusion: Health professionals' use of diagnostic labels and management strategies for PFP mostly align with current recommendations. More research is needed to investigate the relationship between diagnostic labels and patients' management preferences, and the reasons for health professionals' choice of diagnostic labels for PFP.

目的：探讨卫生专业人员在治疗髌骨股骨痛（PFP）时常用的诊断标签，调查对PFP的治疗偏好，以及影像学表现、患者特征和临床医生的专业知识是否影响卫生专业人员对PFP使用的诊断标签。方法：我们对具有膝关节疼痛管理经验的卫生专业人员进行了在线横断面调查，以探索卫生专业人员对PFP使用的诊断标签。使用描述性统计对人口统计学和结局数据进行汇总。进行逻辑回归分析，以探讨是否多年的经验和临床医生的专业知识影响诊断标签的使用。结果：156名参与者为我们的主要结局（诊断标签的使用）提供了数据，139名参与者完成了调查。PFP最常用的诊断标签是“髌股疼痛”（83%）、“前膝关节疼痛和/或综合征”（54%）和“髌股疼痛综合征”（44%）。PFP最常见的治疗策略包括运动治疗（98%）、患者教育（85%）、手工治疗（63%）和髌骨贴敷（58%）。如果影像学发现半月板撕裂（37%）或滑囊/脂肪垫发炎（38%），大约三分之一的卫生专业人员会修改对PFP的诊断。自我报告具有优秀/良好诊断技能或具有更多年经验的卫生专业人员不太可能根据影像学结果改变他们的标签。结论：卫生专业人员对PFP的诊断标签和管理策略的使用与目前的建议基本一致。诊断标签与患者管理偏好之间的关系，以及卫生专业人员选择PFP诊断标签的原因，需要更多的研究。

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引用次数: 0

Is pregnancy a major risk factor for musculoskeletal pain? A cross-sectional study 怀孕是肌肉骨骼疼痛的主要危险因素吗？横断面研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-27 DOI: 10.1016/j.msksp.2025.103482

Mai Mhajne , Asaf Weisman , Tomer Yona , Youssef Masharawi

Background

Musculoskeletal pain during pregnancy is commonly considered prevalent, though evidence primarily comes from cross-sectional studies lacking appropriate control groups.

Objective

To examine the prevalence of musculoskeletal pain among pregnant women compared to non-pregnant women as a reference group.

Design

Observational cross-sectional.

Methods

1651 women (589 pregnant, 1062 non-pregnant) in Israel completed an online survey using the Hebrew Extended Nordic Musculoskeletal Questionnaire and SF-12. Chi-square tests and logistic regression analyses examined associations between pregnancy status and pain prevalence while controlling for confounding factors including age, BMI, education, employment, lifestyle factors, and medical history.

Results

Pregnant women reported higher rates of upper back pain (67.1 % vs. 56.4 %, p = 0.02) and lower back pain (73.9 % vs. 64.9 %, p = 0.004), while non-pregnant women reported more hip/thigh pain (54.5 % vs. 48.4 %, p < 0.001). However, after controlling for confounders in multivariate regression, these associations became non-significant. Pregnant women had significantly lower physical component scores (43.31 ± 9.33 vs. 48.08 ± 8.41, p < 0.001). Physical health status (PCS-12) was the strongest predictor of current low back pain (OR = 0.92, 95 % CI: 0.90–0.94, p < 0.001), pregnancy status showed no independent association (OR = 1.19, 95 % CI: 0.77–1.84, p = 0.430). Smoking emerged as a significant risk factor (OR = 2.02, 95 % CI: 1.03–3.96, p = 0.042).

Conclusion

This study challenges the assumption that pregnancy inherently causes higher musculoskeletal pain prevalence. Physical health status plays a more substantial role than pregnancy status per se, highlighting the multifactorial nature of pregnancy-related musculoskeletal pain.

背景：怀孕期间肌肉骨骼疼痛通常被认为是普遍存在的，尽管证据主要来自缺乏适当对照组的横断面研究。目的：以孕妇和非孕妇为对照，研究肌肉骨骼疼痛的患病率。设计：观察性横断面。方法：1651名以色列妇女（589名孕妇，1062名非孕妇）使用希伯来扩展北欧肌肉骨骼问卷和SF-12完成了一项在线调查。卡方检验和逻辑回归分析检验了妊娠状态和疼痛患病率之间的关系，同时控制了混杂因素，包括年龄、体重指数、教育、就业、生活方式因素和病史。结果：孕妇报告更高的上背部疼痛发生率（67.1%对56.4%,p = 0.02）和下背部疼痛发生率（73.9%对64.9%,p = 0.004），而非孕妇报告更多的髋部/大腿疼痛发生率（54.5%对48.4%,p）。结论：本研究挑战了怀孕本身导致更高肌肉骨骼疼痛患病率的假设。身体健康状况比妊娠状况本身起着更重要的作用，突出了妊娠相关肌肉骨骼疼痛的多因素性质。

{"title":"Is pregnancy a major risk factor for musculoskeletal pain? A cross-sectional study","authors":"Mai Mhajne , Asaf Weisman , Tomer Yona , Youssef Masharawi","doi":"10.1016/j.msksp.2025.103482","DOIUrl":"10.1016/j.msksp.2025.103482","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal pain during pregnancy is commonly considered prevalent, though evidence primarily comes from cross-sectional studies lacking appropriate control groups.</div></div><div><h3>Objective</h3><div>To examine the prevalence of musculoskeletal pain among pregnant women compared to non-pregnant women as a reference group.</div></div><div><h3>Design</h3><div>Observational cross-sectional.</div></div><div><h3>Methods</h3><div>1651 women (589 pregnant, 1062 non-pregnant) in Israel completed an online survey using the Hebrew Extended Nordic Musculoskeletal Questionnaire and SF-12. Chi-square tests and logistic regression analyses examined associations between pregnancy status and pain prevalence while controlling for confounding factors including age, BMI, education, employment, lifestyle factors, and medical history.</div></div><div><h3>Results</h3><div>Pregnant women reported higher rates of upper back pain (67.1 % vs. 56.4 %, p = 0.02) and lower back pain (73.9 % vs. 64.9 %, p = 0.004), while non-pregnant women reported more hip/thigh pain (54.5 % vs. 48.4 %, p < 0.001). However, after controlling for confounders in multivariate regression, these associations became non-significant. Pregnant women had significantly lower physical component scores (43.31 ± 9.33 vs. 48.08 ± 8.41, p < 0.001). Physical health status (PCS-12) was the strongest predictor of current low back pain (OR = 0.92, 95 % CI: 0.90–0.94, p < 0.001), pregnancy status showed no independent association (OR = 1.19, 95 % CI: 0.77–1.84, p = 0.430). Smoking emerged as a significant risk factor (OR = 2.02, 95 % CI: 1.03–3.96, p = 0.042).</div></div><div><h3>Conclusion</h3><div>This study challenges the assumption that pregnancy inherently causes higher musculoskeletal pain prevalence. Physical health status plays a more substantial role than pregnancy status per se, highlighting the multifactorial nature of pregnancy-related musculoskeletal pain.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"81 ","pages":"Article 103482"},"PeriodicalIF":2.2,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859067","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}

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