Musculoskeletal Science and Practice最新文献_第3页

Neuroimmune interactions in musculoskeletal conditions. An introduction for clinicians 肌肉骨骼疾病中的神经免疫相互作用。给临床医生的介绍

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-11 DOI: 10.1016/j.msksp.2025.103469

Ivo J. Lutke Schipholt , Michel W. Coppieters , Gwendolyne G.M. Scholten-Peeters , Mark R. Hutchinson , David M. Klyne

Background

The immune system protects against invading pathogens and helps maintain homeostasis. Other pivotal roles include the regulation of tissue health through interactions with the nervous system. Understanding how these neuroimmune interactions may go awry in musculoskeletal conditions and how they can be targeted therapeutically may optimise patient care.

Methods

We conducted a clinically focused narrative review of the role of the immune and nervous systems in musculoskeletal health and conditions such as neck pain, back pain and osteoarthritis and how psychosocial and behavioural factors impact these conditions via interacting with neuroimmune functioning.

Results

The interplay between the immune and nervous system is involved in both the physiology and pathology of musculoskeletal tissues, including bone, joint, nerve, muscle and tendon. We describe this at the local tissue, whole nervous system, and systemic (blood) level and how psychosocial and behavioural factors impact immune activity and influence outcomes. We also highlight recent advances in medical imaging and multi-omics that shed new light on the interplay between the immune and nervous systems in musculoskeletal conditions. Advances in understanding these relationships provide promising new treatment avenues for musculoskeletal conditions and important insights into how psychosocial- and behavioural-based therapies such as exercise and cognitive behavioural therapy work and can be optimised to improve outcomes.

Conclusions

This review provides clinicians with a foundation in the neuroimmunology of musculoskeletal conditions. It also explores how the immune and nervous systems, and their interplay can be modulated to improve prevention and management strategies.

免疫系统保护机体免受病原体入侵，并帮助维持体内平衡。其他关键作用包括通过与神经系统的相互作用来调节组织健康。了解这些神经免疫相互作用如何在肌肉骨骼疾病中出错，以及如何靶向治疗，可能会优化患者护理。方法：我们对免疫和神经系统在肌肉骨骼健康和颈部疼痛、背部疼痛和骨关节炎等疾病中的作用以及社会心理和行为因素如何通过与神经免疫功能的相互作用影响这些疾病进行了临床重点叙述综述。结果免疫系统与神经系统的相互作用涉及骨、关节、神经、肌肉和肌腱等肌肉骨骼组织的生理和病理。我们在局部组织、整个神经系统和全身（血液）水平上描述了这一点，以及社会心理和行为因素如何影响免疫活动和影响结果。我们还强调了医学成像和多组学的最新进展，这些进展为肌肉骨骼疾病中免疫系统和神经系统之间的相互作用提供了新的视角。了解这些关系的进展为肌肉骨骼疾病提供了有希望的新治疗途径，并对基于社会心理和行为的疗法（如运动和认知行为疗法）如何起作用以及如何优化以改善结果提供了重要见解。结论本综述为临床医生在肌肉骨骼疾病的神经免疫学方面提供了基础。它还探讨了如何调节免疫和神经系统及其相互作用，以改善预防和管理策略。

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引用次数: 0

Corrigendum to “Osteoarthritis Hip and Knee Service (OAHKS) in a community health setting compared to the hospital setting: A feasibility study for a new care pathway” [Musculoskel.l Sci.d Pract., 49 (2020) 102167] “骨关节炎髋关节和膝关节服务（OAHKS）在社区卫生环境中与医院环境相比较：一种新的护理途径的可行性研究”的勘误表[musculoskkel]。l科学。d Pract。科学通报，49(2020):102167]。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-10 DOI: 10.1016/j.msksp.2025.103467

Alison J. Gibbs , Nicholas F. Taylor , Raphael Hau , Christian Barton , Chris Fong , Leanne Roddy , Kylie J. Durant , Leanne D. deVos , Jason A. Wallis

引用次数: 0

Neuro-immune contributors to persistent musculoskeletal pain: from mechanisms to clinical assessment and management 神经免疫对持续性肌肉骨骼疼痛的影响：从机制到临床评估和管理。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-10 DOI: 10.1016/j.msksp.2025.103468

Colette Ridehalgh , Joel Fundaun , Scott Farrell

Introduction

Persistent musculoskeletal (MSK) pain conditions are highly prevalent and economically burdensome. Although extensive research has explored various management strategies for these conditions, most interventions yield only modest effects. Recently, there has been increasing recognition of neuro-immune contributions in several persistent MSK pain conditions not traditionally associated with such influences.

Purpose

The aim of this Masterclass is to provide an overview of some key neuro-immune factors that may contribute to persistent MSK pain whilst detailing both simple bedside and advanced novel methods to identify such neuro-immune contributions. It will also examine why an understanding of such contributions may be beneficial for the assessment and management of people with persistent MSK pain conditions.

Implications

Understanding neuro-immune contributions to persistent MSK pain and how to identify them will help clinicians to i). consider the involvement of the nervous and immune systems when managing people with persistent MSK pain conditions, ii). better understand the use of both simple bedside tests and novel methods to identify such mechanisms and iii). consider how neuro-immune contributions may inform management strategies.

持续性肌肉骨骼（MSK）疼痛条件是高度普遍和经济负担。尽管广泛的研究探索了针对这些疾病的各种管理策略，但大多数干预措施仅产生适度的效果。最近，人们越来越多地认识到，在几种与此类影响传统上无关的持续性MSK疼痛条件下，神经免疫的作用。目的：本大师班的目的是提供一些可能导致持续性MSK疼痛的关键神经免疫因素的概述，同时详细介绍简单的床边和先进的新方法来识别此类神经免疫贡献。它也将检查为什么这样的贡献的理解可能是有益的评估和管理的人与持续性MSK疼痛条件。含义：了解神经免疫对持续性MSK疼痛的影响以及如何识别它们将有助于临床医生：1)在管理持续性MSK疼痛患者时考虑神经和免疫系统的参与；2)更好地理解使用简单的床边测试和新方法来识别这些机制；3)考虑神经免疫的影响如何为管理策略提供信息。

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引用次数: 0

The representation of individuals from ethnically minoritised groups in pain science education randomised controlled trials: a scoping review 疼痛科学教育随机对照试验中少数民族个体的代表性：范围审查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-08 DOI: 10.1016/j.msksp.2025.103466

J. Pun , J. Franklin , S. Browne , J. Mankelow , A. Mardon , J. Watson , H.B. Leake , C.G. Ryan

Background

Pain science education seeks to improve an individual's understanding of their pain, and thus improve outcomes. It has been primarily developed and tested within western cultures. The extent and nature of ethnically minoritised group involvement in pain science education trials is unknown.

Objective

This scoping review aimed to investigate the level of representation of people from ethnically minoritised groups in pain science education randomised controlled trials.

Methods

This scoping review follows Joanna Briggs Institute guidelines and is reported in line with PRISMA-SCR guidelines. The following search engines were reviewed: CINAHL, EMBASE, MEDLINE, AMED and APA PSYCArticles. Eligible studies were randomised controlled trials involving people with chronic pain who had received pain science education as a focused intervention. The two stage study selection process and data extraction were completed by independent reviewers. Data is presented to quantify ethnically minoritised representation.

Results

Sixty-two studies were included in the review, totaling 4685 participants. Nineteen studies reported on ethnicity, ten included no participants from minoritised groups, whilst nine included ethnically minoritised participants ranging from 3 to 29 %.

Conclusion

Overall, this review identified that participant ethnicity is not commonly reported in pain science education randomised controlled trials, which highlights an urgent need for better reporting. Where data on ethnicity was reported, ethnically minoritised groups were largely under-represented, raising questions about the generalisability of existing evidence, and underscoring the need for more inclusive and representative research practices in pain science education trials.

疼痛科学教育旨在提高个人对疼痛的理解，从而改善治疗效果。它主要是在西方文化中发展和测试的。少数民族群体参与疼痛科学教育试验的程度和性质尚不清楚。目的本综述旨在调查少数民族在疼痛科学教育随机对照试验中的代表性水平。方法本综述遵循乔安娜布里格斯研究所的指南，并根据PRISMA-SCR指南进行报道。本文综述了以下几个搜索引擎：CINAHL、EMBASE、MEDLINE、AMED和APA PSYCArticles。符合条件的研究是随机对照试验，涉及接受疼痛科学教育作为重点干预的慢性疼痛患者。两个阶段的研究选择过程和数据提取由独立审稿人完成。提供数据是为了量化少数民族的代表性。结果纳入62项研究，共4685名受试者。19项研究报告了种族，10项研究没有少数民族参与者，而9项研究包括少数民族参与者，范围从3%到29% %。结论：总体而言，本综述发现疼痛科学教育随机对照试验中参与者种族的报道并不普遍，这表明迫切需要更好的报道。在种族数据报告中，少数族裔群体的代表性不足，这引发了对现有证据的普遍性的质疑，并强调了在疼痛科学教育试验中需要更具包容性和代表性的研究实践。

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引用次数: 0

Predictors of response to physical exercise for low back pain: a secondary analysis of the ReViEEW trial 腰痛患者对体育锻炼反应的预测因素：review试验的二次分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-03 DOI: 10.1016/j.msksp.2025.103465

Ander Espin , Ana Rodriguez-Larrad , Aida Ruiz-Fernández , Andrea Martín-Pérez , Naiara Fernández-Gutiérrez , Lars Louis Andersen , Jon Irazusta

Background

Non-specific low back pain (nsLBP) is a prevalent and disabling condition, especially among eldercare workers. Although physical exercise is strongly recommended for nsLBP, individual responses vary considerably. Understanding the characteristics that distinguish responders from non-responders could lead to more personalized and effective interventions.

Objectives

To identify predictors of response to physical exercise for nsLBP in eldercare workers.

Design

Secondary analysis of the ReViEEW randomized controlled trial.

Methods

Participants (n = 77) with baseline nsLBP intensity of ≥2 on the 0–10 numerical rating scale were included. The intervention consisted of a 12-week, twice-weekly videoconference-supervised exercise program. Responders were defined as those with ≥2-point reduction in pain post-intervention. Thirty-eight variables across eight multidimensional domains were compared between responders and non-responders using independent samples T or Mann–Whitney U tests. Variables showing between-group differences (p < 0.1) were entered into multiple logistic regression analysis.

Results

Thirty-nine participants (51 %) were classified as responders. Of the 38 variables only three differed between groups: responders had significantly higher nsLBP intensity (p = 0.045), lower anxious symptomatology (p = 0.040), and lower hypnotic/anxiolytic medication use (p = 0.092) compared to non-responders. In the regression model, higher baseline pain intensity independently predicted favorable response (OR = 1.37; 95 % CI: 1.03–1.81), while higher anxiety predicted poorer response (OR = 0.79; 95 %CI: 0.64–0.97).

Conclusions

Higher baseline pain intensity and lower anxiety levels were independent predictors of favorable response to physical exercise for nsLBP in eldercare workers. These findings may inform more targeted clinical decision-making and treatment selection in this population.

Trial registration

ClinicalTrials.gov, (NCT05050526). Registered 20 September 2021—Prospectively registered.

背景：非特异性腰痛（nsLBP）是一种常见的致残疾病，尤其是在老年护理人员中。尽管强烈建议进行体育锻炼来治疗非slbp，但个体的反应差异很大。了解反应者和非反应者的区别特征可以导致更个性化和有效的干预措施。目的：确定老年护理人员对非slbp患者体育锻炼反应的预测因素。设计：review随机对照试验的二次分析。方法：纳入0-10数值评定量表中基线nsLBP强度≥2的参与者（n = 77）。干预包括一个为期12周，每周两次的视频会议监督的锻炼计划。应答者定义为干预后疼痛减轻≥2分的患者。使用独立样本T或Mann-Whitney U检验比较响应者和非响应者之间8个多维域的38个变量。显示组间差异的变量(p)结果：39名参与者（51%）被归类为应答者。在38个变量中，组间只有3个不同：与无反应者相比，反应者的nsLBP强度显著较高（p = 0.045），焦虑症状较低（p = 0.040），催眠/抗焦虑药物使用较低（p = 0.092）。在回归模型中，较高的基线疼痛强度独立预测良好的反应（OR = 1.37; 95% CI: 1.03-1.81），而较高的焦虑预测较差的反应（OR = 0.79; 95% CI: 0.64-0.97）。结论：较高的基线疼痛强度和较低的焦虑水平是老年护理人员对非slbp患者体育锻炼反应良好的独立预测因素。这些发现可能为这一人群提供更有针对性的临床决策和治疗选择。试验注册：ClinicalTrials.gov, （NCT05050526）。已注册- 2021年9月20日已注册。

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引用次数: 0

Pain, grip strength, and motor imagery reaction time are associated with pain and disability in individuals with chronic lateral elbow tendinopathy 慢性肘关节外侧病变患者的疼痛、握力和运动意象反应时间与疼痛和残疾有关。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-01 DOI: 10.1016/j.msksp.2025.103463

Hasan Gercek , Emine Cihan , Fatih Celik , Bayram Sonmez Unuvar , Zubeyir Sari

Background

Chronic lateral epicondylitis(LE), is associated with persistent pain and functional impairment in the upper extremity. While peripheral factors such as pain and muscle strength are well recognized, emerging evidence suggests that central mechanisms, including motor imagery ability and body awareness, may also contribute to dysfunction.

Objective

The aim of this study was to investigate the effect of pain intensity, motor imagery performance, grip strength, body awareness and pain duration on pain and disability in individuals with chronic LE.

Design

Cross-sectional.

Methods

This cross-sectional study included 98 individuals diagnosed with chronic LE. Function was assessed using the Patient-Rated Tennis Elbow Evaluation(PRTEE). Pain intensity was measured via the Visual Analog Scale(VAS), grip strength via hand dynamometry, motor imagery through left/right hand judgment using the Recognise™ application, and body awareness using the Body Awareness Questionnaire. Multiple linear regression analysis was performed to determine predictors of functional status.

Results

The regression model was statistically significant(F = 10.984, p < 0.001), explaining 49.6 % of the variance in function(adjusted R² = 0.496). Pain during activity(β = 0.449, p < 0.001), pain at rest(β = 0.196, p = 0.049), pain duration(β = 0.207, p = 0.023), grip strength(β = 0.343, p < 0.001), and motor imagery reaction time(β = 0.228, p = 0.016) were significant predictors. Accuracy in motor imagery and body awareness did not significantly predict function.

Conclusion

Function in chronic LE is influenced by both peripheral and central factors. Rehabilitation approaches should therefore integrate strategies addressing both musculoskeletal impairments and altered neuromotor control to improve functional outcomes.

Trial registiration

Prospectively registered on Clinicaltrials.gov on 07/17/2024 (registration number: NCT06459102) (Link: https://clinicaltrials.gov/study/NCT06459102?term=NCT06459102&rank=1).

背景：慢性外上髁炎（LE）与上肢的持续性疼痛和功能障碍有关。虽然疼痛和肌肉力量等外围因素已得到充分认识，但新出现的证据表明，包括运动想象能力和身体意识在内的中枢机制也可能导致功能障碍。目的：探讨疼痛强度、运动意象表现、握力、身体意识和疼痛持续时间对慢性LE患者疼痛和残疾的影响。设计:横断面。方法：本横断面研究包括98例诊断为慢性LE的个体。使用患者评分网球肘评估（PRTEE）评估功能。通过视觉模拟量表（VAS）测量疼痛强度，通过手部动力测量测量握力，通过使用recognition™应用程序通过左/右手判断来测量运动图像，使用身体意识问卷来测量身体意识。采用多元线性回归分析确定功能状态的预测因子。结果：回归模型具有统计学意义（F = 10.984, p 2 = 0.496）。活动时疼痛（β = 0.449, p）结论：慢性LE的功能受外周和中枢因素的影响。因此，康复方法应整合针对肌肉骨骼损伤和改变的神经运动控制的策略，以改善功能结果。试验注册：于2024年7月17日在Clinicaltrials.gov上前瞻性注册（注册号：NCT06459102）（链接：https://clinicaltrials.gov/study/NCT06459102?term=NCT06459102&rank=1）。

{"title":"Pain, grip strength, and motor imagery reaction time are associated with pain and disability in individuals with chronic lateral elbow tendinopathy","authors":"Hasan Gercek , Emine Cihan , Fatih Celik , Bayram Sonmez Unuvar , Zubeyir Sari","doi":"10.1016/j.msksp.2025.103463","DOIUrl":"10.1016/j.msksp.2025.103463","url":null,"abstract":"<div><h3>Background</h3><div>Chronic lateral epicondylitis(LE), is associated with persistent pain and functional impairment in the upper extremity. While peripheral factors such as pain and muscle strength are well recognized, emerging evidence suggests that central mechanisms, including motor imagery ability and body awareness, may also contribute to dysfunction.</div></div><div><h3>Objective</h3><div>The aim of this study was to investigate the effect of pain intensity, motor imagery performance, grip strength, body awareness and pain duration on pain and disability in individuals with chronic LE.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 98 individuals diagnosed with chronic LE. Function was assessed using the Patient-Rated Tennis Elbow Evaluation(PRTEE). Pain intensity was measured via the Visual Analog Scale(VAS), grip strength via hand dynamometry, motor imagery through left/right hand judgment using the Recognise™ application, and body awareness using the Body Awareness Questionnaire. Multiple linear regression analysis was performed to determine predictors of functional status.</div></div><div><h3>Results</h3><div>The regression model was statistically significant(F = 10.984, p < 0.001), explaining 49.6 % of the variance in function(adjusted R<sup>2</sup> = 0.496). Pain during activity(β = 0.449, p < 0.001), pain at rest(β = 0.196, p = 0.049), pain duration(β = 0.207, p = 0.023), grip strength(β = 0.343, p < 0.001), and motor imagery reaction time(β = 0.228, p = 0.016) were significant predictors. Accuracy in motor imagery and body awareness did not significantly predict function.</div></div><div><h3>Conclusion</h3><div>Function in chronic LE is influenced by both peripheral and central factors. Rehabilitation approaches should therefore integrate strategies addressing both musculoskeletal impairments and altered neuromotor control to improve functional outcomes.</div></div><div><h3>Trial registiration</h3><div>Prospectively registered on Clinicaltrials.gov on 07/17/2024 (registration number: NCT06459102) (Link: <span><span>https://clinicaltrials.gov/study/NCT06459102?term=NCT06459102&rank=1</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"81 ","pages":"Article 103463"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688668","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

Spinal range of motion during different swim strokes in people with chronic low back pain: a randomised crossover trial 慢性腰痛患者不同泳姿时的脊柱运动范围：一项随机交叉试验。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-12-01 DOI: 10.1016/j.msksp.2025.103464

Deborah M. Wareham , Mark J. Hancock , Petra L. Graham , Eoin W. Doyle , Natasha C. Pocovi , Joel T. Fuller

Background

The spinal biomechanics of different swim strokes may impact swimming's suitability for chronic low back pain patients, but this remains unexplored.

Objective

Compare spinal range of motion between different swimming strokes in chronic low back pain patients.

Design

Randomised crossover trial.

Method

Chronic low back pain participants completed 100m of freestyle, breaststroke, and backstroke in a random order during one indoor pool session. Inertial measurement units were worn at T2 and S2 spinal landmarks. The primary outcome was inter-sensor range of motion (T2 and S2 sensor difference) for flexion/extension, rotation and lateral flexion. Mixed-effect models compared strokes.

Results

Twenty-two females and 8 males participated (age: 43 ± 15, pain intensity: 2.9 ± 2.2). Flexion/extension range of motion was greatest for breaststroke (22.6 ± 11.3°); increases were small compared to freestyle (Mean difference [MD]: 3.6 [95 % Confidence interval: -2.1 to 9.2]; p = 0.29) and large compared to backstroke (MD: 8.8 [3.2 to 14.5]; p = 0.001). Rotation range of motion was greatest for freestyle (36.7 ± 23.3°); increases were trivial compared to backstroke (MD: 2.6 [-6.5 to 11.6]; p = 0.78) and large compared to breaststroke (MD: 27.1 [18.1 to 36.1]; p < 0.001). Lateral flexion range of motion was greatest for freestyle (32.6 ± 10.6°); increases were moderate to large compared to backstroke (MD: 6.7 [1.2 to 12.2]; p = 0.01) and breaststroke (MD: 25.2 [19.7 to 30.7]; p < 0.001).

Conclusion

Freestyle produced the largest overall spinal range of motion, with the most rotation and lateral flexion. Breaststroke produced the most flexion/extension. Backstroke produced mostly rotation and lateral flexion.

背景：不同泳姿的脊柱生物力学可能会影响慢性腰痛患者的游泳适应性，但这方面的研究尚未深入。目的：比较不同泳姿对慢性腰痛患者脊柱活动度的影响。设计：随机交叉试验。方法：慢性腰痛的参与者在一次室内泳池中以随机顺序完成100米自由泳、蛙泳和仰泳。在T2和S2脊柱地标处佩戴惯性测量装置。主要结果是屈伸、旋转和侧屈的传感器间运动范围（T2和S2传感器差异）。混合效果模型比较了笔画。结果：女性22人，男性8人，年龄43±15岁，疼痛强度2.9±2.2。屈伸活动范围在蛙泳中最大（22.6±11.3°）；与自由泳相比，增加幅度较小（平均差异[MD]: 3.6[95%置信区间：-2.1至9.2];p = 0.29），而与仰泳相比，增加幅度较大（MD: 8.8[3.2至14.5];p = 0.001）。自由式旋转幅度最大（36.7±23.3°）；与仰泳相比，增加的幅度很小（MD: 2.6[-6.5至11.6];p = 0.78），而与蛙泳相比，增加的幅度很大（MD: 27.1[18.1至36.1]）；p结论：自由泳产生了最大的脊柱整体运动范围，有最多的旋转和侧屈。蛙泳产生最多的屈曲/伸展。仰泳主要产生旋转和侧屈。

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引用次数: 0

Physiotherapist factors associated with the intention to deliver psychologically informed physiotherapy in persistent low back pain: An online cross-sectional vignette study 物理治疗师因素与持续腰痛提供心理知情物理治疗的意图相关：一项在线横断面小研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-27 DOI: 10.1016/j.msksp.2025.103462

Claire Earl , Debbie J. Bean , Gwyn N. Lewis

Background

Prior qualitative research has revealed several barriers to physiotherapists delivering psychologically informed physiotherapy (PIP). It is not known which factors are most relevant to PIP delivery.

Objectives

To determine the proportion of physiotherapists in Aotearoa/New Zealand who intend to deliver PIP to persons with non-specific low back pain (LBP), and to determine factors associated with the intention to deliver PIP.

Design

This study used a cross-sectional online vignette case survey design.

Setting

Aotearoa/New Zealand registered physiotherapists who regularly treat LBP were invited to participate.

Methods

Participants (n = 224) outlined their intended assessment and treatment plan for two vignettes with persistent LBP. They then completed the Knowledge and Attitudes of Pain Questionnaire (KNAP), components of the Determinants of Implementation Behaviour Questionnaire (DIBQ) and demographic questions.

The proportion of physiotherapists intending to deliver PIP was determined by scoring participants’ vignette plans as psychologically informed or non-psychologically informed. Binary regression was used to determine which questionnaire and demographic variables were associated with the intention to deliver PIP.

Results

One third of participants intended to deliver PIP in the management of LBP. Binary regression analysis showed that pain knowledge and attitudes were consistently associated with the intention to deliver PIP across vignettes (OR = 1.05, 95 % CI = 1.01–1.08; p = .015) (OR = 1.05, 95 % CI = 1.02–1.09, p = .005). Beliefs about the consequences of PIP was associated with the intention to deliver PIP in one vignette (OR = 2.15, 95 % CI = 1.12–4.11, p = .021).

Conclusion

Findings suggest that physiotherapists’ knowledge and attitudes towards pain and their belief that PIP is effective are associated with PIP delivery. Improving pain knowledge and beliefs around PIP may improve the quality of LBP management.

背景：先前的定性研究揭示了物理治疗师提供心理知情物理治疗（PIP）的几个障碍。目前尚不清楚哪些因素与PIP交付最相关。目的：确定Aotearoa/新西兰打算为非特异性腰痛（LBP）患者实施PIP治疗的物理治疗师的比例，并确定与实施PIP治疗意图相关的因素。设计：本研究采用横断面在线小案例调查设计。设置：邀请新西兰/新西兰的注册物理治疗师定期治疗LBP。方法：参与者（n = 224）概述了他们对两名持续性腰痛患者的预期评估和治疗计划。然后，他们完成了疼痛知识和态度问卷（KNAP），实施行为决定因素问卷（DIBQ）的组成部分和人口统计问题。物理治疗师打算提供PIP的比例是通过将参与者的小插曲计划评分为心理知情或非心理知情来确定的。使用二元回归来确定哪些问卷和人口统计变量与提供PIP的意图相关。结果：三分之一的参与者打算在LBP的治疗中使用PIP。二元回归分析显示，疼痛知识和态度与跨小节提供PIP的意图一致（OR = 1.05, 95% CI = 1.01-1.08; p = 0.015）（OR = 1.05, 95% CI = 1.02-1.09, p = 0.005）。在一个小插曲中，对PIP后果的信念与实施PIP的意图相关（OR = 2.15, 95% CI = 1.12-4.11, p = 0.021）。结论：研究结果表明，物理治疗师对疼痛的认识和态度以及他们对PIP有效的信念与PIP的实施有关。提高PIP的疼痛知识和信念可以提高腰痛管理的质量。

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引用次数: 0

Structure and function of the Achilles tendon and plantarflexors after non-surgical management of Achilles tendon rupture: A cross-sectional study 非手术治疗跟腱断裂后跟腱和跖屈肌的结构和功能：一项横断面研究

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-25 DOI: 10.1016/j.msksp.2025.103459

Samuel Briggs-Price , Tom Yates , Jitendra Mangwani , Maneesh Bhatia , Annette Jones , Klaudia Mielcarek , Amy Solaini , Shing Yan Leung , Karin Gravare Silbernagel , Kim Hebert-Losier , Robert-Jan de Vos , Neal L. Millar , Bill Vicenzino , Seth O'Neill

Background

Achilles tendon rupture (ATR) impacts the structure and function of the tendon and triceps surae. We aimed to describe recovery at different time points after injury using ultrasound imaging, strength testing and patient reported outcomes.

Methods

Cross-sectional study design, collecting data from 15 different non-surgically managed participants at six independent rehabilitation time points (week 0, 8, 10, 16, 26, 52 post ATR). Outcomes included ultrasound tissue characterisation (UTC), isometric plantarflexor strength, Achilles tendon rupture score (ATRS), Euroqol 5-dimension, hospital anxiety and depression scale and Tampa Scale for Kinesiophobia. UTC echo type percentage is reported as aligned fibrillar structure (AFS) and disorganised fibrillar structure (DFS).

Findings

Participants mean (SD) age was 48 years (15.8), 91 % male, body mass index 29kg/m2 (4.3) and 54 % was white British. Primary mechanism of injury was sport (71 %).

Ruptured tendon cross-sectional area (CSA) was 303.55 mm² (90.43) at 10 weeks and 218.18 mm² (61.82) at 52 weeks post ATR. For the ruptured tendon, later assessment time points were associated with decreased AFS but had no association with DFS.

Isometric plantarflexor strength on the ruptured limb at 52 weeks was 61.3 kg (20.8) or 0.7x bodyweight (BW). Non-ruptured plantarflexor strength was 93.3 kg (29.5) or 1.1x BW. Leg symmetry index at 52 weeks was 67 %. ATRS at 52 weeks was 75.1 (16.5).

Conclusion

Substantial tendon remodelling may occur during the initial 52 weeks post ATR, CSA was 28 % lower from 10 weeks to 52 weeks. At 52 weeks there was persistence of fibrillar disorganisation, isometric plantarflexor weakness and reduced function.

Trial registration

ClinicalTrials.gov ID: NCT05676632.

背景：跟腱断裂（ATR）会影响跟腱和肱三头肌表面的结构和功能。我们的目的是通过超声成像、力量测试和患者报告的结果来描述损伤后不同时间点的恢复情况。方法采用横断面研究设计，收集15名不同的非手术治疗参与者在6个独立康复时间点（ATR后第0、8、10、16、26、52周）的数据。结果包括超声组织表征（UTC）、等距跖屈肌强度、跟腱断裂评分（ATRS）、Euroqol 5维量表、医院焦虑抑郁量表和坦帕运动恐惧症量表。UTC回声类型百分比报告为排列纤维结构（AFS）和无组织纤维结构（DFS）。研究发现，参与者的平均（SD）年龄为48岁（15.8岁），91%为男性，体重指数为29kg/m2(4.3)， 54%为英国白人。损伤的主要机制是运动（71%）。ATR后10周断裂肌腱横截面积（CSA）为303.55 mm2(90.43)， 52周为218.18 mm2（61.82）。对于断裂肌腱，稍后的评估时间点与AFS下降有关，但与DFS无关。52周时骨折肢体的跖屈肌强度为61.3 kg（20.8）或0.7倍体重（BW）。未破裂的跖屈肌强度为93.3 kg（29.5）或1.1x体重。52周时腿部对称指数为67%。52周ATRS为75.1（16.5）。结论ATR术后52周内可发生大量肌腱重建，10周至52周CSA降低28%。52周时，纤维组织持续紊乱，跖屈肌无力和功能下降。临床试验注册。gov ID: NCT05676632。

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引用次数: 0

How to summarise or combine lumbar MRI-findings for studying associations with low back pain: A modified Delphi study 如何总结或结合腰痛相关研究的mri结果：一项修正的德尔菲研究

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-24 DOI: 10.1016/j.msksp.2025.103446

Line Dragsbæk , Per Kjær , Rikke Krüger Jensen , Mark Hancock , Katie de Luca , Tue Secher Jensen

Background

There is a lack of understanding on how to optimally combine MRI findings to assess their association with low back pain (LBP).

Objective

To explore expert opinions on optimal approaches to sum or combine lumbar spine MRI findings, and to identify specific combinations of MRI findings considered most strongly associated with LBP.

Design

A two-round modified Delphi study.

Methods

The participants indicated whether a sum score or the most severe finding was most optimal to sum different MRI findings. They also suggested combinations of MRI findings believed to be most strongly associated with 5 different LBP phenotypes (acute/chronic LBP with or without non-radicular leg pain; acute/chronic LBP with radicular leg pain; chronic LBP with bilateral leg pain, and neurogenic claudication). Data were analysed descriptively and visualised using graphs.

Results

Fifty-five multidisciplinary experts participated in round 1 and 39 in round 2. Sum scores were preferred for findings such as disc degeneration, Modic changes, and facet joint degeneration, especially for chronic LBP phenotypes. Using the most severe finding was favoured for nerve root-related or stenotic findings, especially for acute LBP and radicular phenotypes. Suggested combinations varied by phenotype, with disc degeneration, Modic changes, and disc herniation frequent in non-radicular phenotypes, and foraminal stenosis, spondylolisthesis, and nerve root compression more frequent for radicular phenotypes.

Conclusion

The optimal approach to sum or combine lumbar MRI findings depends on the LBP phenotypes. This study provides hypotheses for future research to test the clinical value of combinations of lumbar MRI findings in LBP.

背景：对于如何将MRI检查结果与腰痛（LBP）的相关性进行最佳结合，目前还缺乏了解。目的探讨专家对汇总或组合腰椎MRI表现的最佳方法的意见，并确定与腰痛最密切相关的MRI表现的特定组合。设计：两轮改良德尔菲研究。方法：参与者指出，综合评分或最严重的发现是否最适合综合不同的MRI表现。他们还提出了与5种不同的腰痛表型（急性/慢性腰痛伴或不伴非神经根性腿痛；急性/慢性腰痛伴神经根性腿痛；慢性腰痛伴双侧腿痛和神经源性跛行）最密切相关的MRI结果组合。对数据进行描述性分析，并使用图表进行可视化。结果第一轮共有55名多学科专家参加，第二轮共有39名多学科专家参加。对于椎间盘退变、Modic改变和小关节退变等发现，特别是慢性腰痛表型，总评分是首选的。使用最严重的发现有利于神经根相关或狭窄的发现，特别是急性LBP和神经根表型。建议的组合因表型而异，非神经根型椎间盘退变、模变性和椎间盘突出常见，而神经根型椎间孔狭窄、椎体滑脱和神经根压迫更常见。结论腰椎MRI表现的综合或组合的最佳方法取决于腰痛的表型。本研究为未来的研究提供了假设，以检验腰痛的腰椎MRI表现组合的临床价值。

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