Musculoskeletal Science and Practice最新文献_第5页

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 : 2026-02-01 Epub 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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引用次数: 0

Normalisation of impaired neck muscle function after neck-specific exercises identified by speckle-tracking ultrasound analysis: a longitudinal case-control study of individuals with chronic whiplash-associated disorders compared with healthy controls 斑点跟踪超声分析确定的颈部特异性运动后受损颈部肌肉功能的正常化：与健康对照相比，慢性鞭打相关疾病患者的纵向病例对照研究

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-01 Epub Date: 2025-12-27 DOI: 10.1016/j.msksp.2025.103483

Gunnel Peterson , Erika Andersson , Margaretha Jönsson , Anneli Peolsson

Background

Whiplash injury can impair neck muscle function, which is challenging to assess. Diagnostic ultrasound enables evaluation of musculoskeletal function and exercise effectiveness.

Objectives

To evaluate the function of five dorsal neck muscles before and after 12 weeks of neck-specific exercises in individuals with chronic whiplash-associated disorders (WAD), compared with healthy controls.

Method

Twenty-five individuals with WAD grades II and III and 25 age- and sex-matched controls participated in this study. The WAD group completed a 12-week neck-specific exercise programme. Outcome measures, collected at baseline in both groups and post-intervention in the WAD group, included neck muscle deformation (shortening and/or elongation) assessed by ultrasonography with speckle tracking analyses, neck disability (NDI; Neck Disability Index), neck pain (VAS; Visual Analogue Scale), and neck muscle fatigue (Borg CR-10).

Results

There was a significant difference in neck muscle deformation at baseline, with higher deformation in the WAD group compared with controls (F [1,214] = 14.7, P < 0.001). There was no significant difference in deformation between the groups after three months of neck-specific exercises in WAD compared with control baseline data F [1,200] = 0.1, P = 0.965), indicating restoration towards normal muscle function in the WAD group. The WAD group also improved in disability (NDI; mean 9.8, SD 8.4, P < 0.001), neck pain (VAS; mean 12.1, SD 24.7, p = 0.036), and fatigue (Borg CR-10; median 1.0, IQR; 0.5–2.5, P = 0.019).

Conclusions

The study indicates normalisation of dorsal neck muscle function in individuals with WAD after a neck-specific exercise programme.

背景：鞭伤可损害颈部肌肉功能，其评估具有挑战性。诊断超声可以评估肌肉骨骼功能和运动效果。目的：评价慢性鞭扭伤相关疾病（WAD）患者颈部专项运动前后12周颈部背侧肌肉的功能，并与健康对照进行比较。方法：25例WAD II级和III级患者和25例年龄和性别匹配的对照组参加了本研究。WAD组完成了为期12周的颈部运动计划。结果测量，收集在基线两组和干预后WAD组，包括颈部肌肉变形（缩短和/或伸长）评估超声斑点跟踪分析，颈部残疾（NDI；颈部残疾指数），颈部疼痛（VAS；视觉模拟量表），和颈部肌肉疲劳（Borg CR-10）。结果：基线时颈部肌肉变形有显著差异，与对照组相比，WAD组的变形更高（F [1,214] = 14.7， P）。结论：该研究表明，WAD患者在颈部特定运动计划后，颈背肌肉功能正常化。

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引用次数: 0

Response to Letter to the Editor regarding “Can pre-treatment verbal suggestions influence the short-term effects of spinal manipulation in young adults with chronic non-specific low back pain? A randomized controlled trial” 关于“治疗前口头建议是否会影响患有慢性非特异性腰痛的年轻成人脊柱操作的短期效果？”随机对照试验”。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1016/j.msksp.2025.103479

Kamil Zaworski , Joanna Baj-Korpak , Małgorzata Tokarska-Rodak , Ewa Plażuk , Andżelika Nazarewicz , Joel Bialosky , Giacomo Rossettini

引用次数: 0

The pain education paradox and validation gap 疼痛教育悖论与验证差距

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-01 Epub Date: 2025-12-24 DOI: 10.1016/j.msksp.2025.103476

Asaf Weisman , Monica Noy , Youssef Masharawi

Introduction

Healthcare professionals routinely manage pain, medicine's most common complaint, yet receive critically inadequate pain education, often less than 1 % of curriculum hours, despite pain being present in up to 80 % of clinical consultations. Current pain education programs claim to employ evidence-based approaches. Yet, they operate within a fundamental validation crisis: we cannot validate what constitutes effective practitioner competency because we lack evidence that improved practitioner knowledge translates into better patient outcomes.

Purpose

This paper addresses the validation crisis manifesting across three levels: we don't know which competencies practitioners need, whether our teaching methods develop these competencies, or if practitioner competency matters for patient recovery. We examine how commercial Pain Neuroscience Education programs problematically blur the distinction between practitioner and patient education while masking validation gaps through circular reasoning. The paper presents four foundational competencies that prioritize intellectual honesty over false certainty: understanding pain terminology, integrating contemporary neuroscience, critical appraisal with epistemic humility, and distinguishing between treating pain mechanisms and supporting individuals experiencing pain.

Implications for practice

This framework challenges all healthcare professionals managing pain to abandon unfounded evidence-based claims and embrace radical honesty about uncertainty. For disciplines whose interventions have historically emphasized biomechanical models, including physical therapists, chiropractors, osteopaths, and orthopedic surgeons, this means moving beyond those theories to understand contemporary pain science while clearly communicating scope limitations. The approach enables practitioners to recognize intervention limitations, identify referral needs, set realistic expectations, and avoid nocebo effects from outdated explanations, ultimately serving patients through scientific integrity rather than false promises.

医疗保健专业人员常规处理疼痛，医学上最常见的抱怨，但接受严重不足的疼痛教育，通常不到1%的课程时间，尽管疼痛存在于高达80%的临床咨询。目前的疼痛教育项目声称采用循证方法。然而，他们在一个基本的验证危机中运作：我们无法验证什么构成了有效的从业者能力，因为我们缺乏证据表明，改进的从业者知识可以转化为更好的患者结果。目的：本文解决了三个层面上的验证危机：我们不知道从业者需要哪些能力，我们的教学方法是否培养了这些能力，或者从业者的能力是否对患者的康复很重要。我们研究了商业疼痛神经科学教育项目如何有问题地模糊了医生和患者教育之间的区别，同时通过循环推理掩盖了验证差距。本文提出了四种基本能力，优先考虑智力诚实而不是错误的确定性：理解疼痛术语，整合当代神经科学，批判性评估与认知谦卑，区分治疗疼痛机制和支持个体体验疼痛。这一框架要求所有管理疼痛的医疗保健专业人员放弃毫无根据的基于证据的说法，并接受对不确定性的彻底诚实。对于那些历史上强调生物力学模型的学科，包括物理治疗师、脊椎按摩师、整骨治疗师和整形外科医生，这意味着超越这些理论，了解当代疼痛科学，同时清楚地传达范围限制。该方法使从业者能够认识到干预的局限性，确定转诊需求，设定现实的期望，并避免过时的解释产生反安慰剂效应，最终通过科学诚信而不是虚假承诺为患者服务。

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引用次数: 0

Sensorimotor incongruence is associated with increased symptom severity in people with frozen shoulder: a cross-sectional study 感觉运动不一致与肩周炎患者症状严重程度增加有关：一项横断面研究

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-01 Epub Date: 2025-11-24 DOI: 10.1016/j.msksp.2025.103458

Michel Gcam Mertens , Rodrigo Núñez-Cortés , Enrique Lluch , Mercè Balasch-Bernat , Enrique Sanchis-Sánchez , Marta Morcillo-Alcolea , Lirios Dueñas

Introduction

Frozen shoulder (FS) is a common musculoskeletal condition characterized by shoulder pain and range of motion restrictions. While traditionally considered nociceptive, recent research suggests central pain mechanisms may also be involved.

Objective

This study aimed to determine the effect of experimental sensorimotor incongruence (SMI) on pain and sensory disturbances in people with FS and asymptomatic controls.

Methods

The study included two groups: people with FS and asymptomatic controls. Participants underwent a bimanual coordination test with eight paradigms (four per side: congruent and incongruent with a mirror or whiteboard). Outcome measures were assessed immediately after each paradigm and consisted of pain, discomfort, perceived temperature or weight changes, experiencing an extra or loss of an arm, and feelings of peculiarity.

Results

A total of 69 participants were included (36 with FS and 33 asymptomatic controls). Results showed that people with FS experienced a significant increase in pain and sensory discomfort when exposed to SMI paradigms compared to controls. Both congruent and incongruent paradigms exacerbated pain levels, whereas changes in perceived weight were observed variably across congruent and incongruent movements.

Conclusion

These findings support the hypothesis that SMI plays a crucial role in pain modulation in FS, possibly through altered central pain processing and neuroplastic changes. The results highlight the need for therapeutic approaches addressing both musculoskeletal and neuroplastic components of FS.

肩周炎（FS）是一种常见的肌肉骨骼疾病，以肩关节疼痛和活动受限为特征。虽然传统上被认为是伤害性的，但最近的研究表明，中枢疼痛机制也可能参与其中。目的探讨实验性感觉运动不一致（SMI）对FS患者和无症状对照者疼痛和感觉障碍的影响。方法研究分为两组：FS患者和无症状对照组。参与者进行了8个范式的双手协调测试（每侧4个范式：与镜子或白板一致和不一致）。结果测量在每个模式后立即进行评估，包括疼痛，不适，感知温度或体重变化，经历额外或失去手臂以及特殊感觉。结果共纳入69例受试者，其中FS组36例，无症状对照组33例。结果显示，与对照组相比，FS患者在暴露于SMI范式时疼痛和感觉不适显著增加。一致和不一致的范式都加剧了疼痛水平，而在一致和不一致的运动中观察到的感知体重的变化是可变的。结论这些发现支持了SMI在FS疼痛调节中起关键作用的假设，可能通过改变中枢性疼痛加工和神经可塑性改变。结果强调需要治疗方法解决FS的肌肉骨骼和神经可塑性成分。

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引用次数: 0

Inter-rater reliability of real-time compared to recorded single-leg squat assessment with the qualitative analysis of single leg loading assessment tool (QASLS) in healthy individuals 健康个体单腿负荷评估工具（QASLS）定性分析实时与记录单腿深蹲评估的评分间信度

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2026-02-01 Epub Date: 2025-11-13 DOI: 10.1016/j.msksp.2025.103445

Sebastiano Nutarelli , Luigi Di Filippo , Filippo Frascarolo , Leonardo Pellicciari

Background

The analysis of single-leg (SL) tasks' movement quality helps assess lower limb injury risk. 3D motion capture is the gold standard, but it is costly and often inaccessible. The Qualitative Analysis of Single Leg Loading Assessment Tool (QASLS) offers a reliable and valid alternative. No study compared real-time vs. video-recorded QASLS assessments of single-leg squat (SLS).

Objectives

Comparing the real-time vs. video-recorded QASLS assessment reliability of SLS.

Design

Reliability study.

Methods

100 healthy individuals were included, performing 10 video-recorded SLS per lower limb. An assessor scored them real-time, and an independent rater evaluated the video-recorded tests, both with QASLS. Wilcoxon test was used to study the difference between assessments; inter-rater reliability between real-time vs. video-recorded QASLS assessments was assessed with the intraclass correlation coefficient (ICC) with the 95 % confidence interval (CI).

Results

Wilcoxon test reported significant differences emerged between left real-time and recorded QASLS (Z = −2.780; p = 0.005) and right + left real-time and recorded QASLS (Z = −2.976; p = 0.003); not between right real-time and recorded QASLS (Z = −1.331; p = 0.183). Inter-rater reliability was poor between left real-time and recorded QASLS (ICC = 0.306; 95 % CI:0.118, 0.473) and right + left real-time and recorded QASLS (ICC = 0.425; 95 % CI:0.304, 0.532), and moderate between right real-time and recorded QASLS (ICC = 0.524; 95 % CI:0.365, 0.652).

Conclusions

SLS evaluation with QASLS should be conducted on video-recorded playbacks rather than real-time, since the latter assessment is not reliable.

背景单腿任务运动质量分析有助于评估下肢损伤风险。3D动作捕捉是黄金标准，但它成本高昂，而且往往难以实现。定性分析单腿载荷评估工具（QASLS）提供了一个可靠和有效的替代方案。没有研究比较实时和视频记录的单腿深蹲（SLS） QASLS评估。目的比较实时与录像QASLS评价的可靠性。DesignReliability研究。方法选取100名健康个体，每条下肢进行10次录像SLS。一名评估员对他们进行实时评分，一名独立评分员对录像测试进行评估，两者都使用QASLS。采用Wilcoxon检验研究评估之间的差异；采用类内相关系数（ICC）评估实时与视频记录的QASLS评估之间的等级间信度，置信区间为95%。结果wilcoxon检验报告，左侧实时与记录的QASLS （Z = - 2.780, p = 0.005）和右侧+左侧实时与记录的QASLS （Z = - 2.976, p = 0.003）存在显著差异；正确实时QASLS与记录QASLS之间无差异（Z = - 1.331; p = 0.183）。左侧实时与记录的QASLS （ICC = 0.306, 95% CI:0.118, 0.473）和右侧+左侧实时与记录的QASLS （ICC = 0.425, 95% CI:0.304, 0.532）的评分间信度较差，右侧实时与记录的QASLS （ICC = 0.524, 95% CI:0.365, 0.652）的评分间信度中等。结论采用QASLS对患者的ssls进行评价，应采用录像回放法，而非实时评价，后者评价不可靠。

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引用次数: 0

The Italian version of the University of Wisconsin Running Injury and Recovery Index (UWRI): cross-cultural adaptation, validity and reliability 威斯康辛大学跑步损伤与恢复指数（UWRI）意大利语版：跨文化适应、效度与信度

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-19 DOI: 10.1016/j.msksp.2025.103420

Filippo Maselli , Leonardo Pellicciari , Marco Testa , Valerio Barbari , Fabrizio Brindisino , Firas Mourad , Lorenzo Storari

Objectives

To translate, cross-culturally adapt and study the psychometric properties of the Wisconsin Running Injury and Recovery Index (UWRI) in Italian runners with running-related injuries (RRI).

Design

clinometric study.

Setting

5 private outpatient physical therapy clinics.

Participants

144 subjects with RRI.

Main outcome measures

UWRI translation was performed following international guidelines. Structural validity (confirmatory factor analysis [CFA]), internal consistency (Cronbach's alpha [α]), test-retest reliability (intraclass correlation coefficient [ICC]), measurement error (minimal detectable change [MDC]), and construct validity (hypothesis testing).

Results

UWRI translation was performed without issues. CFA showed a two-factor structure (i.e., running progression and symptom surveillance subscale) (comparative fit index = 0.988; Tucker–Lewis index = 0.977; root mean square error of approximation = 0.049; standardized root mean square residual = 0.042). Each subscale presented high internal consistency (α = 0.92 and 0.75 for the running progression and symptom surveillance subscales, respectively), excellent and good test-retest reliability (ICC = 0.99 and 0.89 for the running progression and symptom surveillance subscales, respectively), and acceptable measurement error (MDC = 0.33 and 2.3 points for the running progression and symptom surveillance subscales, respectively). Construct validity was moderate for both subscales as 50.0 % (2/4) of a-priori hypotheses were satisfied.

Conclusion

The validation process revealed acceptable psychometric properties of the UWRI Italian version, which can be used for research and clinical purposes.

目的对意大利跑步相关损伤（RRI）运动员的威斯康星跑步损伤与恢复指数（UWRI）进行翻译、跨文化适应并研究其心理测量特性。Designclinometric研究。设有5家私人门诊理疗诊所。参与者为144名RRI患者。主要结果测量：世界语言研究所的翻译是按照国际指南进行的。结构效度（验证性因子分析[CFA]）、内部一致性（Cronbach's alpha [α]）、重测信度（类内相关系数[ICC]）、测量误差（最小可检测变化[MDC]）和结构效度（假设检验）。结果wri翻译无问题。CFA显示双因素结构（即跑步进展和症状监测分量表）（比较拟合指数= 0.988；Tucker-Lewis指数= 0.977；近似均方根误差= 0.049；标准化均方根残差= 0.042）。各子量表具有较高的内部一致性（跑步进展和症状监测子量表的α值分别为0.92和0.75）、优异和良好的重测信度（跑步进展和症状监测子量表的ICC值分别为0.99和0.89）和可接受的测量误差（跑步进展和症状监测子量表的MDC值分别为0.33和2.3分）。两个分量表的建构效度均为中等，50.0%（2/4）的先验假设得到满足。结论经验证，UWRI意大利语版的心理测量学性能良好，可用于临床和研究。

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引用次数: 0

Cognitive Muscular Therapy™ for low back pain: a pilot study 认知肌肉疗法™治疗腰痛：一项试点研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-13 DOI: 10.1016/j.msksp.2025.103415

Stephen J. Preece , Jason Smith , Nathan Brookes , Sally Gates , Daniela Ghio

Cognitive Muscular Therapy™ for Chronic Low Back Pain.

Background

Chronic low back pain (cLBP) is a major cause of disability. Research shows that people with cLBP over activate the abdominal and superficial paraspinal muscles and this may indicate an underlying pattern of antagonistic flexor-extensor tone. This study was designed test a new intervention for cLBP, Cognitive Muscular Therapy™ (CMT). CMT integrates biomechanical training to improve postural tone with psychological techniques for pain management.

Methods

The CMT intervention included five components: Understanding back pain, General relaxation, Postural deconstruction, Contextual triggers, and Functional integration and incorporated Electromyography (EMG) biofeedback to visualise erector spinae activity. An observational case series was carried out on fifteen participants with cLBP, who each received seven weekly sessions of CMT. Alongside disability and psychological factors, the activation profile of the erector spinae was measured during walking, using EMG. Five participants provided qualitative feedback through interviews.

Results

Significant clinical improvements were observed. The Roland-Morris Disability Questionnaire score reduced by 7 points, the Pain catastrophizing scale reduced by 13.2 points and the Tampa scale of kinesiophobia reduced by 7.8 points. EMG data suggested improved phasic activation of the erector spinae during walking, while interviews showed increased self-efficacy and improved pain management.

Conclusion

This is the first study of CMT for cLBP, showing promising results in reducing pain and disability. By integrating psychological strategies within a biomechanical framework, CMT offers a novel approach to retraining muscle activity. Future work is now required to explore the proposed mechanism of action and fully quantify the clinical effectiveness of this new intervention.

Trial registration

NCT05611476.

认知肌肉疗法™治疗慢性腰痛。背景：慢性腰痛（cLBP）是致残的主要原因。研究表明，患有cLBP的人过度激活腹部和浅表棘旁肌，这可能表明一种潜在的拮抗屈伸肌张力模式。本研究旨在测试一种新的cLBP干预措施，认知肌肉疗法™（CMT）。CMT将生物力学训练与疼痛管理的心理技术相结合，以改善体位张力。方法：CMT干预包括五个组成部分：理解背痛、全身放松、体位解构、情境触发和功能整合，并结合肌电（EMG）生物反馈来可视化竖脊肌活动。对15名cLBP患者进行了观察性病例系列研究，他们每个人每周接受7次CMT治疗。除了残疾和心理因素外，在行走过程中使用肌电图测量竖脊肌的激活谱。五名参与者通过访谈提供了定性反馈。结果：临床效果明显改善。罗兰-莫里斯残疾问卷得分降低7分，疼痛灾难化量表得分降低13.2分，运动恐惧症坦帕量表得分降低7.8分。肌电图数据显示，行走过程中竖脊肌的相位激活有所改善，而访谈显示自我效能增强，疼痛管理得到改善。结论：本研究首次采用CMT治疗cLBP，在减轻疼痛和残疾方面显示出良好的效果。通过在生物力学框架内整合心理策略，CMT提供了一种再训练肌肉活动的新方法。未来的工作现在需要探索所提出的作用机制，并充分量化这种新干预措施的临床有效性。试验注册：NCT05611476。

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引用次数: 0

“I think there is something not right in my body”: Beliefs and attitudes of active adults with hip/groin pain towards hip crepitus – A qualitative study “我觉得我的身体有些不对劲”：患有髋关节/腹股沟疼痛的积极活动的成年人对髋关节肌痛的信念和态度-一项定性研究。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-10-01 DOI: 10.1016/j.msksp.2025.103427

Fernanda Serighelli , David A. Snowdon , Christian J. Barton , Kay M. Crossley , Matthew G. King , Joanne L. Kemp , Mark J. Scholes , Joshua J. Heerey , Danilo De Oliveira Silva

Background

Hip crepitus is a persistent and highly prevalent symptom in active adults with hip/groin pain. Its presence may influence their perceptions about prognosis, treatment options and sports participation.

Objective

We explored the beliefs and attitudes of active adults with hip/groin pain towards hip crepitus.

Methods

Semi-structured interviews involving 15 adults with hip/groin pain who participated regularly in sports activities were conducted. Verbatim transcriptions of the interviews were independently analysed through a six-phase reflexive thematic analysis by two authors prior to the consensus meetings.

Results

We identified one overarching theme: Crepitus – an unwanted sensation, which divided the sample into two groups based on their description of crepitus and associated symptoms: (i) clicking and tightness and (ii) grinding and pain. The similarities and differences between the two groups were highlighted for the three main themes: (1) Worries related to crepitus – uncertainty and anxiety; (2) Impact of crepitus on sport and daily life – hip flexion avoidance; and (3) Different mindsets about crepitus treatment – keep on moving.

Conclusion

Our findings provide novel information regarding the perspectives of active adults with hip/groin pain towards hip crepitus, generating insights for health professionals on patients’ perceptions. In summary, active adults with hip/groin pain modify their activities, especially hip flexion movements, due to the sensation of hip crepitus. Additionally, they are typically worried about the meaning of their crepitus and the future of their hip joint health and are interested in active treatments to reduce the severity of hip crepitus.

背景：髋关节肌酐是髋关节/腹股沟疼痛的成人活动患者的一种持续性和高度普遍的症状。它的存在可能会影响他们对预后、治疗选择和体育参与的看法。目的：探讨患有髋关节/腹股沟疼痛的成人活动期患者对髋关节肌酐的看法和态度。方法：对15名定期参加体育活动的髋关节/腹股沟疼痛成人进行半结构化访谈。在协商一致会议之前，两位作者通过六阶段反身性专题分析，对访谈的逐字逐句进行了独立分析。结果：我们确定了一个总体主题：Crepitus -一种不想要的感觉，根据他们对Crepitus和相关症状的描述，将样本分为两组：(i)咔哒声和紧绷，（ii）磨碎和疼痛。两组之间的异同主要体现在三个主题上：(1)与信用有关的担忧——不确定和焦虑；(2)肌酐对运动和日常生活的影响-避免髋关节屈曲；(3)不同的治疗思维——坚持前进。结论：我们的研究结果提供了关于髋关节/腹股沟疼痛的活跃成人对髋关节肌痛的看法的新信息，为卫生专业人员提供了对患者看法的见解。综上所述，患有髋关节/腹股沟疼痛的积极活动的成年人，由于髋关节crepitus的感觉，改变了他们的活动，特别是髋关节屈曲运动。此外，他们通常担心他们的crepitus的意义和他们的髋关节健康的未来，并对积极治疗感兴趣，以减少髋关节crepitus的严重程度。

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引用次数: 0

Estimation of the minimal important change for Brief Pain Inventory in patients with persistent spinal pain 评估持续性脊柱疼痛患者简短疼痛量表的最小重要变化

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-04 DOI: 10.1016/j.msksp.2025.103407

Jacob S. Gandløse , Jonathan Vela , Thorvaldur S. Palsson

Background

The Brief Pain Inventory (BPI) is a widely used tool for assessing pain severity and interference, aligning with the bio-psycho-social model. It has been validated in various languages for patients with persistent spinal pain. However, the Minimal Important Change (MIC), which represents the smallest change perceived as meaningful by patients, has not yet been explored for this patient population.

Objective

This study aimed to estimate the MIC for the BPI-DK in patients with persistent spinal pain.

Methods

MIC was estimated using both anchor-based and distribution-based approaches. The anchor-based method was used to calculate mean changes in BPI-DK subscales for patients reporting improvement on the GROC scale. The distribution-based method estimated MIC as 1.96 times the standard error of measurement.

Results

A total of 135 patients completed both baseline and 3-month follow-up questionnaires. Statistically significant MIC scores were found across all subscales. The MIC ranged from 1.37 to 2.61 for severity subscore, 1.59 to 2.91 for physical interference, 1.08 to 3.11 for affective interference, and 1.38 to 2.72 for overall interference subscore, depending on the method used.

Conclusion

This study establishes the MIC for the BPI-DK in patients with persistent spinal pain. Differences between the anchor-based and distribution-based methods highlight the sensitivity of the approach, with distribution-based estimates suggesting changes beyond measurement uncertainty. A 2-point improvement is recommended as clinically meaningful for this population.

简要疼痛量表（BPI）是一种广泛使用的评估疼痛严重程度和干扰的工具，与生物-心理-社会模型相一致。它已在多种语言中用于治疗持续性脊柱疼痛的患者。然而，最小重要变化（MIC），即患者认为有意义的最小变化，尚未对这一患者群体进行探索。目的本研究旨在评估持续性脊柱疼痛患者BPI-DK的MIC。方法采用基于锚点的方法和基于分布的方法估计smic。采用锚定法计算GROC量表改善患者的BPI-DK亚量表的平均变化。基于分布的方法估计MIC为测量标准误差的1.96倍。结果共有135例患者完成了基线和3个月随访问卷。所有子量表的MIC得分均有统计学意义。根据使用的方法，严重干扰的MIC范围为1.37至2.61，物理干扰为1.59至2.91，情感干扰为1.08至3.11，总体干扰为1.38至2.72。结论本研究建立了持续性脊柱疼痛患者BPI-DK的MIC。基于锚点的方法和基于分布的方法之间的差异突出了该方法的敏感性，基于分布的估计表明了测量不确定性之外的变化。对于这一人群，2点的改善是有临床意义的。

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