Musculoskeletal Science and Practice最新文献_第9页

Association between neck muscle size and physical features in individuals with chronic non-specific neck pain: A systematic review 慢性非特异性颈部疼痛患者的颈部肌肉大小和身体特征之间的关系：一项系统综述。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-10-03 DOI: 10.1016/j.msksp.2025.103428

Georgios Sidiropoulos , Michail Arvanitidis , Deborah Falla , Asimakis Kanellopoulos , Maria Tsekoura , Nikolaos Strimpakos , Zacharias Dimitriadis

Background

Despite multiple studies investigating neck muscle structure in people with chronic non-specific neck pain (CNP), findings on the relationship between neck muscle size and commonly assessed physical features are inconsistent, highlighting the need for systematic synthesis and evaluation of the available evidence.

Objective

This systematic review examines the association between neck muscle size and commonly assessed physical features including neck strength, endurance, range of motion, proprioception and head posture in individuals with CNP.

Methods

A systematic search was conducted across MEDLINE, EMBASE, PubMed, CINAHL Plus, and Web of Science from inception to 21 October 2024. The included studies focused on adults with CNP, examining the correlation between measures of neck muscle morphology and physical features. Exclusion criteria included traumatic neck pain, neck surgery, and radiculopathy. Risk of bias was assessed using a modified Newcastle-Ottawa Scale and the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. A narrative synthesis was used to summarise the findings.

Results

Of the 5,912 identified records, eight studies were included, comprising 246 participants. The narrative synthesis of the included studies identified significant correlations between the cross-sectional area (CSA) of longus colli and longus capitis with neck endurance, longus capitis CSA with neck proprioception, and longus colli CSA with measures of postural sway.

Conclusions

Based on very low certainty of evidence, reduced neck muscle size is associated with lower neck endurance, altered proprioception, and increased postural sway in individuals with CNP.

Registration number

CRD42024570776 (PROSPERO).

背景：尽管有多项研究调查了慢性非特异性颈部疼痛（CNP）患者的颈部肌肉结构，但关于颈部肌肉大小与通常评估的身体特征之间关系的研究结果并不一致，这突出了对现有证据进行系统综合和评估的必要性。目的：本系统综述探讨了颈肌大小与CNP患者颈部力量、耐力、运动范围、本体感觉和头部姿势等通常评估的身体特征之间的关系。方法：系统检索MEDLINE， EMBASE, PubMed， CINAHL Plus和Web of Science自成立至2024年10月21日。纳入的研究集中在患有CNP的成年人身上，检查颈部肌肉形态和身体特征之间的相关性。排除标准包括外伤性颈部疼痛、颈部手术和神经根病。偏倚风险采用改良的纽卡斯尔-渥太华量表进行评估，证据的确定性采用推荐、评估、发展和评估分级（GRADE）方法进行评估。采用叙述性综合方法来总结研究结果。结果：在5912份确定的记录中，包括8项研究，包括246名参与者。对纳入研究的叙述综合发现，颈长肌和头长肌的横截面积（CSA）与颈部耐力、颈长肌CSA与颈部本体感觉、以及颈长肌CSA与体位摇摆测量之间存在显著相关性。结论：基于非常低确定性的证据，颈部肌肉尺寸减小与CNP患者的下颈部耐力、本体感觉改变和姿势摇摆增加有关。注册号：CRD42024570776 （PROSPERO）。

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引用次数: 0

“The influence of prescribed frequency, dosage, and type of physiotherapeutic home-based exercises on adherence in patients with non-specific low back pain” “处方频率、剂量和家庭理疗锻炼类型对非特异性腰痛患者依从性的影响”。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-10-15 DOI: 10.1016/j.msksp.2025.103438

B. Moelands , R.M. Arensman , M.A. Timmer , C.J.J. Kloek , T. Koppenaal , C. Veenhof , M.F. Pisters

Background

Non-specific low back pain is commonly treated with exercise therapy. Unfortunately, exercise adherence is low. Several factors influencing adherence have already been identified, but the influence of frequency, dosage, and type of exercise on exercise adherence in patients with non-specific low back pain seems unknown.

Objective

The aim of this study is to determine the influence of prescribed frequency, dosage, and type of physiotherapeutic home-based exercises on adherence in patients with non-specific low back pain.

Methods

An observational longitudinal prospective cohort study with a secondary analysis of the e-Exercise low back pain trial was conducted on 185 patients with non-specific low back pain. The Exercise Adherence Scale (0–100) was measured each physiotherapy session during the treatment period. Missing data was imputed using Multivariate Imputations by Chained Equations. Linear mixed model analyses were conducted to determine the influence of prescribed frequency, dosage, and type of home-based exercises on adherence.

Results

A higher prescribed frequency and dosage is significantly associated with lower adherence to home-based exercises. Every point increase in frequency is associated with a decrease of 0.45 points (confidence interval −0.62: 0.30) in adherence. Similarly, every point increase in dosage is associated with a decrease of 0.24 points (confidence interval −0.39: 0.10) in adherence. Type of home-based exercise is not significantly associated with adherence.

Conclusions

A higher prescribed frequency and dosage of home-based exercises appears to negatively influence adherence in patients with non-specific low back pain. The prescribed type of exercise does not seem to influence adherence.

背景：非特异性腰痛通常用运动疗法治疗。不幸的是，坚持锻炼的人很少。影响运动坚持的几个因素已经被确定，但频率、剂量和运动类型对非特异性腰痛患者运动坚持的影响尚不清楚。目的：本研究的目的是确定处方频率、剂量和家庭物理治疗运动类型对非特异性腰痛患者依从性的影响。方法：对185例非特异性腰痛患者进行观察性纵向前瞻性队列研究，并对电子运动腰痛试验进行二次分析。运动依从性量表（0-100）在治疗期间的每个物理治疗阶段进行测量。缺失数据通过链式方程进行多元插值。进行线性混合模型分析以确定处方频率、剂量和家庭运动类型对依从性的影响。结果：较高的处方频率和剂量与较低的家庭锻炼依从性显著相关。频率每增加一个点，依从性降低0.45点（置信区间-0.62:0.30）。同样，剂量每增加1分，依从性降低0.24分（置信区间-0.39:0.10）。以家庭为基础的锻炼类型与坚持性没有显著关联。结论：较高的家庭运动频率和剂量似乎对非特异性腰痛患者的依从性产生负面影响。规定的运动类型似乎不会影响坚持。

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引用次数: 0

Concurrent validity of the directional preference phenomenon compared to controlled lumbar discography: A supplementary analysis of a diagnostic accuracy study 与控制腰椎椎间盘造影术相比，方向偏好现象的同时有效性：一项诊断准确性研究的补充分析

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-10 DOI: 10.1016/j.msksp.2025.103413

Jean-Philippe Deneuville , Mark Laslett , Alexandra Cervantes , Sylvain Peterlongo , Amine Ounajim , Romain Artico

Background

Persistent low back pain (LBP) is a symptom with many potential causes. Centralisation phenomenon (CP) has emerged as promising diagnostic tools for identifying a subset of discogenic pain. CP represents a subgroup of patients demonstrating Directional Preference (DP) and to date the diagnosticaccuracy of DP has never been assessed. To bridge this gap, this study evaluates the diagnostic accuracy of DP for discogenic pain, compares its properties to CP, and explores the development of clinical diagnostic rules (CDRs) for patients with negative testing for DP, or inability to undergo repeated movement testing.

Methods

103 persistent low back pain patients were assessed by a physiotherapist to collect clinical data and determine DP status. Subsequently, a radiologist performed controlled discography to determine the discogenic pain status. Both the physiotherapist and the radiologist were blinded to each other's findings.

Results

DP demonstrated high diagnostic accuracy (specificity: 0.94; Positive Likelihood Ratio (LR⁺): 7.65) but low screening properties (sensitivity: 0.48; Negative Likelihood Ratio (LR⁻): 0.56). CP showed similar diagnostic properties (specificity: 0.94; LR⁺: 5.57). A CDR for untestable DP yielded low predictive power (Area Under the Curve (AUC): 0.57). Due to limited sample size and missing data, no valid CDR could be established to assist diagnostic decision when DP is negative.

Conclusions

DP is a valid diagnostic tool for mechanical discogenic pain but has limited screening utility. Further studies are needed to refine diagnostic approaches and explore subgroups, such as those with Modic changes/inflammation-driven discogenic pain.

背景：持续性腰痛（LBP）是一种有许多潜在原因的症状。集中化现象（CP）已成为识别椎间盘源性疼痛子集的有前途的诊断工具。CP代表了表现出定向偏好（DP）的患者亚组，迄今为止，DP的诊断准确性从未被评估过。为了弥补这一差距，本研究评估了DP对椎间盘源性疼痛的诊断准确性，将其与CP的特性进行了比较，并探讨了DP检测阴性或无法进行重复运动测试的患者的临床诊断规则（cdr）的发展。方法对103例持续性腰痛患者进行物理治疗师评估，收集临床资料并确定DP状态。随后，放射科医生进行对照椎间盘造影术以确定椎间盘源性疼痛的状态。物理治疗师和放射科医生都不知道对方的发现。结果dp诊断准确率高（特异性0.94，阳性似然比（LR+）： 7.65），筛查性低（敏感性0.48，阴性似然比（LR−）：0.56）。CP表现出类似的诊断特性（特异性：0.94;LR+: 5.57）。不可测DP的CDR产生较低的预测能力（曲线下面积（AUC）： 0.57）。由于样本量有限和数据缺失，当DP为阴性时，无法建立有效的CDR来辅助诊断决策。结论sdp是机械性椎间盘源性疼痛的有效诊断工具，但筛查作用有限。需要进一步的研究来完善诊断方法和探索亚组，例如那些有轻微变化/炎症驱动的椎间盘源性疼痛。

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引用次数: 0

Patients’ expectations and experiences of physiotherapy management of migraine 偏头痛患者对物理治疗的期望与体会

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-16 DOI: 10.1016/j.msksp.2025.103418

Samantha Kelley, Julia Treleaven, Lucy Thomas, Zhiqi Liang

Background

Migraine is a debilitating condition with diverse presentations, and the role of physiotherapy management remains a contentious topic. There is need for an in-depth understanding of patients' expectations and lived experience of physiotherapy management of migraine. Exploration of patients’ perceptions and preferences for treatment may provide valuable management insights for both clinicians and researchers.

Objective

The aim of this study was to explore participants’ perspectives regarding physiotherapy management of migraine through semi-structured interviews with migraine sufferers.

Methods

Twenty single semi-structured interviews were conducted from March until September 2024 following recruitment at the University of Queensland, as well as via social media dissemination and poster placement at the university and various sites in the community. Reflexive thematic analysis was undertaken, and common themes were identified.

Results

The average age of the participants was 38.15 ± 16.2 years. Three key themes were identified from the interviews, with relevant sub-themes explored: (i) Patients have varied expectations of what physiotherapy can offer; (ii) Patient preferences of physiotherapy treatments and outcomes ranged widely (iii) Physiotherapy as part of overall migraine management.

Conclusion

The findings indicate that patients seeking physiotherapy for management of their migraine prioritise short-term relief in parallel with being provided with long-term strategies. Physiotherapists should be equipped with the skills and knowledge to provide personalised advice and education, appropriate manual therapy and other treatments for short-term relief and self-management strategies that patients are seeking, in conjunction with broader medical care.

背景：偏头痛是一种表现多样的衰弱性疾病，物理治疗管理的作用仍然是一个有争议的话题。有必要深入了解患者对偏头痛物理治疗管理的期望和生活经验。探索患者对治疗的看法和偏好可能为临床医生和研究人员提供有价值的管理见解。目的通过对偏头痛患者的半结构化访谈，探讨参与者对偏头痛物理治疗管理的看法。方法在昆士兰大学招募后，于2024年3月至9月进行了20次单次半结构化访谈，并通过社交媒体传播和在大学和社区各地点张贴海报进行了访谈。进行了反身性主题分析，并确定了共同主题。结果患者平均年龄为38.15±16.2岁。从访谈中确定了三个关键主题，并探讨了相关的子主题：(i)患者对物理治疗所能提供的服务有不同的期望；（ii）患者对物理治疗的偏好和结果差异很大（iii）物理治疗作为偏头痛整体治疗的一部分。结论研究结果表明，寻求物理治疗治疗偏头痛的患者优先考虑短期缓解，同时提供长期策略。物理治疗师应具备技能和知识，以提供个性化的咨询和教育、适当的手工治疗和其他短期缓解治疗，以及患者正在寻求的自我管理策略，同时提供更广泛的医疗服务。

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引用次数: 0

Digital health self-management interventions for musicians with playing-related musculoskeletal disorders: A scoping review 音乐家与演奏相关的肌肉骨骼疾病的数字健康自我管理干预：范围审查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-06 DOI: 10.1016/j.msksp.2025.103408

N. Eleryan , R. Hemming , V. Sparkes , L. Sheeran

Introduction

Playing-related musculoskeletal disorders are common in musicians. Self-management interventions are recommended to improve the management of musculoskeletal disorders and support individuals to safely take responsibility for their own health. Digital health interventions are increasingly used to support self-management of musculoskeletal disorders. However, their use in musicians remains poorly understood.

Aim

The aim of this scoping review is to map the available evidence on digital health interventions for the self-management of playing-related musculoskeletal disorders in musicians. This includes summarising the key characteristics of current interventions including content, mode of delivery and theoretical underpinning, their effect on musicians’ ability to continue to play, and exploring any reported adverse effects, to inform future interventions.

Methods

The review followed the Joanna Briggs Institute scoping review framework and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

Results

Nine studies were included. None of the interventions were underpinned by a theoretical framework. All interventions targeted student and orchestral musicians, involving exercise, health education, or both, and were delivered via pre-recorded videos (n = 4), websites (n = 3), and video conferencing (n = 2). Six interventions were home-based, one was conducted at a university, and two included a combination of home-based and workplace sessions. Exercise-based digital health interventions (n = 7) reported improvements in pain and physical outcomes.

Conclusion

The evidence on digital health interventions for musicians is limited, with studies targeting student and orchestral musicians and none applying theoretical frameworks. This highlights the need for broader and more rigorous self-management interventions for PRMSDs in musicians.

与演奏相关的肌肉骨骼疾病在音乐家中很常见。建议采取自我管理干预措施，以改善对肌肉骨骼疾病的管理，并支持个人安全地对自己的健康负责。数字健康干预措施越来越多地用于支持肌肉骨骼疾病的自我管理。然而，人们对它们在音乐家身上的作用仍然知之甚少。目的：本综述的目的是绘制音乐家自我管理与演奏相关的肌肉骨骼疾病的数字健康干预措施的现有证据。这包括总结当前干预的关键特征，包括内容、交付模式和理论基础，它们对音乐家继续演奏的能力的影响，并探索任何报告的不利影响，为未来的干预提供信息。方法本综述遵循乔安娜布里格斯研究所的范围综述框架，并按照系统综述的首选报告项目和范围综述的元分析扩展进行报告。结果纳入9项研究。这些干预措施都没有理论框架支撑。所有干预措施都以学生和管弦乐音乐家为目标，包括锻炼、健康教育或两者兼而有之，并通过预先录制的视频（n = 4）、网站（n = 3）和视频会议（n = 2）进行。六项干预以家庭为基础，一项在大学进行，另外两项包括家庭和工作场所的结合。基于运动的数字健康干预（n = 7）报告了疼痛和身体结果的改善。结论音乐家数字健康干预的证据有限，研究对象是学生和管弦乐音乐家，没有一个应用理论框架。这突出表明需要对音乐家的prmsd进行更广泛和更严格的自我管理干预。

{"title":"Digital health self-management interventions for musicians with playing-related musculoskeletal disorders: A scoping review","authors":"N. Eleryan , R. Hemming , V. Sparkes , L. Sheeran","doi":"10.1016/j.msksp.2025.103408","DOIUrl":"10.1016/j.msksp.2025.103408","url":null,"abstract":"<div><h3>Introduction</h3><div>Playing-related musculoskeletal disorders are common in musicians. Self-management interventions are recommended to improve the management of musculoskeletal disorders and support individuals to safely take responsibility for their own health. Digital health interventions are increasingly used to support self-management of musculoskeletal disorders. However, their use in musicians remains poorly understood.</div></div><div><h3>Aim</h3><div>The aim of this scoping review is to map the available evidence on digital health interventions for the self-management of playing-related musculoskeletal disorders in musicians. This includes summarising the key characteristics of current interventions including content, mode of delivery and theoretical underpinning, their effect on musicians’ ability to continue to play, and exploring any reported adverse effects, to inform future interventions.</div></div><div><h3>Methods</h3><div>The review followed the Joanna Briggs Institute scoping review framework and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.</div></div><div><h3>Results</h3><div>Nine studies were included. None of the interventions were underpinned by a theoretical framework. All interventions targeted student and orchestral musicians, involving exercise, health education, or both, and were delivered via pre-recorded videos (n = 4), websites (n = 3), and video conferencing (n = 2). Six interventions were home-based, one was conducted at a university, and two included a combination of home-based and workplace sessions. Exercise-based digital health interventions (n = 7) reported improvements in pain and physical outcomes.</div></div><div><h3>Conclusion</h3><div>The evidence on digital health interventions for musicians is limited, with studies targeting student and orchestral musicians and none applying theoretical frameworks. This highlights the need for broader and more rigorous self-management interventions for PRMSDs in musicians.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103408"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020386","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

Network analysis of cognitive, physical/functional, sensory, and pain processing-related factors in individuals with knee osteoarthritis 膝骨关节炎患者的认知、身体/功能、感觉和疼痛处理相关因素的网络分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-10-10 DOI: 10.1016/j.msksp.2025.103434

Bruno Ruocco Verengue , Patrícia Gabrielle dos Santos , Barbara Greco Miura , Aron Charles Barbosa , Gabriela Nascimento de Santana , Almir Vieira Dibai-filho , Soraia Micaela Silva , Cid André Fidelis de Paula Gomes

Background

Knee osteoarthritis (KOA) is a complex condition influenced by cognitive, physical, functional, sensory, and pain-processing-related factors, all of which contribute to pain and limitations in daily activities. Understanding how these factors are connected is vital for better disease management.

Objectives

To use network analysis to explore the relationships among cognitive (self-efficacy and catastrophizing), physical/functional (functionality and strength), sensory (central sensitization symptoms), and pain-processing-related factors (pain intensity) in individuals with KOA.

Methods

Two hundred and forty individuals with KOA participated in this cross-sectional study. The assessments included: Numeric Pain Rating Scale (NPRS), Central Sensitization Inventory (CSI), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule (WHODAS), and quadriceps isometric strength (QIS). The network was estimated using the graphical LASSO method combined with a walktrap algorithm to identify clusters and connections between nodes (factors).

Results

The estimated network indicates that pain self-efficacy plays a key role in linking clinical and psychosocial factors, such as physical disability, pain during activities, and maladaptive pain thoughts. Its prominent position underscores its importance as a potential target for assessment and intervention in individuals with KOA.

Conclusion

Self-efficacy, as measured by the PSEQ, appears to be a central factor connected to physical/functional and sensory factors in individuals with KOA.

背景：膝关节骨关节炎（KOA）是一种复杂的疾病，受认知、身体、功能、感觉和疼痛处理相关因素的影响，所有这些因素都会导致疼痛和日常活动受限。了解这些因素是如何联系在一起的，对于更好地管理疾病至关重要。目的：利用网络分析探讨KOA患者的认知（自我效能和灾难化）、身体/功能（功能和力量）、感觉（中枢致敏症状）和疼痛加工相关因素（疼痛强度）之间的关系。方法：对240例KOA患者进行横断面研究。评估包括：数字疼痛评定量表（NPRS）、中枢致敏量表（CSI）、疼痛灾难化量表（PCS）、疼痛自我效能问卷（PSEQ）、安大略省西部和麦克马斯特大学骨关节炎指数（WOMAC）、世界卫生组织残疾评估表（WHODAS）和股四头肌等肌力（QIS）。使用图形LASSO方法结合步行陷阱算法来识别聚类和节点（因素）之间的连接，对网络进行估计。结果：该网络表明疼痛自我效能在连接临床和社会心理因素（如身体残疾、活动时疼痛和不适应疼痛思想）方面起着关键作用。它的突出位置强调了它作为评估和干预KOA患者的潜在目标的重要性。结论：由PSEQ测量的自我效能感似乎是与KOA个体的身体/功能和感觉因素相关的中心因素。

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引用次数: 0

Effectiveness of remotely-delivered Psychologically-Informed Physical Therapy (PIPT) for people with chronic pain: a systematic review with meta-analysis 远程心理知情物理治疗（PIPT）对慢性疼痛患者的有效性：一项荟萃分析的系统综述。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-10-08 DOI: 10.1016/j.msksp.2025.103432

Matteo Cioeta , Luca Giacobbe , Marco Medugno , Davide Lampasi , Leonardo Pellicciari , Giuseppe Giovannico , Germano Guerra , Giovanni Galeoto

Objective

To evaluate the effectiveness of remotely-delivered Psychologically-Informed Physical Therapy (PIPT) for individuals with chronic pain (CP) through a systematic review and meta-analysis.

Methods

Seven databases were searched until May 2025. Randomized controlled trials (RCTs) assessing PIPT effects by physiotherapists for CP people were included. Primary outcomes were pain and disability; secondary outcomes included quality of life, self-efficacy, kinesiophobia, and costs. The risk of bias (RoB) and certainty of evidence (CoE) were assessed using the Cochrane RoB 2.0 tool and GRADE approach, respectively. Random effect meta-analyses were performed.

Results

Four RCTs (n = 911 participants) involving patients with knee osteoarthritis were included. Meta-analyses showed low CoE that remotely-delivered PIPT reduces pain (MD = -0.81 at 6 months; −0.50 at 12 months) and moderate CoE that it can reduce disability (MD = -3.44 at 6 months; −5.71 at 12 months) compared to other remote interventions. Quality of life improvements were also reported but did not exceed the minimal clinically important difference. One study showed improved self-efficacy but no significant effects on kinesiophobia or healthcare costs. The RoB was assessed as ranging from some concerns to high.

Conclusion

Compared to other remote intervention, there is low CoE that PIPT can decrease pain,moderate CoE that PIPT can reduce disability and low CoE that PIPT can improve quality of life. Although effect sizes were small, these findings support the integration of psychological principles into telerehabilitation. Further research is warranted to explore its generalizability to other CP conditions and to compare its effectiveness against psychologist-led interventions.

目的：通过系统回顾和荟萃分析，评估远程心理知情物理治疗（PIPT）对慢性疼痛（CP）患者的疗效。方法：检索至2025年5月的7个数据库。随机对照试验（rct）评估物理治疗师对CP患者的PIPT效果。主要结局是疼痛和残疾；次要结局包括生活质量、自我效能、运动恐惧症和费用。分别使用Cochrane RoB 2.0工具和GRADE方法评估偏倚风险（RoB）和证据确定性（CoE）。进行随机效应荟萃分析。结果：纳入4项随机对照试验（n = 911名受试者），涉及膝关节骨关节炎患者。荟萃分析显示，与其他远程干预相比，低CoE远程PIPT可以减轻疼痛（6个月时MD = -0.81； 12个月时MD = -0.50），中等CoE可以减轻残疾（6个月时MD = -3.44； 12个月时MD = -5.71）。生活质量的改善也有报道，但没有超过最小的临床重要差异。一项研究显示，自我效能有所提高，但对运动恐惧症或医疗费用没有显著影响。RoB的评估范围从一些关注到高。结论：与其他远程干预相比，PIPT在减轻疼痛方面具有低CoE，在减轻残疾方面具有中等CoE，在改善生活质量方面具有低CoE。虽然效应量很小，但这些发现支持将心理学原理整合到远程康复中。进一步的研究需要探索其在其他CP条件下的普遍性，并将其与心理学家主导的干预措施的有效性进行比较。

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引用次数: 0

Exploring how to deliver person-centred physiotherapy with adolescents experiencing musculoskeletal pain: a qualitative study 探索如何为经历肌肉骨骼疼痛的青少年提供以人为本的物理治疗：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: 2025-10-15 DOI: 10.1016/j.msksp.2025.103437

R. Joslin , C. Harwood , M. Donovan-Hall , M. Barker , L. Roberts

Background

Musculoskeletal pain in adolescents is common and can become a long-term problem and continue into adulthood. Person-centred care is recognised globally as best practice, but it is unclear how to personalise physiotherapy for adolescents experiencing musculoskeletal pain and injury.

Objectives

The aim was to understand adolescent perspectives on how physiotherapists can deliver person-centred care.

Design

A qualitative interview study was undertaken as part of a larger programme of research to design an intervention using the person-based approach.

Method

Semi-structured individual interviews were conducted with a purposive sample of 11 adolescents (6 young women and 5 young men) aged 14–17 years, receiving physiotherapy at a single NHS site in England. Their perspectives on how best to deliver personalised care within physiotherapy were sought.

Results

Six themes were developed from the interview data and portrayed the dynamic nature of person-centred care. These were labelled make it right for me, get to know me, explain to me, encourage me, hear me and let me choose.

Conclusions

New perceived needs specific to this population were highlighted. These included recognising the vulnerability and lack of control experiences by adolescents, as well the importance of adults (parents and physiotherapists) acknowledging the extent to which they facilitate or constrain the delivery of person-centred care. Adolescents with non-traumatic musculoskeletal pain expressed different service needs compared to those with traumatic musculoskeletal injuries. However, the need to address the social and emotional impacts of pain, injury, and rehabilitation was universally recognised.

Clinical trial registration

The wider programme of research including this qualitative study is registered and listed on the ISRCTN registry with study registration number ISRCTN18918987.

背景：肌肉骨骼疼痛在青少年中很常见，可能成为一个长期问题并持续到成年。以人为本的护理是全球公认的最佳实践，但目前尚不清楚如何为经历肌肉骨骼疼痛和损伤的青少年提供个性化的物理治疗。目的：目的是了解青少年对物理治疗师如何提供以人为本的护理的看法。设计：一项定性访谈研究作为一个更大的研究项目的一部分进行，以设计使用以人为本的方法的干预措施。方法：对11名14-17岁的青少年（6名年轻女性和5名年轻男性）进行半结构化的个人访谈，这些青少年在英格兰的一个NHS站点接受物理治疗。他们对如何在物理治疗中最好地提供个性化护理的看法被寻求。结果：从访谈数据中发展出六个主题，并描绘了以人为本的护理的动态性质。这些都被贴上了“让它适合我”、“了解我”、“向我解释”、“鼓励我”、“倾听我”和“让我做出选择”的标签。结论：强调了针对这一人群的新感知需求。其中包括认识到青少年的脆弱性和缺乏控制经验，以及成年人（父母和物理治疗师）承认他们在多大程度上促进或限制以人为本的护理的提供的重要性。与创伤性肌肉骨骼损伤的青少年相比，非创伤性肌肉骨骼疼痛的青少年表达了不同的服务需求。然而，解决疼痛、伤害和康复的社会和情感影响的必要性是普遍公认的。临床试验注册：包括本定性研究在内的更广泛的研究计划已在ISRCTN注册中心注册并列出，研究注册号为ISRCTN18918987。

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引用次数: 0

Exploring and comparing bracing protocols for acute isolated posterior cruciate ligament injuries: A scoping review of rationales and approaches 探索和比较急性孤立性后交叉韧带损伤的支具方案：基本原理和方法的范围审查

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-09-10 DOI: 10.1016/j.msksp.2025.103412

W.J. Sura , B.S. Gill , A. Walker

Background

Posterior cruciate ligament (PCL) injuries often result in persistent knee laxity and functional deficits, highlighting the importance of treatment. Dynamic bracing is widely employed in non-operative management, yet standardised protocols remain undefined.

Aim

This scoping review maps existing literature on dynamic bracing for acute isolated PCL injuries and identifies evidence gaps to guide future research.

Methods

A systematic search of PubMed, Embase, CINAHL, and SportDiscus identified relevant studies published up to July 2024. The Population, Concept, and Context framework guided study selection. Eligible studies included articles reporting on non-operative management of acute PCL injuries using dynamic bracing protocols initiated within 12 weeks of injury.

Results

Of 1810 screened studies, 13 met inclusion criteria: seven primary research studies and six reviews. Bracing protocols varied significantly in type, duration, knee flexion angles, weight-bearing status, and activity restrictions. No studies compared different dynamic bracing protocols or directly evaluated their efficacy. Most studies lacked a clear rationale for protocol design, with only four citing prior studies. No recommendation can be made on a bracing protocol.

Conclusion

Evidence on dynamic bracing for acute PCL injuries is limited and inconsistent. Comparative studies are needed to establish standardised protocols and optimize non-operative PCL management.

后交叉韧带（PCL）损伤通常导致持续的膝关节松弛和功能缺陷，强调了治疗的重要性。动态支具在非手术治疗中被广泛应用，但标准化方案尚未明确。目的对急性孤立性PCL损伤动态支具的现有文献进行综述，找出证据缺口，指导未来的研究。方法系统检索PubMed、Embase、CINAHL和SportDiscus截止到2024年7月发表的相关研究。人口、概念和背景框架指导研究选择。符合条件的研究包括报道在损伤12周内使用动态支具方案进行急性PCL损伤非手术治疗的文章。结果在筛选的1810项研究中，13项符合纳入标准：7项主要研究和6项综述。支撑方案在类型、持续时间、膝关节屈曲角度、负重状态和活动限制方面存在显著差异。没有研究比较不同的动力支撑方案或直接评估其疗效。大多数研究缺乏方案设计的明确基本原理，只有四项研究引用了先前的研究。不能就支撑协议提出任何建议。结论动态支具治疗急性PCL损伤的证据有限且不一致。需要进行比较研究，以建立标准化的方案和优化非手术PCL管理。

{"title":"Exploring and comparing bracing protocols for acute isolated posterior cruciate ligament injuries: A scoping review of rationales and approaches","authors":"W.J. Sura , B.S. Gill , A. Walker","doi":"10.1016/j.msksp.2025.103412","DOIUrl":"10.1016/j.msksp.2025.103412","url":null,"abstract":"<div><h3>Background</h3><div>Posterior cruciate ligament (PCL) injuries often result in persistent knee laxity and functional deficits, highlighting the importance of treatment. Dynamic bracing is widely employed in non-operative management, yet standardised protocols remain undefined.</div></div><div><h3>Aim</h3><div>This scoping review maps existing literature on dynamic bracing for acute isolated PCL injuries and identifies evidence gaps to guide future research.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, CINAHL, and SportDiscus identified relevant studies published up to July 2024. The Population, Concept, and Context framework guided study selection. Eligible studies included articles reporting on non-operative management of acute PCL injuries using dynamic bracing protocols initiated within 12 weeks of injury.</div></div><div><h3>Results</h3><div>Of 1810 screened studies, 13 met inclusion criteria: seven primary research studies and six reviews. Bracing protocols varied significantly in type, duration, knee flexion angles, weight-bearing status, and activity restrictions. No studies compared different dynamic bracing protocols or directly evaluated their efficacy. Most studies lacked a clear rationale for protocol design, with only four citing prior studies. No recommendation can be made on a bracing protocol.</div></div><div><h3>Conclusion</h3><div>Evidence on dynamic bracing for acute PCL injuries is limited and inconsistent. Comparative studies are needed to establish standardised protocols and optimize non-operative PCL management.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103412"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049159","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

What do we know about safety netting patients at risk of metastatic spinal cord compression? A scoping review 我们对有转移性脊髓压迫风险的患者的安全网了解多少？范围审查。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2025-11-01 Epub Date: 2025-08-26 DOI: 10.1016/j.msksp.2025.103397

Philippa C. Hacking , Gillian Yeowell , Susan Greenhalgh

Background

Metastatic spinal cord compression is a potentially devastating consequence of cancer. This oncological emergency requires early recognition and treatment to prevent irreversible spinal cord injury and paralysis. Provision of information to at risk patients has been recommended in the 2023 NICE Guidelines. However, it is unclear when, how and what information should be provided.

Aim

To investigate how healthcare professionals provide safety netting information to patients at risk of metastatic spinal cord compression.

Methods

This scoping review utilised the Arksey and O'Malley Framework and the recommendations by the Joanna Briggs Institute. Relevant literature was identified following a systematic search of three databases, with grey literature accessed through a targeted search of relevant websites. Following data charting, thematic analysis was used to identify salient themes across the dataset.

Results

A total of N = 197 records were identified. Following removal of duplicates, title and abstract screening, N = 24 records were screened and N = 9 were included for full analysis. Three key themes were identified: information format and dissemination, health education and raising awareness, and timeliness of safety netting.

Implications

All patients with or at risk of developing bony metastases should be provided with safety netting information about metastatic spinal cord compression. Generalist clinicians should be prepared to share this information to empower patients to present early with symptoms. Further research is needed to explore the information needs and perspectives of patients with or at risk of metastatic spinal cord compression.

背景：转移性脊髓压迫是癌症的潜在破坏性后果。这种肿瘤急症需要及早发现和治疗，以防止不可逆转的脊髓损伤和瘫痪。2023年NICE指南建议向高危患者提供信息。然而，目前尚不清楚应在何时、如何以及提供何种信息。目的：调查医疗保健专业人员如何为有转移性脊髓压迫风险的患者提供安全网信息。方法：本综述采用了Arksey和O'Malley框架和乔安娜布里格斯研究所的建议。通过对三个数据库的系统搜索确定了相关文献，通过对相关网站的有针对性的搜索获得了灰色文献。在数据图表之后，使用主题分析来确定整个数据集的突出主题。结果：共识别N = 197条记录。在去除重复、标题和摘要筛选后，筛选了N = 24条记录，其中N = 9条纳入完整分析。确定了三个关键主题：信息格式和传播、卫生教育和提高认识以及安全网的及时性。意义：所有患有或有发生骨转移风险的患者都应提供有关转移性脊髓压迫的安全网信息。全科医生应该准备好分享这些信息，以使患者能够早期出现症状。需要进一步的研究来探索转移性脊髓压迫或有转移性脊髓压迫风险的患者的信息需求和观点。

{"title":"What do we know about safety netting patients at risk of metastatic spinal cord compression? A scoping review","authors":"Philippa C. Hacking , Gillian Yeowell , Susan Greenhalgh","doi":"10.1016/j.msksp.2025.103397","DOIUrl":"10.1016/j.msksp.2025.103397","url":null,"abstract":"<div><h3>Background</h3><div>Metastatic spinal cord compression is a potentially devastating consequence of cancer. This oncological emergency requires early recognition and treatment to prevent irreversible spinal cord injury and paralysis. Provision of information to at risk patients has been recommended in the 2023 NICE Guidelines. However, it is unclear when, how and what information should be provided.</div></div><div><h3>Aim</h3><div>To investigate how healthcare professionals provide safety netting information to patients at risk of metastatic spinal cord compression.</div></div><div><h3>Methods</h3><div>This scoping review utilised the Arksey and O'Malley Framework and the recommendations by the Joanna Briggs Institute. Relevant literature was identified following a systematic search of three databases, with grey literature accessed through a targeted search of relevant websites. Following data charting, thematic analysis was used to identify salient themes across the dataset.</div></div><div><h3>Results</h3><div>A total of N = 197 records were identified. Following removal of duplicates, title and abstract screening, N = 24 records were screened and N = 9 were included for full analysis. Three key themes were identified: information format and dissemination, health education and raising awareness, and timeliness of safety netting.</div></div><div><h3>Implications</h3><div>All patients with or at risk of developing bony metastases should be provided with safety netting information about metastatic spinal cord compression. Generalist clinicians should be prepared to share this information to empower patients to present early with symptoms. Further research is needed to explore the information needs and perspectives of patients with or at risk of metastatic spinal cord compression.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"80 ","pages":"Article 103397"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076610","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