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The Journal of Orthopaedic and Sports... Jun 2024We aimed to quantify the proportion not attributable to the specific effects (PCE) of physical therapy interventions for musculoskeletal pain. Intervention systematic... (Meta-Analysis)
Meta-Analysis Review
Which Portion of Physiotherapy Treatments' Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-Analysis of Randomized Placebo-Controlled Trials.
We aimed to quantify the proportion not attributable to the specific effects (PCE) of physical therapy interventions for musculoskeletal pain. Intervention systematic review with meta-analysis. We searched Ovid, MEDLINE, EMBASE, CINAHL, Scopus, PEDro, Cochrane Controlled Trials Registry, and SPORTDiscus databases from inception to April 2023. Randomized placebo-controlled trials evaluating the effect of physical therapy interventions on musculoskeletal pain. Risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB 2). The proportion of physical therapy interventions effect that was not explained by the specific effect of the intervention was calculated, using the proportion not attributable to the specific effects (PCE) metric, and a quantitative summary of the data from the studies was conducted using the random-effects inverse-variance model (Hartung-Knapp-Sidik-Jonkman method). Sixty-eight studies were included in the systematic review (participants: n = 5238), and 54 placebo-controlled trials informed our meta-analysis (participants: n = 3793). Physical therapy interventions included soft tissue techniques, mobilization, manipulation, taping, exercise therapy, and dry needling. Placebo interventions included manual, nonmanual interventions, or both. The proportion not attributable to the specific effects of mobilization accounted for 88% of the immediate overall treatment effect for pain intensity (PCE = 0.88, 95% confidence interval [CI]: 0.57, 1.20). In exercise therapy, this proportion accounted for 46% of the overall treatment effect for pain intensity (PCE = 0.46, 95% CI: 0.41, 0.52). The PCE in manipulation excelled in short-term pain relief (PCE = 0.81, 95% CI: 0.62, 1.01) and in mobilization in long-term effects (PCE = 0.86, 95% CI: 0.76, 0.96). In taping, the PCE accounted for 64% of disability improvement (PCE = 0.64, 95% CI: 0.48, 0.80). The outcomes of physical therapy interventions for musculoskeletal pain were significantly influenced by factors not attributable to the specific effects of the interventions. Boosting these factors consciously to enhance therapeutic outcomes represents an ethical opportunity that could benefit patients. .
Topics: Humans; Musculoskeletal Pain; Randomized Controlled Trials as Topic; Physical Therapy Modalities; Exercise Therapy
PubMed: 38602164
DOI: 10.2519/jospt.2024.12126 -
Sports Medicine (Auckland, N.Z.) Mar 2018Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses.
OBJECTIVES
(1) To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs. 11) and match simulations.
METHODS
A first screening phase consisted of a systematic search on PubMed (MEDLINE) and SportDiscus databases until March 2016. Inclusion criteria were: longitudinal study with soccer players; match or validated protocol; duration > 45 min; and published in English.
RESULTS
A total of 77 eligible studies (n = 1105) were used to compute 1196 effect sizes (ES). Half-time assessments revealed small to large alterations in immunological parameters (e.g. leukocytes, ES = 1.9), a moderate decrement in insulin concentration (ES = - 0.9) and a small to moderate impairment in lower-limb muscle function (ES = - 0.5 to - 0.7) and physical performance measures (e.g. linear sprint, ES = - 0.3 to - 1.0). All the systematically analyzed fatigue-related markers were substantially altered at post-match. Hamstrings force production capacity (ES = - 0.7), physical performance (2-4%, ES = 0.3-0.5), creatine kinase (CK, ES = 0.4), well-being (ES = 0.2-0.4) and delayed onset muscle soreness (DOMS, ES = 0.6-1.3) remained substantially impaired at G + 72 h. Compared to simulation protocols, 11 vs. 11 match format (CK, ES = 1.8) induced a greater magnitude of change in muscle damage (i.e. CK, ES = 1.8 vs. 0.7), inflammatory (IL-6, ES = 2.6 vs. 1.1) and immunological markers and DOMS (ES = 1.5 vs. 0.7) than simulation protocols at post-assessments. Neuromuscular performances at post-match did not differ between protocols.
CONCLUSION
While some parameters are fully recovered (e.g. hormonal and technical), our systematic review shows that a period of 72 h post-match play is not long enough to completely restore homeostatic balance (e.g. muscle damage, physical and well-being status). The extent of the recovery period post-soccer game cannot consist of a 'one size fits all approach'. Additionally, the 'real match' (11 vs. 11 format) likely induces greater magnitudes of perceptual (DOMS) and biochemical alterations (e.g. muscle damage), while neuromuscular alterations were essentially similar. Overall, coaches must adjust the structure and content of the training sessions during the 72-h post-match intervention to effectively manage the training load within this time-frame.
Topics: Athletic Performance; Female; Humans; Male; Motor Activity; Muscle Contraction; Muscle Fatigue; Muscle Strength; Myalgia; Soccer
PubMed: 29098658
DOI: 10.1007/s40279-017-0798-8 -
Physiotherapy Research International :... Apr 2022Musculoskeletal disorders are among the leading causes of disability globally, but their role in patients with dizziness and imbalance is not well understood or...
BACKGROUND AND PURPOSE
Musculoskeletal disorders are among the leading causes of disability globally, but their role in patients with dizziness and imbalance is not well understood or explored. Such knowledge may be important as musculoskeletal pain and dizziness can mutually influence each other, leading to a complex condition requiring more comprehensive approaches to promote successful recovery. We conducted a systematic review to examine the extent and characteristic of reported musculoskeletal pain in patients with dizziness.
METHODS
A comprehensive literature search in Medline, Embase, Cochrane, Scopus, Amed, Google Scholar, SveMed+, and Web of Science was conducted in March 2021. Inclusion criteria were studies examining patients with a vestibular diagnosis, patients with cervicogenic dizziness and patients included based on having dizziness as a symptom; and reported musculoskeletal pain. Data regarding age, sex, sample size, diagnosis and musculoskeletal pain was extracted. The Crowe Critical Appraisal Tool was used for assessing methodical quality of the included studies.
RESULTS
Out of 1507 screened studies, 16 studies met the inclusion criteria. The total sample consisted of 1144 individuals with dizziness. The frequency of patients reporting pain ranged between 43% and 100% in the included studies. Pain intensity were scored between 5 and 7 on a 0-10 scale. Pain in the neck and shoulder girdle was most often reported, but musculoskeletal pain in other parts of the body was also evident.
DISCUSSION
In the included studies, musculoskeletal pain was highly prevalent in patients with dizziness, with pain intensity that may have a moderate to severe interference with daily functioning. Pain in the neck and shoulder is well documented, but there are few studies addressing musculoskeletal pain in additional parts of the body. More research is needed to understand the relations between dizziness and musculoskeletal pain.
Topics: Dizziness; Humans; Musculoskeletal Pain; Neck; Prevalence; Shoulder
PubMed: 35191148
DOI: 10.1002/pri.1941 -
The Clinical Journal of Pain May 2023The aims of this systematic review were to identify the different versions of the Tampa Scale of kinesiophobia (TSK) and to report on the psychometric evidence relating...
OBJECTIVE
The aims of this systematic review were to identify the different versions of the Tampa Scale of kinesiophobia (TSK) and to report on the psychometric evidence relating to these different versions for people experiencing musculoskeletal pain.
METHODS
Medline [Ovid] CINAHL and Embase databases were searched for publications reporting on the psychometric properties of the TSK in populations with musculoskeletal pain. Risks of bias were evaluated using the COSMIN risk of the bias assessment tool.
RESULTS
Forty-one studies were included, mainly with a low risk of bias. Five versions of the TSK were identified: TSK-17, TSK-13, TSK-11, TSK-4, and TSK-TMD (for temporomandibular disorders). Most TSK versions showed good to excellent test-retest reliability (intraclass coefficient correlation 0.77 to 0.99) and good internal consistency (ɑ=0.68 to 0.91), except for the TSK-4 as its reliability has yet to be defined. The minimal detectable change was lower for the TSK-17 (11% to 13% of total score) and the TSK-13 (8% of total score) compared with the TSK-11 (16% of total score). Most TSK versions showed good construct validity, although TSK-11 validity was inconsistent between studies. Finally, the TSK-17, -13, and -11 were highly responsive to change, while responsiveness has yet to be defined for the TSK-4 and TSK-TMD.
DISCUSSION
Clinical guidelines now recommend that clinicians identify the presence of kinesiophobia among patients as it may contribute to persistent pain and disability. The TSK is a self-report questionnaire widely used, but 5 different versions exist. Based on these results, the use of TSK-13 and TSK-17 is encouraged as they are valid, reliable, and responsive.
Topics: Humans; Musculoskeletal Pain; Kinesiophobia; Psychometrics; Reproducibility of Results; Pain Measurement; Surveys and Questionnaires
PubMed: 36917768
DOI: 10.1097/AJP.0000000000001104 -
BMC Public Health Jan 2014Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures... (Review)
Review
BACKGROUND
Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question.
METHODS
A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180-193, 2001).
RESULTS
After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case-control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively.
CONCLUSIONS
On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified.
Topics: Humans; Middle Aged; Models, Psychological; Musculoskeletal Pain; Occupational Health; Reward; Risk Factors; Stress, Psychological
PubMed: 24428955
DOI: 10.1186/1471-2458-14-37 -
International Journal of Occupational... Jun 2023s. This study aimed to determine the prevalence and regions of the body in which musculoskeletal injuries occur in musicians, as well as to identify risk factors related...
s. This study aimed to determine the prevalence and regions of the body in which musculoskeletal injuries occur in musicians, as well as to identify risk factors related to their occurrence. A search was carried out in the PubMed, Scopus, Web of Science and Cinahl databases for publications between 2006 and 2020. Observational studies on the prevalence of musculoskeletal injuries or their risk factors in musicians aged 18-65 years were eligible for inclusion, and the methodological quality and risk of bias were assessed. . In total, 31 studies on multiple instruments and 17 studies on individual instruments were included. Quality was rated as high in 65% of the studies. Lifetime prevalence of injuries ranged from 46 to 90% and current prevalence from 9 to 63%. The most common region of pain was the neck, being present in all instrument families. Being female is a predisposing factor to the appearance of musculoskeletal problems in musicians. . Musicians frequently suffer musculoskeletal injuries. The most common regions of the body in which these injuries occur are the neck and shoulders. Numerous risk factors were found to be predisposing to musculoskeletal injuries. We note that there are fewer studies on specific instruments.
Topics: Humans; Female; Male; Musculoskeletal Pain; Prevalence; Occupational Diseases; Musculoskeletal Diseases; Neck; Risk Factors; Music
PubMed: 35678565
DOI: 10.1080/10803548.2022.2086742 -
Occupational and Environmental Medicine Mar 2016A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with... (Review)
Review
A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed.
Topics: Cost-Benefit Analysis; Employment; Humans; Musculoskeletal Pain; Occupational Health; Outcome Assessment, Health Care; Sick Leave; Workplace
PubMed: 26740689
DOI: 10.1136/oemed-2015-103208 -
Physical Therapy in Sport : Official... Nov 2021To evaluate the impact of interventions on pain associated with DOMS. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the impact of interventions on pain associated with DOMS.
DATA SOURCES
PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy".
ELIGIBILITY CRITERIA
Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced.
RESULTS
One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I = 60 %), cryotherapy (p = 0,002 I = 100 %), phototherapy (p = 0,0001 I = 95 %), vibration (p = 0,004 I = 96 %), ultrasound (p = 0,02 I = 97 %), massage (p < 0,00001 I = 94 %), active exercise (p = 0,0004 I = 93 %) and compression (p = 0,002 I = 93 %) have a better positive effect than the control in the management of DOMS.
CONCLUSION
Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.
Topics: Cryotherapy; Exercise; Humans; Myalgia; Pain Management; Physical Therapy Modalities; Randomized Controlled Trials as Topic
PubMed: 34365084
DOI: 10.1016/j.ptsp.2021.07.005 -
Scandinavian Journal of Medicine &... Mar 2018The main objective was to systematically review the scientific literature about the effects of exergame-based interventions on musculoskeletal pain, as well as to... (Meta-Analysis)
Meta-Analysis Review
The main objective was to systematically review the scientific literature about the effects of exergame-based interventions on musculoskeletal pain, as well as to provide directions for the clinical practice. A systematic search was conducted in four electronic databases following PRISMA guidelines. The inclusion criteria were as follows: (a) the subjects were suffering musculoskeletal pain, (b) the study was randomized controlled trial (RCT), (c) intervention was based on exergames, (d) the article was written in English, and (e) the article was not an abstract or summary presented in a congress or conference. Risk of bias and quality of evidence were evaluated using the PEDro Scale and GRADE approach, respectively. A meta-analysis was carried out to determine effect sizes. Seven studies were selected in the systematic review. The meta-analysis included those six articles which reported means and SD before and after treatment and used a visual analog scale or a Numeric Pain Rating Scale. Four of the seven articles reported significant reduction in pain while the rest did not found any significant change in pain after the intervention. The overall effect size for pain was -0.51 (95% CI from -1.25 to 0.23) with large heterogeneity. Although four of the seven articles reported significant within-group differences, zero was included in the CI of the overall effect size. Therefore, up-to-date there is not enough evidence to conclude that exergames improve musculoskeletal pain.
Topics: Exercise Therapy; Games, Recreational; Humans; Musculoskeletal Pain; Pain Measurement; Randomized Controlled Trials as Topic
PubMed: 28452070
DOI: 10.1111/sms.12899 -
BMC Musculoskeletal Disorders May 2023Chronic musculoskeletal pain (CMP) is a complex condition that is mainly treated with analgesic drugs. However, antidepressant intervention is also an important factor... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic musculoskeletal pain (CMP) is a complex condition that is mainly treated with analgesic drugs. However, antidepressant intervention is also an important factor in the treatment of CMP. Duloxetine is an effective treatment option for patients with CMP as its antidepressant effect. The purpose of this article is to evaluate the efficacy and safety of duloxetine in treating CMP.
DATABASES AND DATA TREATMENT
We searched PubMed, Web of Science, Embase, Cochrane Library from inception to May, 2022. Randomized controlled trials (RCTs) evaluating the efficacy and safety of duloxetine versus placebo in patients with CMP were included. We identified 13 articles and studied a population of 4201 participants in 4 countries.
RESULTS
This meta-analysis showed that the duloxetine has statistically significant compared with the placebo control, benefits on 24-hour average pain, living quality, physical function, and global impressions and there was no difference in the incidence of serious adverse event. In general, duloxetine can improve mood and pain level at the same time.
CONCLUSIONS
This review shows a significant contribution of duloxetine to CMP symptom relief. This meta-analysis improved that duloxetine can significantly reduce the pain level of patients, improve depressive symptoms and global impression, and has no obvious serious adverse reactions. However, additional studies are required to confirm the relationship between psychological diseases and chronic pain and explore their internal links.
Topics: Humans; Duloxetine Hydrochloride; Musculoskeletal Pain; Analgesics; Chronic Pain; Antidepressive Agents
PubMed: 37198620
DOI: 10.1186/s12891-023-06488-6