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Brazilian Journal of Physical Therapy Jun 2024Migraine may be accompanied by several cervical musculoskeletal dysfunctions, for example an altered performance on the Craniocervical Flexion Test (CCFT). However, CCFT...
BACKGROUND
Migraine may be accompanied by several cervical musculoskeletal dysfunctions, for example an altered performance on the Craniocervical Flexion Test (CCFT). However, CCFT measurement properties are still unclear in patients with migraine.
OBJECTIVES
To determine intra- and inter-examiner reliability, construct validity, standard measurement error (SEM), and minimal detectable change (MDC) of the CCFT in patients with migraine.
METHODS
Women diagnosed with migraine were considered eligible for this study. Participants were assessed by two examiners for the inter-examiner reliability, and with 7-10 days interval for the intra-examiner reliability. Construct validity was assessed considering headache and neck pain frequency and intensity, and self-reported questionnaires, including the Headache Impact Test - 6 items (HIT-6), the 12-item Allodynia Symptom Checklist/Brazil (ASC-12), and the Neck Disability Index (NDI). In addition, participants performed cervical endurance and maximal voluntary isometric contraction of the cervical flexors.
RESULTS
A total of 103 women with migraine were recruited. The intra-examiner reliability was rated as good (ICC= 0.81, 95% CI: 0.73, 0.87), while the inter-examiner reliability was rated as moderate (ICC= 0.55, 95% CI: 0.40, 0.67). The intra and inter-examiner SEM were 1.31 and 1.36 mmHg respectively, and MDC were 3.63 and 3.77 mmHg. The HIT-6 and the cervical endurance flexion test were associated with the CCFT in a multiple linear regression model (p = 0.004, R = 0.35).
CONCLUSION
The CCFT presents adequate intra- and inter-examiner reliability. Better performance on the CCFT test was associated with better HIT-6 scores and greater cervical endurance time, which was not influenced by the presence of neck pain.
PubMed: 38936314
DOI: 10.1016/j.bjpt.2024.101085 -
Musculoskeletal Science & Practice Jun 2024Many physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended...
BACKGROUND
Many physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended intervention (Back2Action) was developed to assist physiotherapists to manage people with persistent spinal pain and coexisting psychosocial risk factors associated with the development or maintenance of persistent pain.
OBJECTIVE
This study aimed to gain insight into the experiences of physiotherapists with this blended psychosocial intervention.
DESIGN
and methods: This was an interpretative qualitative study with a reflexive thematic analysis of semi-structured interviews with physiotherapists (N = 15) who delivered Back2Action. The interview started with the grand-tour question: "What was your experience in using Back2Action?" Physiotherapist were encouraged to provide examples, and follow-up questions were posed to ensure a deeper understanding could be reached.
RESULTS
Four themes were constructed: Physiotherapists became increasingly aware of (1) their own implicit expectations, biases and skills, and underlying treatment paradigms, and (2) the implicit expectations from their patients towards them. This led to (3) creating a deeper and stronger therapeutic alliance with the patient, but also (4) an understanding that implementation of a true biopsychosocial intervention - even if offered in a blended form - requires more practice, confidence and resources.
CONCLUSIONS
Back2Action is considered a valuable treatment to deliver a biopsychosocial intervention in primary care. Considering the high level of knowledge, skills and competency of the participating physiotherapists, the perceived barriers may be more difficult to overcome for more junior physiotherapists.
PubMed: 38936263
DOI: 10.1016/j.msksp.2024.103121 -
Physical Therapy in Sport : Official... Jun 2024To evaluate non-contact injury prevention strategies of professional men's soccer clubs in elite North American league soccer. To understand the application, perceived...
OBJECTIVE
To evaluate non-contact injury prevention strategies of professional men's soccer clubs in elite North American league soccer. To understand the application, perceived effectiveness and barriers to implementation.
DESIGN
Online cross-Sectional Study.
SETTING
North American elite soccer teams.
PARTICIPANTS
96 medical and performance support staff of elite North American teams.
MAIN OUTCOME MEASURE
The survey consisted of 20 questions and captured 1) practitioners' demographics; 2) perceptions of risk factors; 3) the use of assessment and monitoring strategies; and 4) perceptions of the implementation of injury prevention programmes'.
RESULTS
Injury prevention programmes were perceived as 'effective' (Median 4, Interquartile range 4-4) and reduced injury rates (n = 94, 98%, 95 CI% 93 to 99). A range of potential risk factors were rated as "very important" (4.58 ± 0.52 Likert scale points; mean ± standard deviation). A multi-disciplinary approach to the design, application and monitoring of programmes was generally adopted. Competing training priorities (n = 75, 78%, 95 CI% 69 to 85) and game schedules (n = 71, 74%, 95 CI% 64 to 82) were the most prevalent barriers to injury prevention implementation.
CONCLUSIONS
Injury prevention programmes were perceived as effective in reducing non-contact injuries. Managing the conflicting priorities between scheduling training, tactical and conditioning goals were considered the key barriers to desired implementation.
PubMed: 38935993
DOI: 10.1016/j.ptsp.2024.06.003 -
Journal of Diabetes and Metabolic... Jun 2024Osteoporotic fractures can result in significant health complications and an increased risk of death. Registry studies could provide better treatment options and improve...
BACKGROUND
Osteoporotic fractures can result in significant health complications and an increased risk of death. Registry studies could provide better treatment options and improve patient outcomes by providing useful information about the disease. The present study describes the protocol for an osteoporosis registry in Iran.
MATERIALS AND METHODS
This registry is a prospective multicenter cohort study recruiting patients with osteoporosis from Iran. The inclusion criteria of the study are individuals diagnosed with primary or secondary osteoporosis according to the diagnostic criteria of the study; patients will be identified and recruited from outpatient clinics in this registry. All patients diagnosed with primary or secondary osteoporosis are the target population of the study. Our expected sample size is 1000 participants and the study will continue for at least 2 years. The measurements of the Iranian Osteoporosis Registry include four parts: (i) variables measured by the specific questionnaires package, (ii) bone mineral density (BMD, (iii) clinical examination, and (iv) lab data. The final questionnaire package includes "demographics information", "socioeconomic status", "lifestyle", "reproductive health", "medical history and medication", "Osteoporosis diagnosis gap", "Osteoporosis adherence and treatment gap", "fracture history and fall risk assessment", "FRAX ® tool ", "hospitalization and death outcomes", "low back pain", "hospitalization history", "attitude toward osteoporosis", "osteoporosis awareness", "osteoporosis related-performance", "quality of life (Iranian version of SF12 questionnaire )", and "food frequency questionnaire (FFQ)". Clinical examination of this registry includes anthropometric measurements (including height, weight, body mass index (BMI), waist circumference, hip circumference, and right wrist circumference), and blood pressure. The baseline questionnaires will be filled out right after patients are diagnosed with osteoporosis and then osteoporotic patients will be followed up regularly on a yearly basis. In the follow-up visit, variables that may have changed over time are updated. The main outcomes include registration of fall, fracture, hospitalization, medication adherence, and death. An online web-based user-friendly software is also developed for data collection. Data analysis will be conducted with the collaboration of data-mining experts and epidemiologists at the end of each follow-up.
CONCLUSION
The Iran Osteoporosis Registry will be a valuable source of information regarding osteoporosis outcomes (i.e. fractures, hospitalizations, adherence, and death at the national level), and its results will be very beneficial and practical for policy makers in the field of musculoskeletal diseases.
PubMed: 38932820
DOI: 10.1007/s40200-023-01334-x -
Ergonomics Jun 2024This study compared the number of postural shifts and perceived discomfort while leaning and sitting on an air-filled seat cushion for 1 hour. Sixty office workers...
This study compared the number of postural shifts and perceived discomfort while leaning and sitting on an air-filled seat cushion for 1 hour. Sixty office workers typed a standard text while leaning on a cushion placed behind the low back, sitting on a cushion placed under the buttocks, and sitting without a cushion (a control condition). The number of postural shifts was collected using a seat pressure mat device. Low back discomfort was assessed using the Borg CR-10 scale. Leaning on a seat cushion (22 shifts/h) led to a significantly higher number of postural shifts than sitting on a seat cushion (18 shifts/h) and the control condition (20 shifts/h). Leaning or sitting on a seat cushion significantly decreased low back discomfort compared to the control condition (p < 0.05). Leaning on a seat cushion placed behind the low back may be an effective means of preventing low back pain among office workers.
PubMed: 38932623
DOI: 10.1080/00140139.2024.2372006 -
Postgraduate Medical Journal Jun 2024De Quervain's tenosynovitis (DQt) is a prevalent chronic inflammatory musculoskeletal disorder predominantly affecting the radial aspect of the wrist. This study...
BACKGROUND
De Quervain's tenosynovitis (DQt) is a prevalent chronic inflammatory musculoskeletal disorder predominantly affecting the radial aspect of the wrist. This study conducted a comprehensive review of the efficacy of acupuncture in treating De Quervain's tenosynovitis (DQt). Although there is evidence suggesting that acupuncture can alleviate symptoms of DQt-characterized by pain, swelling, and functional impairment-higher-level evidence is still required to further substantiate its efficacy and safety. This study conducted a comprehensive review of the efficacy of acupuncture in treating De Quervain's tenosynovitis (DQt).
METHODS
By systematically searching databases such as PubMed, Science Direct, Web of Science, Google Scholar, EMbase, PEDro, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chongqing VIP China Science, Technology Journal Database (VIP), we retrieved randomized controlled trial (RCT) literature on acupuncture for DQt, with the search period extending to November 1, 2023. After extracting and assessing data from the included literature, we performed Meta-analysis using RevMan 5.4.1 software.
RESULTS
The results encompassed 14 RCT papers, involving 851 patients. The Meta-analysis findings indicated that, when compared to topical analgesics, acupuncture demonstrated a significant increase in treatment effectiveness (RR = 1.24; 95% CI = 1.11, 1.39, P = 0.0002) and a notable reduction in VAS pain scores (MD = -1.06; 95% CI = -1.51, -0.61, P < 0.00001). However, no statistically significant difference was observed in conney wrist joint scores. Furthermore, acupuncture was found to reduce VAS pain scores compared to the waiting list group. In comparison to corticosteroid injections (CSI), acupuncture did not show statistical significance in VAS, effectiveness rate, and conney wrist scores.
CONCLUSION
Acupuncture exhibited a promising trend in alleviating pain associated with DQt and enhancing treatment effectiveness. Nonetheless, due to limitations in the quantity and quality of the included studies, these findings warrant further validation through additional research.
PubMed: 38932434
DOI: 10.1093/postmj/qgae057 -
Sensors (Basel, Switzerland) Jun 2024The present pilot study aimed to propose an innovative scale-independent measure based on electroencephalographic (EEG) signals for the identification and quantification...
OBJECTIVE
The present pilot study aimed to propose an innovative scale-independent measure based on electroencephalographic (EEG) signals for the identification and quantification of the magnitude of chronic pain.
METHODS
EEG data were collected from three groups of participants at rest: seven healthy participants with pain, 15 healthy participants submitted to thermal pain, and 66 participants living with chronic pain. Every 30 s, the pain intensity score felt by the participant was also recorded. Electrodes positioned in the contralateral motor region were of interest. After EEG preprocessing, a complex analytical signal was obtained using Hilbert transform, and the upper envelope of the EEG signal was extracted. The average coefficient of variation of the upper envelope of the signal was then calculated for the beta (13-30 Hz) band and proposed as a new EEG-based indicator, namely Piq, to identify and quantify pain.
MAIN RESULTS
The main results are as follows: (1) A Piq threshold at 10%, that is, Piq ≥ 10%, indicates the presence of pain, and (2) the higher the Piq (%), the higher the extent of pain.
CONCLUSIONS
This finding indicates that Piq can objectively identify and quantify pain in a population living with chronic pain. This new EEG-based indicator can be used for objective pain assessment based on the neurophysiological body response to pain.
SIGNIFICANCE
Objective pain assessment is a valuable decision-making aid and an important contribution to pain management and monitoring.
Topics: Humans; Electroencephalography; Pilot Projects; Male; Female; Adult; Chronic Pain; Pain Measurement; Middle Aged; Signal Processing, Computer-Assisted; Young Adult
PubMed: 38931657
DOI: 10.3390/s24123873 -
Journal of Clinical Medicine Jun 2024Neck pain is a pathology with a high impact in terms of physical disability in modern society. The position of the head is related to neck pain. The Frankfort plane...
Neck pain is a pathology with a high impact in terms of physical disability in modern society. The position of the head is related to neck pain. The Frankfort plane determines the position of the skull in space. The profile photograph of the subjects was used to determine the Frankfort plane and to study its degree of inclination. Myofascial pain syndrome is one of the most common causes of musculoskeletal pain. Trigger points are hyperirritable spots located in a palpable taut band of skeletal muscle that is painful on compression or stretch and causes a local twitch in response to snapping or palpation of the band. The aim of this study was to analyze the relationship between the Frankfort plane and the presence of myofascial trigger points causing cervical myofascial pain. : This is a cross-sectional descriptive observational study. All subjects underwent a photographic study to determine the degree of Frankfort plane inclination, and the posterior cervical musculature was palpated to find myofascial trigger points that were measured with a pressure algometer in three cervical locations on the right and left sides. Our study included 47 subjects who had suffered at least one episode of cervical pain in their lifetimes. The mean age was 22.3 ± 2.9 years. Statistically significant results were found in the first right location and sports practice ( = 0.007), in the second right location and gender ( = 0.0097), in the second right location and sports practice ( = 0.0486), in the third right location and gender ( = 0.0098), and in the first, second, and third left locations and gender ( = 0.0083; = 0.024; = 0.0016, respectively). In the correlation between the Frankfort plane and the presence of myofascial trigger points, all locations were positive, with the first right location being statistically significant ( = 0.048). A positive relationship was found between the Frankfort plane and the presence of myofascial trigger points. The greater the angle of the Frankfort plane, the less the myofascial pain.
PubMed: 38930143
DOI: 10.3390/jcm13123614 -
Journal of Clinical Medicine Jun 2024Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries...
Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries (RCIs) are notable for their high prevalence. The critical shoulder angle (CSA) is a significant radiological measure for determining the diagnosis and progression of patients with these conditions. Although there are reports in the international literature about this measure, in our country, guideline values considering these two pathologies are unknown. Our objective was to assess patients diagnosed with GHOA and RCI using an AP X-ray view and the CSA. To conduct this, we identified differences between sexes and age categories. Fifty-nine adult patients with GHOA and RCI were included. CSA grades varied depending on the age category and type of injury evaluated. Significant differences between the age ranges of 40 and 54 ( = 0.05), 55-69 ( = 0.001), and 70-84 ( = 0.017) were observed. Patients with RCI tended to be younger and have a higher CSA compared to those with GHOA. It is important to have more normative values and to continue monitoring the critical shoulder angle in these patients.
PubMed: 38929939
DOI: 10.3390/jcm13123408 -
Journal of Personalized Medicine Jun 2024Osteoarthritis (OA) is the most common complex musculoskeletal disorder, resulting from the degeneration of the articular cartilage and characterized by joint pain and...
Osteoarthritis (OA) is the most common complex musculoskeletal disorder, resulting from the degeneration of the articular cartilage and characterized by joint pain and dysfunction that culminate in progressive articular cartilage loss. We present our experience in the management of hip and knee OA by means of the intra-articular injection of fat micrograft, describing our approach, which was developed from the belief in the powerful reparative effect of autologous fat graft on damaged tissue, as well as its natural lubricating effect on the joints. Inclusion criteria were as follows: men and women, aged 20 to 80 years, that referred articular pain of the hips and/or knees, showing initial-stage degenerative OA. From October 2018 to July 2023, a total of 250 patients underwent treatment with the Sefficare device (SEFFILINE srl, Bologna, Italy). The Superficial Enhanced Fluid Fat Injection device was used to perform autologous regenerative treatments in a safe, standardized, easy, and effective way on 160 women, 64%, and 90 men, 36%. A total of 190 procedures (76%) involved the knees, with 20 patients who were bilaterally treated, while 60 procedures, all unilateral, involved the hips (24%). The mean age at treatment was 52.4 years. Before treatment, each patient had undergone X-rays and Magnetic Resonance Imaging (MRI) of the painful hip/knee to evaluate and grade the articular OA. Postoperatively, each patient was assessed after one, three, six, and twelve months. The donor site postoperative course was uneventful other than minimal discomfort. Clinically, the ROM (range of motion) of the treated knee/hip increased an average of 10 degrees 3 months after treatment, but the stiffness was reduced, as reported by the patients. The VAS (Visual Analog Scale) was submitted at 3, 6, and 12 months, demonstrating a progressive reduction of pain, with the best score obtained at six months postoperatively. In total, 85% of patients were satisfied one year after treatment, with a considerable improvement in pain and quality of life. The satisfactory outcome of this minimally invasive procedure indicates that the intra-articular injection of fat micrograft can replace or considerably delay the need for the classical major joint replacement surgery, thanks to its impact on the quality of life of patients and financial cost.
PubMed: 38929825
DOI: 10.3390/jpm14060604