Adapted physical activity programs for the prevention and treatment of musculoskeletal pain induced by aromatase inhibitors in non-metastatic breast cancer patient: a scoping review.

BACKGROUND: Aromatase inhibitor is associated with a high incidence of Aromatase Inhibitor-Associated Musculoskeletal Syndrome (AIMSS) in postmenopausal women with hormone-sensitive breast cancer. OBJECTIVE: This scoping review aims to identify available information regarding the frameworks, models, or strategies of adapted physical activity (APA) programs implemented for the prevention and management of AIMSS. METHODS: Search was realized by two independent reviewers in six databases following PRISMA-ScR guidelines. Data of included articles were extracted, and risk of bias analyzed. RESULTS: Finally, 14 were included. No study has examined APA in the prevention of AIMSS. There is no solid evidence supporting the impact of APA on the management of AIMSS. However, evidence suggests that an APA program can reduce the worst joint pain and improve the quality of life. CONCLUSION: Future research will enlighten clinical practices with the development of personalized APA programs in hormone-sensitive breast cancer.

The Prevalence of Musculoskeletal Pain and Assessment of Potential Risk Factors Among a Sample of Medical Students in Giza, Egypt.

INTRODUCTION: Musculoskeletal pain (MSP) is one of the most prevalent conditions among global medical students, affecting their daily lifestyle. In this study, we seek to determine the prevalence of MSP and its associated risk factors in a sample of medical students at Misr University for Science and Technology, Egypt. METHODS: A cross-sectional study was conducted between December 2023 and February 2024, with a sample size of 1472 students who filled out a modified version of the Standardized Nordic Questionnaire. Demographic variables, study hours, and special habits were collected and analyzed. The prevalence of MSP in the past week and year was documented and analyzed using common risk factors. RESULTS: A total of 971 responses were considered for analysis (66% of the total sample size and 27.7% of the total medical students). The majority were between 18 and 25 years old, with 50.7% males and 49.3% females. The median age was 21 (20-23) years. Most of the students were in their fifth year (23.8%). The prevalence of at least one MSP site was 459 (47.2%) in the past week and 702 (72.2%) in the past year. MSP in the past year was significantly associated with females (OR = 2.45, 95% CI = 1.82-3.3, p = 0.001) and those with a family history of autoimmune disease (OR = 2.19, 95% CI = 1.3-3.5, p = 0.001), while it was significantly associated in the past week with females (OR = 1.72, 95% CI = 1.3-2.2, p = 0.001) and those with a personal history of autoimmune disease (OR = 2.26, 95% CI = 1.09-4.7, p = 0.025). In the past year, neck pain was significantly associated with females (OR = 1.83, 95% CI = 1.42-3.27, p = 0.001) and those with a family history of autoimmune disease (OR = 1.4, 95% CI = 1.01-2.08, p = 0.047). Students living inside October city were less likely to have neck pain in the past year than those who lived outside October city (OR = 0.73, 95% CI = 0.56-0.94, p = 0.017). Shoulder pain in the past year was significantly associated with females (OR = 2.9, 95% CI = 2.1-3.98, p = 0.001) and those with a family history of autoimmune disease (OR = 1.9, 95% CI = 1.28-2.81, p = 0.001) while back pain in the past year was significantly associated with females (OR = 2.1, 95% CI = 1.6-2.7, p = 0.001). Gender was the only factor that was associated with MSP on multivariate regression analysis for the past week (p = 0.001) and past year (p = 0.001). CONCLUSION: MSP is highly prevalent among medical students in Egypt, especially females, those with a personal history of autoimmune disease, and those with a family history of autoimmune disease. Despite the high prevalence and the effect on daily lifestyle, very few medical students sought help. More studies are needed to evaluate other risk factors and effective approaches to alleviate MSP among medical students in Egypt.

Exploring athlete pain assessment experiences and priorities; a two-part qualitative series of athlete and physiotherapist interactions. Part Two. "Forging our future" - Athlete and physiotherapists' priorities for pain assessment and beyond.

OBJECTIVES: To explore the priorities and directions of athlete upper and lower limb pain assessment by facilitating shared understandings of athletes and sport physiotherapists. DESIGN: Qualitative research using a hermeneutic phenomenological approach. METHODS: We carried out focus groups comprising a deliberate criterion sample using a constructivist perspective. At the end of each focus group, we used the nominal group technique method to generate a list of consensus-based priorities for future pain assessment. Our paper follows the consolidated criteria for reporting qualitative research (COREQ) guidelines. RESULTS: We completed five focus groups, comprising twelve athletes (female, n = 5, male, n = 7) and four sport physiotherapists (male, n = 4). Two final themes (and six subthemes) were developed; I Enhanced Communication and Pain Descriptions (describing and representing pain, better communication, the role of technology, providing direction and setting the pace), and II Integrating Sport Specific and Multidimensional Assessments (broadening the pain assessment toolkit, the role of technology). We developed a set of thirteen practical priorities for pain assessment that span the subjective, objective, and general aspects of the athlete pain assessment. CONCLUSIONS: We have presented stakeholder-generated perspectives, direction and priorities for athlete pain assessment. Athletes and physiotherapists must continue to work together to achieve a comprehensive sport-specific multidimensional pain assessment experience alongside their wider support networks to ensure optimal representation and communication. We have highlighted some available pain assessment tools and strategies and outlined how novel tools may address certain gaps. Researchers, clinicians, and athletes can consider the practical guidance we have provided to address these priorities.

[Sanogenetic mechanisms of cyclic local traction therapy in the treatment of neurological manifestations of degenerative diseases in the spine. (Literature review)]. / Sanogeneticheskie mekhanizmy tsiklichnoi lokal'noi traktsionnoi terapii v lechenii nevrologicheskikh proyavlenii degenerativnykh zabolevanii pozvonochnika. (Obzor literatury).

New information on the results of scientific research may change the understanding of the etiology and pathogenesis of diseases, which makes adjustments in treatment approaches. Cyclic local traction therapywas created in USA by the group of scientists for NASA (Axiom Worldwide, Tampa, FL) and approved by FDA in 2003. The year 2023 is the 20th anniversary of its successful application in practical medicine. Evaluating the effectiveness of the method, it has been shown that after undergoing treatment in patients with chronic back pain, the height of the intervertebral discs increases, pain syndrome and frequency of taking pain medications decreases, daily activity and duration of walking without pain increases. It is assumed that the treatment effect was achieved due to the «vacuum¼ effect, which could contribute to the regeneration of the intervertebral disc. It is also known about the possibility of intervertebral disc herniation reduction after a course of traction therapy and it was believed that this was ensured by «retraction¼ of the hernia back into the intervertebral space under the influence of the longitudinal ligament. However, fundamental studies of the past century and the present indicate the presence of other mechanisms affecting the structures of the vertebral motor segment, especially the processes occurring inside the intervertebral disc and contributing to the regression of the intervertebral disc herniation.

Chronic Musculoskeletal Pain and Risk of Incident Parkinson's Disease: A 13-Year Longitudinal Study.

BACKGROUND: Chronic musculoskeletal pain often co-occurs with Parkinson's disease (PD); however, whether individuals with chronic pain have a higher risk of developing PD is unclear. OBJECTIVES: To investigate the associations between chronic pain and incident risk of three neurodegenerative parkinsonism categories including PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). METHODS: This study included 355,890 participants (mean [standard deviation] age, 56.51 [8.07] years, 48.40% male) who did not have parkinsonism at baseline from a population-based cohort. Musculoskeletal pain in the hip, neck/shoulder, back, knee, or "all over the body" was assessed. Chronic pain was defined if pain lasted ≥3 months. Participants were categorized into four groups: no chronic pain, having one or two, three or four sites, and pain "all over the body." The diagnosis of PD, MSA, and PSP used self-reports, hospital records, and death registries. Multivariable-adjusted Cox regression was performed for the analyses. RESULTS: Over a median follow-up of 13.0 years, 2044 participants developed PD, 77 participants developed MSA, and 126 participants developed PSP. In multivariable analyses, there was a dose-response relationship between number of chronic pain sites and incident risk of PD (hazard ratio, 1.15; 95% confidence interval, 1.07-1.23). Participants with one or two pain sites and three or four pain sites had an 11% and 49% increased risk of developing PD, respectively. There were no associations between chronic pain and MSA or PSP. CONCLUSIONS: Chronic musculoskeletal pain was independently associated with PD, suggesting that chronic pain could be used to identify individuals at risk of developing PD. © 2024 International Parkinson and Movement Disorder Society.

Musculoskeletal disorders and quality of life of artisanal fishermen from riverside localities in the Brazilian Amazon.

BACKGROUND: Artisanal fishing is widely practiced in the Amazon region. However, the exhaustive labor demand impacts on the health of fishermen. Thus, this study aimed to evaluate the prevalence of musculoskeletal disorders (MSDs) and the relationship with the quality of life (QoL) of artisanal fishermen. METHODS: A cross-sectional study was carried out, evaluating male fishermen from two rural communities bordering Janauacá lake, Amazonas. Data were collected through interviews, using REDCap installed on smartphones. The Nordic Musculoskeletal Questionnaire was utilized to identify the body regions with the greatest pain complaints, and QoL was assessed using the mental and physical components of the SF-12. After the descriptive analysis, linear regression analysis was performed to evaluate the association between the occurrence of MSDs and the components of QoL. The analyses were performed using Stata SE software, version 17. RESULTS: In total, 115 fishermen were evaluated. MSDs were reported in all of the body regions assessed, with a higher prevalence in the lower (80.0%) and upper (43.5%) back, and knee (40.9%). Lower QoL scores were observed in emotional performance (20.7 ± 4.0), physical performance (25.1 ± 4.3), and mental health (29.0 ± 13.6). It was observed that individuals with any MSD presented worse QoL in the physical component (ßadj=-5.0; 95%CI=-9.7; -0.3). CONCLUSION: The findings showed a high prevalence of MSDs in the study population, as well as its impact on the QoL of artisanal fishermen. This highlights the need to reorganize health services to prevent the occurrence of MSDs, as well as for their treatment and rehabilitation.

Prevalence and treatment of chronic musculoskeletal pain focused on service gaps: a comparative analysis by age group and body part.

Background: Occupational health, grounded in occupational medicine, aims to enhance the well-being and labor productivity of the working population. Within this realm, there has been growing concern over the increasing instances of labor loss due to diminished physical capacity and the rise in musculoskeletal disorders. Chronic pain is also associated with musculoskeletal disorders. Another pressing issue related to chronic musculoskeletal pain was needed assistance services are underutilized, is referred to as a "service gap". Understanding trends based on age and affected regions of the body is indispensable for developing strategies to address chronic musculoskeletal pain in workers. This study aimed to elucidate age-specific trends in the prevalence and number of pain sites in chronic musculoskeletal pain as well as the patterns of treatment during chronic musculoskeletal pain, categorized by age and affected site. Methods: This study was conducted in December 2022 in contract to Cross Marketing Inc. The survey began on December 12, 2022 and ended on December 15, 2022. An online survey was administered to 1,946 participants (973 women and 973 men), and responses were collected, ensuring a roughly equal distribution of samples among men and women across six age groups ranging from their 20 to 70 s. The survey inquired about the presence of chronic pain in each of the eight body parts and the adoption of five different treatments when experiencing pain. Statistical analysis was performed using the chi-square test, with the measurement data categorized by age group and body part. Results: The results indicated a significantly higher prevalence of chronic pain at three or more sites among individuals in their 30 s: the prevalence of pain at each of the eight body sites varied with age. Approximately half of the participants did not engage in specific treatments during episodes of chronic pain. The presence or absence of treatment showed no significant differences according to affected site or age group. This study revealed age- and body part-related relationships with chronic musculoskeletal pain in middle-aged patients and highlighted healthcare service gaps in its management in Japan.

Prevalence and Predictors of Carpal Tunnel Syndrome Symptoms Among Teachers in Jazan: A Cross-Sectional Study.

Background  Carpal tunnel syndrome (CTS) is a common musculoskeletal condition of the hand and wrist frequently associated with repetitive hand motion and environmental considerations. Teachers are more likely to acquire CTS because of their lengthy writing and computer use. This study aimed to determine the prevalence of CTS symptoms and related variables among schoolteachers in Jazan, Saudi Arabia. Methods This study was conducted as a cross-sectional survey of teachers in Jazan, utilizing an online platform for data collection. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was the primary tool used to determine symptom intensity and functional status. The data were rigorously analyzed using a range of statistical methods, including descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman's correlation, the chi-square test, Fisher's exact test, and binary logistic regression, ensuring the robustness of the findings. Results The study comprised 336 schoolteachers with a mean age of 43.3 ± 6.5 years, of whom 58.0% were female and 42.0% were male. About 8.0% of instructors reported CTS symptoms. Female gender (median Symptom Severity Scale (SSS): 15.0 vs. 12.0, p < 0.001; median Functional Status Scale (FSS): 8.0 vs. 8.0, p < 0.001), increased time spent writing (r = 0.237, p < 0.001 for SSS; r = 0.217, p < 0.001 for FSS), and presence of comorbidities such as diabetes (median SSS: 16.0, p = 0.002; median FSS: 8.0, p = 0.001) had a negative correlation with symptom severity (r = -0.174, p = 0.002) and functional impairment (r = -0.141, p = 0.011). Surgical therapy (median SSS: 32.0; median FSS: 24.0; p<0.001) and post-treatment symptom recurrence (median SSS: 28.0; median FSS: 22.0; p<0.001) were associated with increased severity and disability. According to binary logistic regression, increased writing time significantly predicted CTS diagnosis (OR = 1.151, 95% CI: 1.024-1.295, p = 0.018). Conclusion CTS symptoms are common among Jazan teachers, and various sociodemographic, vocational, and clinical variables influence their intensity and functional status. Ergonomic treatment, early identification, and suitable management measures are critical for preventing and mitigating the effects of CTS among teachers. Additional research is required to develop focused therapies and enhance the results of this occupational group.

Efficacy of Thiocolchicoside for Musculoskeletal Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Despite the fact that thiocolchicoside has been widely used in the treatment of musculoskeletal pain, its efficacy has never been systematically evaluated. We carried out a systematic review and meta-analysis of randomized clinical trials (RCTs) to appraise the existing evidence on the efficacy of thiocolchicoside for musculoskeletal pain management. Methods: The literature search was performed on multiple databases, extracting reports of RCTs evaluating the efficacy of thiocolchicoside compared to placebo or no exposure. The reduction in pain intensity was evaluated through between-groups mean differences (MDs) in Visual Analogue Scale (VAS) scores after the intervention. The pooled effect estimates were compared to a minimally important difference (MID) of 1 point on a scale from 0 to 10. Results: We retrieved eight RCTs, including a total of 1397 patients. All the included studies were determined as being at high risk of bias. Seven trials evaluated patients with acute low back pain. After 2-3 days of treatment, the pooled MD in VAS score was -0.49 (95%CI = -0.90; -0.09) compared to controls. After 5-7 days of treatment, the summary MD was -0.82 (95%CI = -1.46; -0.18). Conclusions: Although thiocolchicoside was found to significantly reduce patient-reported low back pain, the clinical impact was very small, as the pooled effect estimates were below the MID, and the overall certainty of evidence was very low. In light of the safety concerns raised by the European Medicine Agency, an in-depth analysis on the risk-benefit balance of thiocolchicoside is required.

Effects of progessive vs. constant protocol whole-body vibration on muscle activation, pain, disability and functional performance in non-specific chronic low back pain patients: a randomized clinical trial.

Background and Objective: Non-specific chronic low back pain (NSCLBP) is a prevalent condition causing significant disability and functional impairment. Whole-body vibration exercise (WBVE) has emerged as a new treatment method, but additional research is necessary to determine the optimal parameters of WBVE that would be beneficial for patients experiencing chronic low back pain (CLBP). This study aims to investigate the effects of two type of WBVE (constant vs progressive) on pain, disability, functional performance, and muscle activity in patients with NSCLBP. Methods: Thirty-two individuals diagnosed with chronic low back pain (CLBP) without any specific causes were enrolled and randomly assigned to one of two intervention groups: a constant/fixed protocol WBVE group or a progressive protocol WBVE group. Participants underwent WBVE sessions for around 30 min, thrice weekly over a period of 8 weeks. Primary outcomes assessed included pain intensity, functional disability, functional performance, and electromyographic activity of core musculature, measured at baseline and upon completion of the intervention period. Temporal changes of each outcome variable across different periods and between groups were measured with repeated measures 2×2 mixed ANOVA. Further, the paired t-test was performed to compare pre- and post-treatment values within each group. Results: Significant improvements were observed in both the constant and progressive WBVE protocol groups. Pain intensity decreased by 64.2% (p < 0.001) in the constant group and by 61.1% (p < 0.001) in the progressive group. Functional disability decreased by 48.1% (p < 0.001) in the constant group and by 53.3% (p < 0.001) in the progressive group. Functional performance improved by 16.5% (p < 0.001) in the constant group and by 16.9% (p < 0.001) in the progressive group. Electromyography (EMG) demonstrated significant improvements across all measured variables except % maximum voluntary isometric contraction (%MVIC) of external obliques (EO) in both intervention groups with time (p < 0.001). There was no statistically significant difference in the magnitude of improvement between the constant and progressive WBVE protocols (p > 0.05), indicating both modalities' effectiveness in ameliorating CLBP symptoms and associated functional impairments. Conclusion: The study demonstrates that both progressive and constant WBVE protocols are equally effective in reducing pain and disability in NSCLBP patients. These findings support the inclusion of progressive WBVE in clinical practice, offering a flexible treatment option that can be tailored to individual patient needs, ensuring both tolerability and effectiveness. This contributes valuable evidence towards optimizing WBVE protocols for managing NSCLBP.

The prevalence of occupational-related low back pain among working populations in sub-saharan Africa: a systematic review and meta-analysis.

INTRODUCTION: Work-related musculoskeletal disorders represent a major public health problem, contributing significantly to the global burden of disability-adjusted life years and affecting the quality of life of all population groups. The main problem in most musculoskeletal disorders is low back pain. Therefore, our study aims to identify the overall prevalence of work-related low back pain among the working population in sub-Saharan Africa. METHODS: Research published between 2010 and 2023 in English, conducted in Sub-Saharan Africa was included in this systematic review and meta-analysis. Using Boolean logic operators and targeted keywords, we searched for publications on a number of electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The Joanna Briggs Institute Critical Appraisal techniques were utilized to conduct a quality assessment of the papers and ascertain their relevance to the study. The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model. Sensitivity studies were carried out to determine the causes of heterogeneity and the impact of outliers. RESULTS: In this study, a total of 970 articles were retrieved, and 35 studies were included in the systematic review and meta-analysis. The overall estimated pooled prevalence of low back pain among the working population in sub-Saharan Africa was (55.05% [95% CI: 49.34, 60.76]). Based on a sub-group analysis by countries, the higher pooled prevalence of low back pain was found in Uganda at (61.48% [95% CI: 40.39, 82.57]), while the lower pooled prevalence of low back pain was in Ghana at (34.48% [95% CI: 17.96, 51.01]). CONCLUSIONS: This systematic review and meta-analysis found that 55.05% of the included study participants experienced low back pain in the previous years. Therefore, it is recommended that policymakers incorporate and enhance strategies for the prevention and management of low back pain within the health system management guidelines of each country.

Association between sleep duration and chronic musculoskeletal pain in US adults: a cross-sectional study.

Background: This study aims to explore the association between sleep duration and the prevalence of chronic musculoskeletal pain (CMP). Methods: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010, which involved multiple centers across the United States. The study included 3,904 adults selected based on age and complete data availability. Demographic variables such as gender, age, race, and socioeconomic status (represented by the poverty-to-income ratio) were considered. Results: Of the participants, 1,595 reported less than 7 h of sleep, 2,046 reported 7-8 h, and 263 reported more than 9 h of sleep. Short sleep duration was associated with higher odds of CMP (OR, 1.611, 95% CI: 1.224-2.120, p = 0.005). Long sleep duration also showed a higher prevalence (OR, 1.751; 95% CI, 0.923 to 3.321; p = 0.059), although this result was not statistically significant. A U-shaped relationship emerged (Effective degree of freedom (EDF) = 3.32, p < 0.001), indicating that 7 h of sleep was associated with the lowest odds of CMP. In individuals with sleep durations less than 7 h, each hour increment correlated with 22.8% reduced odds of CMP (OR, 0.772; 95% CI, 0.717-0.833; p = 0.002). Beyond 7 h, each hour increment was associated with 38.9% increased odds of CMP (OR, 1.389; 95% CI, 1.103-1.749; p = 0.049). Conclusion: The findings suggest that both insufficient and excessive sleep durations are linked to a higher prevalence of CMP, highlighting the importance of optimal sleep duration for musculoskeletal health.

The STarT Back Screening Tool: The Nepali Translation, Cross-Cultural Adaptation and Measurement Properties in Adults With Non-Specific Low Back Pain.

INTRODUCTION/OBJECTIVE: The STarT Back Screening Tool (SBST) stratifies low back pain (LBP) patients based on their risk of chronicity to guide treatment accordingly. The absence of its validated Nepali version limits stratified LBP care in Nepal. The study aimed to translate and cross-culturally adapt the SBST into Nepali and evaluate its measurement properties in adults with LBP. METHODS: The measurement properties of the Nepali SBST were evaluated in 102 Nepali adults with non-specific LBP. We assessed content validity, internal consistency, test-retest reliability, construct and discriminant validity. Item redundancy was evaluated using Cronbach's alpha (α > 0.90), test-retest reliability using Intraclass Correlation Coefficient (ICC2,1) and Cohen's kappa using established cutoffs score for categorising patients into risk groups, construct validity using hypothesis testing (if a minimum of 75% of the hypotheses were supported), and discriminant validity using Area Under the Curve (AUC) with the reference scales administered at baseline. RESULTS: Cronbach's alpha scores were 0.72 for the overall scale and 0.66 for the psychosocial subscale. Test-retest reliability values were good to excellent with ICC2,1 of 0.94 (95% CI: 0.87-0.97) for the overall scale and 0.87 (95% CI: 0.73-0.94) for the psychosocial subscale and Kappa values of 0.68 (95% CI: 0.43-0.93) for the overall scale and 0.79 (95% CI: 0.52-1.00) for psychosocial subscale. Construct validity was confirmed as 100% of a priori hypotheses were met. Acceptable discriminative validity was observed with reference scales with AUCs (0.75-0.80). CONCLUSIONS: Nepali SBST demonstrates the reliability and validity of screening for chronicity risk in Nepali adults with LBP. Future studies should evaluate its responsiveness, predictive abilities, and effectiveness in stratifying LBP patients in the Nepalese context.

Design and development of an eHealth intervention to support self-management in people with musculoskeletal disorders: 'eHealth: it's TIME'.

OBJECTIVE: This study aimed to co-design and develop a user-centred, theory-based eHealth-mediated self-management support follow-up prototype for adults with musculoskeletal disorders. DESIGN: A three-step system development cycle was employed. Step 1 involved creating intervention features and content, with two focus groups reviewing prioritised eHealth intervention elements based on earlier research. Step 2 involved heuristic testing using Nielsen's 10 heuristic principles. Step 3 incorporated qualitative think-aloud interviews and the System Usability Scale. SETTING: Republic of Ireland. PARTICIPANTS: Step 1 included adults with musculoskeletal disorders (n = 12). Step 2 involved five reviewers. Step 3 included people with musculoskeletal disorders (n = 5) and musculoskeletal physiotherapists (n = 5). RESULTS: Participants in step 1 approved four main intervention components, which map to recognised theoretical frameworks, and suggested increased use of visual and interactive elements. Heuristic testing in step 2 identified design and navigation issues. In Step 3, usability testing, additional navigation, content and design recommendations were identified. The overall median system usability score (interquartile range) was 75 (0) out of 100 for adults with musculoskeletal disorders and 77.5 (2.5) out of 100 for musculoskeletal physiotherapists, indicating good usability. CONCLUSION: A theory-based, user-centred eHealth-mediated follow-up self-management support prototype has been developed for people with musculoskeletal disorders, with the next steps focusing on feasibility testing in clinical practice, with a more diverse population.

A Local Heating Profile to Manage Lower Back Pain in an Automotive Seat: A Pilot Study.

Lower back pain (LBP) is one of the most prevalent health losses in adults worldwide. Historically, heat has been successfully used for treating pain and relieving tight muscles. Given the effective contact with the occupant's back and proximity to the heat source, coupled with increasing commute times, automotive seats offer an opportunity to intervene. Fifteen adults (nine female) who experienced acute, subacute, and chronic lower back pain were recruited to examine the effectiveness of heat delivered to the lower back in providing temporary pain relief. Participants sat in a car seat for 38 min on two days, which included a 5-min baseline followed by a 33-min intervention; control, or localized. For the control condition, participants sat for 33 min without any thermal devices on, while the localized condition heated and maintained the seat surface temperature of the lower seat back area to ~45 °C. Over the 33-min control condition, the back skin temperature increased by ~1-2 °C and did not impact the subjective LBP. Heating the lower back for 33 min to ~39 °C reduced the subjective LBP by 10%. We demonstrated that lower back pain can be alleviated from an automotive seat providing heat to the lower back within normal commute times in those with lower back pain.

Treatment Approaches Utilized in Africa for the Management of Low Back Pain: A Scoping Review.

OBJECTIVES: This study aimed to review and describe the scientific literature on approaches used for the management of nonspecific low back pain (NSLBP) in Africa. METHODS: For this scoping review, a comprehensive literature search was conducted using the EBSCO host platform to search the following databases: CINAHL with full text, MEDLINE with Full Text, PubMed, Springer Nature Journals, Directory of Open Access Journals, Science Direct, Gale OneFile: Health & Med, Google Scholar, and Gale Health & wellness. Articles published between January 1990 and March 2021 were included. We used Boolean operators and Medical Subject Headings (MeSH) with the JBI Scoping Review Methodology framework. Results were reported using the PRISMA extension for scoping reviews (PRISMA-ScR). RESULTS: The search yielded 425 articles; 22 articles met the criteria for inclusion. Various disciplines were consulted for the management of NSLBP including primary care medical physicians, physiotherapists, chiropractors, orthopedic surgeons, pastors, and traditional healers. Management of NSLBP involves pain medication as the most common form of treatment. The review suggests that understanding cultural beliefs and biopsychosocial factors is important for managing NSLBP in Africa. Although attempts are being made in some countries to encourage the adoption of international and locally developed evidence-based guidelines, very few practitioners are providing such care. CONCLUSION: The peer-reviewed published literature on the treatment of NSLBP in Africa is limited and with few exceptions of low quality. In order to provide a higher level of care for people disabled with NSLBP in Africa considerable further research and greater collaboration and utilization of limited clinical resources are needed.

Rasch validation of the revised body awareness rating questionnaire (BARQ-R) in adults with and without musculoskeletal pain.

BACKGROUND: The Revised Body Awareness Rating Questionnaire (BARQ-R) is a self-report measure of body awareness. First aim: evaluate the structural validity of BARQ-R with Rasch analysis in community-dwelling Americans with and without musculoskeletal pain. Subaim: validate a Rasch analysis of BARQ-R done in Norwegian adults with musculoskeletal pain, through a secondary analysis in our sample of Americans with musculoskeletal pain. METHODS: BARQ-R has 12 items with scores ranging from 0 (completely disagree) to 3 (completely agree), with higher total scores reflecting lower degrees of body awareness. Through Rasch analysis, we evaluated unidimensionality, item hierarchy, and structural validity with item and person fit, targeting, person separation reliability (PSR), local item dependence (LID), differential item functioning (DIF), and principal components analysis of residuals (PCAR). RESULTS: We recruited 623 adults with and without musculoskeletal pain (average age = 50.27 ± 17.25 years). After rescoring 1 item and deleting 3 items, the 9-item Rasch-based BARQ-R had no misfitting items, the hierarchical ordering of the items followed clinical expectations, 3 (0.48%) misfitting persons, person mean location: -0.62 ± 1.03 logits (max -0.53, min 0.72 logits), minimal floor effect (1.93%) and ceiling effect (0.48%), no DIF, and PSR = 0.72. LID was found in 5 item pairs. The PCAR's eigenvalue was 2.18. The secondary Rasch analysis in 152 adults with musculoskeletal pain (average age = 52.26 ± 16.13 years), demonstrated that, after rescoring 2 items, BARQ-R had no misfitting items and only 2 (1.32%) misfitting persons, good targeting (person mean location: -0.36 ± 0.88 logits), minimal floor effect (0.01%), no ceiling effect (0.00%), and PSR = 0.75. LID was found in 6 item pairs. The PCAR's eigenvalue was 2.47. CONCLUSIONS: BARQ-R had good item and person fit. PSR with items covering a limited logit range suggests that differing levels of body awareness are measured with only modest precision. Adding and revising items to cover a wider range of body awareness and to better address concepts of internal body awareness and body movements would improve BARQ-R's utility. Further analyses are needed before BARQ-R's use for research or in the clinic. In addition, future BARQ-R Rasch validation is needed in other populations with body awareness deficits, such as stroke or spinal cord injury.

Exploring the Importance of Race and Gender Concordance Between Patients and Physical Therapists in Digital Rehabilitation for Musculoskeletal Conditions: Observational, Longitudinal Study.

BACKGROUND: Race/ethnicity and gender concordance between patients and providers is a potential strategy to improve health care interventions. In digital health, where human interactions occur both synchronously and asynchronously, the effect of concordance between patients and providers is unknown. OBJECTIVE: This study aimed to evaluate the impact of race/ethnicity or gender concordance between patients and physical therapists (PTs) in engagement and the clinical outcomes following a digital care program (DCP) in patients with musculoskeletal (MSK) conditions. METHODS: This secondary analysis of 2 prospective longitudinal studies (originally focused on assessing the acceptance, engagement, and clinical outcomes after a remote DCP) examined the impact of both race/ethnicity concordance and gender concordance between patients and PTs on outcomes for a digital intervention for MSK conditions. Outcomes included engagement (measured by the completion rate and communication, assessed by text interactions), satisfaction, and clinical outcomes (response rate, ie, percentage of patients achieving at least a minimal clinically important change in pain, measured by the Numerical Pain Rating Scale [NPRS]; anxiety, measured by the Generalized Anxiety Disorder 7-item scale [GAD-7]; depression, measured by the Patient Health Questionnaire 9-item [PHQ-9]; and daily activity impairment, measured by the Work Productivity and Activity Impairment [WPAI] questionnaire). RESULTS: Of 71,201 patients, 63.9% (n=45,507) were matched with their PT in terms of race/ethnicity, while 61.2% (n=43,560) were matched for gender. Concordant dyads showed a higher completion rate among White (adjusted odds ratio [aOR] 1.11, 95% CI 1.05-1.19, P<.001) and Hispanic (aOR 1.27, 95% CI 1.08-1.54, P=.009) groups, as well as women (aOR 1.10, 95% CI 1.06-1.18, P<.001), when compared to discordant dyads. High and similar levels of interaction between patients and PTs were observed across race/ethnicity and gender dyads, except for Asian concordant dyads (adjusted ß coefficient 5.32, 95% CI 3.28-7.36, P<.001). Concordance did not affect satisfaction, with high values (>8.52, 95% CI 8.27-8.77) reported across all dyads. Response rates for pain, anxiety, and daily activity impairment were unaffected by race/ethnicity concordance. An exception was observed for depression, with White patients reporting a higher response rate when matched with PTs from other races/ethnicities (aOR 1.20, 95% CI 1.02-1.39, P=.02). In terms of gender, men had a slightly higher pain response rate in discordant dyads (aOR 1.08, 95% CI 1.01-1.15, P=.03) and a higher depression response rate in concordant dyads (aOR 1.23, 95% CI 1.05-1.47, P=.01). CONCLUSIONS: Race/ethnicity and gender concordance between patients and PTs does not translate into higher satisfaction or improvement for most clinical outcomes, aside from a positive effect on treatment completion. These results highlight the importance of other PT characteristics, in addition to race/ethnicity or gender concordance, suggesting the potential benefit of experience, languages spoken, and cultural safety training as ways to optimize care. TRIAL REGISTRATION: ClinicalTrials.gov NCT04092946, NCT05417685; https://clinicaltrials.gov/study/NCT05417685, https://clinicaltrials.gov/study/NCT04092946.

[Diagnosis and management of work related musculoskeletal disorders as occupational diseases in Germany].

This article introduces the occupational disease diagnosis of work-related musculoskeletal disorders such as lumbar and spinal injuries in Germany, and focuses on the research and standard values of the maximum pressure tolerance of intervertebral discs. This article mainly introduces the dose model limits and their applications proposed by the Mainz Dortmund Dosis model (MDD), the judgment of the German Social Court (Bundessozialgericht, BSG), and the German Spinal Research Re evaluation (Deutsche Wirbels ulentudieⅡ, DWSⅡ) ; X-ray manifestations and measurements of intervertebral disc injury; Problems in actual cases and diagnosis. In order to provide reference and inspiration for the occupational diseases diagnosis of work related musculoskeletal disorders in China.

Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM).

BACKGROUND: Musculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation. METHODS: This process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients. RESULTS: Eight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model's essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients. CONCLUSIONS: This process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely.