A bibliometric study on trends in chiropractic research from 1920 to 2023.

OBJECTIVE: An increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. METHODS: A bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. RESULTS: Over the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. CONCLUSION: This study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.

Heat therapy in rheumatic and musculoskeletal diseases - an overview of clinical and molecular effects.

Rheumatic and musculoskeletal diseases (RMDs) usually lead to morphological and functional deficits of various extend, increased morbidity and a considerable loss of quality of life. Modern pharmacological treatment has become effective and can stop disease progression. Nonetheless, disease progression is often only slowed down. Moreover, pharmacological treatment does not improve functionality per se. Therefore, multimodal treatment of rheumatic disorders with physical therapy being a key element is of central importance for best outcomes. In recent years, research into physical medicine shifted from a sole investigation of its clinical effects to a combined investigation of clinical effects and potential changes in the molecular level (e.g., inflammatory cytokines and the cellular autoimmune system), thus offering new explanations of clinical effects of physical therapy. In this review we provide an overview of studies investigating different heat applications in RMDs, their effect on disease activity, pain and their influence on the molecular level.

Application and thinking of musculoskeletal ultrasound in diagnosis and treatment of musculoskeletal diseases with acupuncture and moxibustion. / è‚Œéª¨è¶ å£°åœ¨é’ˆç¸è¯Šæ²»è‚Œè‚‰éª¨éª¼ç–¾ç— ä¸­çš„è¿ç”¨ä¸Žæ€è€ƒ.

Musculoskeletal ultrasound (MSUS) is characterized as the dynamic, real-time and continuous visualization, the quantitative and qualitative localization,the simple operation and the absence of use contraindication. As a tool for auxiliary examination, treatment, evaluation and research, in acupuncture and moxibustion, MSUS may improve the accuracy of acupoint location, guide the direction and depth of needle insertion, monitor the reactions of deqi, guarantee the safety of operation and quantify the effect evaluation. Hence, it may provide an objective basis for acupuncture and moxibustion research and be conductive to display the operation techniques of acupuncture and moxibustion by means of objective approaches such as imaging and data.

MR-guided focused ultrasound therapy of extra-abdominal desmoid tumors: a multicenter retrospective study of 105 patients.

OBJECTIVE: To assess the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment extra-abdominal desmoids. METHODS: A total of 105 patients with desmoid fibromatosis (79 females, 26 males; 35 ± 14 years) were treated with MRgFUS between 2011 and 2021 in three centers. Total and viable tumors were evaluated per patient at last follow-up after treatment. Response and progression-free survival (PFS) were assessed with (modified) response evaluation criteria in solid tumors (RECIST v.1.1 and mRECIST). Change in Numerical Rating Scale (NRS) pain and 36-item Short Form Health Survey (SF-36) scores were compared. Treatment-related adverse events were recorded. RESULTS: The median initial tumor volume was 114 mL (IQR 314 mL). After MRgFUS, median total and viable tumor volume decreased to 51 mL (95% CI: 30-71 mL, n = 101, p < 0.0001) and 29 mL (95% CI: 17-57 mL, n = 88, p < 0.0001), respectively, at last follow-up (median: 15 months, 95% CI: 11-20 months). Based on total tumor measurements (RECIST), 86% (95% CI: 75-93%) had at least stable disease or better at last follow-up, but 50% (95% CI: 38-62%) of remaining viable nodules (mRECIST) progressed within the tumor. Median PFS was reached at 17 and 13 months for total and viable tumors, respectively. NRS decreased from 6 (IQR 3) to 3 (IQR 4) (p < 0.001). SF-36 scores improved (physical health (41 (IQR 15) to 46 (IQR 12); p = 0.05, and mental health (49 (IQR 17) to 53 (IQR 9); p = 0.02)). Complications occurred in 36%, most commonly 1st/2nd degree skin burns. CONCLUSION: MRgFUS reduced tumor volume, reduced pain, and improved quality of life in this series of 105 patients with extra-abdominal desmoid fibromatosis. CLINICAL RELEVANCE STATEMENT: Imaging-guided ablation is being increasingly used as an alternative to surgery, radiation, and medical therapy for the treatment of desmoid fibromatosis. MR-guided high-intensity focused ultrasound is an incisionless ablation technique that can be used to reduce tumor burden effectively and safely. KEY POINTS: • Desmoid fibromatosis was treated with MR-guided high-intensity focused ultrasound in 105 patients. • MR-guided focused ultrasound ablation reduced tumor volume and pain and improved quality of life. • MR-guided focused ultrasound is a treatment option for patients with extra-abdominal desmoid tumors.

Global research landscape on the crosstalk between ferroptosis and musculoskeletal diseases: A bibliometric and visualized analysis.

Over the past 11 years, mounting evidence has suggested a significant association between ferroptosis and the development and progression of musculoskeletal (MSK) diseases, such as osteoporosis and osteoarthritis. However, a comprehensive bibliometric analysis summarizing the relationship between ferroptosis and MSK diseases is currently lacking. The present study collected articles and reviews on the topic of ferroptosis in MSK diseases. The data were collected from January 1st, 2012 to June 30th, 2023 by screening the Web of Science database. Various tools, including VOSviewer, CiteSpace, Pajek, the R package, and others, were used to conduct bibliometric and visualization analyses. Notably, China, the USA, and Italy emerged as primary contributors, jointly accounting for over 80 % of published documents, thereby shaping research in this domain. Among the diverse institutions, Shanghai Jiao Tong University, Soochow University, and Huazhong University of Science and Technology displayed the highest productivity levels. The most prolific authors include Sun Kai, Shang Peng, and Jing Xingzhi. Oxidative Medicine and Cellular Longevity stood out with the largest number of publications in this area. The five most significant disorders in this field are bone fractures, osteosarcoma, bone neoplasms, joint diseases, and osteoporotic fractures. This study represents an inaugural comprehensive bibliometric analysis, presenting a holistic view of the knowledge framework and developmental patterns in ferroptosis concerning MSK diseases over the previous eleven years. This information can aid researchers in acquiring a thorough grasp of this domain and offer invaluable insights for forthcoming explorations.

Expanding the therapeutic potential of Salvia miltiorrhiza: a review of its pharmacological applications in musculoskeletal diseases.

Salvia miltiorrhiz, commonly known as "Danshen" in Chinese medicine, has longstanding history of application in cardiovascular and cerebrovascular diseases. Renowned for its diverse therapeutic properties, including promoting blood circulation, removing blood stasis, calming the mind, tonifying the blood, and benefiting the "Qi", recent studies have revealed its significant positive effects on bone metabolism. This potential has garnered attention for its promising role in treating musculoskeletal disorders. Consequently, there is a high anticipation for a comprehensive review of the potential of Salvia miltiorrhiza in the treatment of various musculoskeletal diseases, effectively introducing an established traditional Chinese medicine into a burgeoning field. AIM OF THE REVIEW: Musculoskeletal diseases (MSDs) present significant challenges to healthcare systems worldwide. Previous studies have demonstrated the high efficacy and prospects of Salvia miltiorrhiza and its active ingredients for treatment of MSDs. This review aims to illuminate the newfound applications of Salvia miltiorrhiza and its active ingredients in the treatment of various MSDs, effectively bridging the gap between an established medicine and an emerging field. METHODS: In this review, previous studies related to Salvia miltiorrhiza and its active ingredients on the treatment of MSD were collected, the specific active ingredients of Salvia miltiorrhiza were summarized, the effects of Salvia miltiorrhiza and its active ingredients for the treatment of MSDs, as well as their potential molecular mechanisms were reviewed and discussed. RESULTS: Based on previous publications, Salvianolic acid A, salvianolic acid B, tanshinone IIA are the representative active ingredients of Salvia miltiorrhiza. Their application has shown significant beneficial outcomes in osteoporosis, fractures, and arthritis. Salvia miltiorrhiza and its active ingredients protect against MSDs by regulating different signaling pathways, including ROS, Wnt, MAPK, and NF-κB signaling. CONCLUSION: Salvia miltiorrhiza and its active ingredients demonstrate promising potential for bone diseases and have been explored across a wide variety of MSDs. Further exploration of Salvia miltiorrhiza's pharmacological applications in MSDs holds great promise for advancing therapeutic interventions and improving the lives of patients suffering from these diseases.

Guidelines for the diagnosis and treatment of knee osteoarthritis with integrative medicine based on traditional Chinese medicine.

Knee osteoarthritis (KOA) is a common geriatric disease in middle-aged and elderly people. Its main pathological characteristics are articular cartilage degeneration, changes in subchondral bone reactivity, osteophyte formation at joint edges, synovial disease, ligament relaxation or contracture, and joint capsular contracture. The prevalence rate of symptomatic KOA in middle-aged and elderly people in China is 8.1%, and this is increasing. The main clinical manifestations of this disease are pain and limited activity of the knee joint, which seriously affect the quality of life of patients and may cause disability, posing a huge burden on society and the economy. Although the pathogenesis of KOA is not clear, the treatment of KOA is diverse, and Chinese medicine, which mainly relies on plant-based natural products, has a relatively stable and reliable curative effect. This guideline aims to emphasize the evidence-based staging and stepped treatment of KOA and the therapeutic effect of integrative medicine based on traditional Chinese medicine on KOA. We make recommendations that include the adoption of manual therapy, acupuncture, external application of herbs, herbal plasters, exercise therapy, and other integrative medicine based on traditional Chinese medicine. Users of the above guidelines are most likely to include clinicians and health managers in healthcare settings.

Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness.

Background: Tendinopathy is a common, painful and functionally limiting condition, primarily managed conservatively using exercise therapy. Review questions: (i) What exercise interventions have been reported in the literature for which tendinopathies? (ii) What outcomes have been reported in studies investigating exercise interventions for tendinopathy? (iii) Which exercise interventions are most effective across all tendinopathies? (iv) Does type/location of tendinopathy or other specific covariates affect which are the most effective exercise therapies? (v) How feasible and acceptable are exercise interventions for tendinopathies? Methods: A scoping review mapped exercise interventions for tendinopathies and outcomes reported to date (questions i and ii). Thereafter, two contingent systematic review workstreams were conducted. The first investigated a large number of studies and was split into three efficacy reviews that quantified and compared efficacy across different interventions (question iii), and investigated the influence of a range of potential moderators (question iv). The second was a convergent segregated mixed-method review (question v). Searches for studies published from 1998 were conducted in library databases (n = 9), trial registries (n = 6), grey literature databases (n = 5) and Google Scholar. Scoping review searches were completed on 28 April 2020 with efficacy and mixed-method search updates conducted on 19 January 2021 and 29 March 2021. Results: Scoping review - 555 included studies identified a range of exercise interventions and outcomes across a range of tendinopathies, most commonly Achilles, patellar, lateral elbow and rotator cuff-related shoulder pain. Strengthening exercise was most common, with flexibility exercise used primarily in the upper limb. Disability was the most common outcome measured in Achilles, patellar and rotator cuff-related shoulder pain; physical function capacity was most common in lateral elbow tendinopathy. Efficacy reviews - 204 studies provided evidence that exercise therapy is safe and beneficial, and that patients are generally satisfied with treatment outcome and perceive the improvement to be substantial. In the context of generally low and very low-quality evidence, results identified that: (1) the shoulder may benefit more from flexibility (effect sizeResistance:Flexibility = 0.18 [95% CrI 0.07 to 0.29]) and proprioception (effect sizeResistance:Proprioception = 0.16 [95% CrI -1.8 to 0.32]); (2) when performing strengthening exercise it may be most beneficial to combine concentric and eccentric modes (effect sizeEccentricOnly:Concentric+Eccentric = 0.48 [95% CrI -0.13 to 1.1]; and (3) exercise may be most beneficial when combined with another conservative modality (e.g. injection or electro-therapy increasing effect size by ≈0.1 to 0.3). Mixed-method review - 94 studies (11 qualitative) provided evidence that exercise interventions for tendinopathy can largely be considered feasible and acceptable, and that several important factors should be considered when prescribing exercise for tendinopathy, including an awareness of potential barriers to and facilitators of engaging with exercise, patients' and providers' prior experience and beliefs, and the importance of patient education, self-management and the patient-healthcare professional relationship. Limitations: Despite a large body of literature on exercise for tendinopathy, there are methodological and reporting limitations that influenced the recommendations that could be made. Conclusion: The findings provide some support for the use of exercise combined with another conservative modality; flexibility and proprioception exercise for the shoulder; and a combination of eccentric and concentric strengthening exercise across tendinopathies. However, the findings must be interpreted within the context of the quality of the available evidence. Future work: There is an urgent need for high-quality efficacy, effectiveness, cost-effectiveness and qualitative research that is adequately reported, using common terminology, definitions and outcomes. Study registration: This project is registered as DOI: 10.11124/JBIES-20-00175 (scoping review); PROSPERO CRD 42020168187 (efficacy reviews); https://osf.io/preprints/sportrxiv/y7sk6/ (efficacy review 1); https://osf.io/preprints/sportrxiv/eyxgk/ (efficacy review 2); https://osf.io/preprints/sportrxiv/mx5pv/ (efficacy review 3); PROSPERO CRD42020164641 (mixed-method review). Funding: This project was funded by the National Institute for Health and Care Research (NIHR) HTA programme and will be published in full in HTA Journal; Vol. 27, No. 24. See the NIHR Journals Library website for further project information.

Tendons are cords of strong, flexible tissue that attach muscles to bones, allowing joints to move. Tendinopathy is a common condition that can affect any tendon in the body, causing pain and limiting function. Exercise is often used to treat tendinopathy. We examined over 500 research papers on exercise for tendinopathy. The most common tendons to be studied were the calf (Achilles), knee (patellar), elbow and shoulder. Strengthening exercise was studied most often, especially in lower-limb tendinopathy. Other types of exercise such as stretching, balance and aerobic activity were less common, but were used to some extent in the upper and lower limbs. We found that exercise therapy is safe and beneficial for the tendinopathies that have been studied to date. Exercise may be most beneficial when combined with another intervention such as injection or electro-therapy. Strengthening exercise may be most beneficial for lower-limb tendinopathies. However, more research is needed on the type of strengthening and the dosage, such as how many exercises and how much resistance to use. Shoulder tendinopathies may benefit from exercise that targets joint flexibility and position more than strengthening. We also found that people who receive exercise therapy for tendinopathy are generally satisfied with the effect it has on their symptoms. Finally, we found that an individualised, person-centred approach to delivering exercise therapy is valued by people with tendinopathy. They also believe that the patient-healthcare provider relationship is important for promoting the confidence and motivation people need to continue with exercise programmes, especially when they complete them independently. Although we examined a lot of papers, many of the studies were low quality. This means there is still a need for high-quality studies to tell us how effective specific types of exercise are for specific tendinopathies. There is also a need for more studies on patients' and professionals' experiences of receiving or providing exercise for tendinopathy.

Effects of Postural Shifting Frequency on Perceived Musculoskeletal Discomfort During 1-Hour Sitting in Office Workers.

OBJECTIVE: The purpose of this study was to evaluate the effects of postural shifting frequency on perceived musculoskeletal discomfort during 1 hour of sitting in healthy office workers. METHODS: An experimental study comparing 3 different postural shifting frequencies was conducted on 60 healthy office workers who were asked to sit for an hour. The effects of 3 postural shifts (ie, 10, 20, and 30 times/h) on discomfort, measured by Borg's CR-10 scale, were compared. A seat pressure mat was used to confirm an individual's postural shift. RESULTS: Postural shifting frequency of 10 to 30 times/h had significant effects on perceived discomfort in the neck, shoulder, and upper and lower back during 1-hour sitting. At the neck and shoulder, a postural shifting frequency of 30 times/h significantly reduced perceived discomfort compared to a postural shifting frequency of 10 times/h during 1-hour sitting. At the upper and lower back, a postural shifting frequency of 20 to 30 times/h significantly reduced perceived discomfort compared to a postural shifting frequency of 10 times/h. CONCLUSION: Postural shifts of 30 times/h provided buffering effects on perceived musculoskeletal discomfort at the neck, shoulder, and upper and lower back.

Efficacy and safety of single or consecutive double high-dose oral cholecalciferol supplementation in adult patients with vitamin D deficiency.

BACKGROUND AND AIM: Enhancing vitamin D levels as a crucial modifiable risk factor may provide a critical contribution to prevent susceptibility to various diseases, including musculoskeletal, autoimmune, and inflammatory rheumatic diseases as well as promoting overall health. However, adherence to daily vitamin D supplementation is generally poor, and there are some concerns regarding the high-dose vitamin D supplementation's safety. We aimed to investigate whether a single oral dose of 300,000 IU or consecutive two-day dosing of 300,000 IU each day of cholecalciferol could sufficiently and safely elevate vitamin D levels. METHODS: This cross-sectional study was conducted on 160 inpatients with vitamin D deficiency and various musculoskeletal diseases.Subjects with serum 25(OH)D levels between 10 and 20 ng/mL (mild to moderate deficiency) received a single oral dose of 300,000 IU cholecalciferol, while those with severe vitamin D deficiency (<10 ng/mL) were supplemented with consecutive two-day doses of 300,000 IU cholecalciferol (a total of 600,000 IU). RESULTS: After one week of replacement therapy, the 25(OH)D levels increased from 6.3 (4.0-9.9) ng/mL to 53.3 (8.3-84.4) ng/mL and from 15.0 (10.1-19.6) ng/mL to 38.4 (16.3-67.7) in the group with severe and those with the mild-to-moderate vitamin D deficiency, respectively. Except for three patients, nearly all patients (98%) achieved levels above 20 ng/mL. No signs of toxicity were observed in any of the patients. During the 6-month follow-up, falls were observed in 3 patients (2.8%), but no fractures were reported. CONCLUSION: A single dose of 300,000 IU of oral cholecalciferol or two consecutive doses with a total dose of 600,000 IU cholecalciferol can effectively and reliably increase the 25(OH)D serum levels within one week in nearly all patients. The results may contribute to optimizing treatment strategies for vitamin D deficiency and re-evaluating the potential negative impact of high-dose vitamin D supplementation.

Kinesiología Musculoesquelética Pediátrica en Chile, ¿Qué piensan los profesionales? / Pediatric musculoskeletal physical therapy in Chile; what do professionals think?

Introducción. La kinesiología musculoesquelética pediátrica es una especialidad reconocida en el mundo pero que en Chile está muy poco desarrollada. Objetivo. El objetivo de este estudio fue recolectar la opinión de profesionales acerca de la kinesiología musculoesquelética pediátrica en Chile, para exponer la creciente necesidad que existe de fomentar esta área en el país. Esto para impulsar su desarrollo y buscar alcanzar los estándares europeos y norte americanos, donde ésta se reconoce como una especialidad. Métodos. Se utilizó una encuesta online de 10 preguntas creada por la autora para recopilar la opinión de traumatólogos/as, kinesiólogos/as y estudiantes de último año de kinesiología acerca de la kinesiología musculoesquelética pediátrica en Chile. Los resultados se presentan como frecuencia absoluta y porcentaje de respuesta para cada pregunta. Resultados. de las 232 respuestas, 82.92% fueron de kinesiólogos/as y 8.19% fueron de traumatólogos/as. De acuerdo con estos profesionales, la kinesiología es un complemento esencial a la traumatología (98.71%), y la kinesiología pediátrica es diferente a la de los/as adultos/as (92.67%). Esta última requiere de habilidades técnicas (89.22%) y relacionales (96.98%) específicas. También se piensa que es un área poco desarrollada en Chile (90.09%), la cual debería desarrollarse (89.66%). Conclusiones. los traumatólogos/as y kinesiólogos/as de Chile están de acuerdo en que la kinesiología musculoesquelética pediátrica es un área de práctica que está poco desarrollada y que debería desarrollarse en Chile. Este estudio muestra un vacío que existe en la kinesiología chilena, el cual debería llenarse con futuras investigaciones científicas y cambios en los programas educacionales.

Background. Pediatric musculoskeletal physiotherapy is a recognized specialty in the world but it is underdeveloped in Chile. Objective. The aim of this study was to collect professionals' opinion about pediatric musculoskeletal physiotherapy in Chile to expose the growing need to promote this area of practice in the country. This to encourage its development for the good of our children and adolescents, and to seek to achieve European and north American standards, where this area of practice is recognized as specialty. Methods. An online self-created survey was used to collect orthopedic medical doctors and physiotherapists' opinions on pediatric musculoskeletal physiotherapy in Chile trough 10 Likert scale questions. Results are presented as absolute frequency and percentage for each question. Results. 232 responses were included in the analysis, where 82.92% of the responders were physiotherapists and 8.19% were orthopedic medical doctors. According to these professionals, physiotherapy is an essential complement to orthopedics (98.71%), and pediatric physiotherapy is different from adult physiotherapy (92.67%), so it needs technical (89.22%) and relational (96.98%) specific skills. They also think that it is an underdeveloped area of expertise in Chile (90.09%) that should be developed (89.66%). Conclusions. Chilean orthopedic medical doctors and physiotherapists agreed that pediatric musculoskeletal physiotherapy is an underdeveloped area of practice that should be developed in the country. This study shows an existing void in Chilean physiotherapy that should be filled in with future research and changes in educational programs.

A Novel Approach to Assess Balneotherapy Effects on Musculoskeletal Diseases-An Open Interventional Trial Combining Physiological Indicators, Biomarkers, and Patients' Health Perception.

The present study aimed to evaluate whether a 14-day period of balneotherapy influences the inflammatory status, health-related quality of life (QoL) and quality of sleep, underlying overall health state, and clinically relevant benefits of patients with musculoskeletal diseases (MD). The health-related QoL was evaluated using the following instruments: 5Q-5D-5L, EQ-VAS, EUROHIS-QOL, B-IPQ, and HAQ-DI. The quality of sleep was evaluated by a BaSIQS instrument. Circulating levels of IL-6 and C-reactive protein (CRP) were measured by ELISA and chemiluminescent microparticle immunoassay, respectively. The smartband, Xiaomi MI Band 4, was used for real-time sensing of physical activity and sleep quality. MD patients improved the health-related QoL measured by 5Q-5D-5L (p < 0.001), EQ-VAS (p < 0.001), EUROHIS-QOL (p = 0.017), B-IPQ (p < 0.001), and HAQ-DI (p = 0.019) after balneotherapy; the sleep quality was also improved (BaSIQS, p = 0.019). Serum concentrations of IL-6 were markedly decreased after the 14-day balneotherapy (p < 0.001). No statistically significant differences were observed regarding the physical activity and sleep quality data recorded by the smartband. Balneotherapy may be an effective alternative treatment in managing the health status of MD patients, with a decrease in inflammatory states, along with positive effects on pain reduction, patient's functionality, QoL, quality of sleep, and disability perception status.

The role of therapist-patient relationships in facilitating engagement and adherence in upper extremity rehabilitation.

BACKGROUND: Active patient engagement and adherence are essential for successful rehabilitation outcomes, particularly in complex cases such as work-related musculoskeletal injuries. Although the therapist-patient relationship is a significant component of successful care coordination, there has been limited examination of this relationship within upper extremity musculoskeletal rehabilitation. OBJECTIVE: To explore therapists' perspectives on how the therapist-patient relationship intersects with engagement and adherence in the provision of holistic and collaborative rehabilitation services. METHODS: Data were collected from four therapists over three months. Descriptive statistics were generated from the Sport Injury Rehabilitation Adherence Scale (SIRAS) and the Rehabilitation Therapy Engagement Scale (RTES) completed by therapists following visits from a sub-sample of patients (n = 14). Weekly semi-structured group interviews (n = 13) were analyzed using an iterative grounded theory-informed process. Emerging themes were identified, refined, and situated within the context of quantitative results. RESULTS: SIRAS scores averaged 14.4 (SD: 1.0) and RTES scores averaged 42.5 (SD: 3.5), indicating high perceived patient engagement and adherence. Four themes emerged from therapist interviews: (1) dynamic power; (2) co-constructed engagement; (3) emotional states; (4) complementary therapy contexts. CONCLUSION: In this engaged and adherent setting, therapist-patient relationships were complex and intimate, and extended beyond education and physical interventions. Careful management of this relationship was central to active patient participation and engagement. Incorporating holistic techniques may provide more structure for managing and communicating these aspects of care. These findings provide a preliminary understanding of the impact of therapeutic relationships on engagement and collaborative care.

Effectiveness of psychosocial interventions for pediatric patients with scoliosis: a systematic review.

Background: Pediatric patients affected by scoliosis have complex psychological and social care needs, and may benefit from psychosocial interventions. We therefore aimed to summarize evidence of the efficacy of psychosocial interventions for this patient population. Methods: Literature was identified by searching Medline, PsycINFO, Embase, EBSCO Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to 20 March 2022. Articles that evaluated the effectiveness of psychosocial interventions for pediatric patients diagnosed with scoliosis and reported at least one quantitative outcome were included. Article eligibility, data extraction, and quality assessment (using the Cochrane Collaboration's Risk of Bias Tool and Methodological Index for Non-Randomized Studies) were performed by two independent researchers. Findings are presented using narrative synthesis. Results: We identified ten studies, all of which focused on adolescent idiopathic scoliosis. Studies included a total of 1007 participants, most of whom were female. Three studies focused on patients undergoing bracing, six on patients undergoing spinal surgery, and one on patients broadly. Brace compliance monitoring and counseling were found to significantly improve brace compliance quality and quantity. Proactive mental healthcare delivery by nurses after spinal surgery was similarly found to improve outcomes. Several studies examined the efficacy of brief educational interventions; most did not report clear evidence of their efficacy. The methodological quality of studies was often unclear due to limitations in articles' reporting quality. Conclusions: Research on the efficacy of psychosocial interventions for pediatric patients with scoliosis is limited, with interventions involving frequent patient-provider interactions showing the most promise. Future clinical and research efforts should focus on developing and testing psychosocial interventions for this patient population, with emphasis on multidisciplinary teams delivering holistic care. Trial registration number: PROSPERO number CRD42022326957.

Nursing interventions for patients with rheumatic and musculoskeletal diseases on biological therapies: a systematic literature review.

Investigating unmet needs and identifying the necessary interventions for patients affected by rheumatic and musculoskeletal diseases (RMDs) may help significantly to ensure the continuity and quality of the chronic care pathway. To this aim, the contribution of rheumatology nurses requires further evidence. The aim of our systematic literature review (SLR) was to identify the nursing interventions directed towards patients with RMDs undergoing biological therapy. To retrieve data, a search was carried out in the MEDLINE database, the Cumulative Index to Nursing and Allied Health Literature (CINAHL database), the APA PsycINFO database and the Excerpta Medica Database (EMBASE) from 1990 to 2022. The systematic review was carried out in accordance with the relevant PRISMA guidelines. Inclusion criteria were as follows: (I) adult patients with RMDs, (II) undergoing therapy with Biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs), (III) original and quantitative research papers in English with available abstract, (IV) specific to nursing interventions and/or outcomes. Two independent reviewers screened the identified records for eligibility according to their title and abstract, full texts were subsequently assessed and, finally, data was extracted. Critical Appraisal Skills Programme (CASP) tools were used to evaluate the quality of the studies included. Among the 2348 records retrieved, 13 articles met the inclusion criteria. These consisted of six randomised controlled trials (RCTs), one pilot study and six observational studies on RMDs. In a total population of 2004 patients, 43% (862/2004) of the cases concerned rheumatoid arthritis (RA) and 56% (1122/2004) of the cases concerned spondyloarthritis (SpA). Three major nursing interventions were identified, namely education, patient-centred care and data collection/nurse monitoring, which were correlated with high satisfaction rates regarding care, increased self-care capacity and treatment adherence among patients. All interventions followed a protocol defined in collaboration with rheumatologists. The large degree of heterogeneity in the interventions did not allow the performance of a meta-analysis. Rheumatology nurses are part of a multidisciplinary team caring for patients with RMDs. Following an accurate initial nursing evaluation, rheumatology nurses can plan and standardise their interventions focusing primarily on patient education and personalised care based on actual needs, such as psychological well-being and disease control. However, the training for rheumatology nurses should define and standardise, as much as possible, the competencies required for the detection of disease parameters. Key Points • This SLR provides an overview of nursing interventions for patients with RMDs. • This SLR considers the specific population of patients on biological therapies. • Training for rheumatology nurses should standardise, as much as possible, the knowledge and methods required for detecting disease parameters. • This SLR highlights the various competencies of rheumatology nurses.

Reliability of the Joint Position Sense Error Test for Women With Neck Pain and Asymptomatic Men and Women.

OBJECTIVE: The purpose of this study was to evaluate the intra-rater between-days reliability of the joint position sense error (JPSE) test in asymptomatic men and women, as well as in women with neck pain. METHODS: Fourteen asymptomatic men and 27 women (14 asymptomatic and 13 with neck pain) participated. The JPSE test was performed during right and left cervical rotation (10 trials for each side) in 2 sessions, with at least 7 days between them. The head repositioning error during the JPSE test (in degrees) was measured and used to calculate the intra-rater between-days reliability of the test, evaluated through the intraclass correlation coefficient and Bland-Altman analyses. Independent t tests were calculated to compare the head repositioning errors of asymptomatic women and men. The minimal detectable change was also calculated. RESULTS: The neck pain group showed higher intraclass correlation coefficient values (0.866 and 0.773, good reliability) compared to the asymptomatic men (0.478 and 0.403, poor reliability) and to the asymptomatic women (-0.161 and 0.504, poor and moderate reliability, respectively) for both right and left cervical rotation, respectively. Considering Bland-Altman analyses, the neck pain group showed better agreement between the measurements for right cervical rotation than the asymptomatic groups. CONCLUSION: The results indicate that the methodology used to perform the JPSE test in this study may be a reliable way to assess the proprioception of women with neck pain in clinical settings.

Can the Combination of Rehabilitation and Vitamin D Supplementation Improve Fibromyalgia Symptoms at All Ages?

Several studies have indicated a correlation between vitamin D deficiency and widespread chronic pain syndromes, such as fibromyalgia. During this study, the effect of supplementation with vitamin D in association with physical exercise in patients with fibromyalgia was evaluated, in terms of improvement of pain, functional capacity and quality of life, also evaluating the presence of any differences in age. A single-center, observational, comparative study was conducted in 80 fibromyalgia patients. They are randomized into 2 groups: Group A, consisting of patients ≤50 years; and group B, consisting of patients >50 years. Both received weekly supplementation with 50,000 IU cholecalciferol for 3 months in association with a rehabilitation protocol. Patients were assessed at enrollment (T0), 3 months (T1), and 6 months (T2) from the initial assessment with blood vitamin D dosage and administration of rating scales (NRS, FIQ, and SF-12). From the comparison between the two groups, we have seen that in young people, supplementation with high-dose vitamin D improves short-term musculoskeletal pain and long-term functional capacity. Conversely, musculoskeletal pain and long-term quality of life improve in the elderly. Supplementing with high doses of vitamin D in fibromyalgia patients improves the quality of life and pain in the elderly and also the functional capacity in the young.

Placebo-Related Adverse Events in Rheumatoid Arthritis.

Prospective, double-blind, randomized, placebo-controlled studies are considered to provide the highest quality of interventional evidence. This meta-analysis summarizes the frequencies of adverse events according to the Medical Dictionary for Regulatory Activities (MedDRA) in the placebo arms of 101 such studies in rheumatoid arthritis, including a total of 17,150 patients in the placebo arms and 37,819 patients in the verum arms. Placebo-treated patients reported more than one adverse event in a median of 55.0%, 65.5%, and 72.5% (compared to 72.3% in the verum arms), and a serious adverse event in 2.5%, 5.8%, and 8.6% (compared to 5.9% in the verum arms), with stable doses of corticosteroids, conventional synthetic disease-modifying antirheumatic drugs (DMARDs), and biological DMARDs as background therapies, respectively. Odds ratios were comparable between placebo and verum arms for nausea (1.00 with 95% confidence interval (CI) 0.86-1.17), for hepatobiliary disorders (1.08 with CI 0.85-1.36), for abnormal hepatic functions (1.09 with CI 0.83-1.44), and general disorders and administration site conditions (1.39 with CI 0.95-2.03). A publication bias has to be assumed for nausea (p = 0.018; Egger's test), diarrhoea (p = 0.022), and serious infections and infestations (p = 0.009). In conclusion, patients should be aware that "adverse events" may occur even with placebo medication, independent from an additional verum medication added to the background therapy. Further studies are warranted to respect and overcome the psychological and other issues related to these placebo-related "adverse events".

[Organizational and hospital structure for the integrated care of orthogeriatic patients]. / Organisation und Klinikstruktur für die integrierte Betreuung orthogeriatrischer Patienten.

Numerous studies have shown that geriatric cooperation models in traumatology lead to significantly reduced morbidity and mortality rates. Even though national and international orthopedic and trauma societies recommend expanding these concepts to include nontrauma-related musculoskeletal diseases, unfortunately, to date only a few of these projects have been implemented. The present article deals with the necessary personnel and infrastructural implementation of a so-called orthogeriatric concept and puts the special features of this new type of treatment in direct comparison with known traumatological cotreatment concepts.

Analysis of Spin in the Reporting of Studies on Electroanalgesia for Musculoskeletal Pain.

OBJECTIVE: The purpose of this study was to analyze the quality of reporting and presence of spin in abstracts of randomized clinical trials (RCTs) on the use of electroanalgesia for musculoskeletal pain. METHODS: The Physiotherapy Evidence Database (PEDro) was searched from 2010 to June 2021. Inclusion criteria were RCTs using electroanalgesia in individuals with musculoskeletal pain, written in any language, comparing 2 or more groups, and with pain as 1 of the outcomes. Two blinded, independent, and calibrated evaluators (Gwet's AC1 agreement analysis) performed eligibility and data extraction. General characteristics, report of outcomes, quality of reporting (Consolidated Standards of Reporting Trials for Abstracts [CONSORT-A]), and spin analysis (7-item spin checklist and spin analysis per section) were extracted from abstracts. RESULTS: Of 989 studies selected, 173 abstracts were analyzed after screening and eligibility criteria. Mean risk of bias on the PEDro scale was 6.02 ± 1.6 points. Most abstracts did not report significant differences for primary (51.4%) and secondary (63%) outcomes. Mean quality of reporting was 5.10 ± 2.4 points in the CONSORT-A, and spin was 2.97 ± 1.7. Abstracts had at least 1 type of spin (93%), and the conclusion presented the greatest number of spin types. More than 50% of abstracts recommended an intervention without significant differences between groups. CONCLUSION: This study found that the majority of RCT abstracts on electroanalgesia for musculoskeletal conditions in our sample had a moderate to high risk of bias, incomplete or missing information, and some type of spin. We recommend that health care providers who use electroanalgesia and the scientific community be aware of spin in published studies.