Introduction Pelvic floor muscle training (PFMT) is the first-line treatment for stress urinary incontinence (SUI), but evidence comparing it with Pilates is limited. We compared PFMT with mat Pilates with pelvic floor muscle (PFM) contraction cueing in postmenopausal women with SUI. Methods In this assessor-blinded randomized controlled trial, 24 women performed PFMT or mat Pilates with PFM contraction cueing (two supervised group sessions/week, 12 weeks). The primary outcome was urinary incontinence severity (ICIQ-SF). Exploratory secondary outcomes were PFM strength (modified Oxford scale) and endurance, voiding frequency and leakage episodes (7-day bladder diary), and sexual function (FSFI). Groups were compared by baseline-adjusted analysis of covariance including all randomized participants (multiple imputation). Results Four participants (two per group) were lost to follow-up. ICIQ-SF scores did not differ between groups (adjusted mean difference [MD] 0.20 points; 95% CI −4.12 to 4.53; p = 0.921). PFMT produced greater improvements in PFM strength (MD 0.98 grade; 95% CI 0.34 to 1.62), endurance (MD 2.35 s; 95% CI 0.32 to 4.38) and nighttime voiding frequency (MD −0.99 voids/night; 95% CI −1.73 to −0.25), but only the strength difference remained significant after Holm adjustment. Daytime voiding, leakage episodes and sexual function did not differ. Conclusion PFMT improved PFM strength and, less robustly, endurance and nighttime voiding more than mat Pilates with PFM contraction cueing, but was not superior for incontinence severity, leakage, daytime voiding or sexual function. Given the small sample, missing data and multiple outcomes, these findings are preliminary.
Increased use of electronic devices like smartphones, laptops, computers, and tablets has become an integral part of daily life. The rise in digital screen time has been linked to a growing burden of musculoskeletal disorders, with prolonged screen exposure associated with neck pain, back pain, shoulder pain, headaches, dry eyes, text neck syndrome, and forward head posture. The study has been carried out to provide a comprehensive bibliometric and visual analysis of global trends, significant authors, and publication trends, keyword co-occurrence, organizations, countries, journals, and research hotspots related to musculoskeletal disorders associated with screen time from the data indexed in the SCOPUS multidisciplinary database from 2003 to 2026. The SCOPUS yielded a total of 1171 articles, out of which 950 articles were selected based on the inclusion criteria. Research output was low until 2014, rose gradually from 2015 to 2020, and peaked sharply in 2023 (134 articles). The USA has been the most productive country among other countries with 145 publications. According to the keyword co-occurrence, the neck region and lower back regions were the most affected parts of the body. These findings highlight a growing research focus on screen-time-related musculoskeletal disorders, particularly affecting the neck and lower back. The identified hotspots, key contributors, and collaboration patterns offer valuable guidance for future research, clinical practice, and preventive strategies addressing the rising public health concerns.
For several decades, pre-manipulative positional testing occupied a central place in the teaching and practice of cervical manual therapy. In 2020 it was removed from the International IFOMPT Cervical Framework, on the grounds that the predictive ability of these provocative tests to identify individuals at risk is lacking and that some evidence argues against their use. Many clinicians, including osteopaths trained before that revision, were taught these tests as a safety procedure and have not been offered a clear account of what replaces them.This narrative review addresses that gap. It does not propose a new screening test, nor does it substitute for the Framework. It sets out what the contemporary evidence supports, what it does not, and how an osteopath may reason through a cervical presentation when no single test can exclude vascular pathology. Particular attention is given to the patient history, which the Framework identifies as the principal source of judgement, and to the components of physical examination that remain recommended: blood pressure, cranial nerve examination selected by vascular territory, and carotid palpation and auscultation. The article closes with the implications for clinical decision-making, informed consent, recognition of an event in progress, and osteopathic education.
