Background/Aim: Musculoskeletal care has experienced an increase in the use of practitioner-assisted stretching over the past decade. However, its durability and effectiveness have only been quantified in very few studies. In this current study, the clinical effectiveness of the Stretch Zone Method, perceived health, and the standardized method of practitioner-assisted stretching are evaluated. Methods: A three-phased prospective cohort study assigned 32 participants to four conditions over 4 weeks. Three conditions received practitioner-assisted stretching at varying frequencies and durations, and one condition served as a no-stretching control. Thirty-five range-of-motion (ROM) measures were taken through a goniometric test at baseline, post-program, and 30-day follow-up. The SF-36 instrument was used to assess the health status of participants. Results: MCID was surpassed by post-intervention changes in 33 of 35 ROM measurements. The lumbar flexion was increased by 8°, hip flexion by 10°, and trunk lateral flexion by 5°. The participants in the highest dosage arm (twice weekly, 60 minutes) attained 25% higher gains in ROM in comparison with the lower dosage groups. Eighty-one percent of initial gains were retained (27 ROM metrics), which was a significant improvement at 30-day follow-up. Seven of eight domains also exhibited a significant improvement in SF-36 scores. Conclusions: The Stretch Zone protocol provides dose-responsive, clinically meaningful increases in flexibility, as well as health perception. Whereas reduction was partial at 30 days, most benefits were maintained with high-frequency dosing. The results encourage the inclusion of the applied through guided stretching in a mobility rehabilitation therapy program.
Background: Artificial intelligence (AI) tools for spine imaging analysis are rapidly entering clinical practice, with many systems demonstrating impressive technical performance in detecting vertebral fractures, quantifying degenerative changes, and measuring alignment parameters. However, conservative spine care practitioners-including chiropractors, physiotherapists, and osteopaths-face unique challenges in evaluating whether these tools genuinely support patient care. Technical accuracy alone does not establish clinical utility, particularly when imaging findings correlate poorly with symptoms and functional outcomes. Furthermore, concerns persist regarding algorithmic bias, equity of access, deskilling risks, inadequate post-market surveillance, and potential for technological paternalism that undermines shared decision-making. Methods: We synthesized evidence from recent systematic reviews of AI performance in spine imaging, implementation science frameworks, health equity literature, professional competency standards, and patient-centered care principles. Drawing on Kumar, et al.'s [1] comprehensive technical review and extending it with multidimensional considerations relevant to conservative practice, we developed a six-step clinical decision algorithm. This framework integrates critical appraisal domains spanning technical validity, clinical utility for functional outcomes, equity and bias, clinical reasoning support, safety governance, and patient-centeredness. Results: The resulting algorithm guides practitioners through systematic evaluation of AI tools before adoption. Step 1 assesses technical validity and generalizability across relevant populations. Step 2 examines clinical utility specifically for conservative care contexts, requiring evidence linking AI outputs to functional outcomes rather than merely anatomical classifications. Step 3 evaluates equity dimensions, including dataset representativeness and performance across demographic subgroups. Step 4 considers whether the tool enhances clinical reasoning without promoting automation bias. Step 5 reviews governance mechanisms for continuous safety monitoring. Step 6 ensures patient-centered implementation supporting shared decision-making. Each step includes specific evidence requirements and decision criteria, with tools assigned to one of four adoption categories: Ready, Conditional, Research-Only, or Not Recommended. Conclusion: This practice-based decision framework provides conservative practitioners with structured criteria for evaluating AI imaging tools before clinical deployment. By extending beyond technical performance metrics to encompass clinical utility for functional outcomes, equity considerations, clinical reasoning support, safety governance, and patient-centeredness, the algorithm addresses critical dimensions often overlooked in AI validation studies. Conservative practitioners can use this tool to make evidence-informed decisions that prioritize patient welfare and professional integrity over technological enthusiasm, ensuring AI adoption genuinely enhances rather than compromises the quality and equity of spine care delivery.
Limited research exists regarding challenges encountered by individuals with congenital unilateral upper limb differences (CUULD). There is a gap in understanding the impact of these challenges on everyday activities and interventions received. This poses a challenge for rehabilitative professionals to tailor treatments to address the unique needs of this population. This study examined the musculoskeletal concerns of individuals with CUULD, the impact on daily activities and the satisfaction of treatments received for these concerns. Data was gathered from 95 participants with CUULD using a 19-question survey including symptoms, activities impacted, treatments received and perceived satisfaction of those interventions. Data was analyzed using descriptive statistics and frequency analysis. The results indicate that 82% of respondents have or currently experience musculoskeletal issues with 41% experiencing these by the age of 25. Neck pain was the highest reported symptom (51%) followed by general pain (43%) and tingling/numbness (42%). Treatments received indicate a wide variety with mixed satisfaction. Lastly, participants rated weightlifting/strength training as the most impacted activity with yard work/general maintenance rated second. This study highlights the impact of CUULD on individuals and their daily activities and underscores the need for interventions that target the symptoms experienced and address engagement in impacted activities.
Background: Neglected radiocarpal dislocations are rare and may have functional repercussions on the injured limb. Objective: The aim of this study was to evaluate the functional results of our management of neglected radiocarpal dislocation. Patient and method: This was a retrospective and descriptive study of five cases of neglected radiocarpal dislocation between January 2011 and December 2020. Patients were collected from various hospitals in Abidjan, Ivory Coast (some private centers and the orthopaedic surgery and trauma department of Cocody University Hospital). The minimum consultation time was 11 weeks. The initial treatment was traditional in 3 cases and failure of hospital treatment in 2 cases. Lesions were classified according to the Dumontier classification. Treatment was surgical in all cases. Functional results were assessed using the Quick DASH score and the modified Green and O'Brien score. Results: Patients were assessed for function at a minimum follow-up of 24 months. The total Quick DASH score was obtained using the formula: [(Sum) × 1.1] × 5/2. The mean Quick DASH score was 88.55 (extremes: 74.25 and 99). The mean modified Green and O'brien score was 96 (extremes: 80 and 100). Conclusion: Our functional results were satisfactory overall, as demonstrated by assessments using recognised and reliable tools. Further studies with a larger sample size are needed to confirm the conclusions of our study.
Orthopaedics is a subject with a wide variety of diseases and strong specialties, among which the sports medicine subspecialty is a rapidly developing specialty. In particular, the sports medicine department has been subdivided in the orthopedics department of the national super first-class comprehensive hospital, and on the basis of the sports medicine specialty, professional groups have been subdivided by location, and teaching tasks from various sources and at different levels have been undertaken. In the field of shoulder arthroscopy, the application of the Trimano universal mechanical arm provides a simple and feasible scheme for the minimally invasive treatment of shoulder joint diseases. At the same time, standardized coordination can be provided for the treatment posture of shoulder arthroscopy with individual differences, providing a high standard model for the teaching of sports medicine specialty
There is a widely acknowledged biological sex difference in anterior cruciate ligament (ACL) injuries, with females at a significantly higher risk compared to males. Due to the sex difference, the influence of the sex hormone estrogen has been investigated. Consequently, the aim of this study through reviewing current literature was to explore the association fluctuations in estrogen concentration during the menstrual cycle and altered ACL extracellular matrix (ECM) structure and subsequent function.
The practice of classical ballet requires constant, prolonged physical training periods, and the repetition of aesthetic movements that exceed anatomical limits. Joint misalignment during sustained posture or movement execution is one of the principal risk factors for injury in the dance world.
Abstract BACKGROUND: Chronic knee pain, primarily associated with knee osteoarthritis (OA), is a leading cause of disability among older adults and place an immense burden on patients and healthcare systems, exceeding $80 billion in direct medical costs annually. Current non-surgical solutions to treat chronic knee pain provide limited relief of symptoms. The present study aims to assess the long-term effect of a biomechanical, non-invasive intervention on total knee replacement (TKR) incidence and the utilization of healthcare resources over five years. METHODS: This was a retrospective study among older adults with chronic knee pain, primarily due to OA, who received the biomechanical intervention between 2014 and 2017. An independent survey institute contacted patients between August and September 2022 to confirm their surgical status and utilization of other healthcare services, covering at least five years of follow-up. During the intervention, patients were provided with a FDA-cleared shoe-like device, which includes two convex pods attached to the sole. The pods are attached to the shoe in a customized manner based on the patient's gait and pain (i.e., calibrated). The device shifts the foot's center of pressure to reduce the knee joint load and alleviate pain. The device also creates controlled perturbation that challenges gait and posture stability and creates neuromuscular training. Patients were instructed to wear the device for up to 2-3 hours a day during their daily routine and invited to follow-up sessions for treatment modifications. RESULTS: Four hundred and fourteen patients responded to the survey. Their mean (SD) age was 66.5 (4.2) years, 65% were women and 82% of patients were diagnosed with knee OA. At five years since inception, the TKR incidence rate was 18.4% with 95% CI (14.6%, 22.1%). Most responders (79%) reported using other healthcare resources and services to treat their knee pain before the intervention. Of them, 64% ceased receiving intra-articular injections to the knee, 44% discontinued using pain medication and 46% stopped receiving physiotherapy. CONCLUSION: This biomechanical, non-invasive intervention is a beneficial and sustainable intervention that reduces healthcare resource utilization, including avoidance of TKR and chronic knee pain. With the constant increase in the prevalence of chronic knee pain, offering this intervention to patients can help address the increasing burden on the healthcare system and society. TRIAL REGISTRATION: NIH protocol no. NCT00767780
Publications are aplenty, particularly during the COVID-19 pandemic. As of February 10, 2022, there are 241,998 publications on the Web of Science Core Collection. Of these publications, 22,457 are review articles, and 147,381 are articles. The United States of America (n = 67026) and the Republic of China (n = 23,929) contributed to most of the pandemic publications.
For the purpose of this study a group of 40 healthy volunteers (26 male and 14 female), were finally selected out of 50 healthy volunteers initially examined. The results are presented regarding the Thoracic Forward Flexion and Thoracic Backward Flexion (Extension), the Lumbar Forward Flexion and Lumbar Backward Flexion (Extension), the Thoracic Spine Bending Tests and the Lumbar Spine Bending Tests.
Participants were recruited from their workplaces and assigned to a treatment arm, with both participant and investigators blinded. Baseline measurements of participants' PPT obtained, and VAS used to determine pain severity. One of 6 treatments was applied with re-assessment of PPT 7 minutes later. Comparison of the baseline and treatment scores was due using two-way repeated measures ANOVA. Trial registered retrospectively - NCT03939884.
Background: College students engage in large amounts of sedentary behavior which have been linked to adverse mental health outcomes. Poor postural habits due to the increase in this behavior, in conjunction with prolonged mobile phone usage, can lead to poor posture in these younger populations. As such, this study aims to identify how college-students feel about their posture, the prevalence of pain patterns, psychological status, and their knowledge of intervention options available. Methods: A descriptive, observation survey study collected data from a healthy college-age population of 58 male and 100 female (n = 158) (mean = 21.6 ± 1.9y). Survey included assessments of self-perceived attitudes regarding posture, ergonomics, neck disability (NDI), mental health outcomes, knowledge of postural rehabilitation techniques, and range of motion (ROM). Results: In total, 88.6% of participants wished their posture was better, 93.7% and 96.2% believed their standing and sitting postures could be improved, respectively. Thirty-five percent of participants qualified as Mild or Moderate Disability based upon their cumulative NDI scores. Strong correlations (r = 0.61) between participants' self-reported need to improve standing and sitting posture, and a moderate correlation (r = -0.47) between pain when sitting and total NDI. Conclusion: We noted a prevalence of posture-related issues and the impacts on daily function including sleeping and sitting. Future research should look to objectively assess posture through validated measures to investigate the extent of posture-related pain and dysfunction. To alleviate early-onset neck pain and reduce the risk of developing future chronic neck pain, college aged populations need education on proper posture and rehabilitation interventions designed to alleviate pain and dysfunction over the short-and long-term.
Background: Lateral epicondylitis (LE) is a common cause of elbow pain. Besides conservative treatments, ozone therapy is getting attention due to its safety and effectiveness. This study aimed to assess the effectiveness of ozone therapy in lowering pain and tenderness and improving joint function. Methods: Patients clinically diagnosed with LE were included in our study. Baseline assessments including age, gender, involved elbow, tenderness, pain, and function scores were done. All the patients underwent up to ten sessions of ozone injection in the pain site. Each injection was between six to ten ml of 30 µg/ml ozone gas into the lateral epicondyle. After the treatment regimen, tenderness, pain, and function scores were assessed. Results: Of the 28 patients with LE, 16 and 12 were female and male, respectively. More than 80% had high physical activities with their involved elbow. Comparing the pain, tenderness, and function before and after the treatment, all parameters were statistically improved (P < 0.05). These results were consistent in both men and women subgroups. Conclusion: Ozone therapy is a safe and effective procedure in patients with LE to reduce pain and tenderness, in addition to improving performance. However, large clinical trials are warranted to compare ozone injection with routinely used treatments by clinicians.
Despite the evolution in implant design, surgical technique, rehabilitation and better medical training, a great number of patients are not satisfied with the final result of Total Knee Arthroplasty (TKA). The conventional TKA technique could result in a high number of outliers in limb alignment and are related to a high rate of residual symptoms.
Background: Musculoskeletal disorders (MSKD) create a significant burden on individuals and society.Physical activity is an effective way of self-managing MSKD.Global health policy routinely recommends the instigation of management approaches to support people with MSKD to engage in physical activity.However, there is considerable heterogeneity in outcome measurement and establishing whether interventions are effective or not.A way of addressing this is to develop a core outcome set (COS).This study aims to identify a COS for exercise and physical activity interventions for people with MSKD.Methods: Guidance from the COMET initiative was followed.The study had two phases.1) A systematic search of effectiveness studies investigating interventions that aim to increase physical activity levels in people with MSKD was conducted.All outcome concepts evaluated were extracted from the included studies.2) Patients with MSKD and expert stakeholders then participated in an online and workshop-based consensus process.In accordance with other COS development studies, 70% agreement was required for a concept to be included in the final COS.Results: Phase 1: 25 studies were identified from the systematic searches and 50 conceptually different outcomes were extracted.Phase 2: 14 group members were recruited to the consensus phase.Function, Patient satisfaction, Physical activity, Quality of Life, Pain, Cost-effectiveness, Self-efficacy, Knowledge to plan future exercise, Utilisation of health services were the concepts that reached the 70% threshold for inclusion in the final COS. Conclusions:This study provides a COS that could provide an outcome measurement strategy in interventions that aim to increase exercise and physical activity in people with MSKD.
