BackgroundCentral sensitization (CS) is a key mechanism in chronic pain, but its relationship with cervical muscle pressure pain thresholds (PPT) and disability in myofascial pain syndrome (MPS) remains unclear.ObjectiveTo investigate the clinical characteristics and functional determinants of CS in patients with chronic neck MPS.MethodsThis prospective cross-sectional study included 98 patients with chronic neck MPS. Participants were categorized into High CSI (n=58) and Low CSI (n=40) groups using a Central Sensitization Inventory (CSI) cutoff score of 40. Disability (NDI), neuropathic pain (painDETECT), quality of life (SF-12), and PPTs of the upper trapezius, levator scapulae (LSP), and splenius cervicis (SC) were assessed. Multivariate linear regression was performed.ResultsA high CSI score (≥40), reflecting prominent symptoms associated with central sensitivity, was identified in 59.2% of the participants. The High CSI group was significantly older and had higher BMI, NDI, and painDETECT scores (p < 0.05). Mean LSP PPT was significantly lower in the High CSI group (p = 0.003, rank-biserial correlation = 0.350), while splenius cervicis (SC) showed high sensitivity in both groups. The regression model explained 40% of the variance in CSI scores (R2 = 0.40). NDI score (β = 0.48, p < 0.001) and age (β = 0.23, p = 0.01) were the only independent predictors.ConclusionsClinicians evaluating chronic neck MPS should routinely screen for CS using the CSI. Identifying a High CSI phenotype early enables the integration of multimodal, centrally-targeted therapies to mitigate severe functional disability, rather than relying solely on peripheral structural interventions.
BackgroundAltered patellar height is associated with abnormal patellofemoral joint mechanics and is considered a structural risk factor for pain and instability. Although patellar height has been primarily explained by local knee structures, the contribution of static spinopelvic alignment remains unclear.ObjectiveTo compare spinopelvic alignment according to patellar height and to explore whether pelvic and spinal alignment variables are independently associated with patellar height.MethodsThis cross-sectional observational study included 71 young adults classified into patella alta, normal, and patella baja groups using the Insall-Salvati index. Pelvic tilt angle, lumbar lordosis angle, and thoracic kyphosis angle were measured in a standing position. Group differences were analyzed using one-way analysis of variance with Bonferroni post hoc tests. Multiple linear regression analysis was performed to identify independent predictors of patellar height.ResultsSignificant group differences were observed in pelvic tilt, lumbar lordosis, and thoracic kyphosis (all p < 0.001). The patella alta group demonstrated the greatest anterior pelvic tilt and lumbar lordosis, whereas the patella baja group showed reduced spinal curvature. In regression analysis, pelvic tilt angle independently predicted patellar height (β = 0.601, p < 0.001) explaining 44.6% of the variance, while lumbar lordosis and thoracic kyphosis were not significant predictors.ConclusionPatellar height is significantly associated with pelvic alignment, particularly anterior pelvic tilt. These findings highlight the importance of considering proximal spinopelvic alignment as a related postural factor when assessing patellar height.
BackgroundOsteoporosis (OP) is a systemic skeletal disorder characterized by reduced bone density and microarchitectural deterioration, leading not only to fragility fractures but also to progressive spinal deformities. Recent evidence suggests that OP may contribute to degenerative spinal diseases (DSDs), yet longitudinal data remain limited.ObjectiveThis study aimed to evaluate the long-term risk and temporal relationship between newly diagnosed OP and subsequent development of major DSD subtypes using a nationwide population-based cohort.MethodsA retrospective cohort study was conducted by utilizing data from the Korean National Health Insurance Service (NHIS) between 2002 and 2013. Newly diagnosed OP cases were identified and matched 1:10 using propensity score matching. Outcomes included four major DSD subtypes-intervertebral disc disorders, spinal stenosis, spondylosis, and spondylolisthesis-identified using claims-based ICD-10 codes. Incidence rate ratios (IRRs) were calculated, and multivariable Cox proportional hazards models were applied to estimate adjusted hazard ratios (aHRs), controlling for demographic and clinical covariates. A 3-year washout period and up to 9 years of follow-up were implemented.ResultsAmong over one million participants, both osteoporosis groups-with and without pathological fractures-showed significantly elevated IRRs and aHRs for all major DSD subtypes compared with matched controls. The risk elevation was pronounced and sustained in OP patients without pathological fractures.ConclusionOP was independently associated with an increased long-term risk of DSDs, including among patients without pathological fractures. These findings underscore the need for early risk stratification and proactive spinal health management in patients with OP to mitigate the growing burden of spine disorders in aging populations.
PurposeThis study aimed to evaluate differences in diaphragm and deep abdominal muscle function between patients with ankylosing spondylitis (AS) and healthy controls and to examine their relationships with clinical parameters, including spinal mobility, quality of life, and balance performance.Materials and MethodsPatients with AS and healthy controls were included. Diaphragm and deep abdominal muscles were evaluated using two-dimensional ultrasonography. The clinical status of AS patients was assessed using ASDAS, BASDAI, BASFI, BASMI, and ASQoL. Static and dynamic balance were assessed with the NeuroCom Balance Master, including limits of stability (LOS) and sit-to-stand (STS) tests.Results30 AS patients (27 male, 3 female) and 33 healthy controls (27 male, 6 female) were assessed. Ultrasound measurements showed significant between-group differences in diaphragm thickness at end-expiration (p = 0.021), transversus abdominis (TrA) thickness at rest (p = 0.009), and TrA thickening fraction during the abdominal drawing-in maneuver (p = 0.010). AS patients demonstrated lower scores in several LOS and STS parameters compared with controls (p < 0.05). A significant negative correlation was found between the thickening fraction of the internal oblique muscle (TFIO) and ASQoL (r = -0.371, p < 0.05). TFIO showed positive correlations with BASMI (r = 0.439, p < 0.05) and tragus-to-wall distance (r = 0.461, p < 0.05). For the internal oblique muscle, resting thickness correlated positively with cervical rotation (r = 0.464, p < 0.01), while TFIO correlated negatively with cervical rotation (r = -0.571, p < 0.01).ConclusionAS patients exhibit greater diaphragm end-expiratory thickness and resting TrA thickness than controls; however, reduced TrA thickening fraction indicates functional impairment despite these structural changes.
BackgroundChronic low back pain (CLBP) is the most frequent musculoskeletal disorder with many influencing factors, impairing the individual's pain and function management.ObjectiveWe conducted this study to explore the effect of Pilates exercise on pain and function in women with CLBP, especially in postmenopausal women.MethodsPubMed, Embase, Web of Science, Cochrane Library, PEDro and CINAHL were searched up to April 11, 2026. Randomized controlled trials on the effect of Pilates exercise on women with CLBP vs. no intervention or other interventions were included. SMDs with 95% CIs were estimated by a random-effects model. Subgroup analyses were conducted by age, follow-up time, and region. In addition, subgroup analyses based on follow-up time and region were performed among postmenopausal individuals. We assessed the included studies for risk of bias by the NIH Quality Assessment Tool for Controlled Intervention Studies, sensitivity analysis by the leave-one-out method, and for publication bias by the funnel plot and Egger's test.ResultsThe meta-analysis revealed that Pilates achieved pain relief (SMD -1.88, 95% CI -2.46 to -1.31) and functional improvement (SMD -1.08, 95% CI -1.43 to -0.74). Both menopausal (pain: SMD -2.07, 95%CI -2.90 to -1.25) (function: SMD -1.11, 95% CI -1.53 to -0.7 0) and non-menopausal (pain: SMD -1.58, 95%CI -2.13 to -1.03) (function: SMD -1.03, 95% CI -1.75 to -0.31) women benefited from Pilates, with pain relief and functional improvements. P < 0.001.ConclusionsPilates exercise can achieve pain relief and functional improvement in women both in postmenopausal and non-postmenopausal populations.
BackgroundThe biopsychosocial approach has become increasingly central to modern physiotherapy, yet validated instruments for assessing this shift remain limited in Turkey.ObjectiveThis study aimed to translate and culturally adapt the Knowledge and Attitudes of Pain (KNAP) questionnaire into Turkish and to evaluate its psychometric properties among physiotherapists and physiotherapy students.MethodsFollowing established cross-cultural adaptation guidelines, the KNAP was administered to 405 participants, including physiotherapy students and practicing physiotherapists. Internal consistency was assessed using Cronbach's alpha, while test-retest reliability was evaluated with the intraclass correlation coefficient (ICC) in a randomly selected subsample of 120 participants over a 7-day interval. Construct validity was examined through exploratory factor analysis (EFA) and correlations with the PABS-PT-TR and HC-PAIRS-TR.ResultsKNAP-TR showed strong internal consistency (α = 0.84) and good test-retest stability (ICC = 0.88; 95% CI: 0.71-0.93; p < 0.001). Principal Axis Factoring with Promax rotation supported a two-factor structure accounting for 54.71% of the total variance, with factor loadings ranging from 0.41 to 0.78. Correlations with the HC-PAIRS-TR (r = -0.540, p < 0.001), the biopsychosocial subscale of the PABS-PT-TR (r = 0.510, p < 0.001), and its biomedical subscale (r = -0.440, p < 0.001) confirmed construct validity, with no floor or ceiling effects observed.ConclusionKNAP-TR demonstrates satisfactory preliminary psychometric properties and represents a suitable tool for assessing pain-related knowledge and attitudes among physiotherapists and physiotherapy students in Turkey. Confirmatory factor analysis is recommended in future work to further validate its factor structure.
BackgroundAccurate sagittal spinal assessment is crucial in physiotherapy, but current methods strike a balance between precision and practicality. Radiographic measures are valid but impractical for repeated use, whereas observational tools, such as the Selective Functional Movement Assessment (SFMA), are subjective. Device-based approaches, such as Idiag M360, are validated but costly. Smartphone-based systems, such as TricuroGo, offer accessible alternatives, although their validity remains underexplored.ObjectiveThis study evaluated TricuroGo's validity for assessing sagittal spinal posture, mobility, and stability compared with Idiag M360 and SFMA.MethodsNinety-three adults (36 men, 57 women; mean age 30.6 ± 12.3 years) underwent same-day testing with TricuroGo, Idiag M360, and SFMA. Posture, flexion, extension, and Matthias-test stability were assessed across thoracic, lumbar, and pelvic regions. Device agreement was analyzed with Bland-Altman plots, Pearson's r, or Spearman's ρ. SFMA outcomes were compared with TricuroGo by percent agreement and Spearman correlation.ResultsTricuroGo showed strong correlation with Idiag M360 for posture (r = 0.66-0.83), flexion (r = 0.56-0.88), and extension (r = 0.73-0.80), with 92-96% of Bland-Altman values within the limits. Stability associations were weaker (ρ = 0.23-0.42). Agreement with SFMA was moderate for sagittal flexion (75%, ρ = 0.47) and quadruped diagonals (74%, ρ = 0.41), but negligible for single-leg stance. Subgroup analyses revealed stronger agreement among older participants and those with a higher body mass index (BMI), with variability observed across different smartphone models.InterpretationTricuroGo provides valid and practical assessments of sagittal posture and mobility comparable to those of Idiag M360; however, its stability measure diverges from functional balance tests. It is a promising and portable solution for spinal evaluation in clinical and telehealth settings.
Background and ObjectiveBoth rheumatoid arthritis (RA) and knee osteoarthritis (KOA) are associated with increased cardiovascular diseases (CVDs) risk. Although lifestyle factors have been studied in these patients, data directly comparing CVDs risk awareness between RA and KOA remain limited. Therefore, this study aimed to compare CVDs awareness, physical activity, nutritional habits, and cardiovascular risk factors between female patients with RA and KOA.MethodsFemale patients aged ≥40 years with RA, diagnosed according to the 2010 ACR/EULAR-classification criteria, or KOA, diagnosed according to the ACR-classification criteria, were enrolled. Demographic data and comorbidities were recorded. CVDs risk awareness was assessed using the Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) Scale, physical activity using the International Physical Activity Questionnaire (IPAQ)-Short Form, eating habits using the Nutrition Attitudes Scale (NAS), and CVDs risk using the Framingham Risk Score (FRS).ResultsThe study was completed with 60 RA and 60 KOA patients. Age, weight, and presence of diabetes were significantly higher in KOA group (p < 0.001, p = 0.032, and p = 0.039,respectively), and exercise habits were significantly lower in RA group compared to KOA group(p = 0.008). There was no significant difference between the CARRF-KL and NAS groups (p = 0.629, p = 0.094, respectively). In contrast to exercise habits, IPAQ scores were significantly lower in KOA group than in RA group(p = 0.019). Furthermore, the FRS was significantly higher in KOA group (p = 0.026).ConclusionAlthough CVDs risk awareness was similar between RA and KOA patients, cardiovascular risk was higher in KOA group. Assessment of cardiovascular risk and lifestyle-related factors may contribute to improved preventive strategies in these patients.
BackgroundCentral sensitization (CS), characterized by amplified nociceptive processing within the central nervous system, is considered a key mechanism in chronic nonspecific low back pain (CNLBP). Although manual therapy (MT) is widely used in musculoskeletal rehabilitation, its effectiveness in patients with confirmed CS remains unclear. This study evaluated the effects of MT on CS, pain, disability, and quality of life in individuals with CNLBP.MethodsForty participants with physician-diagnosed CNLBP and CS (CSI ≥40) were randomly assigned to either an MT group (n = 20) or a conventional physiotherapy group (CT, n = 20). Both interventions were administered over a 4-week period. Outcomes included the Central Sensitization Inventory (CSI), Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and SF-36 Health Survey. Pre- and post-treatment scores were compared within and between groups.ResultsBoth groups demonstrated significant post-treatment improvements. In the MT group, significant improvements were observed in VAS, CSI, and ODI scores (all p < 0.001). In the CT group, significant improvements were also observed in VAS (p < 0.001), CSI (p = 0.044), and ODI (p = 0.009). Between-group analyses demonstrated significantly greater improvements in the MT group for CSI (p < 0.001), VAS (p = 0.045), and ODI (p = 0.010). Significant improvements across all SF-36 domains were observed in the MT group, whereas the CT group improved only in role limitations. Between-group comparisons showed greater improvements in physical function and general health perception in the MT group.ConclusionBoth interventions improved outcomes in patients with CNLBP and CS; however, adding MT to CT produced greater improvements in CS, pain, disability, and quality of life than CT alone.
BackgroundStress fractures are categorized as fatigue or insufficiency fractures and are most frequently observed in athletes and military personnel. Their occurrence during pregnancy is rare, but pregnancy-related osteoporosis can predispose patients to insufficiency fractures.MethodWe report a rare case of bilateral talar stress fractures associated with pregnancy-related osteoporosis in a multiparous woman who presented with progressively worsening heel pain during late pregnancy and the postpartum period. Initial radiographs were inconclusive, prompting further evaluation with magnetic resonance imaging (MRI), which revealed bilateral talar stress fractures. Laboratory investigations assessing calcium metabolism and vitamin D levels supported metabolic bone involvement. Bone mineral density measurement using dual-energy X-ray absorptiometry (DEXA) confirmed pregnancy-related osteoporosis.ResultThe patient was managed conservatively with analgesics, calcium and vitamin D supplementation, and a structured physical therapy program. Gradual clinical improvement was observed, and symptoms resolved over a 1-2 year follow-up period without the need for surgical intervention.ConclusionThis case highlights the importance of considering stress fractures in pregnant and postpartum patients presenting with persistent heel pain. Early recognition, appropriate imaging, and metabolic evaluation are crucial for diagnosis. Conservative treatment can lead to favorable long-term outcomes. Increased awareness among healthcare providers is essential to avoid delayed diagnosis in this uncommon but significant condition.
BackgroundThe Spine Functional Index (SFI) is a patient-reported outcome measure used to evaluate functional limitations in patients with spinal disorders. However, no validated Arabic version has been available, limiting standardized assessment in Arabic-speaking populations.MethodsThis prospective cross-sectional validation study translated and culturally adapted the SFI into Arabic (SFI-AR) following internationally accepted guidelines, including forward and back-translation, expert committee review, and pilot testing. Adults aged ≥18 years with spinal pain or dysfunction completed the SFI-AR and the Arabic Chronic Pain Grade Scale (CPGS-AR). A clinically stable subgroup repeated the SFI-AR after 5-10 days. Psychometric evaluation assessed interpretability, internal consistency, test-retest reliability, measurement error, structural validity using exploratory and confirmatory factor analyses, and convergent validity.ResultsA total of 411 patients were included, with 137 completing the retest. Internal consistency was excellent (Cronbach's α = 0.954), and test-retest reliability was outstanding (ICC(2,1) = 0.998; 95% CI: 0.997-0.998). Measurement error was low (SEM 4.27; MDC 12.56). No significant floor or ceiling effects were observed. Exploratory factor analysis supported an essentially unidimensional structure, explaining 48.29% of the variance, and confirmatory factor analysis showed acceptable fit for a single-factor model (CFI = 0.905; TLI = 0.896; RMSEA = 0.073; SRMR = 0.065). Convergent validity was confirmed by strong correlations with CPGS-AR disability (ρ = 0.915) and moderate correlations with pain intensity (ρ = 0.692; p < 0.001).ConclusionThe SFI-AR is a reliable, valid, and culturally adapted instrument for assessing spinal function in Arabic-speaking populations, supporting its use in clinical practice and research.
BackgroundAdolescence is a critical developmental period during which habitual postural patterns and musculoskeletal behaviors are established. Altered sagittal alignment in this stage has been linked to discomfort, reduced body awareness, and later functional limitations. Understanding these relationships may support early musculoskeletal risk identification.ObjectiveTo examine the associations between sagittal postural angles, multisite musculoskeletal pain, and body awareness in school-aged adolescents.MethodsThis cross-sectional study included 325 adolescents (210 girls, 115 boys; mean age 15.4 ± 0.9 years). Posture was assessed photogrammetrically using five sagittal angles. Musculoskeletal pain was evaluated with the Cornell Musculoskeletal Discomfort Questionnaire, and body awareness with the Body Awareness Questionnaire. Sex differences were examined using Mann-Whitney U tests, and associations were analyzed with linear regression adjusted for age, sex, and Body Mass Index.ResultsGirls demonstrated greater Trunk Angle (p = 0.005), lower body awareness (p = 0.011), and higher prevalence of neck (p = 0.001) and right shoulder pain (p = 0.012). Lower Extremity Angle was negatively associated with neck and low back pain, whereas Trunk Angle was positively associated with wrist pain. Higher body awareness showed a protective relationship with pain. These associations were small and should be interpreted as exploratory.ConclusionPostural alignment, body awareness, and musculoskeletal pain appear interrelated in adolescents. Findings offer clinically relevant insights for pediatric physiotherapists, highlighting the value of early school-based postural screening and awareness-focused education to support healthier alignment and potentially reduce discomfort.
ObjectiveThis retrospective case series aimed to describe 36-month skeletal, biochemical, safety, and patient-reported outcomes in five postmenopausal women with mastocytosis treated with denosumab.MethodsA technical expert panel (TEP) retrospectively evaluated five consecutive eligible patients with osteoporosis associated with indolent systemic mastocytosis. All subjects underwent physiatric assessment, DXA assessment, and Mini-Osteoporosis Quality of Life (Mini-OQoL) evaluation using the validated Italian version of the questionnaire. Data collected at baseline (T0), 18 months (T1), and 36 months (T2) following initiation of denosumab 60 mg every 6 months, combined with cholecalciferol and calcium supplementation according to individual requirements, were descriptively analyzed.ResultsOver 36 months, femoral and lumbar spine T-scores showed modest improvement/stabilization. Mean femoral T-score improved from -3.9 ± 0.3 at baseline to -3.5 ± 0.3 at 36 months, while lumbar spine T-score improved from -4.3 ± 0.5 SD to -3.9 ± 0.4. Vitamin D levels normalized during follow-up, and Mini-OQoL scores improved from 54.2 ± 9 to 67.3 ± 6. However, BMD remained within the osteoporotic range and one vertebral fracture was documented at 36 months. No severe adverse events were recorded.ConclusionsIn this case series, denosumab was associated with stabilization or modest improvement of BMD and improvement in patient-reported quality of life over 36 months in women with osteoporosis secondary to indolent systemic mastocytosis. These preliminary observations should be interpreted cautiously because of the small sample size, lack of a comparator, and occurrence of one new vertebral fracture during follow-up. Thus, larger multicenter prospective studies are required.
ObjectiveThis case report aimed to describe effects in balance, gait, and functional recovery observed during a multimodal technology-assisted rehabilitation program in a patient following total ankle and total talus replacement (TATTR).MethodsA 59-year-old man (history of ankle fracture-dislocation) developed persistent pain, progressive avascular necrosis of the talus, and advanced ankle osteoarthritis. He underwent TATTR on January 19th, 2025. Then, he underwent a rehabilitation program combined joint mobility recovery, progressive strengthening, proprioceptive training using the Pro-Kin 252 system, gait retraining on an antigravity treadmill, and visual-feedback gait optimization with the Walker View device. We assessed Berg Balance, Tinetti, Barthel Index, EQ-5D, stabilometric variables, gait parameters, and passive ankle range of motion at baseline (T0), 1 month (T1), 3 months (T2), and 5 months (T3).ResultsOverall, clinical outcomes improved from baseline to the 5-month follow-up; stabilometric analysis showed marked reductions in eyes-closed ellipse area and perimeter from T0 to T3 (Area T0: 318 mm2; T3: 77 mm2; Perimeter T0: 742.37 mm; T3: 555.27 mm). Berg Balance Scale increased from 30 to 56, Tinetti total score from 9 to 29, EQ-5D index from 0.169 to 1.0, and Barthel Index from 70 to 100. Gait parameters also improved, with left step length increasing from 39 cm to 50 cm and left contact time decreasing from 1.01 s to 0.84 s.ConclusionsThis case report suggested that a tailored multimodal rehabilitation program supported by advanced technologies might be associated with improvements in balance, gait, and functional independence after TATTR.
BackgroundObesity is an established independent risk factor for osteoarthritis (OA). BMI cannot reflect fat distribution, while abdominal obesity is more closely related to OA. ABSI, AIP, and CMI are novel abdominal obesity indices with good predictive performance, but their associations with OA remain unclear.ObjectiveTo explore the independent associations of ABSI, AIP, CMI with OA risk in U.S. adults, clarify dose-response relationships, and compare their predictive ability.MethodsThis cross-sectional study included 11,319 participants from NHANES 2011-2016. Weighted logistic regression, RCS, subgroup analysis, and ROC analysis were applied.ResultsAfter full adjustment, elevated AIP and CMI were independently associated with higher OA risk (AIP: OR = 1.36; CMI: OR = 1.55). AIP showed a linear positive association, and CMI had an inverted U-shaped association with OA. ABSI showed no significant association. The associations were stronger in adults ≤60 years and non-Hispanic white individuals. ABSI had the highest AUC (0.637).ConclusionElevated AIP and CMI are independently associated with OA, modified by age and ethnicity. AIP and CMI can be used for OA risk stratification in young and middle-aged adults with abdominal obesity and metabolic disorders.
ObjectiveTo systematically evaluate the effectiveness of blood flow restriction exercise (BFRE) on disability and pain in individuals with chronic non-specific low back pain CNSLBP.MethodsA systematic review of randomized controlled trials was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched up to September 2025. Eligible studies compared therapeutic exercise programs incorporating BFRE with identical or conventional exercise interventions without BFRE. Oswestry Disability Index or its modified version was the primary outcome. Risk of bias was evaluated using the Cochrane RoB 2 tool. The study protocol was registered in PROSPERO with the identification code CRD420261283862.ResultsThree randomized controlled trials involving 104 participants were included. All studies reported significant within-group improvements in disability following BFRE-based interventions. In two trials, reductions in disability were significantly greater in the BFRE groups compared with control interventions, despite the use of lower external loads. In the remaining trial, between-group differences did not reach statistical significance, although absolute improvements favored BFRE. Pain intensity generally improved to a greater extent in BFRE groups. Nevertheless, overall risk of bias was low, with some concerns related to missing outcome data in one study.ConclusionsBFRE may represent a potential adjunct to exercise-based rehabilitation for CNSLBP; however, current evidence remains preliminary, heterogeneous, and insufficient to establish clear superiority over standard exercise interventions. Further adequately powered randomized controlled trials with standardized protocols are needed to clarify its effectiveness, safety, and optimal application parameters.
BackgroundLow back pain (LBP) is associated with psychological and breathing symptoms, such as dysfunctional breathing (DB) and hyperventilation syndrome (HVS), possibly more evident in females through autonomic-anxiety mechanisms.ObjectiveTo estimate the frequency of a positive screening result for a probable HVS/DB symptom profile among females with LBP using the Nijmegen Questionnaire (NQ), compare features and autonomic-anxiety symptoms across screening-defined groups (HVS+/HVS-), and explore associations between features and the NQ total score (NQ_total) and an autonomic-anxiety subscale (NQ_AA).MethodsThis exploratory secondary analysis included 87 females with LBP from a cross-sectional primary care study, assessing age, body mass index (BMI), pain duration, pain intensity, and NQ scores; NQ ≥20 was used as a pragmatic screening threshold. Group differences and associations were analysed using nonparametric tests, with multivariable regression for NQ_AA and exploratory PCA to examine symptom structure.ResultsFifty-one per cent of participants screened positive for a probable HVS/DB symptom profile. The HVS + group had significantly higher NQ_total and NQ_AA scores, with no differences in age, BMI, pain duration, or pain intensity. The only consistent finding was a modest positive association between pain intensity and NQ_AA, which remained the sole independent correlate despite the model explaining little variance. PCA suggested a two-component structure, separating respiratory and autonomic-anxiety symptoms, explaining 40.7% of variance.ConclusionA probable HVS/DB symptom profile was common in the sample and primarily reflected a higher autonomic-anxiety symptom burden. NQ may provide complementary information during assessment, but findings should be interpreted cautiously and require further confirmation.
BackgroundSarcopenia is a progressive skeletal muscle disorder associated with increased disability, morbidity, and mortality. Ultrasound has gained increasing attention as an accessible and repeatable tool for muscle assessment.ObjectiveThis study aimed to map the global research trends and technological evolution in ultrasound-based sarcopenia assessment from 1997 to 2025.MethodsA total of 1574 records were retrieved from the Web of Science Core Collection. Bibliometric analyses were performed using CiteSpace, VOSviewer, and the bibliometrix R package. Sankey diagrams were used to visualize thematic flows between ultrasound assessment dimensions and outcome-related research topics.ResultsPublications showed a prolonged latent phase, steady growth, and rapid acceleration after 2019, peaking in 2025. Keyword and thematic-flow analyses identified a three-stage evolution: an early Morphometry Phase centered on muscle size and atrophy, a Qualitative Transition Phase emphasizing muscle quality and chronic disease contexts, and an Advanced Functional and AI Phase characterized by elastography, AI-assisted analysis, and outcome-related topics. Research contexts expanded across geriatrics, nephrology, critical care, surgical oncology, and rehabilitation-related research.ConclusionUltrasound-based sarcopenia research has shifted toward multidimensional muscle assessment and technology-assisted analysis. Because this study did not appraise individual study quality or clinical effect sizes, the findings should be interpreted as bibliometric patterns and research priorities rather than direct evidence of diagnostic or prognostic effectiveness.
BackgroundLow back pain is a global health challenge that requires constant progress to aid its management. Currently, artificial intelligence, as a major technological shift, has entered medicine to guide and improve management, and it is slowly being used for low back pain. With the growing number of studies, there is a lack of a summary of them.ObjectiveThe objective of this study is to investigate the effectiveness of artificial intelligence-based interventions in improving pain and functional outcomes among adults with low back pain when compared to standard interventions.MethodsA comprehensive search of PubMed, Scopus, and Web of Science was conducted. Intervention groups received artificial intelligence-based interventions, while control groups received standard interventions for low back pain. After data extraction, assessment of risk of bias was done, and then a meta-analysis was performed.ResultsFive studies met the inclusion criteria and were included in the systematic review, and four of them in the meta-analysis. Artificial intelligence-based interventions demonstrated lower pain scores (p = 0.001) and lower disability scores (p = 0.02) at endpoints than controls. Review of the studies revealed either significant or no improvement in the quality of recovery and psychological factors between the groups.ConclusionBased on the existing evidence, artificial intelligence-guided interventions, when compared to standard interventions, may improve pain and disability in adults with low back pain. But further research is necessary to establish its clinical relevance and future use.
