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Question: Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions?, Design: Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis., Participants: A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney., Intervention: One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting., Outcome Measures: The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of -15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks., Results: The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (-3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. Whilst non-inferiority margins were not set for the secondary outcomes, the 95% CI of the mean between-group difference ruled out clinically meaningful differences., Conclusion: Remotely delivered physiotherapy with support via phone, text and an app is as good as face-to-face physiotherapy for the management of musculoskeletal conditions., Trial Registration: ACTRN12619000065190., (Copyright © 2024 Australian Physiotherapy Association. All rights reserved.)

Background: Patient-centred care is essential for high quality musculoskeletal care, however, few evidence-based opportunities exist that address the barriers to implementation for clinicians., Objective: To develop and evaluate a simulation-based educational strategy for musculoskeletal physiotherapists to increase knowledge and confidence in patient-centred care., Methods: Repeated-measures, single-group educational interventional descriptive study. Primary outcome was participant-reported knowledge and confidence in patient-centred care. Customized survey data was collected at baseline (T1) (N = 22), immediately after a face-to-face workshop (T2) (N = 22), and six weeks after the workshop (T3) (N = 17). Secondary outcomes included sustained implementation using the Normalization Measure Development (NoMAD) tool. Repeated-measures ANOVA was used to analyse primary outcomes., Results: Our participants were typically female (72%), early career (mean 3.3 years post-graduate) and culturally diverse (67%). Significant increases in participant confidence were noted at all time points on all five learning outcomes (repeated measures ANOVA, p < 0.001 to p = 0.009). Participants had very high baseline knowledge and no further increases were found following the intervention (p > 0.05). Normalization Measure Development data indicated high coherence, high cognitive participation, and high reflexive monitoring, with neutral results for collective action., Conclusion: A novel, psychologically-informed, simulation-based educational strategy is effective in improving musculoskeletal physiotherapist confidence in patient-centred care. Participants reported implementation of skills learnt in the workshop into subsequent clinical practice., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier Ltd.)

Objective: This article presents a qualitative evaluation of a 13-week digital intervention, 'Let's Move with Leon', designed to improve physical activity in people with a musculoskeletal condition., Study Design: A qualitative evaluation embedded within a randomised controlled trial assessing the effectiveness of the intervention at improving self-reported physical activity., Methods: A total of 184 participants received the intervention and were asked each week for 13 weeks to provide comment on their use and the usefulness of the digital physical activity behaviour change intervention. In addition, after 13 weeks, 12 participants took part in a semistructured interview to understand their use and the usefulness of the intervention. A thematic analysis was conducted on the combined qualitative data set., Results: A total of 128 of the 184 intervention participants (70.11%) provided at least one qualitative comment over the course of the evaluation (mean number of comments per participant = 5); in total, 674 comments were received. The thematic analysis identified three themes: (1) dipping in and out, (2) one size does not fit all and (3) monitoring and feedback. The qualitative data suggest that participants used the intervention sporadically, dipping in and out due to other commitments, and competing programmes, their changing physical ability, confidence and motivation. Not getting off to a good start was detrimental to use; many wanted to come back to the programme at a more appropriate time. A 'one size fits' approach catered for some but not all participants. Whilst not a predetermined intervention component the act of monitoring levels of activity as a data collection method seemed to encourage physical activity but may also result in negative social comparisons., Conclusion: Digital physical activity behaviour change interventions are not one-size-fits-all; personalisation is key. Monitoring of activity by a named person can create commitment. Many dip in and out. Digital physical activity behaviour change interventions could complement physiotherapy exercises for people with musculoskeletal conditions. Signposting to local activities should be considered., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Person-centered care specifically focuses on the whole person and is an important component of contemporary care for people with musculoskeletal pain conditions. Evidence suggests however, that some clinicians experience difficulties with integrating person-centered care principles into their clinical practice. Therefore, the purpose of this masterclass is to provide a framework that enables clinicians to incorporate person-centered principles in their management of people with musculoskeletal pain conditions. To support clinicians in overcoming some of the reported obstacles, we provide practical recommendations aimed at putting principles of person-centered care into practice. The framework supporting clinicians' delivery of person-centered care in practice consists of three key-principles: A) a biopsychosocial understanding of the person's experience; B) person-focused communication; and C) supported self-management. The framework includes three phases: 1) identification and goal setting, 2) coaching to self-management, and 3) evaluation. Building a therapeutic relationship underpins these phases and is an overarching element that weaves through the key-principles and phases of the framework. We use a clinical case to illustrate the practical implementation of these recommendations., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Non-traumatic complaints of the arm, neck and/or shoulder (CANS) are difficult-to-treat musculoskeletal conditions. CANS treatment has varying degrees of success, particularly in the working population., Objectives: To evaluate the experiences and needs of physiotherapists (PTs) and exercise therapists (ETs) regarding the treatment of working patients with CANS., Design: An exploratory qualitative focus group study was conducted., Method: Qualitative data were collected from 27 therapists who were purposefully recruited for their broad range of experience and qualifications. The data was analysed using thematic analysis., Results: Both PTs and ETs assess CANS extensively by exploring their patients' psychosocial factors, work-related factors, illness beliefs, and working conditions. Therapists apply hands-off treatment interventions, such as coaching the patient to make behavioural changes and providing self-management support. However, therapists experience many difficulties in these areas, resulting in a need to learn more about coaching techniques for behavioural change, engaging in meaningful conversations about the patient's perspective, supporting patients in building a strong social network in the workplace, and creating a professional network for collaboration., Conclusions: The treatment of working people with CANS is difficult for PTs and ETs. Therapists express a need to learn more about supporting self-management, applying coaching techniques and engaging in meaningful conversations. Moreover, therapists indicate a need to establish a professional multidisciplinary network to support collaborations with other disciplines to treat working patients with CANS., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Prescription opioid use in Australia has increased over the last 3 decades. The majority of opioids are prescribed and dispensed in primary care, however, there are few studies that are specific to opioid prescribing in this setting. Evidence about the impact of key government policy strategies to optimize opioid prescribing in primary care is limited. The aim of this study is to examine the impact of recent policy changes and clinical guidelines on opioid prescribing in primary care., Methods and Analysis: Longitudinal analysis of people prescribed opioid analgesics using Population Level Analysis and Reporting (POLAR) data. POLAR is a primary care dataset comprising 464 primary health care practices in Victoria, Australia. People prescribed opioid analgesics between 2015 and 2020 will be included. The impact of opioid policies and guideline recommendations will be evaluated using interrupted time series models. Group- based trajectory modelling and multivariate regression will be used to identify patterns of opioid cessation and the provision of corresponding non-opioid interventions., Ethics and Dissemination: The study has received Monash University Human Research Ethics Committee approval (ID 24139). Permission to access, collate and use POLAR data is granted from Outcome Health as the data custodians. The results of this study will be disseminated through publication in international journals, presented at national and international scientific conferences, and disseminated to consumers, policy makers, primary care providers and primary health networks., Protocol Registration Details: EU PAS Register (EUPAS43218)., Competing Interests: Declaration of competing interest SN has received untied research funding to study opioid harms from Seqirus and is a named investigator on an implementation study of buprenorphine depot funded by Indivior. JSB has received grant funding or consulting funds from the National Health and Medical Research Council (NHMRC), Medical Research Future Fund (MRFF), Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organisations all unrelated to this work. All grants and consulting funds were paid to the employing institution., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: To systematically review and analyse whether musculoskeletal conditions affect peripheral joint muscle force control (i.e. magnitude and/or complexity of force fluctuations)., Methods: A literature search was conducted using MEDLINE, CINAHL and SPORTDiscus databases (from inception-8th April 2021) for studies involving: 1) participants with musculoskeletal disease, injury, surgery, or arthroplasty in the peripheral joints of the upper/lower limb; 2) comparison with an unaffected control group or unaffected contralateral limb; and 3) measures of the magnitude and/or complexity of force fluctuations during targeted isometric contractions. The methodological quality of studies was evaluated using a modified Downs and Black Quality Index. Studies were combined using the standardized mean difference (SMD) in a random-effects model., Results: 14 studies (investigating 694 participants) were included in the meta-analysis. There was a significant effect of musculoskeletal conditions on peripheral joint muscle force coefficient of variation (CV; SMD = 0.19 [95 % CI 0.06, 0.32]), whereby individuals with musculoskeletal conditions exhibited greater CV than controls. Subgroup analyses revealed that CV was only greater: 1) when comparison was made between symptomatic and asymptomatic individuals (rather than between affected and contralateral limbs; SMD = 0.22 [95 % CI 0.07, 0.38]); 2) for conditions of the knee (SMD = 0.29 [95 % CI 0.14, 0.44]); and 3) for ACL injury post-surgery (SMD = 0.56 [95 % CI 0.36, 0.75])., Conclusion: Musculoskeletal conditions result in an increase in peripheral joint muscle force CV, with this effect dependent on study design, peripheral joint, and surgical status. The greater force CV is indicative of decreased force steadiness and could have implications for long-term tissue health/day-to-day function., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Musculoskeletal conditions are the world's fourth largest burden of disease, accounting for more than 50% of chronic health conditions in the population aged >50 years (Briggs et al., 2016). This increasing burden is due to a progressively overweight, sedentary and ageing population and is often poorly recognised as a priority globally in an under-resourced health care system. This article reviews the current literature to identify where Orthopaedic Nurse Practitioners (ONPs) currently fill gaps in care delivery through varied scopes of practice in musculoskeletal trauma, degenerative disease, tumour and bone health. The varied scopes of practice include, fracture management, surgical assisting, performing surgical and/or advanced clinical procedures, prescribing treatment for bone health, conducting home visits and managing ONP led outpatient clinics. The article will outline current ONP roles in orthopaedic trauma, pain management, fragility hip fractures, osteoporosis, bone and soft tissue sarcoma and surgical assisting which effectively address long waiting lists, gaps in care delivery and reduce costs currently being managed by the health care system., Method: A brief search of the literature published from January 2008-January 2020 on CINAHL, Cochrane Library, MEDLINE, Joanna Briggs Institute, Ovid, PubMed, Embase and Pro Quest databases was undertaken using key words Orthopaedic Nurse Practitioner, Advanced Practice Nurse (APN), musculoskeletal health, bone health, nurse-led and nurse specialist., Conclusion: ONPs offer an innovative, viable and cost-effective solution to providing comparable, effective and efficient care with varied scopes of practice and valuable experience in both the inpatient and outpatient settings., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Objectives: The objective was to assess the potential for biased treatment effects associated with patient-reported outcome measures (PROMs) of varying psychometric quality in randomized clinical trials (RCTs) for rotator cuff disease (RCD)., Study Design and Setting: We searched for RCTs published in the past 5 years (January 2011 to December 2016) in the top five 2015 impact factor orthopedic journals. We accepted RCTs including human participants with RCD, published in English, and using PROMs specific to RCD. We extracted data on study design, sample size, risk of bias for RCTs, quality of PROM used, estimates of effect, and associated measures of variance. PROMs were given numerical ratings of psychometric quality from a prior publication. Continuous measures of effect were transformed by dividing the effect estimate by the standard deviation. Multilevel linear regression analyses were performed to determine whether PROM quality was associated with the magnitude of effect., Results: Overall, we included 72 RCTs reporting 174 separate outcomes. Mean sample size was 66.8 (95% CI 62.30 to 71.27), mean risk of bias score across all studies was 7.00/10 (95% CI 6.72 to 7.29), psychometric quality summary scores ranged from -2 to 10, and the standardized mean effect estimate was 0.47 (95% CI -0.17 to 1.11). Regression revealed that higher-quality PROMs had smaller estimates of effect (β = -0.32; 95% CI -0.51 to -0.13; P = 0.001). We also found that a longer follow-up period predicted slightly increased effect estimates (β = 0.08; 95% CI 0.02 to 0.13; P = 0.007)., Conclusions: PROMs with poor or unknown psychometric properties overestimate treatment effects in clinical research of RCD by 68.4% (β -0.32/standardized mean effect 0.47). To our knowledge, this is the first empirical evidence that variations in the quality of PROMs bias treatment effect estimates. Researchers and clinicians using data from PROMs must be cautious to explore the quality of that measure so as to not mislead decision-making resulting from biased outcomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Study Design: Prospective cohort study including patients with shoulder pain in primary care physiotherapy., Background: There is an increased tendency to use diagnostic ultrasound to aid the diagnostic strategy and target treatment. It is a relatively cheap and accessible imaging technique but the implications for practice and patients are unknown., Objectives: To study the influence of diagnostic ultrasound (DUS) on diagnostic work-up, treatment modalities and recovery., Methods: Participants (n = 389) with a new episode of shoulder pain were assessed at baseline and followed for 6, 12 and 26 weeks. Diagnostic work-up, including the use of DUS, and treatment strategies were reported by the therapists at 3, 6 and 12 weeks., Results: Most patients (41%) were diagnosed with subacromial impingement/pain syndrome after physical examination or DUS. DUS was used in 31% of the participants. Tendinopathy was the most found abnormality in this sub-population. Patients who underwent DUS were more frequently treated using exercise therapy. Patients that not had DUS were more likely to receive massage therapy, trigger point therapy or mobilisation techniques. Logistic regression analyses did not show a significant association between DUS and recovery after 26 weeks (0.88, 95%CI:0.50-1.57). Correcting for the therapist as a confounder using a multilevel binary logistic regression did not show a significant cluster effect., Conclusion: Diagnostic US as a work-up component does not seem to influence diagnosis or recovery but does influence the choice of treatment modality. Conclusions are limited to observational data. High quality randomized trials should study the effect of DUS on recovery., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Musculoskeletal (MSK) conditions are very common and represent a major concern for the society and global health. The manual therapy technique Mulligan's Mobilisation with Movement (MWM) has shown promising results in treating a variety of MSK conditions. The aim of this review was to systematically review the literature to establish whether MWM treatment is effective for improving pain and function in patients with MSK conditions related to peripheral joints., Methods: Seven electronic databases (MEDLINE (through Ovid), EMBASE (through ovid), CINAHL (through EBSCO), Cochrane (CENTRAL), Web of Science, SPORTDiscus (through EBSCO) AND PEDro) were searched up to November 2017 for randomized controlled trials (RCTs). The quality of the evidence was rated using the GRADE approach., Results: Seven published trials were identified in which all trials presented positive clinical outcome in pain and function of MWM. Moderate quality evidence was found for the effectiveness of MWM in pain and function in patients with chronic ankle instability (CAI) and hip osteoarthritis (OA). There was found low quality evidence for shoulder impingement syndrome (SIS) and low and very low quality evidence for lateral epicondylalgia., Conclusion: Overall MWM interventions applied to peripheral joints seems to be superior to placebo and no intervention controls, but not in comparison with other medical or physiotherapy interventions. There is a need for more high quality trials that investigate the short and long-term effect of a series of MWM interventions., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Chronic pain conditions and posttraumatic stress disorder (PTSD) commonly co-occur and are associated with opioid use disorder (OUD). The aims of this paper were to identify prevalence estimates of OUD among individuals with and without PTSD and assess independent and combined contributions of PTSD and chronic pain conditions on OUD in a nationally representative sample., Methods: Data were extracted from 36,309 individuals from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Past-year PTSD and OUD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 edition. Respondents reported physician-confirmed, past-year chronic pain conditions, categorized into musculoskeletal pain (e.g., arthritis), digestive pain (e.g., pancreatitis), and nerve pain (e.g., reflex sympathetic dystrophy). We examined the weighted prevalence of OUD among those with and without PTSD. Multiple logistic regressions examined the association between PTSD and chronic pain conditions on OUD., Results: The prevalence of OUD was higher among those with PTSD than those without. Comorbid PTSD/musculoskeletal pain and PTSD/nerve pain conditions were associated with increased odds of OUD, compared to those with neither PTSD nor chronic pain conditions. Digestive pain conditions were not associated with OUD. Comorbid PTSD/musculoskeletal pain conditions demonstrated an additive relationship on OUD compared to musculoskeletal pain conditions and PTSD alone., Conclusions: Results reveal that musculoskeletal pain and nerve pain conditions are associated with increased odds of OUD, but only musculoskeletal pain conditions display an additive relationship on OUD when combined with PTSD. These findings have implications for opioid management and screening among those with comorbid conditions., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This article reviews topical management strategies for degenerative osteoarthritis (OA) of the knee. A search of Pubmed, Embase and the Cochrane library using MeSH terms including "topical," "treatment," "knee" and "osteoarthritis" was carried out. Original research and review articles on the effectiveness and safety, recommendations from international published guidelines and acceptability studies of topical preparations were included. Current topical treatments included for the management of knee OA include topical nonsteroidal anti-inflammatory drugs, capsaicin, salicylates and physical treatments such as hot or cold therapy. Current treatment guidelines recommend topical nonsteroidal anti-inflammatory drugs as an alternative and even first-line therapy for OA management, especially among elderly patients. Guidelines on other topical treatments vary, from recommendations against their use, to in favor as alternative or simultaneous therapy, especially for patients with contraindications to other analgesics. Although often well-tolerated and preferred by many patients, clinical care still lags in the adoption of topical treatments. Aspects of efficacy, safety and patient quality of life data require further research., (Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Background: Chronic conditions are among the major causes of work disability (WD), which is associated with lower employment, less economic activity, and greater dependence on social programs, while limiting access to the benefits of employment participation., Objective/hypothesis: We estimated the overall prevalence of WD among working-age (18-64 years) U.S. adults and the most common causes of WD overall and by sex. Next, we estimated the prevalence and most common causes of WD among adults with 12 common chronic conditions by sex and age. We hypothesized that musculoskeletal conditions would be among the most common causes of WD overall and for individuals with other diagnosed chronic conditions., Methods: Data were obtained from years 2011, 2012, and 2013 of the National Health Interview Survey. WD was defined by a "yes" response to one or both of: "Does a physical, mental, or emotional problem NOW keep you from working at a job or business?" and "Are you limited in the kind OR amount of work you can do because of a physical, mental or emotional problem?", Results: Overall, 20.1 million adults (10.4% (95% CI = 10.1-10.8) of the working-age population) reported WD. The top three most commonly reported causes of WD were back/neck problems 30.3% (95% CI = 29.1-31.5), depression/anxiety/emotional problems 21.0% (19.9-22.0), and arthritis/rheumatism 18.6 (17.6-19.6). Musculoskeletal conditions were among the three most common causes of WD overall and by age- and sex-specific respondents across diagnosed chronic conditions., Conclusions: Quantifying the prevalence and causes of work disability by age and sex can help prioritize interventions., (Published by Elsevier Inc.)

Objectives: The inclusion of musculoskeletal conditions within multimorbidity research is inconsistent, and working-age populations are largely ignored. We aimed to: (1) estimate multimorbidity prevalence among working-age individuals with a range of musculoskeletal conditions; and (2) better understand the implications of decisions about the number and range of conditions constituting multimorbidity on the strength of associations between multimorbidity and burden (e.g., health status and health care utilization)., Study Design and Setting: Using data from the Australian National Health Survey 2007-08, the associations between burden measures and three ways of operationalizing multimorbidity (survey, policy, and research based) within the working-age (18-64 years) musculoskeletal population were estimated using multiple logistic regression (age and gender adjusted)., Results: Depending on definition, from 20.2% to 75.4% of working-age individuals with musculoskeletal conditions have multimorbidity. Irrespective of definition, multimorbidity was associated with increased likelihood of subjective health burden, pain or musculoskeletal medicines use, nonmusculoskeletal specialist and pharmacist (advice only) consultations, and reduced likelihood of not consulting health professionals. A group with intermediate health outcomes was considered multimorbid by some, but not all definitions. With the restrictive policy and research multimorbidity definitions, this intermediate group is included within the reference population (i.e., are considered nonmultimorbid). This worsens the reference group's apparent health status thereby leveling the comparative burden between those with and without multimorbidity. Consequently, dichotomous cut points lead to similar associations with burden measures despite the increasingly restrictive multimorbidity definitions used., Conclusions: All multimorbidity definitions were associated with burden among the working-age musculoskeletal population. However, dichotomous cut points obscure the gradient of increased burden associated with restrictive definitions., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: In randomized trials, the primary analysis should be consistent with the intention-to-treat (ITT) principle and should address missing data appropriately to draw valid inferences. This review focuses on current practices relating to the ITT principle and methods to handle missing data in the major musculoskeletal journals., Study Design and Setting: A systematic review of randomized trials published in 2010 and 2011 in five musculoskeletal journals was performed., Results: We reviewed 91 trials: 38% performed a full ITT analysis (analyzing outcome data for all randomized participants) and 31% performed a partial ITT analysis (excluding participants with no follow-up data). The overall median dropout was 12%; 60% of trials had more than 10% dropouts, and 32% of trials had more than 20% dropouts. Among those that performed an ITT analysis, the majority adopted a form of single imputation; last observation carried forward was the designated approach in most cases. Mixed models for repeated measures and/or multiple imputations were limited to eight trials., Conclusion: It appears that many trials reporting missing data are inappropriately analyzed and may therefore be prone to biased estimates and invalid inferences., (Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.)

Military service members comprise a young and physically active population who are at increased risk for musculoskeletal injuries and conditions related to sports and physical training. Even during times of war, musculoskeletal injuries and conditions related to sports and physical training, not associated with combat, are the leading cause of medical evacuation from theater. As a result, these injuries significantly compromise military readiness, and they can lead to an increased risk for reinjury and long-term disability among military service members. Regardless of the mechanism of injury, the large volume and types of musculoskeletal injuries and conditions that affect soldiers are similar to those that are commonly seen and treated in sports medicine clinics and practices. Recently, the US Marine Corps, Navy, and Army have recognized the value of the sports medicine model of care to improve the access, efficiency, and effectiveness of care for solders who experience musculoskeletal injuries related to sports and training. A highly skilled sports medicine team of providers and allied health care professionals (eg, athletic trainers, physical therapists), with expertise in the prevention, assessment, diagnosis, and management of musculoskeletal injuries and conditions, will continue to be an integral cog in the effective management of these types of injuries into the future, as the sports medicine model continues to expand across the military health system., (Published by Elsevier Inc.)

Objectives: To identify the content and reporting details of randomised controlled trials of yoga for musculoskeletal conditions through a systematic review of the literature., Design: Twenty electronic databases were searched to identify randomised controlled trials (RCTs) of yoga interventions for musculoskeletal conditions. Eligibility criteria were full-text, peer reviewed articles, of RCTs with yoga as a primary intervention, on a population aged 18 years and over, with a clinical diagnosis of a musculoskeletal condition. Data relating to study characteristics, yoga styles, yoga practices, home practice, and reporting were extracted and summarised., Results: Seventeen articles met inclusion criteria, representing five musculoskeletal conditions: low back pain, osteoarthritis, rheumatoid arthritis, kyphosis, and fibromyalgia. 15 studies were non-residential, and two were residential. Study duration ranged from 1 to 24 weeks; weekly dosage of yoga ranged from 1 to 56h. Five styles of posture-based Hatha yoga were specified. Intervention content included seven yoga practises: postures, breathing, relaxation, meditation, philosophy, chanting, and cleansing practises. Ten studies either encouraged or requested home practice. Reporting details included class plans, posture lists, and diagrams. Due to insufficient detail regarding delivery of the yoga intervention only eight of the 17 interventions were considered replicable as reported., Conclusions: Evaluation of study characteristics and yoga components indicated several areas of homogeneity across studies, suggesting an existing degree of standardisation. However, heterogeneity related to intervention content and reporting impeded determination of intervention content and delivery. Standardisation of content, nomenclature, and reporting details is recommended to enhance protocol transparency, replication, and comparison of intervention effectiveness., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions?, Design: Systematic review of randomised trials., Participants: People with musculoskeletal conditions., Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy., Outcome Measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery., Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality., Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436., (Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.)