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Magnetoencephalography (MEG) is a non-invasive functional imaging technique for pre-surgical mapping. However, movement-related MEG functional mapping of primary motor cortex (M1) has been challenging in presurgical patients with brain lesions and sensorimotor dysfunction due to the large numbers of trials needed to obtain adequate signal to noise. Moreover, it is not fully understood how effective the brain communication is with the muscles at frequencies above the movement frequency and its harmonics. We developed a novel Electromyography (EMG)-projected MEG source imaging technique for localizing early-stage (-100 to 0 ms) M1 activity during ~l min recordings of left and right self-paced finger movements (~1 Hz). High-resolution MEG source images were obtained by projecting M1 activity towards the skin EMG signal without trial averaging. We studied delta (1-4 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (15-30 Hz), gamma (30-90 Hz), and upper-gamma (60-90 Hz) bands in 13 healthy participants (26 datasets) and three presurgical patients with sensorimotor dysfunction. In healthy participants, EMG-projected MEG accurately localized M1 with high accuracy in delta (100.0%), theta (100.0%), and beta (76.9%) bands, but not alpha (34.6%) or gamma/upper-gamma (0.0%) bands. Except for delta, all other frequency bands were above the movement frequency and its harmonics. In three presurgical patients, M1 activity in the affected hemisphere was also accurately localized, despite highly irregular EMG movement patterns in one patient. Altogether, our EMG-projected MEG imaging approach is highly accurate and feasible for M1 mapping in presurgical patients. The results also provide insight into movement-related brain-muscle coupling above the movement frequency and its harmonics.

Background Clinical practice guidelines emphasize the importance of the prevention and treatment of non-specific back pain through exercise therapy and health education. However, it has not yet been confirmed that the combination of exercise plus education is more effective than usual medical care.Objective The aim of this study was to determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than usual medical care.Materials and methods A systematic search in PubMed, Scopus, Web of Science and Medline was conducted with the terms Back Pain, Neck Pain, Musculoskeletal Pain, Exercise, Exercise Therapy, Health Education, Cognitive Behavioral Therapy, Primary Prevention, Secondary Prevention and Clinical Trial. The inclusion criteria were: articles published from 2016 to 2021, the intervention included exercise and education, and the sample consisted of non-specific back pain patients.Results A total of 4 randomized controlled trials were selected (average PEDro score 6.5 points). The meta-analysis showed statistically significant differences in the pain intensity, standardized mean differences was found to be −0.75 (95% CI = −1.41 to −0.08; p = 0.03); and in disability, standardized mean differences was found to be −0.24 (95% CI = −0.38 to −0.1; p = 0.001).Conclusions Interventions combining exercise and education seem to have a greater preventive effect on non-specific back pain than usual medical care.Key messagesExercise therapy and health education combination prevent better non-specific back pain than usual care.Combining exercise with educational interventions has a higher improvement on disability and kinesophobia than usual care.

Background: Neck pain is a health problem worldwide. To prevent it, experts recommend exercise and education. Objective: To evaluate the effects of a Back School-based intervention for the prevention of nonspecific neck pain in a healthy adult population. Methods: A randomized controlled trial with 58 participants with no history of neck pain within the past six months. The experimental group performed an 8-week Back School-based program. The control group maintained their usual lifestyle. Primary outcomes, which include the number of episodes, days and intensity of neck pain, and the number of medical visits, were recorded in a 1-year follow-up diary and analyzed using the Mann-Whitney test. Secondary outcomes, such as neck flexor, neck extensor, and scapular muscles endurance, were analyzed using the ANOVA test. Results: In the analysis of the primary outcomes, no significant differences were found in the number of episodes (p = 0.068,d = −0.49), number of days (p = 0.059,d = −0.54), or the average intensity of neck pain (p = 0.061,d = −0.53). There were significant changes in the number of medical visits (p = 0.033,d = −0.57). Moving to secondary outcomes, significant interactions were observed in neck flexor (p = 0.045, ηp2 = 0.036) and neck extensor endurance (p = 0.049, ηp2 = 0.035), but not in scapular muscle endurance (p = 0.536, ηp2 = 0.003). Conclusions: The Back School-based program reduced the number of medical visits and increased the endurance of the cervical musculature. Trial registration in ClinicalTrials.gov: NCT05260645. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain syndrome is a condition with an increasing incidence in recent years, being known as the most common cause of knee pain in adults and adolescents. Undiagnosed and untreated, this condition can worsen over time. The aggravation leads to an increase in the intensity of the pain and the risk of injury, along with an increase in stress on the other joints of the lower limb. The objective of this study was to evaluate the contribution of shockwave therapy to a functional rehabilitation programme for patients with patellofemoral pain syndrome. Materials and Methods: The study was carried out on a group of 64 subjects (32 males and 32 females), aged between 20 and 39 years. The subjects were divided into two groups: 32 subjects who followed a program of functional rehabilitation based on low- and medium-frequency electrotherapy, ultrasound and laser therapy, along with a physical therapy program lasting approximately 3 weeks, and 32 subjects who followed a functional rehabilitation program based on shockwave therapy and specific physical therapy exercises lasting approximately 3 weeks. Results: Following the protocols applied to the two groups, the pain reported by the patients decreased, while the functional parameters of the knee improved, better results being obtained in the group that performed shock wave therapy together with specific physical therapy programs (Cohen Index 5916, p < 0.001). Conclusions: This study indicates that radial shockwave therapy combined with physiotherapy may provide additional benefits for patellofemoral syndrome, including greater pain reduction and improved joint mobility, compared to traditional treatments. However, further research is needed to confirm these findings and their broader clinical applicability. [ABSTRACT FROM AUTHOR]

Background/Objective: Short hamstring syndrome is common in the general population and can lead to impaired balance, function, and posture, and increased risk of injuries. Local treatments have obtained controversial results, so it is necessary to evaluate the effectiveness of other types of therapy such as osteopathic treatment. To evaluate the efficacy of osteopathic techniques in increasing the elasticity of the hamstring musculature in short hamstring syndrome. Methods: A systematic review of randomised controlled trials was conducted in PubMed, Medline, Cinhal, Scopus, WOS, SPORTDiscuss, and PEDro. The PEDro scale was used to evaluate the methodological quality and the RoB2 for the evaluation of biases. Results: A total of eight articles were selected. Most of the participants were assessed with the Active Knee Extension or Straight Leg Raise tests. The osteopathic techniques used were the muscle energy technique, suboccipital inhibition, and vertebral mobilisations. As for the control interventions, they mainly included passive stretching and placebo. Conclusions: The results suggest that osteopathic techniques are more effective than placebo or other interventions in increasing flexibility in adult patients with short hamstring syndrome. This effect can be explained by neurophysiological (Golgi apparatus, neuromuscular spindle activity, and Hoffmann reflex) and structural factors (dura mater, posture, and myofascial chains). Nevertheless, the evidence suggests that it would be beneficial to incorporate this type of treatment into flexibility improvement programmes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE: To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD: A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS: A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD = - 2.02 (95% CI = - 2.71 to - 1.33; p < 0.001), the disability variable with SMD = - 1.14 (95% CI = - 1.63 to - 0.65; p < 0.001), and the kinesiophobia variable with SMD = - 1.8 (95% CI = - 2.54 to - 1.05; p < 0.001). CONCLUSION: Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner. [ABSTRACT FROM AUTHOR]

Background: Lumbopelvic pain is considered the most frequent complication during pregnancy. Objective: To compare whether the combination of exercise with education is more effective for the treatment of low back and/or pelvic pain (PP) than each of these interventions separately in pregnant women. Search Strategy: A systematic review was performed in WOS, PEDro, PubMed, Cochrane, and ClinicalTrials.gov. The terms used were low back pain, PP, pregnancy, pregnant woman, exercise, exercise therapy, health education, and prenatal education. Selection Criteria: The PICO question was then chosen as follows: P—population: pregnant women with nonspecific low back pain or PP; I—intervention: exercise therapy plus health education; C—control: only exercise therapy or only health education; O—outcome: characteristics of pain, disability, and kinesophobia; S—study designs: randomized controlled trial. Data Collection and Analysis: Two reviewers independently screened articles for eligibility. The following inclusion criteria were applied for the selection of studies: (i) published in the past 10 years; (ii) exercise plus health education was administered compared with a group receiving either exercise or education alone; and (iii) the sample consisted of pregnant women with nonspecific low back pain or PP. This review excluded: (i) nonrandomized controlled trials; and (ii) articles whose full text was not available. The meta‐analysis was performed using the random‐effects model, due to the observed heterogeneity. Main Results: A total of 13 articles were selected. There is a significant decrease in pain in the combination of exercise and education compared with education alone (standardized mean difference, −0.29 [95% confidence interval, −0.47 to −0.11]). With respect to disability, there is a significant decrease in the exercise and education group compared with the group that only addressed education (standardized mean difference, −0.37 [95% CI, −0.60 to −0.14]). One article analyzed kinesophobia, reporting no significant changes. Conclusion: The combination of exercise and education seems to be more effective in reducing pain and disability in pregnant women with low back and/or PP than the use of education alone. In kinesophobia, the results found are not significant. Synopsis: The combination of exercise and education is more effective in reducing pain and disability in pregnant women with low back and/or pelvic pain than education alone. [ABSTRACT FROM AUTHOR]