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Objective: Micronutrient status, specifically vitamin D and iron, represent modifiable factors for optimizing military readiness. The primary purpose of this investigation was to determine associations between micronutrient deficiency (i.e., iron status and 25-hydroxy-vitamin D [25(OH)D]) and operationally relevant outcomes (i.e., skeletal health, musculoskeletal injury) at baseline and post-10 weeks of arduous military training. Methods: A total of 227 (177 men, 50 women) Marine Officer Candidates School (OCS) candidates who completed OCS training with complete data sets were included in this analysis. Vitamin D and iron status indicators were collected at two timepoints, pre (baseline) and post OCS. Musculoskeletal outcomes at the mid- and proximal tibial diaphysis were assessed via peripheral quantitative computed tomography. Results: Micronutrient status declined following OCS training in men and women and was associated with musculoskeletal outcomes including greater bone strength (strength strain index) at the mid-diaphysis site in those with optimal status (M = 38.26 mm3, SE = 15.59) versus those without (M = −8.03 mm3, SE = 17.27). In women (p =.037), endosteal circumference was greater in the deficient group (M = 53.26 mm, SE = 1.19) compared with the optimal group (M = 49.47 mm, SE = 1.31) at the proximal diaphysis. In men, greater baseline hepcidin concentrations were associated with an increased likelihood of suffering musculoskeletal injury during training. Conclusions: Vitamin D and iron status declined over the course of training, suggesting impaired micronutrient status. Differences in musculoskeletal outcomes by micronutrient group suggests optimal vitamin D and ferritin concentrations may exert beneficial effects on bone fatigability and fracture reduction during military training. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Hamstring extensibility plays a significant role in maintaining postural alignment essential for a functional musculoskeletal system. When hamstring extensibility is lacking, individuals are placed at a higher risk for developing various lumbar spine, pelvis, knee, and foot dysfunctions. Limited hamstring extensibility is common, occurring in as much as 40% of college students and 86% of the adult population. Therefore, it is essential to maintain hamstring extensibility, which can be aided by understanding intervention effectiveness for improving flexibility. Purpose: To critically appraise the literature on the effectiveness of Active Release Technique (ART) for the treatment of hamstring extensibility deficits. Clinical Question: What is the effect of ART in a healthy population with or without hamstring extensibility deficits? Summary of Key Findings: Three studies were included for critical appraisal. Two studies concluded a single treatment session of ART that individuals possessing limited straight leg raise range of motion experienced improved active knee extension, popliteal angle, and sit-and-reach test measures. In the third study, a single session of ART was effective at improving hamstring extensibility in males without hamstring extensibility dysfunction. Clinical Bottom Line: Based on the current level 1 and level 3 evidence, ART may be an effective treatment to produce acute increases in hamstring extensibility. Future research is still needed. Strength of Recommendation: Level B evidence exists to support the use of ART to improve hamstring extensibility in the healthy population. [ABSTRACT FROM AUTHOR]

There is a powerful global trend toward deeper integration of digital twins into modern life driven by Industry 4.0 and 5.0. Defense, agriculture, engineering, manufacturing, and urban planning sectors have thoroughly incorporated digital twins to great benefit across their respective product lifecycles. Despite clear benefits, a digital twin framework for health and medical sectors is yet to emerge. This paper proposes a digital twin framework for precision neuromusculoskeletal health care. We build upon the International Standards Organization framework for digital twins for manufacturing by presenting best available computational models within a digital twin framework for clinical application. We map a use case for modeling Achilles tendon mechanobiology, highlighting how current modeling practices align with our proposed digital twin framework. Similarly, we map a use case for advanced neurorehabilitation technology, highlighting the role of a digital twin in control of systems where human and machine are interfaced. Future work must now focus on creating an informatic representation to govern how digital data are passed to, from, and within the digital twin, as well as specific standards to declare which measurement systems and modeling methods are acceptable to move toward widespread use of the digital twin framework for precision neuromusculoskeletal health care. [ABSTRACT FROM AUTHOR]

In this review, we elaborate on how musculoskeletal (MSK) modeling combined with dynamic movement simulation is gradually evolving from a research tool to a promising in silico tool to assist medical doctors and physical therapists in decision making by providing parameters relating to dynamic MSK function and loading. This review primarily focuses on our own and related work to illustrate the framework and the interpretation of MSK model-based parameters in patients with 3 different conditions, that is, degenerative joint disease, cerebral palsy, and adult spinal deformities. By selecting these 3 clinical applications, we also aim to demonstrate the differing levels of clinical readiness of the different simulation frameworks introducing in silico model-based biomarkers of motor function to inform MSK rehabilitation and treatment, with the application for adult spinal deformities being the most recent of the 3. Based on these applications, barriers to clinical integration and positioning of these in silico technologies within standard clinical practice are discussed in the light of specific challenges related to model assumptions, required level of complexity and personalization, and clinical implementation. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders (MSDs) are common among nursing professionals and require effective management strategies. Implementing targeted training programs for nurses is a vital approach to reduce these problems. Aim: This study aimed to evaluate problem‐based learning (PBL) effectiveness in reducing work‐related musculoskeletal symptoms (WMSs) among nurses. Methods: Fifty Iranian nurses participated in this interventional study. Some data were collected by a demographic/occupational questionnaire and a Persian version of the Nordic Musculoskeletal Questionnaire (P‐NMQ). Some other was gathered by Rapid Entire Body Assessment (REBA) and PBL method. Results: The prevalence of WMSs during the last 12 months in the subjects was related to the lower back (76%), wrists/hands (70%), neck (64%), and knee (64%), respectively. The results showed that the prevalence of WMSs decreased significantly only in the subjects' elbow region in the postintervention (p = 0.031). Although the prevalence decreased in the postintervention stage in other regions, this decrease was not statistically significant (p > 0.05). Conclusions: This study showed that the implementation of PBL could reduce the WMSs prevalence and the level of nurses' exposure to risk factors for MSDs. [ABSTRACT FROM AUTHOR]

Purpose: To explore what patients with rheumatic and musculoskeletal diseases (RMDs) need and receive of follow-up care after specialized rehabilitation, and whether received follow-up is associated with health outcomes after 1 year. Further, to compare these findings with patients' experiences to improve the understanding of how follow-up takes place. Methods: In a mixed methods study, patients received a rehabilitation programme designed to improve the continuity in rehabilitation across care levels. A total of 168 patients completed questionnaires, of which 21 were also interviewed. Results: At discharge, most patients reported needs for follow-up. These needs were largely met within 1 year, mainly resulting from patients' initiatives to re-connect with previous contacts. The degree of received follow-up was not associated with goal attainment, quality of life, or physical function. Factors related to providers (competence, communication skills), context (delays, limited access to care), and patients (motivation, life situation, preferences) seemed to be decisive for the progress of the rehabilitation process over time. Conclusions: The results provide evidence that access to follow-up care is crucial to patients with RMDs. However, it also highlights several factors that may influence its impact. These results can be used to optimise design and implementation of future follow-up interventions. IMPLICATIONS FOR REHABILITATION: Healthcare providers should take greater responsibility for creating continuity in rehabilitation across levels of care. Follow-up care should be adapted to patients' needs, goals, and preferences as regards content, timing, and mode of delivery. Follow-up should be linked to a rehabilitation plan for each patient to ensure continuity of care. More effective communication systems across service levels should be established. [ABSTRACT FROM AUTHOR]

Background: Preoperative adjacent disc height (DH) was found as an independent risk factor for adjacent segment degeneration (ASD) after percutaneous kyphoplasty (PKP), indicating the preoperative status of the adjacent intervertebral discs may be closely related to adjacent segment complications. To establish the reference intervals (RIs) for adjacent DH of fresh osteoporotic vertebral compression fracture (OVCF) in Chinese postmenopausal women, and investigate the association with adjacent segment complications after PKP. Methods: Consecutive inpatients diagnosed with fresh OVCF between November 2015 and August 2023 were reviewed. The enrolled patients were divided into subgroups based on injured vertebral level; then, the cranial and caudal DH were measured. The characteristics of DH among subgroups were identified, and specific RIs were established using the indirect Hoffmann method. The associations between DH and adjacent segment complications were assessed using multivariate analysis. Results: The DH of the cranial disc was significantly lower than the corresponding caudal disc in all vertebral levels, which showed an increasing trend from T11 to L4. The RIs of DH were as follows: T11 (cranial), 2.14–5.14 mm; T11 (caudal), 2.64–5.89 mm; T12 (cranial), 2.69–5.77 mm; T12 (caudal), 3.18–6.57 mm; L1 (cranial), 3.05–6.59 mm; L1 (caudal), 3.40–8.29 mm; L2 (cranial), 3.68–8.36 mm; L2 (caudal), 4.57–9.78 mm; L3 (cranial), 4.53–8.92 mm; L3 (caudal), 5.26–10.07 mm; L4 (cranial), 4.70–11.42 mm; and L4 (caudal), 5.52–12.12 mm. Increased risks of adjacent segment complications after PKP were observed in patients with decreased adjacent DH. Conclusion: The estimated vertebral level and disc level-specific RIs for adjacent DH of fresh OVCF were established in the Chinese postmenopausal women population. A decrease in adjacent DH posed high risks of adjacent segment complications after PKP for treating OVCF. [ABSTRACT FROM AUTHOR]

The rotator cuff, comprising the subscapularis, supraspina-tus, infraspinatus, and teres minor muscles, plays a crucial role in stabilizing the glenohumeral joint by securing the head of the humerus within the glenoid cavity of the scapula. The tendinous insertions of these muscles generate tension within the capsule, enhancing joint stability during muscular activity. The rotator cuff is susceptible to damage from disease, injury, or trauma, which can result in tears or ruptures of one or more tendons. The evaluation of the infraspinatus muscle and tendon is vital for diagnosing and managing various shoulder pathologies. Accurate imaging to determine the specific muscle involvement and injury severity significantly impacts treatment decisions. Diagnostic musculoskeletal ultrasound (MSK-US) has emerged as a valuable tool for assessing the infraspinatus muscle and tendon, offering real-time, dynamic assessment capabilities essential for precise diagnosis and effective rehabilitation planning. This article reviews the utility and advantages of MSK-US in evaluating the infraspinatus muscle and tendon, emphasizing technique specifics, diagnostic accuracy, and comparative efficacy against other imaging modalities. It details a systematic approach to the ultrasound examination technique for the infraspinatus, including patient positioning and identification of common pathologies such as tears, tendinopathy, and calcifications. With recent advancements in transducer strength, image resolution, and operator training, ultrasound serves as an excellent alternative imaging modality for diagnosing rotator cuff tears. This article aims to equip rehabilitation professionals with a comprehensive understanding of MSK-US as a diagnostic tool for the infraspinatus, promoting more precise diagnosis, treatment planning and improved patient outcomes. [ABSTRACT FROM AUTHOR]

AbstractWork-related musculoskeletal disorders are a common cause of absentism and work disability. As work-related musculoskeletal disorders represent an increasingly important issue for occupational therapists, this study determined musculoskeletal disorders among occupational therapists in Turkey. A total of 238 occupational therapists participated and completed the Nordic Musculoskeletal Questionnaire. As a result, 73.1% of participants reported experiencing neck pain and 72.3% reported experiencing low back pain at 12 months. Statistically significant differences were found between participants with and without work-related musculoskeletal disorders regarding gender, experience, workplace type, treatment, and daily working hours (p < 0.05). Occupational therapists may experience work-related musculoskeletal disorders due to not practicing proper body mechanics or non-provision of transferring equipment. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of low back pain among nurses is notably high, which negatively affects their job performance and overall work quality. Aim of study: This research aimed to evaluate the prevalence of low back pain among nurses in Nablus city and investigate how personal and work-related factor and the occurrence of low back pain in this population. Method: Employing a cross-sectional study design, we employed validated instruments, including the Nordic Musculoskeletal Disorder Questionnaire. The study encompassed 258 nursing employees from both the largest and smallest Ministry of Health (MOH) and private sector hospitals in Nablus city, West Bank, Palestine. Data were collected through a self-administered questionnaire. Result: A total of 258 nurses participated in the study, yielding a response rate of 98%. The lifetime prevalence of Low Back Pain (LBP) was 82% (n = 212) throughout their life. Additionally, the prevalence of LBP in the 12 months preceding data collection was 78% (N = 201), 71% (N = 182) in the month leading up to the study, and 61% (N = 156) on the day of data collection. Conclusion: The study disclosed a high prevalence of low back pain among nurses, underscoring the urgency for effective solutions. These findings highlight the need for more comprehensive research to better understand and address this issue. [ABSTRACT FROM AUTHOR]

The article discusses a rare condition called Infantile Fibromatosis Colli, also known as sternocleidomastoid (SCM) tumor, affecting newborns. The condition is benign, self-limiting, and primarily affects males. The article highlights the role of fine-needle aspiration cytology (FNAC) in diagnosing this condition and emphasizes the importance of clinical and cytological evaluation for accurate diagnosis. The study presents a case of fibromatosis colli in an infant, detailing the clinical, radiological, and cytological features necessary for diagnosis and management. The article concludes that FNAC is a quick and precise method for diagnosing this rare condition, which typically requires conservative management. [Extracted from the article]

Osteoarthritis is one of the most common musculoskeletal diseases and increases the risk of severe cardiovascular disease, like heart attack and stroke. In some individuals, osteoarthritis and cardiovascular disease will co-occur. This co-occurrence might be due to shared risk factors, for example high age, lifestyle factors and/or a shared genetic liability for the two diseases. Here, we show that the correlation between osteoarthritis and cardiovascular disease can be explained by shared genetic factors, independent of high age and body weight, and also likely independent of lifestyle factors, like smoking and physical activity level. Findings suggest that genetic factors that are shared for osteoarthritis and cardiovascular disease may contribute to both diseases. Thus, the prevailing idea that osteoarthritis is predominantly a risk factor for cardiovascular disease is challenged. Our findings imply that the current diagnostic boundaries between these diseases may need to be re-evaluated. Osteoarthritis is considered a risk factor for severe cardiovascular disease like ischemic heart disease and myocardial infarction. Studying ~60 000 twins over a 20-year period and applying bivariate classical twin models, this manuscript suggests that shared genetic factors for osteoarthritis and cardiovascular disease may contribute to both diseases. [ABSTRACT FROM AUTHOR]

Depression is a common psychological complication in osteoarthritis (OA) patients, and its incidence gets more and more attention year by year worldwide. This study investigates the association between OA and depression through a bibliometric analysis of published studies. It aims to identify leading authors, institutions, and countries to highlight research hotspots and suggest potential future directions. We collected publications on OA and depression from 1994 to 2024 using the Web of Science Core Collection (WOSCC) database. Bibliographic information, including authorship, country of origin, citation frequency, and visualizations, was generated using VOSviewer, R software, and CiteSpace. A total of 2,342 articles were identified. The United States led in publications with 906 articles, Boston University was the most prolific institution with 56 publications, BMC Musculoskeletal Disorders was the top journal with 71 publications, and Stefania Maggi was the most productive author with 19 publications. The primary research hotspots identified were: "The relationship between depression and OA," "Disability and prevalence," and "Characteristics of older people suffering depression after OA." Predicted future research frontiers include: "Treating depression in OA patients with multimorbidity," "Psychometric properties of instruments for assessing depression and anxiety in OA patients," "Depression or anxiety in patients with surgical intervention," and "Other mental diseases in OA patients." This bibliometric analysis underscores the importance of understanding the link between OA and depressive disorders, potentially guiding new research directions. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo evaluate the measurement properties of the Arabic Patient-Specific Functional Scale (PSFS) in individuals with upper extremity musculoskeletal disorders.Participants with upper extremity musculoskeletal disorders (N = 139) completed the PSFS, Upper Extremity Functional Index (UEFI), the Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS) and the Global Assessment of Function scale (GAF). The same outcome measures were completed again with one week in addition to the Global Rating of Change Scale. The test-retest reliability, measurement error, floor and ceiling effects, and construct validity of the PSFS were examined.The PSFS demonstrated very good test-retest reliability (ICC2,1 = 0.82; 95% CI: 0.71–0.88), with no evidence of floor or ceiling effects. The standard error of measurement was determined to be 0.74 while the minimal detectable change was 1.73 points. The PSFS demonstrated significant negative correlation with DASH, NPRS (−0.58, −0.35), and significant positive correlation with the UEFI and GAF (0.56, 0.50). The PSFS demonstrated statistically higher correlation with the DASH and UEFI compared with the NPRS (p < 0.004) supporting our predefined construct validity hypotheses.The Arabic PSFS is an applicable, reliable, and valid outcome measure of upper-extremity activity limitations for patients with upper extremity musculoskeletal disorders.Patients who exhibit no changes in their clinical condition will consistently exhibit similar scores in the Arabic Patient-Specific Functional Scale (PSFS) when the scale is administered multiple times over a period of time.A patient’s score in the Arabic PSFS can be accurately interpreted by rehabilitation professionals to reflect the degree of activity limitation with confidence.The Arabic PSFS can be effectively utilized in both daily clinical practice and research studies to accurately measure the extent of activity limitation experienced by Arabic-speaking individuals with upper extremity musculoskeletal disorders.The Arabic PSFS allows rehabilitation professionals to quantitatively assess activity limitation in a manner that is culturally and lifestyle-appropriate for Arabic-speaking individuals with upper extremity musculoskeletal disorders.Patients who exhibit no changes in their clinical condition will consistently exhibit similar scores in the Arabic Patient-Specific Functional Scale (PSFS) when the scale is administered multiple times over a period of time.A patient’s score in the Arabic PSFS can be accurately interpreted by rehabilitation professionals to reflect the degree of activity limitation with confidence.The Arabic PSFS can be effectively utilized in both daily clinical practice and research studies to accurately measure the extent of activity limitation experienced by Arabic-speaking individuals with upper extremity musculoskeletal disorders.The Arabic PSFS allows rehabilitation professionals to quantitatively assess activity limitation in a manner that is culturally and lifestyle-appropriate for Arabic-speaking individuals with upper extremity musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions Understanding the patterns and implications of coexisting musculoskeletal conditions is crucial for developing effective management strategies and improving care for older adults. This study aimed to examine the associations between musculoskeletal multimorbidity burden and trajectory and holistic well‐being among middle‐aged and older adults.This prospective study employed data from nine consecutive waves of the English Longitudinal Study of Aging (ELSA), spanning 2002–2018. We used latent class trajectory models (LCTM) to identify groups based on changes in musculoskeletal multimorbidity status. Subsequently, we employed linear mixed models to investigate the associations between musculoskeletal disease burden, trajectory groups, and seven dimensions of holistic well‐being: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), depression, memory, loneliness, social interactions, and life satisfaction.In total, 5272 participants (mean age: 71.9 years; SD: 8.9) were included in the final analysis. Four distinct trajectories were identified: a low‐burden group (48.37%), an emerging group (14.76%), a moderate‐burden group (26.00%), and a persistent burden group (10.87%). After adjustment, the findings demonstrate that the musculoskeletal disorder burden significantly impacts ADLs, depression, memory, social interactions, and life satisfaction in middle‐aged and older adults, with minor effects on IADLs and loneliness. Moreover, with the escalation of the burden, its impact significantly intensifies (p for trend is < 0.001). Compared with the low‐burden group, participants in both the moderate and persistent burden groups exhibited significantly lower capabilities in ADLs, poorer memory, increased social interactions, and lower life satisfaction. The emerging group displayed a similar trend, though without statistically significant results.Our study suggests that the extent and persistence of musculoskeletal disease burden can significantly affect holistic well‐being among middle‐aged and older individuals. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose Methods Results Conclusion Level of Evidence Recurrent shoulder instability, a common musculoskeletal disorder, often involves glenoid bone loss and Hill–Sachs lesions. However, the optimal imaging modality for accurately and reliably quantifying bipolar bone loss remains uncertain. This systematic review aims to evaluate the accuracy and reliability of various imaging modalities in assessing bipolar bone loss in anterior shoulder instability.Major electronic databases were searched for English‐language studies reporting the measurement of glenoid track width and/or determination of on/off track HSL through imaging. Studies reporting statistical measures such as area under the curve, sensitivity, specificity, positive predictive value, NPV, intraobserver reliability and interobserver reliability were included. Data extraction and risk of bias assessment were performed independently by two reviewers.The systematic review included 19 studies comprising 1567 shoulders. Overall, studies could be divided into those looking at the accuracy or reliability of determining glenoid track width, on‐ or off‐track Hill–Sachs lesions and near‐track lesions. Three‐dimensional images of computed tomography (3D‐CT) was the most reliable and accurate imaging modality to measure the glenoid track width. On the opposite, two‐dimensional magnetic resonance imaging (2D‐MRI) did not provide enough evidence of accuracy and reliability in the determination of On/Off track lesions and near‐track lesions.3D‐CT demonstrated excellent reliability for measuring glenoid track width. However, the reliability of 2D‐MRI for determining on/off track Hill–Sachs lesions is still controversial.Level III. [ABSTRACT FROM AUTHOR]

Introduction: Surface electromyography (sEMG) is a non-invasive technique that records muscle electrical activity using skin-surface electrodes, aiding physiotherapists in assessing and treating muscular and neuromuscular conditions. Despite its potential, sEMG remains underutilized in Italy. This study aims to evaluate Italian physiotherapists' knowledge and use of sEMG, specifically among those who completed the Master's Degree in Rehabilitation of Musculoskeletal and Rheumatological Disorders at the University of Genoa. Methods: This cross-sectional study, approved by the University of Genoa's Ethical Committee, utilized an anonymous web survey to gather data from physiotherapy students in the master's program. The survey, developed based on the International Handbook of Survey Methodology, consisted of 12 questions covering demographics, previous sEMG experience, the importance of sEMG in practice and research, and educational satisfaction. Data collection spanned from January to May 2024, with a response rate of 72.7% (93 participants). Descriptive analysis was used to summarize the data. Results: The average age of respondents was 26.5 years, with 55.9% being male. Only 3.2% reported using sEMG in their practice. While 46.2% considered sEMG moderately important for practice, 40.9% deemed it extremely important for research. Most participants felt their undergraduate education inadequately prepared them for using sEMG, with 81.7% rating their preparation as insufficient. Although the master's program improved sEMG knowledge, 66.7% indicated no significant proficiency gain. Conclusion: Italian physiotherapists view sEMG mainly as a research tool rather than a clinical one. The findings highlight the need for curriculum reforms to enhance both theoretical and practical sEMG education. Simplifying and standardizing sEMG protocols and integrating sEMG training into physiotherapy curricula are essential steps to better prepare clinicians for its clinical application. [ABSTRACT FROM AUTHOR]

Objective Individuals positive for anti-cyclic-peptide-antibodies (anti-CCP) and musculoskeletal complaints (MSK-C) are at risk for developing rheumatoid arthritis (RA). In this study we aimed to investigate factors involved in arthritis progression. Methods Anti-CCP2-positive individuals with MSK-C referred to a rheumatologist were recruited. Individuals lacked arthritis at clinical and ultrasound examination and were followed for ≥3 years or until clinical arthritis diagnosis. Blood samples from inclusion were analysed for nine ACPA reactivities (citrullinated α-1-enolase, fibrinogen, filaggrin, histone, vimentin and tenascin peptides); 92 inflammation-associated proteins; and HLA-shared epitope alleles. Cox regression was applied to the data to identify independent predictors in a model. Results Two hundred and sixty-seven individuals were included with median follow-up of 49 months (interquartile range [IQR]: 22–60); 101 (38%) developed arthritis after a median of 14 months (IQR: 6–27). The analysis identified that presence of at least one ACPA reactivity (hazard ratio [HR] 8.0; 95% CI: 2.9, 22), ultrasound-detected tenosynovitis (HR 3.4; 95% CI: 2.0, 6.0), IL-6 levels (HR 1.5; 95% CI: 1.2, 1.8) and IL-15 receptor α (IL-15Rα) levels (HR 0.6; 95% CI: 0.4, 0.9) are significant independent predictors for arthritis progression in a prediction model (Harrell's C 0.76 [ s. e. 0.02], AUC 0.82 [95% CI: 0.76, 0.89], cross-validated AUC 0.70 [95% CI: 0.56, 0.85]). Conclusion We propose a high RA risk phase characterized by presence of ACPA reactivity, tenosynovitis, IL-6 and IL-15Rα and suggest that these factors need to be further investigated for their biological effects and clinical values, to identify individuals at particular low risk and high risk for arthritis progression. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate the muscle thickness and walking test in people with hemophilia A and their correlation to joint health and functional impairments. Design: This is a cross-sectional study. Results: Twenty-nine severe/moderate people with hemophilia Awere enrolled. Muscle thickness of quadriceps and medial gastrocnemius was measured using ultrasound. Joint health and functional capacity were assessed using Hemophilia Joint Health Score, Hemophilia Early Arthropathy Detection with Ultrasound, 6-Minute Walking test, Hemophilia Quality of Life Questionnaire for Adults, and Hemophilia Activities List. Quadriceps muscle thickness significantly correlated with Hemophilia Joint Health Score knee, Hemophilia Early Arthropathy Detection with Ultrasound knee, and Hemophilia Activities List. Calf muscle thickness significantly correlated with the Hemophilia Joint Health Score ankle. After adjusted age and body mass index, calf muscle thickness was inversely associated with the Hemophilia Joint Health Score ankle. Six-Minute Walking test was found to significantly correlate with Hemophilia Joint Health Score total, Hemophilia Early Arthropathy Detection with Ultrasound total, Hemophilia Quality of Life Questionnaire for Adults, and Hemophilia Activities List. Conclusions: Muscle thickness and the distance of 6-Minute Walking Test were linked to assessment of joint health, quality of life, and activity participation in people with hemophilia A. Ultrasound measurement of muscle thickness and walking test seem to be useful tools for the assessment of joint health and functional status in people with hemophilia A. [ABSTRACT FROM AUTHOR]

Chronic musculoskeletal pain and sleep problems/disorders exhibit a recognized bidirectional relationship; yet, systematic investigations of this claim, particularly in a prospective context, are lacking. This systematic review with meta-analysis aimed to synthesize the literature on the prospective associations between sleep problems/disorders and chronic musculoskeletal pain. A comprehensive search across 6 databases identified prospective longitudinal cohort studies in adults examining the relationship between sleep problems/disorders and chronic musculoskeletal pain. Random-effects meta-analyses, using the Hartung–Knapp adjustment for 95% confidence intervals (CIs), were conducted, and all results were presented as odds ratios (ORs). Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Including 16 articles from 11 study populations (116,746 participants), meta-analyses indicated that sleep problems at baseline may heighten the risk of chronic musculoskeletal pain in both short term (OR 1.64, 95% CI 1.01-2.65) and long term (OR 1.39, 95% CI 1.21-1.59). The evidence for different sleep problem categories was very uncertain. Chronic musculoskeletal pain at baseline may increase the risk of short-term sleep problems (OR 1.56, 95% CI 1.02-2.38), but long-term evidence was very uncertain. The impact of only local or only widespread pain on short-term sleep problems was very uncertain, whereas widespread pain may elevate the risk of longterm sleep problems (OR 2.0, 95% CI 1.81-2.21). In conclusion, this systematic review with meta-analysis suggests that sleep problems are associated with an increased risk of chronic musculoskeletal pain, but the bidirectional nature of this relationship requires further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal disorders (MSDs) often arise and develop during dentistry studies. The most affected regions are related to the spine. Possible associations between spinal curve parameters and MSDs have not yet been investigated amongst dentistry students. This longitudinal observational study aimed to determine whether spinal curve changes during dentistry studies, analyse the relationship between objective findings and subjectively declared MSDs and compare spinal curve parameters with those published in the literature. Materials and Methods: Seventy‐three dentistry students answered a questionnaire on MSDs, and were examined using the Spinal Mouse® device at the beginning, in the middle, and at the end of their 5‐year study. Results: The spinal curve exhibited a gender diversity in the lumbar lordosis angle, sacrum inclination, and thoracolumbar ratio. From the first to fifth study year, we observed an increase in the range of motions in the sagittal and frontal planes, an increase in the maximal extent of right lateral inclination, and a decrease in maximal left lateral inclination. Whole‐spine backward inclination increased only in women, and forward sacral inclination decreased. No statistically significant relationships were found between the objective findings and subjectively declared MSDs. Conclusions: The spinal curve shape differed between men and women and changed during dentistry studies. No objective markers or predictors of MSDs were found amongst the dentistry students. These findings can serve as a benchmark for further studies on the association between MSDs and objective findings. [ABSTRACT FROM AUTHOR]

Objective. This study aims to assess the effectiveness of lumbar segmental stabilization exercise (LSSE) in managing spondylolysis and spondylolisthesis. Summary of Background Data. Spondylolysis and spondylolisthesis are spinal disorders associated with lumbar segmental instability. LSSE has shown positive effects in treating these conditions; however, systematic reviews and meta-analyses are lacking. Materials and Methods. A systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines, including studies from the inception of the databases used up to January 2024, was conducted. Disability improvement and pain intensity change were the primary and secondary outcomes, respectively, standardized using Hedges g. Eligible articles underwent independent scrutiny by two authors, who also performed data extraction and quality assessment. Data pooling was accomplished using a random-effects model. Results. In total, five randomized controlled trials comprising 198 participants were included, revealing a trend effect toward disability improvement in the LSSE group (Hedges g =-0.598, 95% CI: -1.211 to 0.016, P=0.056, I2=75.447%). When the LSSE was administered as a single treatment, disability improvement became significant (Hedge g= -1.325, 95% CI: -2.598 to -0.053, P=0.041, I2= 80.020%). No significant effect of LSSE on pain reduction was observed (Hedges g =-0.496, 95% CI: -1.082 to 0.090, P=0.097, I2=73.935%). Conclusions. In summary, our meta-analysis suggests that LSSE can potentially improve disability, especially when used as a single treatment. LSSE appears more beneficial in reducing disability than alleviating pain. Future research on different patient groups is needed to understand comprehensively LSSE's effects on other musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of concurrent physical and cognitive demands as well as age on indicators of muscle fatigue at the wrist. Background: There are few studies examining risk indicators for musculoskeletal disorders associated with work-related physical and cognitive demands that often occur simultaneously in the workplace. Methods: Twenty-four gender-balanced older and 24 gender-balanced younger (mean age 60 and 23 years) participants performed four 30 min dual tasks. Tasks differed by the muscular load level during force tracking: 5% and 10% of maximum voluntary contraction force (MVC) and concurrent cognitive demands on the working memory: easy and difficult. Muscle fatigue was assessed by MVC decline and changes in surface electromyography (increased root mean square: RMS, decreased median frequency: MF) at the extensor digitorum (ED) and extensor carpi ulnaris (EU). Results: A decline in MVC was found in all participants when tracking was performed at 10% MVC (mean ± SD: 137.9 ± 49.2 – 123.0 ± 45.3 N). Irrespective of age, muscular, or cognitive load, RMS increased (ED 12.3 ± 6.5 – 14.1 ± 7.0% MVE, EU 15.4 ± 7.6 – 16.9 ± 8.6% MVE) and MF decreased (ED 85.4 ± 13.6 – 83.2 ± 12.8 Hz, EU 107.2 ± 17.1 – 104.3 ± 16.7 Hz) in both muscles. However, changes in MF of EU tended to be more pronounced in the older group at higher cognitive and lower muscular load, without reaching statistical significance. Conclusion: Maximum voluntary contraction indicated no interaction between muscle fatigue, cognitive load, or age. However, the tendencies toward altered muscle activity due to an increase in cognitive load and older age suggest muscular adaptations while maintaining tracking performance during the onset of fatigue signs in the sEMG signal. Application: If the tendencies in muscle activity are confirmed by further studies, ergonomic assessments in industrial workplaces should consider cognitive load and age when describing the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

In today's dynamic world of information overload and conflict situations of different nature, the emotional stress state is increasingly growing and encompassing all social groups. In the European Union, work stress is the second most common health problem after diseases of the musculoskeletal system and its prevention is one of the priorities of the EU Member States. By definition, stress is a physiological and psychological process by which an individual reacts to events or situations that place increased demands and pressure on him or her. Occupational stress arises in the interactions of people and their occupations. For more than thirty years it has been the subject of attention of scientists, researchers, organizations, and the general public. Burnout syndrome is the end result of a prolonged process of exhaustion in which motivated and committed individuals lose desire and energy in meeting their work goals. The phenomenon of 'professional burnout' does not occur suddenly, but is a cumulative process [ABSTRACT FROM AUTHOR]

Extensive researches have been conducted on transfer learning based fault diagnosis. However, negative information transfer may arise due to significant differences in the subdomain distribution across multiple source domains (MSDs). Most existing methods focus solely on the impact of subdomains from a single source domain (SSD) on the target domain (TD). Therefore, this paper proposed a novel multi-stage alignment multi-source subdomain adaptation (MAMSA) method. The global feature extractor is designed to extract domain-invariant features. Three domain-specific feature extractors capture high-level fault features from different domains with a customized adaptation strategy, which combines adversarial learning and distribution alignment based on multiple pseudo-label-guided local maximum mean discrepancy (MP-LMMD) to learn subdomain-invariant features. MP-LMMD utilizes pseudo-labels generated from all classifiers in the TD to guide the alignment of subdomains, suppressing negative transfer from the source domains (SDs). The experimental results indicate that the MAMSA method has excellent capabilities to suppress negative transfer, and the diagnostic performance can be greatly promoted with MAMSA under cross-working conditions. • A novel multi-stage alignment multi-source subdomain adaptation (MAMSA) method is proposed. • A two-stage feature extractor based on specially designed attention mechanism is proposed. • A multiple pseudo-label-guided local maximum mean discrepancy metric is proposed. • The proposed method can suppress the negative transfer and achieve good diagnostic results. [ABSTRACT FROM AUTHOR]

Osteoarthritis, osteoporosis, and sarcopenia are prevalent musculoskeletal disorders that significantly impact the aging population's health and quality of life. Osteoarthritis, characterized by joint inflammation, leads to pain, stiffness, and reduced mobility. Osteoporosis, a condition marked by bone density loss, increases fracture susceptibility, especially in postmenopausal women and older adults. Sarcopenia, the age-related loss of muscle mass and function, contributes to frailty and an increased risk of falls. Combined, osteoarthritis, osteoporosis and sarcopenia constitute "Musculoskeletal Failure." These 3 conditions share common risk factors like aging, genetics, and hormonal changes, as well as unhealthy lifestyle behaviors resulting in systemic chronic inflammation. Healthy lifestyle behaviors, including regular physical activity and a nutritious diet across the lifespan play a crucial role in the prevention and management of musculoskeletal failure. Awareness of the relationship between lifestyle behaviors, systemic chronic inflammation and the development and progression of these 3 common conditions is a key step in prevention, early detection and are essential for addressing the complex interplay of these musculoskeletal disorders. As the global population ages, understanding and effectively preventing and managing osteoarthritis, osteoporosis, and sarcopenia become paramount for promoting healthy aging and mitigating the societal and economic burden associated with these conditions. [ABSTRACT FROM AUTHOR]

Background: The efficiency and productivity of dentists are affected due to musculoskeletal disorders. Efforts should be made to monitor and reduce these disorders so that proper relation is maintained between body and work. Aims and Objectives: This research evaluates and compares the level of creatine kinase (CK) in operators working in ergonomically correct posture and incorrect posture using a newly developed digitalized alarm sensor attached to a dental operating stool. Materials and Methods: A digitalized alarming sensor was attached to half of the operating stools. Blood samples of the operators were checked for CK levels before working on patients and within 13–24 h after the operators have completed their work on patients. Results: The P value was found to be highly significant in operators without digitalized alarming sensors within 13–24 h after completing their work on patients. There was no significant difference in CK levels before patient interaction between the two groups; the presence of the alarm device had a notable impact on CK levels within 13–24 h after work. Conclusion: The group without the alarm device displayed significantly higher CK levels during this postwork timeframe, suggesting a potential association between the absence of the alarm device and increased CK levels among dental professionals. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dockworkers are exposed to physical overloads that can contribute to the development of musculoskeletal disorders, leading to functional disability and absenteeism. OBJECTIVE: to map, critically appraise, and synthesize the available evidence on the prevalence of musculoskeletal diseases associated with port occupational activities. METHODS: A comprehensive search was conducted in structured and unstructured databases in August 2023, with no date or language restriction, to identify observational studies evaluating the prevalence of musculoskeletal disorders in dockworkers' occupational activity. The risk of bias was assessed using validated tools based on the included study designs. Data from studies were pooled in meta-analyses. The certainty of the evidence was assessed using the GRADE approach. RESULTS: We identified 12 analytical cross-sectional studies involving 7821 participants in ports of five countries. Most studies (75%) had a moderate methodological quality according to the Joanna Briggs Institute tool. Considering the overall worker categories and any musculoskeletal disorders, the meta-analysis showed a prevalence of 58% (95% Confidence Interval [95% CI] 37% to 78%), with degenerative spinal diseases 42% (95% CI –0.6% to 91%) and low back pain 36% (95% CI 21% to 50%) being the most prevalent conditions. Symptoms were predominantly in foremen and stevedores. The certainty of the evidence was very low. CONCLUSIONS: Musculoskeletal disorders seem prevalent among dockworkers, mainly degenerative spinal diseases and low back pain. Studies with greater methodological consistency are still needed to validate these hypotheses and assist in decision-making for implementing preventive and informational policies in maritime port management organizations. PROSPERO registry CRD42021257677. [ABSTRACT FROM AUTHOR]

BACKGROUND: Professional driving requires long hours of work, uncomfortable seats, negotiating rough terrain and highways, and possibly minor repairs and other auxiliary transportation duties. Heavy vehicle drivers driving vehicles such as trucks, bulldozers, etc. due to such working structures are more prone to various musculoskeletal disorders (MSDs) and pain, which is of great concern. OBJECTIVES: In the present study, it is planned to investigate possible ergonomic risk factors such as age, weight, driving exposure, seat suspension systems, lifting heavy weights causing MSDs in drivers of various heavy vehicles. The results of the study are expected to help drivers reduce the risk of MSDs. METHODS: For the present study, the Nordic questionnaire on musculoskeletal disorders was modified and standardized and was administered to the 48 heavy vehicle drivers randomly selected to collect the data. RESULTS: The analysis divulged that over the past 12 months, lower back pain (LBP) emerged as the most dominant pain experienced by 56% of drivers, followed by knee pain (KP) (43%) and neck pain (NP) (39%) respectively. The prevalence of shoulder pain (SP) was observed to be much lower than in previous literature. The logistic regression model further revealed that increasing age, poor suspension system and poor body posture were significantly associated with lower back pain. Additionally, a poor suspension system and lifting heavy weights had significant effect on the drivers' knee pain. CONCLUSION: The results demonstrated the evident necessity for ergonomic consideration in vehicle designing and ergonomic training for heavy vehicle drivers. [ABSTRACT FROM AUTHOR]

Background: The body of literature regarding the use of an upper limb exoskeleton during authentic working conditions is sparse. Objective: The aim of this study was to evaluate the effectiveness of an upper limb exoskeleton in reducing muscle strain during authentic industrial construction work. Methods: Fifteen male participants, comprising of roofers, scaffolders, builders, bricklayers, and graders performing overhead work participated in the study. During work without (REF) and with exoskeleton (EXO), muscle activity from 8 muscles, heart rate (HR), metabolic equivalent (MET), and upper arm elevation angles were recorded. Results: When using the exoskeleton, a significant reduction of 20.2% in average muscle activity of 8 muscles was found. The largest effect focused on m. deltoideus, where 46.2 and 32.2% reduction occurred in medial and anterior parts of the muscle, respectively. HR and MET were unaffected. Upper arm elevation angles were similar between REF and EXO, indicating equal biomechanical loading. Conclusions: This study indicates that exoskeletons show great promise in reducing the potential for musculoskeletal strain during authentic overhead construction work. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work itself and occupational health and safety (OHS) have evolved through industrial revolutions and will also continue to evolve in the future. OBJECTIVE: The aim of this qualitative literature review was to examine how the scientific discussion on new and emerging risks (NERs) related to OHS has evolved in recent decades in developed and newly industrialized countries. METHODS: A search of the Scopus database yielded 34 articles published before 2000 and from 2020 onwards. RESULTS: A review of the articles identified NERs themes related to changes in work patterns, changing workforce and growth in some sectors, climate change, new materials or increased use of materials, new technology and technological development, and viruses. In both article collection periods, possible adverse OHS effects discussed included musculoskeletal disorders, exposure to toxic agents, chemical compounds and hazardous materials, increased stress, increased likelihood of errors and accidents, psychosocial problems, mental fatigue, and increases in work-related illnesses and accidents. CONCLUSIONS: The articles published during both periods discussed similar themes. The main differences were regarding specific time-related cases, such as climate change and COVID-19. Based on the findings of this review, points to consider in OHS management and future studies are discussed. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal injuries are noticeably high among the nursing fraternity, with lower back pain (LBP) being the most prevalent. Therefore, this study aimed to map evidence on the burden of occupational musculoskeletal disorders (MSD) among nurses in sub-Saharan Africa (SSA). Methods: This scoping review was guided by Arksey and O'Malley's framework. We conducted a comprehensive literature search with no date limit from the following databases: Science Direct, PubMed, Sabinet (SA ePublications), EBSCOhost platform, World Health Organization (WHO) Library, Google Scholar, SCOPUS, Taylor and Francis, and WorldCat Academic Search with full text for published studies. The search took place from May 2022 to December 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results, and a thematic content analysis was used to present the emerging themes from the included studies. Results: A total of 16,714 studies were identified after the database search. Only 29 studies met the inclusion criteria after full-article screening and were included for data extraction. The studies reported a total of 6343 participants from different regions in SSA. The 29 included studies showed evidence on the prevalence of MSD, associated risk factors of MSD and LBP among nurses in SSA with some recommendations on how to reduce the prevalence of MSD among nurses. Conclusion: The study findings reveal that there is a high prevalence of MSD among nurses, especially LBP. The etiology of MSD among nurses is multifactorial, and multifaceted strategies to address MSD are recommended. Further research is recommended to explore strategies that can be used to curb the high prevalence of MSD among nurses. [ABSTRACT FROM AUTHOR]

Background: Serious pathology masking as musculoskeletal conditions is rare, still it is pertinent that physiotherapists can recognise it. This ability has been investigated internationally, however the decision-making skills of registered Austrian physiotherapists has not been examined. The aim of this study was to assess the ability of registered Austrian physiotherapists to make accurate keep-refer decisions based on clinical vignettes. Methods: In this national survey registered Austrian (self-)employed physiotherapists were recruited and completed 12 clinical vignettes. Correctly answered vignettes were listed as percentages. Results: 479 physiotherapists participated in the study. The response rate of the self-employed physiotherapists was 8.0%. On average participants classified 70.5% of the musculoskeletal cases, 79.4% of the non-critical medical cases, and 53.3% of the critical medical cases correctly. Conclusion: This study suggests that, despite the limitations of using written clinical vignettes, registered Austrian physiotherapists welcome additional training to improve their skills in identifying serious pathology. Targeted training and educational programs including new and more detailed educational clinical vignettes relevant for non-direct access countries are needed to enhance physiotherapists' diagnostic skills and decision-making processes. [ABSTRACT FROM AUTHOR]

Hippo pathway is an evolutionarily conservative key pathway that regulates organ size and tissue regeneration by regulating cell proliferation, differentiation and apoptosis. Yes-associated protein 1 (YAP)/ WW domain-containing transcription regulator 1 (TAZ) serves as a pivotal transcription factor within the Hippo signaling pathway, which undergoes negative regulation by the Hippo pathway. The expression of YAP/TAZ affects various biological processes, including differentiation of osteoblasts (OB) and osteoclasts (OC), cartilage homeostasis, skeletal muscle development, regeneration and quality maintenance. At the same time, the dysregulation of the Hippo pathway can concurrently contribute to the development of various musculoskeletal disorders, including bone tumors, osteoporosis (OP), osteoarthritis (OA), intervertebral disc degeneration (IDD), muscular dystrophy, and rhabdomyosarcoma (RMS). Therefore, targeting the Hippo pathway has emerged as a promising therapeutic strategy for the treatment of musculoskeletal disorders. The focus of this review is to elucidate the mechanisms by which the Hippo pathway maintains homeostasis in bone, cartilage, and skeletal muscle, while also providing a comprehensive summary of the pivotal role played by core components of this pathway in musculoskeletal diseases. The efficacy and feasibility of Hippo pathway-related drugs for targeted therapy of musculoskeletal diseases are also discussed in our study. These endeavors offer novel insights into the application of Hippo signaling in musculoskeletal disorders, providing effective therapeutic targets and potential drug candidates for treating such conditions. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disease (MSD) is a major cause of disability among older adults, and understanding the role of physical activity (PA) in preventing these conditions is crucial. This study aimed to explore the association between PA levels and MSD risk among adults aged 45 and above, clarify the dose‒response relationship, and provide tailored guidelines. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional analysis was conducted on 15,909 adults aged 45 and over. The study population was divided into MSD (n = 7014) and nMSD (n = 8895) groups based on musculoskeletal health status. PA levels were assessed using the International Physical Activity Questionnaire and categorized into low intensity physical activity (LIPA), moderate vigorous physical activity (MVPA), and vigorous physical activity (VPA). Multivariable logistic regression models and restricted cubic spline regression were used to examine the relationship between PA levels and MSD risk in middle-aged and older adults. Sensitivity analyses and stratified analyses were also performed. Results: The main outcome measures were musculoskeletal diseases prevalence and PA levels. MVPA and VPA reduced MSD risk by 19% [OR = 0.81, 95% CI (0.72, 0.90), P < 0.001] and 12% [OR = 0.88, 95% CI (0.79, 0.98), P < 0.05], respectively. What's more, after adjusting for confounding factors, VPA increased risk by 32% [OR = 1.32, 95% CI (1.04, 1.66), P < 0.05]. The relationship was nonlinear, showing a U-shaped pattern with age and hypertension status as significant moderators. The optimal PA energy expenditure was identified as approximately 1500 metabolic equivalents of tasks (METs) per week for adults aged 45–74, 1400 METs per week for those aged 75 and above, and 1600 METs per week for hypertensive adults aged 45 and older. Conclusions: For adults aged 45 years and older, VPA significantly increases the risk of MSD. Adults aged 45 years and older should adjust their weekly METs based on their age. Additionally, those with hypertension should moderately increase their weekly METs to promote optimal musculoskeletal health. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation. Methods: This process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients. Results: Eight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model's essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients. Conclusions: This process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely. [ABSTRACT FROM AUTHOR]

Lumbar intervertebral disc degeneration is a global musculoskeletal disorder. Total disc replacement is an effective treatment for symptomatic degeneration unresponsive to conservative care. However, current artificial discs, with their joint‐like structural design and homogeneous materials, fail to replicate the 3D anisotropic stiffness of natural discs. Inspired by the intricate structure and material gradient of the natural disc, a biomimetic intervertebral disc is designed and fabricated using multi‐material additive manufacturing. The biomimetic disc exhibits 3D anisotropic stiffness similar to natural discs. By adjusting the hardness, diameter, and arrangement of fibers in annulus fibrosus, the biomimetic disc closely matches the 3D anisotropic stiffness of the natural lumbar disc, exceeding 90% similarity and outperforming existing artificial discs. This highlights the crucial role of fiber properties in disc stiffness regulation and enhances the understanding of biomechanical functions of structures and materials in the annulus fibrosus of human discs. These insights may inspire high‐performance artificial disc designs. [ABSTRACT FROM AUTHOR]

Introduction: Both professional musicians and conservatoire students are at significant risk of developing playing-related musculoskeletal disorders (PRMDs) during their career life. With the growing number of students pursuing a conservatory degree and graduating from music conservatory in China, the aims of this study were: (1) to identify the nature of PRMD and explore the prevalence of PRMD in Chinese conservatoire students; (2) to determine the relevant risk factors with the presence of PRMD among Chinese conservatoire students; and (3) to suggest preventive interventions for young pianists at their early career stage. Methods: A self-reported online survey study was conducted among 363 Chinese conservatoire students who majored in piano performance. Results: Of all respondents, 82.6% reported having had at least one PRMD. The wrist was proved to be the most affected body site, followed by the shoulder, finger and arm. Respondents who experienced PRMD reported "pain," "fatigue," and "stiffness" as the most frequent symptoms. The main risk factors associated with PRMD included gender, years of playing experiences, practice hours, warmup habits before practice, and break-taking during practice. Discussion: Female students, those with longer year of playing experience, those who practice longer hours, those who do not warm up before practice, and those who do not take breaks during practice were found to have more PRMD symptoms and higher level of severity. This study highlights the need to increase awareness of PRMD among conservatoire students and to understand the occurrence of PRMD; it is helpful for young pianists to prevent severe musculoskeletal disorders and implement preventive measures at early career stages. Further studies are suggested to follow up on music students who have had at least one PRMD at different stages of professional musical training. [ABSTRACT FROM AUTHOR]

Background: Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001–2010 and 2015–2018. Methods: We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models. Results: The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35–49 years and remained stable over time, except for slight increase in those aged 65–79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches. Conclusion: The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents' socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD. [ABSTRACT FROM AUTHOR]

Background: Lyme borreliosis is by far the most common vector-borne infection in Western Europe. The most severe manifestation of Lyme borreliosis is Lyme neuroborreliosis (LNB). In LNB symptoms vary from mild to severe and may include late complications that involve both physical and/or neurocognitive constraints. An estimated 25–28% of the LNB population suffers from late complications. This study investigates patient and relative perspectives on everyday life with LNB symptoms, diagnosis, and treatment to identify areas for improvement of healthcare. Methods: A focus group was conducted at Odense University Hospital, Denmark. The focus group comprised 16 participants, nine patients diagnosed with LNB who had been treated at the Clinical Center for Emerging and Vector-borne Infections, and seven relatives of the patients' choice. The focus group lasted 2 ½ hours and was audio recorded as well as documented in field notes. Results: Data analysis was grounded in the conceptual framework of critical psychology and resulted in three main themes: (1) Burden of LNB symptoms in everyday life, (2) A break in the conduct of everyday life caused by LNB and (3) Need for transparent pathways to specialist knowledge. Conclusions: Before diagnosis and treatment, each patient reported varying degrees of non-treatable pain, and cognitive and/or musculoskeletal symptoms. Visible physical symptoms were rare. All patients had experienced that their bodily symptoms remained unaddressed throughout numerous encounters with the healthcare system. The course of LNB comes with a break in patients' everyday lives and self-understandings affecting their ability to work and manage everyday activities. Patients and relatives strongly recommend a specialised LNB clinic. [ABSTRACT FROM AUTHOR]

Background: Globally, Musculoskeletal disorders (MSDs) are the biggest contributor (17%) to years lived with disability. For offering diagnosis and appropriate health interventions options along with follow-up care, it is pertinent to have a thorough awareness of its associated risk factors. Objectives: The study aims to assess the prevalence and association between MSDs and risk factors among the Indian older adults above 45 years. Methodology: Prevalence of MSDs among 28,436 participants was estimated using nationally representative survey on older Indian adults. Spatial distribution maps were created to display the magnitude of MSD prevalence at Indian sub-national level. Association between presence of MSDs and associated risk factors (such as occupation, employment duration, physical activity, BMI, diabetes, hypertension, tobacco usage, and alcohol consumption) was explored through Multivariate logistic regression. P-value <0.05 was considered as statistically significant. Results: MSD was prevalent in over half of participants (53.5 (52.9–54.1)%), with more among females and in those aged >60 years (60.4 (59.3–61.4)%). Overall, joint pain (41.9 (41.3–41.4)%) was more common than back pain (32.6 (32.0–33.1)%). Prevalence was highest in Manipur (81.1 (77.9–83.9)%) and lowest in West Bengal (33.1 (30.7–35.5)%). MSD presence was positively associated with certain occupational groups, pre-obesity (BMI 25–29.9 Kg/m2), currently hypertensive, vigorous physical activity among overall population. Tobacco usage was positively associated, while alcohol consumption was linked to a lower occurrence of MSDs for 45–60 years age group. Conclusions: Customised policy interventions can be developed for specific age category of older Indian adults and musculoskeletal health can be improved by addressing modifiable risk factors such as physical inactivity, tobacco usage, avoiding workplace risks in occupations requiring manual labour as revealed by this study. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) are one of the high-risk working areas in terms of musculoskeletal disability and ergonomic risks including the environment and posture factors. Correct posture technique is often ignored by nurses working in these units. This study was conducted to determine the effect of posture regulation training on work-related musculoskeletal disorders, fatigue level and job performance in nurses working in ICUs. Methods: This quasi-experimental study with one-group pretest-posttest design included 64 intensive care nurses. The nurses received posture regulation training in three different sessions. The post-test was administered four months after the posture regulation training. Results: The nurses reported to frequently have aches, pains and discomfort in the neck, upper back and lumbar regions. After the posture regulation training, their level of pain, ache and discomfort in the neck, right and left shoulder, upper back, lower back and right/left foot areas decreased significantly (p < 0.05). The posture regulation training reduced the levels of behavior/severity and affect, which are sub-dimensions of fatigue, and increased the level of contribution to work, which is a sub-dimension of job performance (p < 0.05). Conclusion: The posture regulation training decreased the level of symptoms in the neck, shoulder, upper back, lower back and foot regions of intensive care nurses and partially improved their fatigue level and job performance. Therefore, posture regulation training should be added to in-service training programs and permanent measures should be taken for ergonomic risks in ICUs. [ABSTRACT FROM AUTHOR]

AbstractResearch on musculoskeletal disorders among tomato farmworkers is limited. This pilot study aims to generate insights and preliminary data on tasks performed by tomato farmworkers at a demonstration test plot, evaluating associated ergonomic risk factors. A demonstration test plot was constructed to simulate tasks performed by tomato farmworkers. Muscle activity in the anterior deltoid and upper trapezius was measured using surface electromyography (sEMG) and compared among tasks. The intensity of physical activity during stake pounding, bucket tossing, and tying tasks was monitored using a GT9X activity monitor. Non-parametric ANOVA revealed that the upper trapezius exhibited the highest muscle activity in all tasks (p < 0.05). Stake pounding showed the highest muscle activity, peak loads, and the most intense physical activity. Future studies will focus on assessing tomato farmworker activities over longer shifts and evaluating the impact of posture, fatigue, and energy expenditure on the risk for musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Chronic low back pain (LBP) is a common musculoskeletal disorder and is often accompanied by functional leg length inequality (FLLI). However, little was known about the effects of gluteal muscle control training in patients with LBP and FLLI. This study was designed to investigate the effects of gluteal control training in patients with LBP and FLLI. This is a double-blinded, randomized controlled study design. Forty-eight LBP patients with FLLI were randomized to the gluteal control training (GT) (47.58 ± 9.42 years) or the regular training (RT) (47.38 ± 11.31 years) group and received allocated training for six weeks. The outcome measures were pelvic inclination (PI), ilium anterior tilt difference (IATD), FLLI, visual analogue scale (VAS), patient specific-functional scale (PSFS), Oswestry disability index (ODI), hip control ability, global rating of change scale (GRoC), and lower extremity strength and flexibility. The intervention effects were compared using two-way repeated measures analysis of variance and chi-square tests with α = 0.05. The results indicated that the GT group showed greater improvement (P < 0.01) in PI (1.03 ± 0.38∘ vs. 1.57 ± 0.51∘), IATD (0.68 ± 0.66∘ vs. 2.31 ± 0.66∘), FLLI (0.3 ± 0.22 vs. 0.59 ± 0.13 cm), VAS (1.41 ± 1.32 vs. 3.38 ± 1.51), hip control ability (2.20 ± 0.45 vs. 0.89 ± 0.74), GRoC at 3rd and 6th week as compared to the RT group. Hip strength and flexibility also improved more in the GT group (P < 0.05). In conclusion, gluteal control training was more effective in improving low back pain and dysfunctions, and should be integrated in the management plan in patients with LBP and FLLI. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with participation and activity limitations face important healthcare challenges. Objectives: We investigated healthcare utilization and characteristics of Canadians living with participation and activity limitations between 2001 and 2010. Methods: We pooled data from 5 cycles of the Canadian Community Health Survey (2001-2010 CCHS). The multistage stratified cluster-sampling method used covered approximately 98% of Canadians, aged 12 years and older residing in private dwellings. We described sociodemographic, behavioral, and health-related characteristics of participants with participation and activity limitations and reported their annual utilization (prevalence; 95% CI) of 7 healthcare providers. Multivariable modified Poisson regression identified individual characteristics associated with healthcare utilization and examined the trends over time. Results: Annually, 8.1 million Canadians aged 12 years and older (29.8%) reported participation and activity limitations. Most common health conditions were back problems (37%) and arthritis (34%). Predominant healthcare providers were medical doctors (88.8%; 95% CI = 88.6-89.0), nurses (16.3%; 95% CI = 16.1-16.6), physiotherapists (15.0%; 95% CI = 14.7-15.2), and chiropractors (14.4%; 95% CI = 14.2-14.7). Overall, males, older adults, immigrants, those with lower education, lower income, recent employment, and better general health were less likely to consult providers. Over time, utilization of most non-medical providers increased. Conclusion: Participation and activity limitations are prevalent in Canada, and most consulted medical doctors. Disadvantaged groups reported lower utilization of most providers, emphasizing access challenges and the need for equitable and integrated healthcare policies. Improving access to rehabilitation services and their inclusion within universal healthcare coverage should be a priority. [ABSTRACT FROM AUTHOR]

A causal link exists between structural differences in the foot and alterations in the lower limb biomechanics, which might predispose an individual to develop characteristic musculoskeletal disorders. This study aimed to determine how the foot structural characteristics, as represented by the medial longitudinal arch flexibility, affect lower limb joint coupling coordination and anterior-posterior ground reaction impulses (GRIs) during walking and running. Following the calculation of arch height flexibility, a total of fifty-four physically active males were grouped and completed gait experiments to collect kinematic and kinetic data synchronously. Inter-joint coordination and variability were calculated from the angle-angle plots of knee-hip, ankle-knee, and metatarsophalangeal (MTP)-ankle couplings based on an optimized vector coding technique. Our results indicate that coupling coordination of interest and its variability, as well as anterior-posterior GRIs, could potentially be influenced due to differences in arch height flexibility. Notably, the individuals with stiff arches exhibited significantly greater coordination variabilities during the early stance for both ankle-knee and MTP-ankle coordination yet significantly smaller for MTP-ankle coordination variabilities during the mid-stance phase. Furthermore, combining the statistical parametric mapping analysis results, the flexible arches experienced a greater proportion of GRIs in the anterior-posterior direction. In conclusion, these observations demonstrated that variations in arch flexibility led to differences in lower limb joint coordination variabilities and GRIs during gait. This fresh insight into inter-joint coordinative function may be useful for enhancing foot motion strategies based on arch structural characteristics. • Inter-joint coordination was quantified using an optimized vector coding technique. • FA experienced a greater proportion of GRIs in the anterior-posterior direction. • Individuals with flexible MLA adopt a conservative gait coordination strategy. [ABSTRACT FROM AUTHOR]

Anatomical parameters of the pelvis, femur, and tibia derived from the full-length radiograph can be used to create a more accurate musculoskeletal model compared to marker-based linear scaling method. However, whether this model leads to more accurate estimations of medial knee contact force (MCF) and lateral knee contact force (LCF) than marker-based linear scaling method is still unknown. This main purpose of this study was to determine whether musculoskeletal model generated from full-length radiograph improves the estimations of MCF and LCF. An open-source dataset including marker trajectories, ground reaction forces, in vivo knee contact forces, and full-length radiograph was used to evaluate the accuracy of full-length radiograph musculoskeletal modeling method. Subject-specific musculoskeletal models were created using anatomical parameters derived from the full-length radiograph or marker-based linear scaling methods. MCF and LCF were estimated using musculoskeletal simulations of normal walking trails. The accuracy of modeling methods was determined by comparing the estimated and in vivo measured MCF and LCF. Compared to the marker-based linear scaling approach, the full-length radiograph musculoskeletal modeling method exhibited decreases of 38.3 % and 41.3 % in root mean square error for MCF and LCF respectively, as well as reductions of 50.0 % and 49.3 % in mean peak errors for MCF and LCF respectively. The full-length radiograph musculoskeletal modeling method provides a more accurate way to estimate MCF and LCF compared to the traditional maker-based linear scaling approach, which may contribute to understand the initiation, progression, and treatment of OA. • Validation of full-length radiograph musculoskeletal modeling method. • More accurate estimation of medial contact force than traditional method. • More accurate estimation of lateral contact force than traditional method. [ABSTRACT FROM AUTHOR]

Gait analysis is essential for evaluating locomotor function and fall risk, particularly in the elderly and in various musculoskeletal disorders. Traditional gait analysis systems face challenges such as technical difficulties, high cost, and complexity of use. Therefore, there is a need for a more accessible and cost-effective system with a wider clinical applicability. This study aimed to validate the newly developed IB-gait® system (InBody, Republic of Korea), a camera-based gait analysis tool, by comparing it against the VICON system. A total of 28 community-dwelling adults without gait abnormalities (mean age 24.9 years) were enrolled in this study. The participants underwent gait analysis at their self-selected speed using VICON and IB-gait® simultaneously. Nine spatiotemporal gait parameters, including stride length (m), step length (m), stride duration (s), double-limb duration (s), stance phase (s), swing phase (s), cadence (velocity × 120/stride length), and gait velocity (m/s) were measured. The agreement between the two systems was tested using Bland-Altman plots and intraclass correlation coefficients (ICC). The IB-gait® showed a high degree of agreement with the VICON system in most gait parameters. The ICC showed excellent reliability for stride length (0.97), step length (0.92), gait velocity (0.97), cadence (0.97), and stride duration (0.79). However, it showed lower reliability in time-based parameters, including double-limb duration (0.12), stance phase (0.54), swing phase (0.241), and stance/swing phase ratio (0.11). The IB-gait® system appears to be a feasible and cost-effective alternative to VICON system for gait analysis, particularly showing a high level of agreement in the distance-based parameters. Its practicality in clinical settings makes it a valuable tool for widespread use in gait analysis. However, further refinement of time-based parameter measurements and validation in diverse patient populations are needed to enhance its applicability. • IB-gait® showed high agreement with the VICON system in most spatiotemporal parameters. • Reliability was excellent for distance-related parameters. • IB-gait® is an accessible, accurate and useful gait analysis system. [ABSTRACT FROM AUTHOR]

The buffy-coat, a layer of leukocytes and platelets obtained from peripheral blood centrifugation, plays a crucial role in tissue regeneration and the modulation of inflammatory responses. This article explores the mechanisms of regenerative inflammation, highlighting the critical role of the buffy-coat in influencing macrophage polarization and its therapeutic potential. Macrophage polarization into M1 and M2 subtypes is pivotal in balancing inflammation and tissue repair, with M1 macrophages driving pro-inflammatory responses and M2 macrophages promoting tissue healing and regeneration. The buffy-coat's rich composition of progenitor cells, cytokines, and growth factors—such as interleukin-10, transforming growth factor-β, and monocyte colony-stimulating factor—supports the transition from M1 to M2 macrophages, enhancing tissue repair and the resolution of inflammation. This dynamic interaction between buffy-coat components and macrophages opens new avenues for therapeutic strategies aimed at improving tissue regeneration and managing inflammatory conditions, particularly in musculoskeletal diseases such as osteoarthritis. Furthermore, the use of buffy-coat-derived therapies in conjunction with other regenerative modalities, such as platelet-rich plasma, holds promise for more effective clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to: (1) test and explain the type of experience scuba diving is among people with physical impairments based on the experience-type framework; (2) assess and describe their personality based on the Big Five domains; and (3) identify if personality, years diving, and diving level predict experience-type. Methods: An explanatory sequential mixed methods design was employed. The quantitative phase used a cross-sectional survey (n = 103). The qualitative phase used follow-up interviews with 15 participants divided into 3 case study groups. Joint displays with meta-inferences integrated the data. Results: Quantitative and qualitative findings concurred on scuba being a transformative experience. 82.52% of survey participants reported scuba as a transformative experience, with no significant differences on experience impact based on impairment category (p = 0.56), impairment onset (p = 0.66), gender (p = 0.08), race/ethnicity (p = 0.51), or age (p = 0.07). Big Five personality domains, years diving, or diving level did not predict experience impact (R2 = 0.14, F(12,90) = 1.304, p = 0.2305). Data strand results differed on salient personality domains. Seven qualitative themes emerged, five on experience-type and two on personality. Conclusions: We recommend the exploration of scuba diving as a prospective rehabilitation intervention. IMPLICATIONS FOR REHABILITATION: Innovative rehabilitation interventions that provide positive experiences and long-term health benefits to people with physical impairments are needed. Participants reported that scuba diving had a positive transformative impact in their lives through positive emotions, peace/relaxation, personal growth, development of skills, social connections, physical and mental healing, and lasting behavioral changes. Reporting scuba diving as a transformative experience was not influenced by the scuba divers' personality domains, diving level, demographic characteristics, or the number of years they had been diving. Authors recommend the consideration and further exploration of scuba diving as a prospective physical and psychosocial rehabilitation intervention. [ABSTRACT FROM AUTHOR]