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Clinical Updates in Physiotherapy for Musculoskeletal Disorders
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Clinical Updates in Physiotherapy for Musculoskeletal Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 4603

Special Issue Editor

Dr. Santiago Navarro Ledesma

E-Mail Website
Guest Editor
1. Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Granada, Spain
2. Department of Physiotherapy, University Chair in Clinical Psychoneuroimmunology (University of Granada and PNI Europe), The Hague, The Netherlands
Interests: physical therapy; exercise; MSK ultrasound; MSK disorders; chronic pain; inflammation; psychoneuroimmunology; sports medicine; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce a call for manuscripts for a Special Issue of the Journal of Clinical Medicine, titled “Clinical Updates in Physiotherapy for Musculoskeletal Disorders”. This Special Issue aims to gather the latest research and advancements in physiotherapy, with a specific focus on addressing musculoskeletal (MSK) disorders through innovative and comprehensive approaches.

In recent years, physiotherapy has made significant strides in understanding and managing MSK conditions. For this Special Issue, we are particularly interested in studies that not only explore individual clinical interventions but also multi-intervention approaches that take into account the multifactorial nature of health. The goal is to fully address the complexity of the patient’s clinical context and provide more effective treatments.

We encourage submissions that highlight the integration of personalized medicine and personalized physiotherapy in the treatment of MSK disorders. This involves tailoring interventions to the specific needs, characteristics, and circumstances of each patient, acknowledging the uniqueness of each case. We welcome studies that explore the interaction between musculoskeletal disorders and psychological, biological, and lifestyle factors. Addressing MSK disorders from a holistic perspective is essential to optimize patient outcomes and enhance long-term clinical effectiveness.

Key topics of interest include (but are not limited to):

  • Novel physiotherapy interventions for the management of musculoskeletal disorders.
  • Studies linking MSK disorders with psychological and biological factors.
  • Research on the role of lifestyle factors and environmental influences in MSK conditions.
  • Clinical evaluations of combined interventions and multidisciplinary strategies.
  • Applications of personalized medicine and physiotherapy in MSK disorder management.

We invite researchers, clinicians, and healthcare professionals to submit original research articles, systematic reviews, and meta-analyses for consideration in this Special Issue. Your contributions will play a key role in advancing the field and improving patient care for those affected by musculoskeletal disorders.

We look forward to receiving your valuable contributions and working together to enhance the clinical management of musculoskeletal disorders through cutting-edge research.

Dr. Santiago Navarro Ledesma
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • musculoskeletal disorders
  • physiotherapy interventions
  • lifestyle
  • psychoneuroimmunology
  • chronic pain
  • inflammation
  • physical therapy

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Published Papers (6 papers)

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Research

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11 pages, 2414 KiB  
Article
Wrist Joint Restriction: Impact on Foot Pressure, Center of Gravity, and the Role of the Dominant Hand
by Leire Cruz Gambero, Gabriel A. Gijón-Noguerón, Salvador Díaz Miguel, Javier Barón-López and Cantero-Téllez Raquel
J. Clin. Med. 2025, 14(8), 2829; https://doi.org/10.3390/jcm14082829 - 19 Apr 2025
Viewed by 241
Abstract
Background: Wrist immobilization is a common clinical intervention for wrist injuries; however, its repercussions on gait parameters and plantar support have not been extensively investigated. Objectives: The purpose of the study was to determine whether wrist immobilization causes alterations in foot [...] Read more.
Background: Wrist immobilization is a common clinical intervention for wrist injuries; however, its repercussions on gait parameters and plantar support have not been extensively investigated. Objectives: The purpose of the study was to determine whether wrist immobilization causes alterations in foot pressure and center of gravity, considering hand dominance and visual conditions (eyes open or closed). Methods: The research experiment was conducted using the PodoPrint S4 platform. Basic descriptive statistics were calculated to summarize the variables. Additionally, in the mixed linear model (t-tests use Satterthwaite’s method) an analysis of variance for repeated measures (ANOVA-RM) was conducted for the determination of the objectives of the study. Results: This study included a total of 44 participants (29 females and 15 males), with an average age of 36.5 years (SD = 17.5). Immobilization, independent of eye condition, resulted in significant alterations in antero-posterior oscillation and in a larger plantar support area. In addition, the results suggest that the eye state significantly influences plantar support, independent of limb immobilization or dominance. Conclusions: Our findings reveal significant alterations in antero-posterior oscillation and plantar support due to immobilization, suggesting a dynamic interplay between wrist function and lower limb biomechanics. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
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14 pages, 1114 KiB  
Article
Cervical Spine Screening Based on Movement Strategies Improves Shoulder Physical Variables in Neck-Related Shoulder Pain Patients: A Secondary Analysis from an Observational Study
by Alberto Roldán-Ruiz, Javier Bailón-Cerezo, Deborah Falla and María Torres-Lacomba
J. Clin. Med. 2025, 14(7), 2433; https://doi.org/10.3390/jcm14072433 - 2 Apr 2025
Viewed by 590
Abstract
Background: It is important to consider the cervical spine as a potential contributor to shoulder pain, indicating the paramount importance of screening the cervical spine in patients with shoulder pain. Objectives: To study the immediate effects of cervical spine screening (CSS) on the [...] Read more.
Background: It is important to consider the cervical spine as a potential contributor to shoulder pain, indicating the paramount importance of screening the cervical spine in patients with shoulder pain. Objectives: To study the immediate effects of cervical spine screening (CSS) on the shoulder active range of motion, isometric strength and self-reported function in patients with neck-related shoulder pain. Methods: A secondary analysis was conducted on data from a previous study. A cervical contribution was considered if a ≥30% shoulder symptom modification of pain intensity (Numeric Pain Rating Scales) was recorded during the most painful shoulder movement after CSS. Pre–post measurements of the shoulder active range of motion (inclinometer) and shoulder isometric strength (dynamometer) were recorded in a single session. Self-reported shoulder function (Shoulder Pain and Disability Index) was assessed at a 1-week follow-up. Results: Among 60 participants, statistically significant changes were found for those with a cervical contribution (n = 30) for shoulder flexion and the abduction range of motion (p < 0.001), with a medium size effect (r = 0.55), and in internal rotation (p = 0.02) and external rotation at 0° abduction (p = 0.008), with a small size effect (r = 0.3 and 0.34, respectively). The self-reported shoulder function in those without a cervical contribution significantly declined from the pre to post measurements (p = 0.002), with a small size effect (r = 0.4). No statistically significant changes were found for the isometric strength in either group. Conclusions: In patients with shoulder pain classified as having a cervical contribution, CSS produces intrasession improvements in the active shoulder range of motion but not in the shoulder isometric strength or self-reported shoulder function. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
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10 pages, 209 KiB  
Article
Impact of Sarcopenia and Functional Relationships Between Balance and Gait After Total Hip Arthroplasty
by So-Yeong Kim, Woon-Su Cho, Chi-Bok Park and Byeong-Geun Kim
J. Clin. Med. 2025, 14(6), 2036; https://doi.org/10.3390/jcm14062036 - 17 Mar 2025
Viewed by 415
Abstract
Background/Objectives: Total hip arthroplasty (THA) is an effective surgical intervention for restoring hip function and alleviating pain caused by osteoarthritis, femoral head avascular necrosis, or fractures. Despite its benefits, postoperative recovery is influenced by various factors, among which sarcopenia plays a critical [...] Read more.
Background/Objectives: Total hip arthroplasty (THA) is an effective surgical intervention for restoring hip function and alleviating pain caused by osteoarthritis, femoral head avascular necrosis, or fractures. Despite its benefits, postoperative recovery is influenced by various factors, among which sarcopenia plays a critical role. This study aimed to analyze the characteristics of sarcopenia in THA patients admitted to a convalescent rehabilitation hospital and examine its relationship with functional variables such as balance and gait independence. Methods: This cross-sectional study included 84 THA patients, categorized into sarcopenia and non-sarcopenia groups using the Asian Working Group for Sarcopenia 2019 criteria. Data were collected on demographic characteristics (e.g., age, gender, height, weight, range of motion (ROM), manual muscle test (MMT)) and functional variables, including balance (Berg Balance Scale, BBS) and gait independence (Functional Ambulation Category, FAC). Results: The prevalence of sarcopenia among THA patients was 44.05%. Significant differences were observed between the sarcopenia and non-sarcopenia groups in sex, age, height, weight, ROM, MMT, BBS, and FAC (p < 0.05). Logistic regression analysis showed that advanced age increased the likelihood of sarcopenia (OR: 1.072, p < 0.05), whereas higher body weight reduced it (OR: 0.784, p < 0.05). However, sarcopenia was not significantly associated with balance (BBS: p = 0.710) or gait independence (FAC: p = 0.990). Instead, a significant positive correlation was found between FAC and BBS (OR: 0.413, p < 0.001), as well as BBS and FAC (OR: 0.467, p < 0.001), indicating that better balance was associated with greater gait independence and vice versa. Additionally, patients who underwent THA due to fractures had a lower FAC compared to those with osteoarthritis (OR: −0.276, p = 0.018). Conclusions: Sarcopenia is prevalent among THA patients, and functional variables such as balance and gait independence are closely associated. Additionally, age and body weight were identified as key factors related to sarcopenia. These findings emphasize the importance of early detection and management of sarcopenia in rehabilitation hospital settings and highlight the significance of functional variables in recovery. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
12 pages, 862 KiB  
Article
Rasch Measurement Model Supports the Unidimensionality and Internal Structure of the Arabic Oswestry Disability Index
by Ali H. Alnahdi, Abdulrahman M. Alsubiheen and Mishal M. Aldaihan
J. Clin. Med. 2025, 14(4), 1259; https://doi.org/10.3390/jcm14041259 - 14 Feb 2025
Viewed by 401
Abstract
Background/Objectives: The objective of this study was to assess the unidimensionality and internal structure of the Arabic version of the Oswestry Disability Index (ODI) in patients with lower back pain (LBP) using the Rasch measurement model. Methods: Patients with LBP (N = 113) [...] Read more.
Background/Objectives: The objective of this study was to assess the unidimensionality and internal structure of the Arabic version of the Oswestry Disability Index (ODI) in patients with lower back pain (LBP) using the Rasch measurement model. Methods: Patients with LBP (N = 113) completed the Arabic ODI during their first visit to physical therapy departments. The Arabic ODI was examined by assessing its fit to the requirements of the Rasch measurement model. Chi-square statistics for item–trait interaction alongside mean item and person fit residuals were used for overall model fit assessment. Additionally, the analysis included assessments for the fit of individual items, the sequence of thresholds, local dependency, unidimensionality using the t-test method, and differential item functioning (DIF) by sex, age, chronicity, and the presence of radiating pain. Results: The overall fit of the Arabic ODI to the Rasch measurement model was supported by non-significant Chi-square statistics (χ2 = 25.32, p = 0.19) and acceptable mean item and person fit residuals. All items showed acceptable fit (standardized fit residual −1.89 to 1.62) with no violation of local item independence. The t-test method supported the scale’s unidimensionality. The ODI showed good internal consistency with a person separation index of 0.85, with good overall targeting of item thresholds to the participants’ lower back function. Items 2, 7, and 10 showed disordered thresholds, and potential bias by sex was detected in item 9 (social life). Conclusions: The Arabic ODI is a unidimensional measure valid for assessing disability due to low back pain; however, indications of the inappropriate functioning of some response options along with potential bias by sex need to be revisited. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
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Review

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20 pages, 731 KiB  
Review
Frozen Shoulder as a Metabolic and Immune Disorder: Potential Roles of Leptin Resistance, JAK-STAT Dysregulation, and Fibrosis
by Santiago Navarro-Ledesma
J. Clin. Med. 2025, 14(5), 1780; https://doi.org/10.3390/jcm14051780 - 6 Mar 2025
Viewed by 845
Abstract
Frozen shoulder (FS) is a complex and multifactorial condition characterized by persistent inflammation, fibrosis, and metabolic dysregulation. Despite extensive research, the underlying drivers of FS remain poorly understood. Recent findings indicate the coexistence of pro-inflammatory and fibrosis-resolving macrophages within affected tissues, suggesting a [...] Read more.
Frozen shoulder (FS) is a complex and multifactorial condition characterized by persistent inflammation, fibrosis, and metabolic dysregulation. Despite extensive research, the underlying drivers of FS remain poorly understood. Recent findings indicate the coexistence of pro-inflammatory and fibrosis-resolving macrophages within affected tissues, suggesting a dysregulated immune response influenced by metabolic and neuroendocrine factors. This review proposes that leptin resistance, a hallmark of metabolic syndrome and chronic inflammation, may play a central role in FS pathogenesis by impairing macrophage polarization, perpetuating inflammation, and disrupting fibrosis resolution. The JAK-STAT signaling pathway, critically modulated by leptin resistance, may further contribute to immune dysregulation by sustaining inflammatory macrophage activation and interfering with tissue remodeling. Additionally, FS shares pathogenic features with fibrotic diseases driven by TGF-β signaling, mitochondrial dysfunction, and circadian disruption, further linking systemic metabolic dysfunction to localized fibrotic pathology. Beyond immune and metabolic regulation, alterations in gut microbiota, bacterial translocation, and chronic psychosocial stress may further exacerbate systemic inflammation and neuroendocrine imbalances, intensifying JAK-STAT dysregulation and leptin resistance. By examining the intricate interplay between metabolism, immune function, and fibrotic remodeling, this review highlights targeting leptin sensitivity, JAK-STAT modulation, and mitochondrial restoration as novel therapeutic strategies for FS treatment. Future research should explore these interconnections to develop integrative interventions that address both the metabolic and immune dysregulation underlying FS, ultimately improving clinical outcomes. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
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25 pages, 622 KiB  
Review
Physiotherapy in Text Neck Syndrome: A Scoping Review of Current Evidence and Future Directions
by Joanna Piruta and Wojciech Kułak
J. Clin. Med. 2025, 14(4), 1386; https://doi.org/10.3390/jcm14041386 - 19 Feb 2025
Viewed by 1658
Abstract
Background: Musculoskeletal disorders associated with excessive smartphone use represent a significant health issue. Text neck syndrome is one such disorder within that group, increasingly affecting individuals worldwide across various age groups. The phenomenon of text neck may occur in individuals who frequently and [...] Read more.
Background: Musculoskeletal disorders associated with excessive smartphone use represent a significant health issue. Text neck syndrome is one such disorder within that group, increasingly affecting individuals worldwide across various age groups. The phenomenon of text neck may occur in individuals who frequently and for prolonged periods adopt a forward-flexed neck and head position while looking at the screens of mobile electronic devices. Various therapeutic methods are used in the treatment of text neck syndrome. However, there is no consensus on text neck rehabilitation, which poses a challenge for physiotherapists. Objective: The aim of this study is to analyze the phenomenon of text neck, with a particular emphasis on current scientific reports regarding the rehabilitation of text neck syndrome. The scoping review was conducted to determine the physiotherapy methods currently used in the treatment of individuals with text neck, assess their impact on symptom reduction, and identify existing knowledge gaps and limitations in the current literature on the rehabilitation of text neck syndrome. Design: A scoping review was conducted on the treatment of text neck syndrome based on electronic databases: PubMed, ResearchGate, Physiotherapy Evidence Database (PEDro), and the Cochrane Library. The databases were searched up to 1 December 2024. The inclusion criteria comprised studies investigating physiotherapy interventions for individuals with text neck, published between 2018 and 2024 and written in English. Results: A total of fifteen papers were reviewed, focusing on various methods used in text neck rehabilitation, including postural correction exercises, stabilization exercises, strengthening and stretching exercises, Pilates, PNF (Proprioceptive Neuromuscular Facilitation), kinesiology taping, Bowen therapy, and manual therapy. Nearly all studies were conducted in the adult population (93%), with the majority of studies taking place in India (60%). Conclusions: In summary, all studies suggest that appropriate physiotherapeutic interventions can provide significant benefits, including pain reduction, posture correction, and improved range of motion in the cervical spine. The best outcomes appear to be achieved by combining various therapeutic techniques. However, further high-quality research is needed to strengthen the evidence and offer reliable recommendations for clinical practice. Additionally, there is limited research on physiotherapy for text neck in the pediatric population, presenting a potential area for future studies. Full article
(This article belongs to the Special Issue Clinical Updates in Physiotherapy for Musculoskeletal Disorders)
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