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Musculoskeletal Diagnosis and Treatment: Connecting Gaps to Enhance Patient Care

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

Deadline for manuscript submissions: 15 October 2025 | Viewed by 8791

Special Issue Editor


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Guest Editor
Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
Interests: anatomy; musculoskeletal system; spine; low back pain; sport injuries; pelvic floor; physiotherapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal disorders affect individuals throughout their lifespan, causing pain, decreased function, and reduced quality of life. These conditions impact over half of adults, with their prevalence increasing as individuals age.

Most patients with musculoskeletal disorders may benefit from conservative treatment such as physiotherapy, thus avoiding unnecessary surgeries.

Although physiotherapy is largely evidence-based, there are still gaps in the diagnosis and treatment decision-making process, despite increased research efforts. This is mainly due to the heterogeneity in disorders, symptoms, and patients, which has further led to the development of personalized treatment.

This Special Issue aims to present recent evidence on the diagnosis and treatment of musculoskeletal disorders to enhance awareness of the importance of the diagnosis process, including differential diagnosis, and the application of appropriate treatment. This will lead to more accurate assessments and better patient care.

Original articles, systematic reviews or meta-analyses are welcomed. We look forward to receiving your submissions.

Prof. Dr. Gali Dar
Guest Editor

Manuscript Submission Information

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Keywords

  • musculoskeletal
  • back pain
  • neck pain
  • knee
  • shoulder
  • diagnosis
  • physiotherapy

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Published Papers (5 papers)

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Research

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10 pages, 564 KB  
Article
Abdominal and Multifidus Muscle Morphology and Function, Trunk Clinical Tests, and Symmetry in Young Elite Archery Athletes
by Gali Dar, Alon Yehiel, Kerith Aginsky, Yossi Blayer and Maya Calé-Benzoor
J. Clin. Med. 2025, 14(17), 5974; https://doi.org/10.3390/jcm14175974 - 24 Aug 2025
Viewed by 570
Abstract
Background/Objectives: Archery is a technical sport involving repetitive and asymmetrical movements that requires trunk stability to enable good performance of the upper extremities. Being an asymmetrical sport, imbalances between sides might appear in the abdominal and back muscles. To assess trunk muscle [...] Read more.
Background/Objectives: Archery is a technical sport involving repetitive and asymmetrical movements that requires trunk stability to enable good performance of the upper extremities. Being an asymmetrical sport, imbalances between sides might appear in the abdominal and back muscles. To assess trunk muscle function and symmetry in young competitive archers. Methods: Analyzing pre-season screening evaluation tests from medical files. This included an ultrasound examination of back and abdominal muscles (transverse abdominus and internal oblique) during rest and contraction and trunk muscle clinical strength tests. Results: Data on 15 elite archery athletes (mean age 17.2 (±2.7) years) were included. No athletes reported low back pain. No differences were found between the dominant and non-dominant sides in all outcome measurements (absolute thickness and percentage difference). Internal oblique muscle thickness during rest and contraction for the dominant side was higher in males compared with females (p < 0.05). The back muscles were more symmetrical than the abdominal muscles. Conclusions: Despite the asymmetrical functional demands of sport archery, young athletes displayed trunk muscle symmetry, particularly in their back muscles. While some variability in abdominal muscle asymmetry was observed, these differences were not statistically significant. Full article
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24 pages, 1780 KB  
Article
Effects of Global Postural Re-Education Versus Specific Therapeutic Exercises on Pain, Head Posture, and Pain-Related Psychosocial Factors in Women with Chronic Nonspecific Neck Pain: A Randomized Clinical Trial
by Tânia Fernandes, Carolina Vila-Chã, Luis Polo-Ferrero, Javier Martín-Vallejo, Ana Silvia Puente-González and Roberto Méndez-Sánchez
J. Clin. Med. 2025, 14(5), 1581; https://doi.org/10.3390/jcm14051581 - 26 Feb 2025
Viewed by 5367
Abstract
Background: The aim of this trial is to compare the effects of two types of exercises, Global Postural Re-education versus specific therapeutic exercises on pain perception, pain threshold to pressure, psychosocial factors associated with pain, and craniocervical posture in women with chronic [...] Read more.
Background: The aim of this trial is to compare the effects of two types of exercises, Global Postural Re-education versus specific therapeutic exercises on pain perception, pain threshold to pressure, psychosocial factors associated with pain, and craniocervical posture in women with chronic nonspecific neck pain. Methods: This study is a randomized, parallel-group, single-blind clinical trial. Fifty-two women with chronic nonspecific neck pain (two excluded) were recruited and randomly assigned to (n = 25) Global Postural Re-education and (n = 25) specific therapeutic exercises. Interventions were carried out for 4 weeks, two sessions per week, and were combined with a daily home exercise program. Numerical Pain Rating Scale, mechanosensitivity to pressure, kinesiophobia, pain catastrophizing, and craniocervical angle were assessed in two pre-intervention assessments, one week apart, and at 2 and 4 weeks after the start of the intervention. Results: Global Postural Re-education was as effective as specific therapeutic exercises, showing improvements in all variables assessed with significant intra-group differences over time and high effect sizes (ŋp2 > 0.157 for all variables). Conclusions: Global Postural Re-education is as effective as a specific therapeutic exercise program in reducing subjective pain perception, local and remote mechanosensitivity, and short-term pain-related psychosocial factors in women with chronic nonspecific neck pain. Full article
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10 pages, 1199 KB  
Article
Factors Associated with Driving Ability and Changes After Immobilization of the Right Lower Limb: A Driving Simulator Study
by Young Cheol Kim, Moo Sik Lee, Byung Hak Oh, Youn Moo Heo, Tae Gyun Kim, Se Jong Yoo and Hyun Jin Yoo
J. Clin. Med. 2025, 14(4), 1396; https://doi.org/10.3390/jcm14041396 - 19 Feb 2025
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Abstract
Introduction: Patients with orthopedic injuries often require cast immobilization therapy using casts. Driving with a cast on the right lower limb restricts many things. This study aimed to investigate the factors associated with driving capacity after orthopedic fixation of the right lower limb [...] Read more.
Introduction: Patients with orthopedic injuries often require cast immobilization therapy using casts. Driving with a cast on the right lower limb restricts many things. This study aimed to investigate the factors associated with driving capacity after orthopedic fixation of the right lower limb in healthy adult volunteers. This study’s hypothesis was that the orthopedic splint immobilization would have delayed reaction when in a driving simulation. Materials and Methods: We carried out an experimental study between 17 April 2023 and 19 May 2023. We set up the study in two phases: a driving simulation experiment without immobilization with a cast on the right lower limb and a driving simulation experiment with immobilization with a cast on the right lower limb. The data collected through the questionnaire were then analyzed in R version 4.2.2. Results: A total of 47 individuals participated in the study with a mean height of 167.68, of which 68.09% were females. Overall, 78.7% of the study participants could not drive after immobilization with a cast on the right lower limb. There was a significant difference between participants who could drive and those who could not drive by height (p = 0.04), age (p = 0.038), and body type (p = 0.046). Conclusions: Our study demonstrates that an individual’s height, age, and body type are associated with an individual’s driving ability after orthopedic immobilization of the right lower limb. Our findings suggest that regulations regarding the ability to drive after orthopedic immobilization of the right lower limb must be reconsidered. Full article
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10 pages, 1946 KB  
Article
Prediction Model for Sciatic Nerve Procedures: A Cross-Sectional Study
by Isabel Minguez-Esteban, Ángel González-de-la-Flor, Jorge Hugo Villafañe, Juan Antonio Valera-Calero, Gustavo Plaza-Manzano, Pedro Belón-Pérez and Carlos Romero-Morales
J. Clin. Med. 2024, 13(24), 7851; https://doi.org/10.3390/jcm13247851 - 23 Dec 2024
Cited by 1 | Viewed by 1391
Abstract
Objectives: We aimed to create a predictive model to estimate sciatic nerve depth using anthropometric and demographic data to enhance safety and precession in needle-based interventions. Setting: The study was conducted at Universidad Europea de Madrid, Spain. Methods: A Cross-sectional observational study was [...] Read more.
Objectives: We aimed to create a predictive model to estimate sciatic nerve depth using anthropometric and demographic data to enhance safety and precession in needle-based interventions. Setting: The study was conducted at Universidad Europea de Madrid, Spain. Methods: A Cross-sectional observational study was carried out between January and April 2024. The study included fifty volunteers aged 18–45 years, without any muscle tone affections, lower limb asymmetries, or history of lower limb surgeries. Demographic and anthropometric data were collected, including sex, age, height, weight, BMI, and leg length measure and thigh circumference at specific points. The sciatic nerve depth was measured using ultrasound imaging under the gluteal fold and in the posterior middle third of the thigh. Results: Correlation analysis revealed significant associations between thigh circumference at the proximal and middle third and sciatic nerve depth. A multiple linear regression model identified that the proximal thigh circumference was a significant predictor of sciatic nerve depth, explaining 44.5% of the variance. The variance increased to 49.7% when gender was added. The depth of the sciatic nerve in the middle third explained 38.2% of the variance. And the inclusion of gender in the model explained 40.8% of the variance for the middle third. Conclusions: This study identify significant predictors such as the thigh girth at the proximal and mid-third levels, gender, and the BMI. These findings suggest that clinicians can use these anthropometric measurements to estimate sciatic nerve depth more accurately, reducing the risk of accidental nerve injury and improve the precision and safety of needling procedures during invasive procedures. Full article
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Other

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21 pages, 926 KB  
Systematic Review
Technical Variations in Lateral Extra-Articular Tenodesis for Anterior Cruciate Ligament Reconstruction: A Systematic Review
by Jan Zabrzyński, Bartosz Turoń, Adam Kwapisz, Achilles Boutsiadis, Maria Zabrzyńska, Maciej Sokołowski, Bartosz Majchrzak, Michalina Adamczyk, Katie Kellett and Gazi Huri
J. Clin. Med. 2025, 14(18), 6510; https://doi.org/10.3390/jcm14186510 - 16 Sep 2025
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Abstract
Background/Objectives: The aim was to provide a comprehensive, systematic review on the Lateral Extra-articular Tenodesis (LET) methods used in anterior cruciate ligament (ACL) reconstruction in the light of recent data. Methods: To identify all of the essential studies that reported relevant [...] Read more.
Background/Objectives: The aim was to provide a comprehensive, systematic review on the Lateral Extra-articular Tenodesis (LET) methods used in anterior cruciate ligament (ACL) reconstruction in the light of recent data. Methods: To identify all of the essential studies that reported relevant data concerning primary outcomes: indications for surgery, surgical technique, graft type, fixation method, and tibial fixation location, an extensive search of the major and significant electronic databases (PubMed, Cochrane Central, ScienceDirect, Web of Science, Embase) was performed by three independent authors. A systematic investigation was conducted in November 2023, with no limits regarding the year of publication. After the database search, three independent reviewers screened all the papers, which followed strictly the inclusion and exclusion criteria, identifying a title, abstract, and full text concerning LET, surgical technique, femoral attachment, tibial attachment, graft type, fixation method, knee angle during fixation, and graft tension at fixation in ACL reconstruction. A systematic review of the collected literature was carried out according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Study quality was assessed using the Cochrane Risk of Bias Tool. Results: Of the 35 papers reviewed, seven surgical techniques of LET differing in the way the procedure was performed were separated. The majority of papers were from Italy (n = 11), USA (n = 3), France (n = 3), and Canada (n = 3). The number of total participants across all studies was 6253. The majority of studies (17 papers) used the Lemaire modified procedure, and 10 papers used the MacIntosh technique modified by the Coker–Arnold approach. Most of the papers mentioned fixation location on the lateral distal part of the femur including six articles referring directly to lateral femoral epicondyle. Most authors (25 papers) defined tibial attachment as Gerdy’s tubercle. The most common graft was the iliotibial band and fixation method was sutures. The types of fixation in the surgical techniques of the collected papers were Sutures, Staples, Anchor, Interference screw, K-wire, Bioabsorbable Screw and Titanium Screw with a serrated polyethylene washer. Conclusions: Despite variability in technique, the Lemaire-modified procedure emerged as the preferred approach for Lateral Extra-articular Tenodesis, suggesting a general consensus around its reliability and reproducibility in clinical practice. The frequent use of the iliotibial band as graft material reflects its accessibility and suitability for reinforcing anterolateral stability. Similarly, the consistent use of sutures and fixation at Gerdy’s tubercle may indicate a favorable balance between technical ease and biomechanical strength. The variability in femoral fixation points—either at the lateral femoral condyle or epicondyle—highlights the ongoing debate or surgeon preference, underscoring the need for further comparative studies to establish optimal fixation strategy. Collectively, these patterns may help guide surgical decision-making, particularly when tailoring procedures to individual patient anatomy or surgical expertise. Full article
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