Journal of Clinical Medicine

Research

Jump to: Review

11 pages, 217 KiB

Open AccessArticle

Muscle Strength Outcomes After ACL Reconstruction Before, During, and After COVID-19-Related Rehabilitation Disruptions

by Martin Rudolf Zore, Nevenka Kregar Velikonja and Mohsen Hussein

J. Clin. Med. 2025, 14(8), 2751; https://doi.org/10.3390/jcm14082751 - 16 Apr 2025

Viewed by 487

Abstract

Background: Healthcare restrictions on non-urgent services during the COVID-19 pandemic led to limited access to rehabilitation and delayed treatment, potentially affecting early and mid-term recovery following anterior cruciate ligament reconstruction (ACLR). However, little is known about its specific consequences on muscle strength recovery [...] Read more.

Background: Healthcare restrictions on non-urgent services during the COVID-19 pandemic led to limited access to rehabilitation and delayed treatment, potentially affecting early and mid-term recovery following anterior cruciate ligament reconstruction (ACLR). However, little is known about its specific consequences on muscle strength recovery in recreational and amateur athletes. Objectives: This study aimed to compare short-term clinical outcomes in ACLR patients before, during, and after the pandemic, spanning from 2020 to 2022. Methods: We conducted a retrospective review of 126 patients who underwent ACLR using a hamstring tendon autograft. Patients were grouped based on the timing of surgery and matched for gender. Clinical outcomes and muscle strength parameters were evaluated using an isokinetic dynamometer. Results: Male patients exhibited no significant differences in muscle strength across all time frames (control, 2020, 2021, and 2022). In contrast, female patients who underwent surgery in 2020 and 2021 showed higher extension asymmetry index deficits (Q-AI: 34.09 ± 14.59% and 36.47 ± 16.36%, respectively) and increased flexion deficits in 2021 (H-AI: 25.14 ± 11.41%). Significant differences were observed in quadriceps and hamstring peak torque values, both absolute and normalized. By 2022, the female group exhibited a reduced extension deficit (Q-AI: 18.64 ± 14.49%) comparable to pre-pandemic levels (Q-AI: 19.84 ± 12.37%), indicating a recovery of knee extensor strength. Conclusion: Our study showed gender-specific differences in muscle strength recovery after ACLR during the COVID-19 pandemic, with females showing poorer outcomes than males at 5 months post-operation. Larger studies with extended follow-up are needed to clarify the pandemic’s impact and gender-specific responses. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

14 pages, 228 KiB

Open AccessArticle

Strengths and Weaknesses of Physiotherapy in the Daily Work of an Intensive Care Unit: A Qualitative Study

by Anabel Solares-Mogollón and Rubén Cuesta-Barriuso

J. Clin. Med. 2025, 14(7), 2283; https://doi.org/10.3390/jcm14072283 - 27 Mar 2025

Viewed by 536

Abstract

Objectives: To describe the strengths and barriers of administering a physiotherapy treatment to patients admitted to an intensive care unit. Methods: Qualitative interpretative description study. Twenty-one health professionals working in an intensive care unit in two referral hospitals were recruited in [...] Read more.

Objectives: To describe the strengths and barriers of administering a physiotherapy treatment to patients admitted to an intensive care unit. Methods: Qualitative interpretative description study. Twenty-one health professionals working in an intensive care unit in two referral hospitals were recruited in the study. Each personal interview began with open-ended questions and then continued with more interview-inspired questions. All healthcare professionals gave their views on their knowledge, perceptions and observations of the strengths and weaknesses of physiotherapy in the treatment of patients admitted to this unit. Results: The analysis highlighted four main topics: (i) knowledge of the role of physiotherapists at the ICU; (ii) benefits of physiotherapy for patients and in a multidisciplinary team environment; (iii) challenges and proposals for improvement in interprofessional collaboration; iv) needs for the implementation of physiotherapy. Conclusions: This study analyzes the opinion of intensive care unit professionals regarding the strengths and barriers of physiotherapy in these units. Healthcare professionals highlight the importance of early physiotherapy treatment, the insufficient number of physiotherapists in these units and the benefits of physiotherapy in the respiratory and functional improvement of patients. The main perceived barriers are communication between professionals and the need to reduce the ratio of patients per physiotherapist. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

13 pages, 763 KiB

Open AccessArticle

Physiotherapy Intervention in the Immediate Postoperative Phase of Lipedema Surgery—Observational Study

by Ángela Río-González, Esther Delgado-Pérez, Elisa García-García, Laura González-Fernández, Sara García-Isidoro and Ester Cerezo-Téllez

J. Clin. Med. 2025, 14(7), 2137; https://doi.org/10.3390/jcm14072137 - 21 Mar 2025

Viewed by 986

Abstract

Background: Lipedema is an adipose tissue disorder in women, with an abnormal fat deposition in lower limbs and occasionally upper limbs. The condition is characterized by pain, bruising, heaviness, and mobility impairment. Objectives: This study aims to evaluate the effects of [...] Read more.

Background: Lipedema is an adipose tissue disorder in women, with an abnormal fat deposition in lower limbs and occasionally upper limbs. The condition is characterized by pain, bruising, heaviness, and mobility impairment. Objectives: This study aims to evaluate the effects of a modified Complete Decongestive Therapy protocol using the Godoy Method in the postoperative period following lipedema surgery. Methods: In total, 293 participants who underwent liposuction for lipedema were studied. The postoperative physiotherapy protocol included Godoy cervical stimuli, Manual Lymphatic Drainage based on Godoy maneuvers, mechanical lymphatic drainage with RAGodoy^®, compression with bandages, skin care, and therapeutic education. Results: This study found that the number of physiotherapy sessions significantly reduced pain (p = 0.000) and other complications (p = 0.007) and increased mobility (p = 0.003). The number of physiotherapy sessions showed significant differences in pain intensity at 90 days post-treatment (p = 0.000). In total, 47.24% of the participants became functionally independent on the third day of the physiotherapy intervention (p = 0.003). A total of 40.96% of the participants developed some complications, although a relationship between inadequate compression and the occurrence of complications was also found in 36.52% of patients. Conclusions: The success of surgical treatment for lipedema not only depends on the surgery itself but also on the proper management of the patient in the perioperative period to minimize complications and prevent recurrence. The Complete Decongestive Therapy protocol modified with the Godoy Method showed effects on pain reduction, mobility increase, edema reabsorption, and prevention of complications, consequently enhancing functionality and quality of life for patients undergoing lipedema surgery. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Graphical abstract

18 pages, 881 KiB

Open AccessArticle

Functional Mobility Studies in Younger Adults: Instrumented Timed Up and Go (iTUG) Test Using Inertial Devices

by Mateusz Kowal, Sławomir Winiarski, Ewa Morgiel, Marta Madej, Krzysztof Proc, Marcin Madziarski, Nicole Wedel and Agata Sebastian

J. Clin. Med. 2025, 14(6), 1944; https://doi.org/10.3390/jcm14061944 - 13 Mar 2025

Viewed by 464

Abstract

Functional Mobility Assessment (FMA) is a challenging task. One example of an FMA is an instrumented Timed Up and Go test (iTUG). Sensor-based interventions are more effective than traditional interventions that use clinical tests to assess a patient’s FMA. Background/Objectives: The aim [...] Read more.

Functional Mobility Assessment (FMA) is a challenging task. One example of an FMA is an instrumented Timed Up and Go test (iTUG). Sensor-based interventions are more effective than traditional interventions that use clinical tests to assess a patient’s FMA. Background/Objectives: The aim of this study is to investigate the variability of selected parameters of the instrumented Time Up and Go test using inertial measurements in healthy younger adults. Methods: A total of 73 subjects participated in the study, including 37 women and 36 men. The mean age was 31 years (SD 5.5 years), the mean height [cm] was 176.2 (SD 91), and the mean BMI [kg/m²] was 26.6 (SD 3.1). The Noraxon MyoMotion Research 18 motion analysis system was used to record raw spatial data. Results: The mean total time to complete the iTUG test was 13.1 ± 1.9 s with a low coefficient of variation (CV), suggesting consistent performance between participants. The recorded spatial and temporal parameters of the gait variables, as well as the kinematic variables of the iTUG test of the studied group of healthy adults, show low variability, except for the mean double support ratio (R − L)/(R + L), which was 4.1 ± 11.0% with a CV of 271.5%, indicating a very high variability. Conclusions: The low variability observed in key parameters, such as total time and percentage of posture, suggests that the iTUG test provides reliable, objective, and reproducible measurements that can serve as normative benchmarks for healthy adults. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

12 pages, 830 KiB

Open AccessArticle

Assessing Physiotherapists’ Adherence to Clinical Practice Guidelines for Ankle Sprain Management in Saudi Arabia: A Cross-Sectional Study with National Online Survey

by Abdulaziz Matouk Althumali and Hosam Alzahrani

J. Clin. Med. 2025, 14(6), 1889; https://doi.org/10.3390/jcm14061889 - 11 Mar 2025

Viewed by 696

Abstract

Background/Objectives: Ankle sprain is one of the most common sports injuries globally. Despite its prevalence, the adequacy of knowledge in managing ankle sprain among physiotherapists in Saudi Arabia has not been assessed. This study aimed to assess the knowledge and degree of adherence [...] Read more.

Background/Objectives: Ankle sprain is one of the most common sports injuries globally. Despite its prevalence, the adequacy of knowledge in managing ankle sprain among physiotherapists in Saudi Arabia has not been assessed. This study aimed to assess the knowledge and degree of adherence to clinical practice guidelines (CPG) for the management of ankle sprains among physiotherapists. Methods: This study was a cross-sectional with national online questionnaire administered to participants through an online platform. It comprised three sections. The first section collected demographic data. The second section presented two clinical cases as the basis for the participants’ management decisions (the first with negative Ottawa Ankle Rules (OAR) and the second with positive OAR); participants were classified as “following”, “partially following”, “not following”, and “partially not following” the CPGs. In the third section, on a Likert scale (1–5), participants indicated how much they agreed with various CPGs statements. Results: A total of 381 physiotherapists (mean age: 28 ± 5; male: 57.1%) completed the questionnaire. In the case of acute ankle sprain with negative OAR, 0.2% of the participants were considered as “following” CPGs, 31.4% as “partially following”, 19.6% as “partially not following”, and 48.5% as “not-following”. In the case of acute ankle sprain with positive OAR, 5.2% were considered as “following” CPGs, 55.9% as “partially not following”, and 38.8% as “not following”. The knowledge assessment section elicited a 50% agreement among the participants on the 11 provided statements. Conclusions: Most physiotherapists have suboptimal adherence to CPG for managing ankle sprains, thus highlighting an evidence-to-practice gap. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

10 pages, 1293 KiB

Open AccessArticle

Intra- and Inter-Rater Reliability of Ultrasound Imaging to Measure Tensor Fasciae Latae Muscle Size

by Elena Estébanez-de-Miguel, Luis Ceballos-Laita, Jesús Gómez-Vallejo, Sandra Jiménez-del-Barrio and Miguel Malo-Urriés

J. Clin. Med. 2025, 14(5), 1731; https://doi.org/10.3390/jcm14051731 - 4 Mar 2025

Viewed by 535

Abstract

Objectives: The objectives of this study were to develop a procedure to measure the cross-sectional area and thickness of tensor fasciae latae muscle, and examine the intra- and inter-rater reliability of this procedure in healthy participants. Methods: The cross-sectional area and [...] Read more.

Objectives: The objectives of this study were to develop a procedure to measure the cross-sectional area and thickness of tensor fasciae latae muscle, and examine the intra- and inter-rater reliability of this procedure in healthy participants. Methods: The cross-sectional area and thickness of tensor fascia latae were evaluated by sonography in 14 healthy subjects (28 lower extremities) in a single session. Two examiners conducted ultrasound examinations and performed the measurements independently. Each examiner was blinded to the measurements of the other examiner. For examination, the transducer was placed transversally to the thigh at the anterior superior iliac spine level and was moved caudally along the tensor fascia latae muscle, ensuring that the volume of the muscle was in the center of the image. The examiners took ultrasound images when the maximum size was reached. Results: The intra-rater reliability for tensor fascia latae measurements was excellent in both examiners (cross-sectional area: ICC2,2 = 0.905–0.969, SEM = 0.29–0.82 mm², MDC = 0.80–2.27; thickness: ICC2,2 = 0.965–0.985, SEM = 0.20–0.60 mm, MDC = 0.55–1.66; all p < 0.001). The inter-rater reliability was good for the cross-sectional area (ICC2,2 = 0.783, SEM = 0.77 mm², MDC = 2.13 mm²). The inter-rater reliability was poor for thickness measurements (ICC2,2 = 0.445, SEM = 2.12 mm, MDC = 5.87 mm) and 2.12 mm for thickness. Conclusions: The procedure developed for measuring the size of the tensor fascia latae muscle with ultrasound images has demonstrated feasibility and excellent intra-rater reliability. The inter-rater reliability was good and poor for cross-sectional area and thickness measurements, respectively. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

12 pages, 526 KiB

Open AccessArticle

Sex-Specific Sensory Profiles Discriminate Between Sensitization at Twelve Weeks in Patients with Acute Low Back Pain: A Retrospective Study

by Pieter J. Gräper, Aldo Scafoglieri and Joannes M. Hallegraeff

J. Clin. Med. 2025, 14(2), 621; https://doi.org/10.3390/jcm14020621 - 19 Jan 2025

Viewed by 637

Abstract

Background/objective: Low back pain (LBP) is the leading cause of disability worldwide, resulting in enormous socio-economic and personal consequences. Sensory profiles during the acute back pain stage will predict central sensitization symptoms in the chronic pain stage, as central sensitization is the main [...] Read more.

Background/objective: Low back pain (LBP) is the leading cause of disability worldwide, resulting in enormous socio-economic and personal consequences. Sensory profiles during the acute back pain stage will predict central sensitization symptoms in the chronic pain stage, as central sensitization is the main mechanism behind nociplastic pain and pain chronicity. Therefore, our objective was to establish overall and sex-specific sensory profile cut-off points that distinguish symptoms of central sensitization at 12 weeks, using a retrospective prognostic cohort study design. Methods: Two hundred and seventeen patients with acute LBP (<6 weeks) were assessed using Receiver Operator Characteristic analyses. Measurements were taken at baseline using the Adolescent/Adult Sensory Profile and follow-up by the Central Sensitization Inventory at 12 weeks, based on the established Central Sensitization Inventory cut-off points for the overall population at ≥30 and ≥40, female patients at ≥33, and male patients at ≥25. Results: In female patients, a Sensory Sensitive cut-off point of ≥30.5 significantly distinguished central sensitization symptoms at 12 weeks, resulting in the following values: Area Under the Curve = 0.81 (95% CI = 0.73; 0.89), sensitivity = 0.89, specificity = 0.63, prevalence = 0.36, positive predictive value = 0.56, negative predictive value = 0.80, and Youden’s index = 0.52. Conclusions: The Sensory Sensitive profile distinguishes female patients with acute LBP with and without central sensitization symptoms at 12 weeks. This cut-off point may be useful in identifying individual sensory preferences and addressing maladaptive behavioral responses to sensory stimulation in clinical practice to prevent chronicity. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

18 pages, 1099 KiB

Open AccessArticle

Online vs. Supervised Training in Relieving Urinary Incontinence and Diastasis Recti Abdominis in Early Postpartum

by Sabina Tim and Agnieszka Mazur-Bialy

J. Clin. Med. 2024, 13(24), 7730; https://doi.org/10.3390/jcm13247730 - 18 Dec 2024

Viewed by 1020

Abstract

Background/Objectives: The postpartum period is marked by numerous physical changes, often leading to pelvic floor disorders (PFD) such as urinary incontinence (UI) and diastasis recti abdominis (DRA). This study aimed to assess the occurrence of UI and DRA in postpartum women and [...] Read more.

Background/Objectives: The postpartum period is marked by numerous physical changes, often leading to pelvic floor disorders (PFD) such as urinary incontinence (UI) and diastasis recti abdominis (DRA). This study aimed to assess the occurrence of UI and DRA in postpartum women and evaluate the effectiveness of physiotherapy in managing UI and DRA. Methods: A total of 396 women, between the 3rd and 5th postpartum day, were randomized into three groups: control (GrCon), online exercise group (GrOnl), and supervised group (GrSup). GrCon received only education, whereas GrOnl and GrSup had three sessions with exercises with physiotherapist—online or supervised. Data were collected through questionnaires, ICIQ FLUTS, body posture assessments, and DRA measurements. Results: The results showed a significant reduction in UI and DRA symptoms across all groups, with the GrSup group showing the greatest improvement. UI symptoms decreased from 49% during pregnancy to 36.9% postpartum, with GrSup women reporting fewer urological complaints compared to the GrOnl and GrCon groups (p < 0.001). DRA incidence dropped from 76.2% in the early postpartum days to 23.4% at six weeks, with GrSup showing the lowest rates (9.8%). Notably, supervised physiotherapy resulted in a higher frequency (94.7%) and correct performance of PFME (72.2%) compared to the online and control groups. Conclusions: The study concludes that supervised physiotherapy is more effective than online sessions in managing postpartum UI and DRA, emphasizing the importance of guided exercise for better outcomes. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

10 pages, 274 KiB

Open AccessArticle

Kinesiophobia and Its Correlation with Upper Limb and Hand Functionality Among Individuals with Wrist/Hand Injury: A Cross-Sectional Study

by Atenea Villalobos-García, Leire Cruz-Gambero, Roberto Ucero-Lozano, Kristin Valdes and Raquel Cantero-Téllez

J. Clin. Med. 2024, 13(24), 7604; https://doi.org/10.3390/jcm13247604 - 13 Dec 2024

Viewed by 1107

Abstract

Background/Objectives: Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study’s [...] Read more.

Background/Objectives: Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study’s objectives are (1) to evaluate the relationship between kinesiophobia, pain catastrophizing, QuickDASH, and Patient-Rated Wrist Evaluation and (2) to evaluate the data regarding the influence that basal kinesiophobia may have on upper limb functionality after wrist/hand immobilization. Methods: Participants referred from different medical centers with a wrist or hand injury that required immobilization were enrolled in the study. Data were collected just after the post-immobilization period. The following outcome measures were evaluated: the QuickDASH, the PRWE (Patient-Rated Wrist Evaluation), the TSK (Tampa Scale of Kinesiophobia), and the PCS (Pain Catastrophizing Scale). Demographics were summarized with descriptive statistics and linear relationships between variables using Pearson’s correlation coefficient. Furthermore, multivariate linear regression analysis was performed to determine whether kinesiophobia could predict upper functional performance. Results: 64 patients (40 women, 24 men) participated in the study. Significant kinesiophobia positive correlations were found between the TSK and the QuickDASH (r = 0.848, p < 0.001) as well as the TSK and the PCS error (r = 0.521, p < 0.001). The regression model explains 30.4% of the variance in upper limb function, suggesting that the PRWE, the Pain Catastrophizing Scale, and the QuickDASH are important in predicting dysfunction. Conclusions: Kinesiophobia may contribute to but is not a significant predictor of dysfunction in this model. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

10 pages, 229 KiB

Open AccessArticle

A Longitudinal Decline in Walking Speed Is Linked with Coexisting Hypertension and Arthritis in Community-Dwelling Older Adults

by Saud M. Alrawaili, Khalid Alkhathami, Mohammed G. Elsehrawy, Mohammed S. Alghamdi, Hussein M. Alkahtani, Norah A. Alhwoaimel and Aqeel M. Alenazi

J. Clin. Med. 2024, 13(18), 5478; https://doi.org/10.3390/jcm13185478 - 15 Sep 2024

Cited by 2 | Viewed by 1125

Abstract

Objective: The aim was to investigate the association between baseline coexistence of hypertension (HTN) and arthritis, HTN alone, or arthritis alone, and their impact on longitudinal physical function measures among community-dwelling older adults over 5 years of follow-up. Methods: Ours was [...] Read more.

Objective: The aim was to investigate the association between baseline coexistence of hypertension (HTN) and arthritis, HTN alone, or arthritis alone, and their impact on longitudinal physical function measures among community-dwelling older adults over 5 years of follow-up. Methods: Ours was a longitudinal prospective cohort study from the second wave (2010–2011) and third wave (2015–2016) of the National Social Life, Health, and Aging Project (NSHAP). Data for older adults were used. Participants were categorized based on self-reported diagnoses into four groups: coexisting HTN and arthritis, HTN only, arthritis only, or neither. Physical performance measures included walking speed using the 3-Meter Walk Test and the Five Times Sit-to-Stand Test (FTSST). Multiple generalized estimating equations with linear regression analyses were conducted, adjusting for age, sex, race, body mass index (BMI) educational level, pain severity, and baseline use of pain and hypertension medications. Results: Data for 1769 participants were analyzed. Slower walking speed was only associated with coexisting HTN and arthritis (B = −0.43, p < 0.001) after accounting for covariates. The coexisting HTN and arthritis group showed no significant association with FTSST (B = 0.80, p = 0.072) after accounting for covariates. Conclusions: The coexistence of baseline HTN and arthritis in older adults is associated with a gradual decline in only walking speed as a physical performance measure in older adults. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

11 pages, 2177 KiB

Open AccessArticle

Gait Performance and Brain Activity Are Improved by Gait Automatization during Robot-Assisted Gait Training in Patients with Burns: A Prospective, Randomized, Single-Blinded Study

by Seung Yeol Lee, Jisu Seo, Cheong Hoon Seo, Yoon Soo Cho and So Young Joo

J. Clin. Med. 2024, 13(16), 4838; https://doi.org/10.3390/jcm13164838 - 16 Aug 2024

Viewed by 1126

Abstract

Background: Patients with lower extremity burn injuries have decreased gait function. Gait dysfunctions are compensated by activation of executive areas such as the prefrontal cortex (PFC). Although robot-assisted gait training (RAGT) can improve gait function, the training mechanisms of RAGT are unknown. We [...] Read more.

Background: Patients with lower extremity burn injuries have decreased gait function. Gait dysfunctions are compensated by activation of executive areas such as the prefrontal cortex (PFC). Although robot-assisted gait training (RAGT) can improve gait function, the training mechanisms of RAGT are unknown. We aimed to determine the clinical effects of RAGT in patients with burns and investigate their underlying mechanisms. Methods: This single-blind, randomized controlled trial involved 54 patients with lower extremity burns. The RAGT group underwent RAGT using SUBAR^® and conventional training. The control (CON) group underwent only conventional training. The primary outcome was cortical activity measured using a functional near-infrared spectroscopy device before and after 8 weeks of training to confirm the compensatory effect of gait dysfunction. The secondary outcomes were the functional ambulation category (FAC) to evaluate gait performance, 6-min walking test (6 MWT) distance to measure gait speed, isometric force and range of motion (ROM) of lower extremities to evaluate physical function, and the visual analog scale (VAS) score to evaluate subjective pain during gait. Results: PFC activation during the gait phase in the RAGT group decreased significantly compared with that of the CON. The VAS score decreased and FAC score improved after 8 weeks of training in both groups. The 6 MWT scores, isometric strengths (the left knee flexor and bilateral ankle plantar flexors), and the ROMs (the extensions of bilateral hip and bilateral knee) of the RAGT group were significantly improved compared with those of the CON. RAGT improved gait speed, lower extremity ROMs, and lower extremity muscles strengths in patients with burns. Conclusions: The improvement in gait speed and cerebral blood flow evaluation results suggests that the automatization of gait is related to the treatment mechanism during RAGT. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

14 pages, 990 KiB

Open AccessArticle

Sensory Profiles Predict Symptoms of Central Sensitization in Low Back Pain: A Predictive Model Research Study

by Pieter J. Gräper, Aldo Scafoglieri, Jacqueline R. Clark and Joannes M. Hallegraeff

J. Clin. Med. 2024, 13(16), 4677; https://doi.org/10.3390/jcm13164677 - 9 Aug 2024

Cited by 3 | Viewed by 1881

Abstract

Background: Acute low back pain has a high prevalence, and when persisting into chronicity, it results in enormous socio-economic consequences. Sensory preferences may be key factors in predicting central sensitization as the main mechanism of nociplastic pain and chronicity. Objectives: Build [...] Read more.

Background: Acute low back pain has a high prevalence, and when persisting into chronicity, it results in enormous socio-economic consequences. Sensory preferences may be key factors in predicting central sensitization as the main mechanism of nociplastic pain and chronicity. Objectives: Build a model to predict central sensitization symptoms using sensory profiles based on the PROGRESS framework. Methods: A Prognostic Model Research study was carried out to predict central sensitization symptoms at 12 weeks, using baseline sensory profiles, based on 114 patients with acute low back pain. Independent variables were sensory profiles, state and trait anxiety, age, duration, pain severity, depressive symptoms, and pain catastrophizing. Results: This model, based on continuous data, significantly predicts central sensitization symptoms at 12 weeks. It contains two significantly contributing variables: sensory profile Sensory Sensitive (unstandardized B-value = 0.42; p = 0.01) and trait anxiety (unstandardized B-value = 0.53; p ≤ 0.001). The model has a predictive value of R² = 0.38. Conclusions: This model significantly predicts central sensitization symptoms based on sensory profile Sensory Sensitive and trait anxiety. This model may be a useful tool to intervene in a bottom–up and top–down approaches to prevent chronicity in clinical practice, including individual sensory preferences and behavioral responses to sensory stimulation in rehabilitation strategies. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

12 pages, 584 KiB

Open AccessArticle

Effect of Local Vibration Therapy on Pain, Joint Position Sense, Kinesiophobia, and Disability in Cervical Disc Herniation: A Randomized Controlled Trial

by Merve Yilmaz Menek, Emre Dansuk and Umut Islam Tayboga

J. Clin. Med. 2024, 13(15), 4566; https://doi.org/10.3390/jcm13154566 - 5 Aug 2024

Cited by 3 | Viewed by 2542

Abstract

Background/Objectives: Vibration therapy approaches are an effective and safe treatment option for musculoskeletal disorders. This study examines the effects of vibration therapy using a percussion massage gun (PMG) on joint position sense, range of motion, pain, functionality, and kinesiophobia in individuals with cervical [...] Read more.

Background/Objectives: Vibration therapy approaches are an effective and safe treatment option for musculoskeletal disorders. This study examines the effects of vibration therapy using a percussion massage gun (PMG) on joint position sense, range of motion, pain, functionality, and kinesiophobia in individuals with cervical disc herniation (CDH). Methods: This single-blind randomized controlled trial involved 44 CDH patients divided into a Vibration Group (VG) and a Conventional Group (CG). The CG underwent a standard physiotherapy treatment heat application, Transcutaneous Electrical Nerve Stimulation (TENS), and exercises for range of motion and strengthening. VG received conventional therapy augmented with vibration therapy (VT) via a PMG. Joint position sense (JPS) using the Laser Pointer Assisted Angle Repetition Test; pain intensity with the Visual Analog Scale, kinesiophobia with the Tampa Scale for Kinesiophobia, and cervical dysfunction with the Neck Disability Index were assessed. Results: Both groups showed statistically significant improvements in pain, kinesiophobia, disability, and proprioception after treatment (p < 0.05). When comparing the difference values between groups, the VG was found to be more effective than the CG in the parameters of VAS activity (p = 0.013). The CG had more improvement in JPS neck left rotation than the VG (p = 0.000). Conclusions: VT, when combined with conventional physiotherapy, is effective in improving pain, proprioception, and functionality in individuals with CDH. These findings support the inclusion of VT as a beneficial adjunct therapy. Further research with larger sample sizes and longer follow-ups is recommended to validate these results and explore the long-term effects of VT on CDH. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

Review

Jump to: Research

14 pages, 653 KiB

Open AccessReview

Mechanisms and Efficacy of Contrast Therapy for Musculoskeletal Painful Disease: A Scoping Review

by Giulia Leonardi, Simona Portaro, Demetrio Milardi, Francesco Bonanno, Ilaria Sanzarello, Daniele Bruschetta, Cristiano Sconza, Adriana Tisano, Jacopo Maria Fontana and Angelo Alito

J. Clin. Med. 2025, 14(5), 1441; https://doi.org/10.3390/jcm14051441 - 21 Feb 2025

Viewed by 2037

Abstract

Background: Contrast therapy (CT) is a non-pharmacological treatment that alternates between cryotherapy and thermotherapy. It helps reduce VAS pain, improve joint ROM, enhance function, alleviate muscle soreness, and manage swelling, while also improving blood circulation. This scoping review summarizes recent studies on [...] Read more.

Background: Contrast therapy (CT) is a non-pharmacological treatment that alternates between cryotherapy and thermotherapy. It helps reduce VAS pain, improve joint ROM, enhance function, alleviate muscle soreness, and manage swelling, while also improving blood circulation. This scoping review summarizes recent studies on its use for musculoskeletal injuries (e.g., exercise-induced muscle damage, ankle sprain), degenerative conditions (e.g., osteoarthritis), and painful disorders (e.g., complex regional pain syndrome), assessing its healing potential compared to other conservative therapies. Methods: PubMed, Scopus, and Cochrane Library were searched to identify relevant publications. Articles were selected using the following inclusion criteria: randomized controlled trials, written in English, published between 2004 and 2024, and addressing the use of CT in the management of musculoskeletal painful conditions. Results: Data from 7 articles and 303 patients with musculoskeletal painful conditions treated with CT were included. There was considerable heterogeneity in terms of treatment protocols, with significant differences in the application method, duration, sequence of individuals in each hot/cold cycle, total treatment time, and the pathologies studied. Nevertheless, all studies showed an improvement in the patients’ initial clinical conditions. Conclusions: This review highlights the lack of guidelines for the clinical use of CT in musculoskeletal painful conditions. The heterogeneity of the studies reviewed (different clinical scores, follow-up periods, data, and samples) makes the results imprecise. In addition, the modest quality of the trials does not allow the authors to draw clear conclusions about the effectiveness of CT compared with other therapies. Full article

(This article belongs to the Special Issue Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Physical Therapy in Musculoskeletal Disorders: Prevention, Diagnosis, Clinical Management and Treatment

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (14 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI