Search Results (640)

Aging is a complex physiological process that profoundly affects the functionality of the musculoskeletal system, contributing to an increase in the incidence of diseases such as osteoporosis, osteoarthritis, and sarcopenia. Cellular senescence plays a crucial role in these degenerative processes, promoting chronic inflammation and tissue dysfunction through the senescence-associated secretory phenotype (SASP). Recently, senotherapeutics have shown promising results in improving musculoskeletal health. Natural compounds such as resveratrol, rapamycin, quercetin, curcumin, vitamin E, genistein, fisetin, and epicatechin act on key signaling pathways, offering protective effects against musculoskeletal decline. On the other hand, molecules such as dasatinib, navitoclax, UBX0101, panobinostat, and metformin have been shown to be effective in eliminating or modulating senescent cells. However, understanding the mechanisms of action, long-term safety, and bioavailability remain areas for further investigation. In this context, physical exercise emerges as an effective non-pharmacological countermeasure, capable of directly modulating cellular senescence and promoting tissue regeneration, representing an integrated strategy to combat age-related diseases. Therefore, we have provided an overview of the main anti-aging compounds and examined the potential of physical exercise as a strategy in the management of age-related musculoskeletal disorders. Further studies should focus on identifying synergistic combinations of pharmacological and non-pharmacological interventions to optimize the effectiveness of anti-aging strategies and promoting healthier musculoskeletal aging. Full article

Sarcopenia is a progressive age-related musculoskeletal disorder characterized by loss of muscle mass, strength, and physical performance, contributing to functional decline and increased risk of disability. Emerging evidence suggests that vitamin D (Vit D) plays a pivotal role in skeletal muscle physiology beyond its classical functions in bone metabolism. This review aims to critically analyze the relationship between serum Vit D levels and sarcopenia in older adults, focusing on pathophysiological mechanisms, diagnostic criteria, clinical evidence, and preventive strategies. An integrative narrative review of observational studies, randomized controlled trials, and meta-analyses published in the last decade was conducted. The analysis incorporated international diagnostic criteria for sarcopenia (EWGSOP2, AWGS, FNIH, IWGS), current guidelines for Vit D sufficiency, and molecular mechanisms related to Vit D receptor (VDR) signaling in muscle tissue. Low serum 25-hydroxyvitamin D levels are consistently associated with decreased muscle strength, reduced physical performance, and increased prevalence of sarcopenia. Although interventional trials using Vit D supplementation report variable results, benefits are more evident in individuals with baseline deficiency and when combined with protein intake and resistance training. Mechanistically, Vit D influences muscle health via genomic and non-genomic pathways, regulating calcium homeostasis, mitochondrial function, oxidative stress, and inflammatory signaling. Vit D deficiency represents a modifiable risk factor for sarcopenia and functional impairment in older adults. While current evidence supports its role in muscular health, future high-quality trials are needed to establish optimal serum thresholds and dosing strategies for prevention and treatment. An individualized, multimodal approach involving supplementation, exercise, and nutritional optimization appears most promising. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Background: Musculoskeletal disorders significantly affect healthcare professionals, particularly physiotherapists, due to the physical demands of their work. The link between physical ailments and psychological distress is especially prominent in clinical settings. Objectives: To assess the prevalence of work-related low back pain (LBP), stress, anxiety, and depression among physiotherapists in Saudi Arabia, and to identify associated local risk factors. Methods: A cross-sectional study using convenience sampling included 710 licensed physiotherapists across Saudi Arabia. Participants completed an online survey containing demographic data and the validated measures, including the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI), and the Depression, Anxiety, and Stress Scale-21 (DASS-21) for psychological distress. Data were analysed using descriptive statistics, chi-square tests, correlation, and regression analyses. Results: Of 710 responses, 697 were valid; 378 physiotherapists reported work-related LBP. The mean pain intensity was 4.6 (SD = 1.6), with 54.2% experiencing moderate to severe disability. Mental health results showed 49.7% had depressive symptoms and 33.9% experienced some level of anxiety. Significant correlations were observed between disability and psychological distress (anxiety: r = 0.382; depression: r = 0.375; stress: r = 0.406; all p < 0.001). Regression analyses indicated psychological distress significantly predicted disability, with R² values ranging from 0.125 to 0.248, being higher among inpatient physiotherapists. Conclusions: This study reveals a high prevalence of LBP and psychological distress among Saudi physiotherapists, with stress being the strongest predictor of LBP severity. Integrated ergonomic and mental health interventions, including workplace wellness programs and psychological support, are recommended to reduce risks and promote a healthier, more sustainable physiotherapy workforce. Full article

Chronic postsurgical or posttraumatic pain (CPSP) is a persistent pain condition lasting beyond three months after tissue injury, often associated with neuropathic features and pathological angiogenesis. This study investigated the feasibility, safety, and therapeutic potential of transarterial embolization (TAE) in patients with CPSP arising from prior musculoskeletal surgeries or interventions. Six patients with refractory pain and imaging evidence of abnormal neovascularization were retrospectively reviewed. TAE was performed using imipenem/cilastatin particles to selectively target pathological vasculature. Eleven procedures were conducted, achieving 100% technical and clinical success. Mean Numeric Rating Scale scores improved significantly from 7.8 at baseline to 1.3 at final follow-up (p < 0.001). No major adverse events occurred, and follow-up imaging demonstrated resolution of inflammation in selected cases. These results support the role of TAE as a minimally invasive treatment option for intervention-related CPSP involving the musculoskeletal system, and further prospective studies are warranted. Full article

Work-related musculoskeletal disorders (WMSDs) are among the most prevalent occupational health issues, particularly affecting public transport drivers due to prolonged sitting, constrained postures, and poorly adaptable cabins. This study addresses the ergonomic risks associated with tram driving, aiming to evaluate biomechanical load and postural stress in relation to drivers’ anthropometric characteristics. A combined methodological approach was applied, integrating two standardized observational tools—RULA and REBA—with anthropometric modeling based on three representatives European morphotypes (SmallW, MidM, and TallM). ErgoFellow 3.0 software was used for digital posture evaluation, and lumbar moments at the L4/L5 vertebral level were calculated to estimate lumbar loading. The analysis was simulation-based, using digital human models, and no real subjects were involved. The results revealed uniform REBA (Rapid Entire Body Assessment) and RULA (Rapid Upper Limb Assessment) scores of 6 across all morphotypes, indicating moderate to high risk and a need for ergonomic intervention. Lumbar moments ranged from 51.35 Nm (SmallW) to 101.67 Nm (TallM), with the tallest model slightly exceeding the recommended ergonomic thresholds. These findings highlight a systemic mismatch between cabin design and user variability. In conclusion, ergonomic improvements such as adjustable seating, better control layout, and driver education are essential to reduce the risk of WMSDs. The study proposes a replicable methodology combining anthropometric, observational, and biomechanical tools for evaluating and improving transport workstation design. Full article

Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring. Full article

Background: Percutaneous electrolysis (PE) is a minimally invasive procedure that utilizes galvanic current delivered through a needle. PE is increasingly employed for musculoskeletal disorders, despite the scarcity of scientific evidence supporting its use. The aim of this systematic review is to synthesize the existing evidence and explore the applications of PE in rehabilitation. Methods: In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted across the PubMed, Web of Science, Scopus, and PEDro databases from inception to July 2025. The search strategy employed the term “Percutaneous Electrolysis” without applying additional filters or time restrictions, ensuring a comprehensive search. Cited references from screened articles were also evaluated for potential inclusion. Studies were included if they met the following criteria: peer-reviewed articles, intervention-based research, relevance to the topic, and publication in English. Results: Of the 181 papers retrieved, 143 were excluded for various reasons, leaving 38 studies. The evidence suggests that PE appears effective in reducing pain and improving function, particularly when combined with exercises such as eccentric training or stretching, though inconsistencies in protocols and patient characteristics, along with unclear mechanisms, show that it warrants further investigation. Conclusions: In conclusion, while PE emerges as a promising therapeutic strategy for musculoskeletal disorders, its full integration into rehabilitation practice necessitates further rigorous research to standardize treatment protocols, elucidate the underlying mechanism, and validate its cost-effectiveness. These steps are essential to establish PE as a robust and evidence-based option within the field of rehabilitation. Full article

Aging is a multifaceted biological process characterized by a progressive decline in cellular function and physiological resilience, increasing the risk of multiple chronic conditions. Chronic lung diseases frequently manifest within the aging population and are closely intertwined with systemic dysfunctions across cardiovascular, musculoskeletal, and neurological systems. In this review, we explore the biological mechanisms linking aging, multiple chronic conditions patterns, and chronic lung disease, with a particular focus on inflammaging and cellular aging. We also highlight shared pathological pathways such as oxidative stress, mitochondrial dysfunction, and the dysregulation of repair processes that underlie both natural aging and the accelerated aging seen in chronic lung disease. Additionally, we discuss the systemic impact of multiple chronic conditions on patient outcomes, including increased frailty, diminished physical capacity, cognitive impairment, and elevated mortality risk. This review advocates for a comprehensive, patient-centered approach that combines early detection, personalized pharmacological therapies targeting inflammatory and senescent pathways, and non-pharmacological interventions such as pulmonary rehabilitation, exercise, and dietary optimization. Emerging therapeutics, including senolytics and anti-inflammatory agents, present promising avenues for mitigating age-related lung decline and managing multiple chronic conditions. Full article

Sarcopenia is a musculoskeletal, progressive, and generalized disease characterized by decreased muscle strength and mass, leading to reduced quality of life. Sarcopenia is directly related to age, a sedentary lifestyle, and poor nutrition. The objective of this study was to evaluate the effect of 12-week progressive intensity Resistance Training (RT) associated with nutritional advice on the frequency of sarcopenia in older adults. A total of 74 older adults (37 in the intervention group and 37 in the control group), with a mean age of 69.1 ± 6.85 years, were included in the study. The sarcopenia status of the participants was assessed at baseline and after a 12-week intervention. In the intervention group, resistance training combined with nutritional counseling reduced the prevalence of sarcopenia from 35.14% to 0% (p < 0.001). Additionally, participants in the intervention group showed significant improvements in handgrip strength (from 27.70 ± 10.71 to 30.24 ± 10.38 kg), chair stand test performance (from 14.04 ± 3.46 to 11.67 ± 1.80 s), and time up and go test (from 7.49 ± 1.20 to 6.74 ± 0.95 s) (p < 0.05). On the other hand, the control group increased the incidence of sarcopenia (p < 0.001). After 12 weeks, progressive intensity RT associated with nutritional advice proved to be an effective treatment to reverse sarcopenia and help participants remain non-sarcopenic. In addition, the results of this study provide information about efficient and non-pharmacological sarcopenia treatment. Full article

Background/Objectives: Public transportation drivers are exposed to a variety of occupational hazards. The scope of this study is to describe the most significant changes in symptoms and work-related disorders in the last decade in a sample of professional drivers from a large Romanian city, and, in particular, the cardio-metabolic and musculoskeletal impact. Methods: A retrospective study on 186 professional tram, trolley, and bus drivers from a total number of 344 employed by the company was conducted. The initial values (pre-employment) of the BMI, blood pressure, cholesterol, fasting glycemia, and musculoskeletal complaints were compared to the values of the last employment check-up. Results: After an average follow-up period of 11 years, BMI increased from 27.69 (SD = 4.68) to 30.06 (SD = 5.2) (p < 0.0001), cholesterol from 201.7 (SD = 39.87) to 212.62 (SD = 42.51), (p = 0.04). The number of cases of high blood pressure (25 to 56, p < 0.0001) and musculoskeletal complaints increased from 3 initial cases to 26 cases of neck pain (p = 0.07), from 2 to 49 cases of dorsal pain (p = 0.02), and from 18 to 59 cases of lumbar pain (p < 0.0001). High blood pressure and low back pain were significantly correlated with tenure, independent of other factors. Conclusions: As tenure is important in the development of cardiovascular and musculoskeletal diseases, specific interventions should be developed in the early stages of the drivers’ career. Full article

With the intensification of global aging, the incidence of age-related diseases (including cardiovascular, neurodegenerative, and musculoskeletal disorders) has been on the rise, and cellular senescence is identified as the core driving mechanism. Cellular senescence is characterized by irreversible cell cycle arrest, which is caused by telomere shortening, imbalance in DNA damage repair, and mitochondrial dysfunction, accompanied by the activation of the senescence-associated secretory phenotype (SASP). In this situation, proinflammatory factors and matrix-degrading enzymes can be released, thereby disrupting tissue homeostasis. This disruption of tissue homeostasis induced by cellular senescence manifests as characteristic pathogenic mechanisms in distinct disease contexts. In cardiovascular diseases, senescence of cardiomyocytes and endothelial cells can exacerbate cardiac remodeling. In neurodegenerative diseases, senescence of glial cells can lead to neuroinflammation, while in musculoskeletal diseases, it can result in the degradation of cartilage matrix and imbalance of bone homeostasis. This senescence-mediated dysregulation across diverse organ systems has spurred the development of intervention strategies. Interventional strategies include regular exercise, caloric restriction, senolytic drugs (such as the combination of dasatinib and quercetin), and senomorph therapies. However, the tissue-specific regulatory mechanisms of cellular senescence, in vivo monitoring, and safety-related clinical translational research still require in-depth investigation. This review summarizes the progress in pathological mechanisms and interventions, providing theoretical support for precision medicine targeting senescence, which is of great significance for addressing health challenges associated with aging. Full article

Objective: Although Global Postural Re-education (GPR) is widely used for musculoskeletal conditions, its specific benefits for this population remain unclear due to inconsistent findings across studies. This systematic review aims to analyze the effects of GPR on pain intensity, functionality, and range of motion (ROM) in individuals with chronic non-specific neck pain. Methods: Computerized search was performed in the Cochrane CENTRAL, Lilacs, EBSCO, PEDro, Pubmed, RCAAP and Scielo databases using the keyword combination (“Global Postural Rehabilitation” OR “Global Postural Reeducation” OR “Global Posture Reeducation” OR “Global Postural Re-education” OR “GPR”) AND (“Neck Pain” OR “Cervicalgia”). Methodological quality was assessed using the Physiotherapy Evidence Database Scale. Results: Six studies with a total of 393 participants (322 women, aged 18–80) were included. The methodological quality was moderate (average PEDro score: 6.7/10), with frequent limitations related to lack of blinding and allocation concealment. Risk of bias was rated as “some concerns” in four studies and “high” in two. GPR was associated with improvements in pain intensity, functionality, and cervical ROM (flexion/extension). While three studies found no significant differences between GPR and static stretching or specific cervical exercises, the remaining three studies reported greater improvements with GPR compared to manual therapy or traditional neck education and exercise therapy. No adverse effects were reported in any of the included trials. Conclusions: GPR appears to be a safe and potentially effective intervention for individuals with chronic non-specific neck pain, particularly in improving pain, function, and cervical ROM. Nonetheless, further high-quality randomized controlled trials are needed to confirm its superiority over other physiotherapeutic interventions and to determine the optimal treatment parameters. PROSPERO registration: CRD420251068974. Full article

Background/Objectives: Injury prevention programs (IPPs) are evidence-based interventions that reduce musculoskeletal injuries in youth sports. Despite their proven benefits, the adoption of IPPs by coaches remains limited. This study aimed to evaluate the awareness, usage, and perceptions of IPPs among youth sports coaches in Poland and to identify factors associated with their implementation. Methods: A cross-sectional study was conducted using a web-based survey tailored to youth sports coaches in Poland. Coaches of athletes aged 9–17 were recruited through targeted outreach to clubs and professional networks. The survey assessed IPP awareness, implementation, perceptions, and sources of information. Statistical analyses included chi-square tests, non-parametric comparisons, Firth’s logistic regression, and cluster profiling. Results: Only 54.6% of coaches (59 out of 108) were aware of IPPs, and among them, just 47.5% reported using them. No significant associations were found between IPP use and demographic variables such as gender, sport, or place of residence. Coaches who were aware of IPPs were significantly younger than those who were unaware (p = 0.029). The information source was the strongest predictor of IPP implementation: coaches trained via formal courses were over 20 times more likely to use IPPs compared to those learning from peers (OR = 20.4, p < 0.001). While coaches generally perceived IPPs as beneficial for fitness and recovery, 28.6% expressed doubts about their effectiveness in reducing injury risk. Conclusions: Despite broadly positive beliefs, only 47.5% of coaches who were aware of IPPs reported using them. Formal training significantly enhances the likelihood of adoption. These findings emphasize the need for structured educational efforts and improved dissemination strategies to promote evidence-based injury prevention in youth sports settings. Full article

Background/Objectives: To investigate associations between Follistatin (FST) gene polymorphisms (SNPs) and baseline musculoskeletal traits, and their interactions with 16-week exercise interventions. Methods: A cohort of 470 untrained Northern Han Chinese adults (208 males, 262 females), sourced from the “Research on Key Technologies for an Exercise and Fitness Expert Guidance System” project, was analyzed. These participants were previously randomly assigned to one of four exercise groups (Hill, Running, Cycling, Combined) or a non-exercising Control group, and completed their respective 16-week protocols. Body composition, bone mineral content (BMC), bone mineral density (BMD), and serum follistatin levels were all assessed pre- and post-intervention. Dual-energy X-ray absorptiometry (DXA) was utilized for the body composition, BMC, and BMD measurements. FST SNPs (rs3797296, rs3797297) were genotyped using matrix assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS) or microarrays. To elucidate the biological mechanisms, we performed in silico functional analyses for rs3797296 and rs3797297. Results: Baseline: In females only, the rs3797297 T allele was associated with higher muscle mass (β = 1.159, 95% confidence interval (CI): 0.202–2.116, P_{_adj} = 0.034) and BMC (β = 0.127, 95% CI: 0.039–0.215, P_{_adj} = 0.009), with the BMC effect significantly mediated by muscle mass. Exercise Response: Interventions improved body composition, particularly in females. Gene-Exercise Interaction: A significant interaction occurred exclusively in women undertaking hill climbing: the rs3797296 G allele was associated with attenuated muscle mass gains (β = −1.126 kg, 95% CI: −1.767 to −0.485, P_{_adj} = 0.034). Baseline follistatin correlated with body composition (stronger in males) and increased post-exercise (primarily in males, Hill/Running groups) but did not mediate SNP effects on exercise adaptation. Functional annotation revealed that rs3797297 is a likely causal variant, acting as a skeletal muscle eQTL for the mitochondrial gene NDUFS4, suggesting a mechanism involving muscle bioenergetics. Conclusions: Findings indicate that FST polymorphisms associate with musculoskeletal traits in Northern Han Chinese. Mechanistic insights from functional annotation reveal potential pathways for these associations, highlighting the potential utility of these genetic markers for optimizing training program design. Full article