Search Results (4,525)

Background: Individuals with spinal cord injury (SCI) frequently experience chronic pain, trunk instability, and respiratory dysfunction. This pilot trial investigated the synergistic effects of a combined neuro-orthotic approach (thoracolumbosacral orthosis (TLSO) plus transcutaneous electrical nerve stimulation (TENS)) versus TLSO alone on pain, trunk control, and respiratory function in chronic incomplete SCI. Methods: Twelve adults with chronic incomplete SCI (T6–T12) were randomized to a combined group (TLSO + TENS) or a control group (TLSO alone) for a four-week intervention. Outcomes included pain (Visual Analogue Scale), trunk control (Trunk Assessment Scale), and respiratory function (tidal volume [VT], respiratory rate [RR], oxygen uptake [VO₂], ventilatory equivalent for oxygen [VE/VO₂], and inspiratory duty cycle [Ti/Ttot]) assessed at three time points (before intervention, immediately after intervention, and after one month). Results: The combined group demonstrated a significant reduction in pain (47.8% vs. 10.4%, p = 0.01) and an improvement in Ti/Ttot (33.3% vs. 4.9%, p = 0.008) compared to the control group. Both groups showed significant improvements in VT and RR over time (p < 0.05), reflecting the biomechanical benefits of TLSO. Conclusions: Integrating TENS with TLSO offers a non-invasive strategy for managing chronic pain and improving respiratory pattern coordination in incomplete SCI. While TLSO optimizes basic ventilatory mechanics, adding TENS significantly enhances neural drive for efficient breathing and pain gating. Future large-scale trials incorporating active task-specific training are needed to restore functional trunk control. Full article

Peripheral neuropathy constitutes a prevalent, albeit underrecognized, extraglandular manifestation of Sjögren’s disease (SjD). Carpal tunnel syndrome (CTS) commonly coexists with SjD; however, the efficacy of standard CTS treatments in this population remains insufficiently characterized. This study evaluated the clinical and biological response to local corticosteroid injection in CTS patients with and without SjD and explored factors potentially associated with treatment outcomes. Twenty patients with SjD and CTS diagnosed based on typical clinical symptoms and supportive ultrasonographic findings and 19 control subjects with idiopathic CTS underwent ultrasound-guided corticosteroid injection. Median nerve cross-sectional area (CSA), the Boston Carpal Tunnel Questionnaire (BCTQ), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were assessed before treatment and 4 weeks after injection. Patients with SjD additionally underwent comprehensive clinical, laboratory, neurophysiological, and patient-reported outcome assessments. Patients with SjD appeared to demonstrate a significantly greater reduction in median nerve CSA following corticosteroid injection compared with controls (mean reduction: 0.46 vs. 0.31 mm²; p = 0.006, Cohen’s d = 0.96, CI90% [0.51, 1.49]). Despite this favorable biological response, clinical improvement was significantly smaller in the SjD group. Patients without SjD exhibited greater improvement in both the BCTQ Symptom Severity Scale (p = 0.021) and Functional Status Scale (p = 0.033), whereas changes in DASH scores did not differ significantly between groups. Patients with concomitant peripheral neuropathies experienced significantly poorer BCTQ improvement than those with isolated CTS, suggesting that neurological comorbidity may contribute to treatment resistance. No significant associations were identified between treatment response and fibromyalgia status or ESSPRI domains. Among quality-of-life measures, only the SF-36 General Health domain differed significantly between neuropathy types. Patients with SjD and CTS exhibit a dissociation between structural improvement of the median nerve and subjective symptom relief after corticosteroid injection. These findings suggest that mechanisms beyond local nerve compression, including coexisting peripheral neuropathy and potentially altered pain processing, may contribute to persistent symptoms. Comprehensive neurological assessment and multidimensional outcome evaluation may improve identification of SjD patients at risk of suboptimal response to conventional CTS therapies. Full article

Background/Objectives: Percutaneous A1 pulley release effectively treats trigger finger, but the additional benefit of concomitant corticosteroid injection remains debated. Moreover, minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) thresholds have not been well established for this procedure, limiting patient-centered interpretation of outcomes. Methods: This retrospective cohort study included 80 patients (40 per group) who underwent percutaneous trigger finger release alone (PR) or with adjunctive triamcinolone injection (PR+CS). Anchor-based MCID and SCB thresholds for QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand), Michigan Hand Outcomes Questionnaire (MHQ), and visual analog scale (VAS) pain were derived using GROC as the external anchor, whereas PASS thresholds were derived using a dichotomous acceptable-state question; ROC analysis was used for all threshold estimates. Group comparisons incorporated effect sizes and responder analyses. Results: MCID thresholds were ΔVAS ≥ 3, ΔQuickDASH ≥ 19, and ΔMHQ ≥ 16.5; SCB thresholds were ΔVAS ≥ 4, ΔQuickDASH ≥ 25, and ΔMHQ ≥ 20; and PASS thresholds were 3-month VAS ≤ 4, QuickDASH ≤ 29, and MHQ ≥ 76. For MCID and SCB, MHQ showed the highest observed AUCs (0.899 and 0.946, respectively). Greater mean improvements in all change scores were observed in the PR+CS group than in the PR group (ΔQuickDASH 24.2 vs. 19.9, p < 0.001, d = 1.39; ΔMHQ 20.5 vs. 15.0, p < 0.001, d = 1.67). However, the magnitudes of the between-group differences did not reach the derived MCID or SCB thresholds. PASS achievement was numerically higher in the PR+CS group than in the PR group (75% vs. 55%), but this difference did not reach statistical significance (p = 0.061). Conclusions: Preliminary MCID, SCB, and PASS estimates were derived for percutaneous trigger finger release; the principal novelty lies in the procedure-specific SCB and PASS estimates, with the SCB estimates being, to our knowledge, the first reported for any trigger finger treatment modality. MHQ showed the highest observed AUCs for MCID and SCB, whereas QuickDASH showed the highest observed AUC for PASS, underscoring the complementary information provided by the three instruments. Although greater mean functional changes were observed in the PR+CS group, the magnitudes of the between-group differences did not reach the derived MCID or SCB thresholds. However, given the retrospective, non-randomized design, these between-group findings remain exploratory and hypothesis-generating and should be viewed as a patient-centered re-interpretation of an established clinical question rather than as new comparative evidence; no causal benefit of adjunctive corticosteroid injection can be inferred. Given the small anchor-defined derivation subgroups and the potential instability of the selected cut-offs, these candidate estimates require prospective external validation in independent cohorts before clinical application. Full article

Background: Advanced varus ankle osteoarthritis is challenging because correction of malalignment must be balanced against preservation of the native ankle joint. This study evaluated the clinical and radiographic outcomes of distal tibial oblique osteotomy (DTOO) with structural strut allografting, which permits individualized correction and provides mechanical support to the osteotomy gap. Methods: This retrospective case series included 20 patients and 20 operated ankles with Takakura stage IIIa (n = 13) or IIIb (n = 7) varus ankle osteoarthritis who underwent DTOO with structural strut allografting between 2012 and 2024. Clinical outcomes included Manchester–Oxford Foot Questionnaire (MOXFQ), American Orthopaedic Foot & Ankle Society (AOFAS), 12-Item Short-Form Survey (SF-12), and Visual Analog Scale (VAS) pain scores. Radiographic parameters included tibial articular surface angle (TAS), tibial lateral surface angle (TLS), medial malleolar angle (MMA), talar tilt angle (TTA), and tibiotalar surface angle (TTS). Results: Significant improvements were observed at final follow-up. MOXFQ scores decreased from 57.66 ± 22.01 to 10.63 ± 9.72 (p < 0.001), AOFAS scores increased from 63.75 ± 15.17 to 85.45 ± 8.37 (p < 0.001), and VAS pain scores decreased from 4.30 ± 1.75 to 1.00 ± 1.30 (p < 0.001). The SF-12 PCS increased from 45.23 ± 8.48 to 47.96 ± 7.93 (p = 0.258), and the MCS increased from 53.51 ± 9.85 to 55.60 ± 4.75 (p = 0.377); neither change was statistically significant. Significant correction was achieved in TAS (p < 0.001), TLS (p < 0.001), MMA (p = 0.019), and TTS (p < 0.001), with no significant change in TTA (p = 0.336). All achieved radiographic union within 3 months postoperatively. Conclusions: DTOO with strut bone allografting enables alignment correction in advanced varus ankle osteoarthritis, including Takakura stage III, while preserving the ankle joint. This technique is an effective joint-preserving option for severe deformities. Full article

Background/Objectives: Adolescent sexuality is multidimensional, yet brief instruments assessing attitudes, experiences, and contextual influences from a biopsychosocial perspective remain limited. This study aimed to develop the Comprehensive Questionnaire on Attitudes, Experiences, and Contexts of Adolescent Sexuality (CIAECSA) and examine its content validity, comprehensibility, feasibility, internal consistency, and exploratory internal structure. Methods: A cross-sectional methodological study comprised three phases: theoretical delimitation and generation of 30 initial items; content evaluation by nine experts and semantic validation with 26 adolescents; and pilot administration to 51 adolescents from educational settings in Toledo, Spain. The pilot sample included 35 females (68.6%), 15 males (29.4%), and one gender-fluid participant (2.0%), aged 12–17 years (mean = 14.41; SD = 1.72). Content validity, perceived clarity, feasibility, Cronbach’s alpha, and principal component analysis with Varimax rotation were examined. Results: The final questionnaire comprised 18 items across three domains: sexuality/gender/anatomy, emotional/physical pain, and self-care/environment. The scale-level Content Validity Index (S-CVI/Ave) was 0.955, and mean perceived clarity was 4.53/5. The mean completion time was 5.52 min. Cronbach’s alpha was 0.800, 0.780, and 0.740 for the three domains and 0.715 for the total scale. The KMO was 0.659, Bartlett’s test was significant (p < 0.001), and an exploratory three-component solution, examined against the prespecified domains, explained 51.4% of the variance. Conclusions: The findings provide favorable evidence of content validity, comprehensibility, feasibility, and internal consistency. The CIAECSA may help identify educational needs and psychosocial factors related to adolescent sexuality, although its internal structure and additional measurement properties require examination in larger, balanced, and independent samples. Full article

BACKGROUND: Plantar fasciitis (PF)is one of the most common causes of heel pain that affecting 10 of the general population. Platelet rich plasma(PRP)has been demonstrated to be helpful in managing PF and reducing plantar facia thickness (PFT). This study objective was to know the effect and efficacy of ultrasound (USG) guided intralesional PRP in PF in relation to pain, PFT and foot function index (FFI). METHODS: A prospective interventional study was conducted in a tertiary care hospital on eighty-five diagnosed cases of unilateral PF. All patients had undergone pain intensity assessment by visual analogue scale (VAS), FFl, and USG examination of PFT after USG guided intralesional PRP injection was assessed at baseline (0 weeks), 2 weeks and 6 weeks. RESULTS: Following USG guided intralesional PRP injection,a statistically significant decrease was noted in plantar fascia thickness (PFT) from baseline 0 (week) 6. 592mm ± 0. 51mm to 5. 169mm ± 0. 39mm and reduced to 4. 07mm ± 0. 39mm at 2nd week and 6th week, respectively (P value 0. 001).A statistically significant reduction of VAS score was noted which reduced from 8. 647 ± 0. 55 to 5. 588 ± 1. 13 (2nd week) and further reduced to 1. 21 ± 1. 06 at the end of 6 weeks (p value 0. 001). Mean FFI in our study at baseline was 85. 494 ± 6. 55, at 2 weeks mean FFI was 49. 341 ± 7. 277 and the end of 6 week it reduced to 24. 235 ± 1. 608 (P value 0. 001) statistically significant decrease was noted. CONCLUSIONS: PRP injection helps in the reduction of heel pain (VAS), reduction in PFT, and improvement in all domains of FFI, leading to enhancement of quality of life. Full article

Background/Objectives: Fibromyalgia (FM) is increasingly recognized as a multisystem disorder characterized by central sensitization and visceral symptom involvement. Irritable bowel syndrome (IBS) and overactive bladder (OAB), which share overlapping pathophysiological mechanisms related to altered visceral processing, are both commonly reported in FM. However, whether gastrointestinal and urinary symptoms cluster within the same patients and whether such clustering is associated with greater FM severity remain insufficiently explored. This study aimed to evaluate the overlap between IBS and OAB in women with FM and to determine whether their coexistence is associated with differences in FM severity. Methods: This cross-sectional observational study included 74 women with FM evaluated at the Physical Medicine and Rehabilitation outpatient clinic of Memorial Ataşehir Hospital between August and December 2025. FM severity was assessed using the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), and FM Severity Score (GSS). OAB symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS), and IBS status was determined based on prior clinical diagnosis. For subgroup severity analyses, patients were categorized as IBS + OAB, OAB only, or neither condition; the two patients with IBS alone were excluded from these comparisons because of the small cell size (n = 72). Results: IBS was present in 13 patients (17.6%) and OAB in 46 patients (62.2%). A substantial overlap between bowel and bladder symptoms was observed: 84.6% of IBS-positive patients had OAB, and IBS prevalence was higher in OAB-positive than OAB-negative patients (23.9% vs. 7.1%; OR = 4.56, 95% CI 0.93–22.24), although this association did not reach statistical significance (p = 0.063). Significant overall group differences were observed for SSS (p < 0.001) and GSS (p = 0.001), whereas WPI did not differ significantly across groups (p = 0.228). Patients with concomitant IBS and OAB had significantly higher GSS scores than both the OAB-only (adjusted p = 0.003) and neither-condition groups (adjusted p = 0.001). In multivariable analysis adjusted for age, concomitant IBS and OAB remained significantly associated with higher GSS (B = 3.77, 95% CI 1.59–5.95; p = 0.001). The regression model explained 18.2% of the variance in GSS (R² = 0.182; p = 0.003). Conclusions: Concomitant IBS and OAB in women with FM were associated with greater overall FM symptom burden, particularly higher SSS and GSS scores, whereas widespread pain severity did not differ significantly across groups. The presence of either IBS or OAB may warrant evaluation for the other condition, as bowel–bladder symptom clustering may characterize a subgroup with greater overall symptom burden and support consideration of a more integrated clinical assessment. Full article

Background and Objectives: Pain has been proposed as a pathway linking chronic disease to healthcare spending, but existing estimates measure exposure, pain and cost in the same period and combine coefficients on incompatible scales. We asked how much of the disease–expenditure association runs through pain when exposure, pain and cost are separated in time. Materials and Methods: In the Korea Health Panel Survey (2019–2023; 54,845 adult person-years), chronic disease at year t, EQ-5D pain/discomfort at t + 1 and out-of-pocket payments during t + 2 were linked, conditioning on pain and payments at t. Direct and indirect effects were estimated by parametric g-computation (randomised-interventional analogues, two-part outcome model, exposure-specific adjustment sets, survey and censoring weights, false discovery rate control). Results: Among 25,692 triplets, pain/discomfort predicted the amount spent among healthcare users (cost ratio, CR 1.099, 95% confidence interval, CI 1.023–1.180) but showed no detectable association with whether care was used (odds ratio, OR 1.136, 0.918–1.406); the contemporaneous cost ratio was substantially larger (1.296), inflated by simultaneity. Three musculoskeletal conditions prospectively predicted pain (false discovery rate q < 0.001). Six conditions had indirect-effect intervals excluding zero, but none survived false discovery rate correction (minimum q = 0.19); where estimable, the proportion mediated was small (2.8% to 4.8%). Conclusions: The disease → pain and pain → payment associations are each established, but the disease-specific mediated amount is not confirmed after multiplicity correction. Contemporaneous designs overstate the indirect association; claims that pain causes a specified share of chronic disease expenditure are not supported. Full article

Women with endometriosis experience chronic cyclic pelvic pain (CCPP) or chronic persistent pelvic pain (CPPP), both of which may be incapacitating even after treatment. Emotional dysregulation in endometriosis impedes patient recovery. This study evaluated the relationships among emotional state, pain perception, and inflammatory biomarkers (IL-1β, IL-6, and TNF-α) in women with endometriosis presenting with CCPP or CPPP. An exploratory, observational, descriptive, cross-sectional, comparative with repeated sampling study was conducted with 52 women diagnosed with endometriosis and experiencing either CPPP or CCPP. Participants completed a psychometric battery including the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI-II), Goldberg General Health Questionnaire (GHQ-30), Hospital Anxiety and Depression Scale (HADS), and Mini-Mental State Examination (MMSE). Pain perception was assessed using the Wong–Baker Pain Rating Scale (FACES). Saliva samples were collected at baseline, during stressor and recovery phases, and concentrations of IL-1β, IL-6, and TNF-α were determined by ELISA. Fifty-two women with endometriosis were included (CPPP: n = 33; CCPP: n = 19). No significant between group differences were observed in emotional state (HADS: p = 0.682; BDI: p = 0.842), anxiety (STAI-State: p = 0.086; STAI-Trait: p = 0.615), general distress (GHQ-30: p = 0.730), or pain intensity (FACES: p = 0.705). The prevalence of depressive symptoms did not differ between groups (CPPP: 69.7% vs. CCPP: 73.7%; χ² = 0.093, p = 0.760). Salivary cytokine levels (IL-1β, IL-6, TNF-α) were comparable between groups across all measurement conditions. Spearman correlations revealed uncorrected significance between TNF-α and emotional distress: basal TNF-α correlated inversely with HADS (ρ = −0.292, p = 0.031) and BDI (ρ = −0.278, p = 0.041); TNF-α under stress correlated with HADS (ρ = −0.329, p = 0.014) and GHQ-30 (ρ = −0.271, p = 0.046); and TNF-α during recovery correlated with GHQ-30 (ρ = −0.363, p = 0.006). These findings indicate that CPPP and CCPP were not associated with statistically significant differences in emotional states or salivary cytokine profiles at the group level. Exploratory pos hoc analyses suggested that pain pattern may moderate the association between TNF-α and psychological burden, particularly in the CCPP subgroup; however, these findings require confirmation in larger studies with prespecified analyses. Exploratory analyses suggested patterns between salivary inflammation and psychological burden; however, these findings should be interpreted cautiously because of the small subgroup size, multiple comparisons, and lack of a matched healthy control group. Full article

Background and Objectives: Fragility fractures of the sacrum are increasingly recognized in elderly osteoporotic patients and can cause persistent pain, immobility, and progressive pelvic ring instability. We previously described a modified S1 corridor targeting the higher-density cranial–ventral S1 vertebral body for safe percutaneous implant placement. This study reports the clinical outcomes of osteoporotic and pathologic sacral fractures treated through this corridor and presents an exploratory comparison of two 3D-printed titanium sacroiliac fusion implants: the triangular iFuse™ Implant System and the threaded iFuse TORQ™ (SI-BONE, Inc., Santa Clara, CA, USA). Materials and Methods: This retrospective single-center study analyzed 58 patients with fragility or pathologic sacral fractures (FFP IIIb–V; OF 2–5) treated via the modified S1 corridor between January 2021 and March 2026. Of these, 27 patients received triangular iFuse™ implants, and 31 patients received threaded iFuse TORQ™ implants. The primary outcome was procedural safety (implant revision, neurological injury, cortical breach). Secondary outcomes included the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pain, operative time, and need for additional fixation. Group comparisons used non-parametric tests; multivariable linear regression adjusted for age, fracture severity (OF classification), and additional fixation. Results: At a mean follow-up of 17.8 ± 9.1 months (iFuse) and 4.1 ± 2.1 months (TORQ), no implant revisions, clinically significant cortical breaches, or neurological injuries were observed in either group. Patient-reported outcome data were available for 48 of 58 patients (20 iFuse, 28 TORQ). Patients in the iFuse™ group were older (80.9 ± 8.5 vs. 76.0 ± 9.8 years; p = 0.050), and OF classification differed between groups, with a higher proportion of OF 4 fractures in the TORQ™ group (p = 0.003). After adjustment for age, OF classification, and additional fixation, TORQ™ implantation was associated with a 15.6-point lower postoperative ODI (p < 0.001), a 13.5-point greater ODI improvement (p < 0.001), a 0.94-point lower postoperative VAS (p = 0.006), and a 1.36-point greater VAS reduction (p < 0.001). Findings remained significant in a sensitivity analysis restricted to patients without additional fixation. Conclusions: Sacroiliac fusion via a modified density-oriented S1 corridor was safe for both large implant types, with no revisions in the analyzed cohort. In this retrospective, non-randomized cohort, threaded iFuse TORQ™ implants were associated with better patient-reported outcomes after adjustment for baseline imbalances. Because the groups were not randomized and follow-up duration differed substantially, these comparative findings are hypothesis-generating and require confirmation in prospective, controlled studies. Full article

Background/Objectives: To synthesize the effects of school-based exercise interventions in adolescents with nonspecific low back pain. Methods: PubMed/MEDLINE, Scopus, Web of Science, CENTRAL, PEDro, ScienceDirect, and supplementary sources were searched through 21 May 2026. Randomized and quasi-randomized controlled trials involving adolescents aged 10–19 years and delivering exercise wholly or substantially within schools were eligible. Risk of bias was assessed using Cochrane RoB 1, and findings were synthesized narratively. Results: Of 1935 records, two randomized trials and one quasi-experimental controlled trial (194 allocated participants) were included. Fanucchi et al. reported between-group reductions in past-month pain of 2.2 cm on a 10-cm visual analogue scale (95% CI 1.0–3.5) at 3 months and 2.0 cm (95% CI 0.5–3.5) at 6 months; absolute reductions in 3-month low back pain prevalence were 24% (95% CI 4–41) and 40% (95% CI 18–57), respectively. Jones et al. reported a large effect size for pain severity after 8 weeks (ES = 1.47). Javadipour et al. reported favorable pain and motor-function outcomes, but incomplete and internally inconsistent reporting limited interpretation. No study assessed low-back-pain-related disability using a validated instrument. All studies had high risk of bias in at least one domain, most commonly blinding. Heterogeneity precluded meta-analysis. Conclusions: Limited evidence suggests that school-based exercise may reduce pain intensity and pain prevalence over six months and improve selected physical outcomes in adolescents aged 12–15 years. The small, heterogeneous evidence base and risk of bias preclude conclusions or recommendations regarding modality or dosage. Full article

Background: Patients receiving palliative and hospice care frequently experience high symptom burden alongside altered body perception due to progressive disease and physical decline. While acupressure has demonstrated beneficial effects on symptoms such as nausea, pain, fatigue, and anxiety, its potential influence on body awareness has not been systematically investigated. Furthermore, evidence regarding the feasibility and implementation of nurse-led acupressure interventions across different palliative and hospice care settings remains limited. This study aims to explore the feasibility, acceptability, and potential effects of acupressure on symptom burden and body awareness in palliative care settings. Methods: This pilot study evaluates a nurse-led acupressure intervention aimed at improving body awareness in patients receiving palliative and hospice care across specialized inpatient and outpatient settings. This study is designed as a prospective, exploratory, mixed-methods pilot and feasibility study using a pre-post design across multiple care settings, including a palliative care unit, specialized palliative home care (SAPV), an inpatient palliative consultation service (PMD), and a hospice. A total of 60–80 adult patients with incurable illnesses will be recruited. The intervention consists of standardised acupressure administered by trained nursing staff, with at least two sessions per participant. Primary outcomes focus on feasibility and acceptability indicators, including recruitment, retention, adherence, intervention documentation, and data completeness. Exploratory clinical outcomes include symptom burden, body awareness, and use of on-demand medication. Quantitative outcomes include symptom burden (MIDOS), body awareness (State Mindfulness Scale—Body subscale), and use of on-demand medication. Qualitative data will be collected through brief patient interviews using the Body Image Assessment (BIA) and semi-structured interviews with patients and healthcare providers after the completed intervention. Data will be analysed using descriptive and exploratory inferential statistics, alongside a linguistic and thematic analysis. Quantitative and qualitative findings will be integrated using a convergent triangulation approach. Discussion: This study will provide first insights into the feasibility and acceptability of acupressure in palliative and hospice care and generate hypotheses regarding its potential effects on symptom relief and body awareness. Findings will inform the design of a future randomized controlled trial and contribute to the implementation of complementary therapies in integrative palliative care. Full article

Temporomandibular disorders are frequently associated with orofacial pain, functional limitations, and psychosocial factors that may contribute to persistent symptoms. Kinesiophobia, or fear of movement, may influence mandibular function and rehabilitation outcomes. This scoping review aimed to map the available evidence on the psychometric properties and cross-cultural adaptations of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD) and to identify gaps in the current literature. Literature searches were conducted in PubMed, Scopus, and the Web of Science Core Collection in March 2026. Reference lists of the included studies were also manually screened. English-language peer-reviewed studies reporting at least one measurement property of the TSK-TMD were included. The methodological quality of the included studies was assessed using the COSMIN Risk of Bias checklist for PROMs by applying the relevant measurement-property boxes and the “worst score counts” principle. The database searches identified 117 records; after removing 56 duplicates, 61 records were screened. Five full-text articles identified through database searching and one additional article identified through manual reference screening met the eligibility criteria, resulting in six included studies. The TSK-TMD appears to be a promising condition-specific patient-reported outcome measure, although measurement error, responsiveness, minimal important change, interpretability, and cross-cultural measurement invariance remain insufficiently investigated. Full article

Background and Objectives: Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint that causes pain and limitation of motion. The aim of this study was to evaluate the clinical outcomes of a modified interpositional arthroplasty technique using an iliotibial band autograft fixed to the proximal phalanx in patients with advanced hallux rigidus. Materials and Methods: This prospective observational case series included 19 patients with Coughlin–Shurnas Grade III or IV hallux rigidus who underwent surgery between February 2023 and February 2025. Clinical outcomes were assessed using Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and range-of-motion (ROM) measurements preoperatively and at postoperative 1, 6, and 12 months. Results: The mean VAS score decreased from 9.0 ± 0.82 preoperatively to 1.58 ± 0.51 at 12 months (p < 0.001). The mean AOFAS score increased from 35.1 ± 2.7 to 74.8 ± 10.9 (p = 0.001). ROM improved significantly at 1 and 6 months; however, the 12-month ROM was not significantly different from the preoperative value (36.3° ± 5.6° vs. 31.0° ± 5.5°, p = 0.082). Conclusions: Interpositional arthroplasty using an iliotibial band autograft fixed to the proximal phalanx was associated with short-term reductions in pain and improvements in functional scores. However, the early increase in range of motion was not maintained to the same extent at 12 months. Full article

Background and Objectives: Movement representation techniques (MRTs), including motor imagery and mirror therapy, have been investigated in several chronic pain conditions; however, their effectiveness in chronic non-specific spinal pain (CNSP) has not been specifically synthesized using meta-analytic methods. This systematic review and meta-analysis aimed to evaluate the effects of MRTs on pain intensity, disability, and kinesiophobia in adults with CNSP. Materials and Methods: A systematic search was conducted in PubMed, CINAHL, Scopus, Cochrane Library, and PEDro, supplemented by grey literature sources. Randomized and non-randomized controlled trials investigating MRTs as a standalone or adjunct intervention in adults with CNSP were eligible. Methodological quality was assessed using the PEDro scale, risk of bias was evaluated using the RoB 2 tool, and certainty of evidence was evaluated using the GRADE approach. Effect sizes were calculated as Hedges’ g using a random-effects model. The review was registered in PROSPERO (CRD42023488671). Results: Nine studies involving 411 participants were included in the systematic review, of which eight randomized trials (337 participants) contributed to the meta-analyses. MRTs showed a large and statistically significant effect on pain intensity (Hedges’ g = −1.63; 95% CI: −2.56 to −0.70; p = 0.001) and a moderate statistically significant effect on disability (Hedges’ g = −0.64; 95% CI: −1.03 to −0.26; p = 0.001). The effect on kinesiophobia was large but not statistically significant (Hedges’ g = −1.55; 95% CI: −3.25 to 0.16; p = 0.075). In analyses restricted to motor imagery, significant effects were observed for pain intensity (Hedges’ g = −1.87; 95% CI: −2.95 to −0.79) and disability (Hedges’ g = −0.75; 95% CI: −1.15 to −0.35), consistent in direction with the primary analyses. Heterogeneity was substantial for pain intensity and kinesiophobia; all pooled trials were judged to be at high risk of bias or to raise some concerns, and the certainty of evidence was very low for all three outcomes. Conclusions: Very low-certainty evidence suggests that MRTs may reduce pain intensity and improve disability in adults with CNSP. Given the high risk of bias and substantial heterogeneity, these estimates are exploratory and do not support firm clinical recommendations. Further well-designed randomized controlled trials with standardized MRT protocols and long-term follow-up are needed. Full article