bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2026–04–05
68 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Ultrasound evaluation of the ulnar nerve in cubital tunnel syndrome: anatomy, normal and abnormal findings, and postoperative aspects.
  2. Interventional treatments for sacroiliac joint pain: a systematic review and network meta-analysis.
  3. Supraspinatus Tendon Thickness Is Associated With Collagen Disorganization in Symptomatic and Asymptomatic Shoulders of Individuals With Unilateral Rotator Cuff Tendinopathy.
  4. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Revision 2026.
  5. Dysphagia Rehabilitation in Disaster-A Mechanistic Review.
  6. Identification of International Classification of Functioning, Disability and Health categories in a multifaceted rehabilitation program for degenerative cerebellar ataxia: a descriptive analysis of real-world clinical practice.
  7. From trauma to fibrosis: a case of ulnar nerve entrapment in Guyon’s canal
  8. Effectiveness of Dry Needling Versus Percutaneous Electrolysis in Achilles Tendinopathy: A Randomized Clinical Trial.
  9. A Nationwide Propensity Score-Matched Analysis Identifying Preinjury Predictors of Complex Regional Pain Syndrome Following Distal Radius Fracture.
  10. Fall risk after total hip replacement: A functional correlation study.
  11. Optimizing Osteoarthritis Management - Therapeutic Efficacy and Evaluation of Intra-Articular Triamcinolone Acetonide Injection.
  12. Impact of lumbar spinal canal stenosis on paravertebral muscle condition: an observational study in Japan.
  13. Achilles Tendon Shear Wave Velocity Within a 1-Year Follow-Up After Non-Operatively Treated Rupture.
  14. Median neuropathy after open reduction and internal fixation: when implant proximity is not the culprit.
  15. Ultrasound-based assessment of talar cartilage in individuals with chronic ankle instability: a systematic review.
  16. Comparison of the effectiveness of extracorporeal shock wave therapy and high-intensity laser therapy in patients with knee osteoarthritis: a single-blind randomized clinical trial.
  17. Hyperbaric Oxygen Therapy in Managing Chronic Pain Syndromes - A Systematic Review.
  18. A Systematic Review on the Efficacy and Safety of Platelet-Rich Plasma in the Management of Achilles Tendon Rupture.
  19. Kinesiophobia in Patients with Chronic Obstructive Pulmonary Disease: A Concept Analysis.
  20. An ICF-based interdisciplinary case management improves functioning, participation, and well-being for people with disabilities in community rehabilitation: a protocol for a randomised controlled trial.
  21. Intensive versus usual rehabilitation programs in stable chronic obstructive pulmonary disease (COPD) patients.
  22. A study investigating the impact of the 'rehabilitation-training integration' intervention strategy on elite weightlifters with chronic low back pain returning to competitive sports.
  23. Insights into the complex relationship between pain and imaging-detected structural damage in knee osteoarthritis.
  24. The Relationship between early and late stimulation of the deltoid muscle in patients undergoing reverse total shoulder arthroplasty. A systematic review with meta-analysis.
  25. Effectiveness of percutaneous electrolysis in subacute and early chronic medial gastrocnemius muscle injuries: a single-blinded randomized clinical trial.
  26. Aponeurotic expansion of the supraspinatus tendon: sonographic spectrum and proposed classifications.
  27. The efficacy of pulmonary rehabilitation on cognitive functions in patients with chronic obstructive pulmonary disease: systematic review.
  28. Effects of exercise-induced hypoalgesia on pressure pain threshold in patients with chronic musculoskeletal pain: A systematic review and meta-analysis.
  29. Evaluating the Safety of Early Return to Play After Metacarpal or Scaphoid Fracture: A Systematic Review.
  30. Paediatric Injuries and E-Mobility Devices: A Call for Regulatory Reform in Queensland.
  31. Perineural Steroid Injections in Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis.
  32. Spinal Cord Stimulation, Peripheral Nerve Stimulation, and Pulsed Radiofrequency in the Management of Herpes Zoster-Related Pain: A Network Meta-Analysis.
  33. Ultrasound-guided percutaneous electrolysis versus dry needling in patients with chronic low back pain a double-blind randomized clinical trial.
  34. Retraction Note: A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA).
  35. Treatment Strategies and Return-to-Sport Outcomes in High-Performance Athletes With Acute Achilles Tendon Rupture: Multicenter Retrospective Study.
  36. Risk factors for progression of supraspinatus tear size and fatty infiltration in nonsurgically treated rotator cuff tears.
  37. Complete avulsion of the proximal hamstring tendon in a young gymnast: a case report.
  38. Combined effect of underwater ultrasound and custom-made insoles in rheumatoid arthritis: a randomized controlled trial.
  39. Application of Transperineal 3-Dimensional Ultrasound in Evaluating Levator Ani Muscle Contraction During Female Pelvic Floor Rehabilitation.
  40. [Pulmonary rehabilitation interventions strategies for patients with chronic obstructive pulmonary disease complicated with anxiety and depression: a summary of best evidence].
  41. A novel platelet-rich plasma clinically induces reliable, rapid, long-term chronic peripheral neuropathic pain elimination.
  42. Comparison of the effects of Kinesio tape and high-intensity laser therapy applied in conjunction with physical therapy on pain, grip strength, and functional level in patients with lateral epicondylitis: A randomized controlled trial.
  43. Does Adding a Pilates Exercise Program Enhance Recovery Outcomes for Sports Hernia? A Randomized Controlled Trial.
  44. Cytopeutics umbilical cord-derived mesenchymal stem cells are associated with earlier clinical improvement compared to bone marrow aspirate concentrate with scaffold in knee cartilage injury: A Phase 1 feasibility and Phase 2 randomized controlled trial.
  45. Comparison between the outcomes of manipulation under anaesthesia versus intra-articular steroid injection in idiopathic adhesive capsulitis.
  46. Comparison of two types of platelet-rich plasma in rotator cuff injury: study protocol for a randomized clinical trial.
  47. Comparative analysis of postoperative outcomes in men and women following total hip replacement surgery.
  48. Anatomical Mapping of the Masseter for Safe Botulinum Toxin Injection: A Cadaveric Study.
  49. Patients' Experiences With Complex Regional Pain Syndrome (CRPS) and a Rehabilitation Program That Combines Graded Motor Imagery (GMI) and Tactile Desensitization (TD).
  50. The impact of custom-made rocker sole shoes on biomechanical parameters of the lower limb during gait and running: A systematic review.
  51. A randomized trial of a digitally delivered, home-based neuromodulation and mindfulness intervention for pain management in older adults with knee osteoarthritis.
  52. Total knee arthroplasty with "Collar Tightening Technique" for advanced knee osteoarthritis with concurrent chronic posterolateral knee dislocation and lateral patellar dislocation: A case report.
  53. Rehabilitation technology for hospitalised older adults: a scoping review.
  54. Telemedicine for rotator cuff syndrome: Asynchronous exercise and remote follow-up in a randomized controlled study.
  55. Feasibility of neuromuscular electrical stimulation for knee osteoarthritis in older women: A double-blind randomized controlled trial.
  56. Differences in neuromechanics during walking in individuals with bilateral and unilateral chronic ankle instability.
  57. Evaluating the Reproducibility of Exercise Protocols in Temporomandibular Disorders Research: A Scoping Review.
  58. The effect of inhaled dry salt on pulmonary mucociliary clearance in obstructive lung disease: A randomised, placebo-controlled, crossover study.
  59. Return to Sport Following Elbow Dislocation: A Systematic Review.
  60. Surgical treatment for medial epicondyle tendinopathy: a systematic literature review.
  61. Aquatic vs. hopping exercises: A novel comparison of their impacts on motor and sensorimotor rehabilitation in chronic ankle instability.
  62. Effects of inspiratory muscle training on exercise capacity, muscle oxygenation and strength, physical activity, and dyspnea in patients with post-COVID-19 syndrome and pulmonary involvement: a randomized controlled triple-blinded study.
  63. Ultrasound assessment of muscle atrophy and its association with functional outcomes in critically ill patients: a systematic review and meta-analysis.
  64. Ultrasound Diagnosis of A2 Pulley Injuries: Landmark-Specific Tendon-Bone Distance and Flexor Tendon Curvature in a Cadaveric Study.
  65. Irreducible metacarpophalangeal joint dislocations: Clinical characteristics, surgical approaches, and outcomes.
  66. Consensus on key evaluation tools for stroke: a Delphi study protocol for the assessment of balance and gait.
  67. Capturing what people with COPD want: a systematic review of goal-oriented measurement instruments.
  68. Five-year real-world outcomes of short-course leukocyte-poor PRP versus standard conservative therapy in early-stage knee osteoarthritis.
  1. J Ultrason. 2026 Apr;26(104): 20260002
    Ultrasound evaluation of the ulnar nerve in cubital tunnel syndrome: anatomy, normal and abnormal findings, and postoperative aspects.
    Aurelio Cosentino, Yacine Carlier, Winston J Rennie, Lionel Pesquer.
      Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb after carpal tunnel syndrome and results from entrapment of the ulnar nerve around the elbow. High-resolution ultrasound has become a central diagnostic modality because of its excellent spatial resolution, capacity for dynamic assessment, and broad availability in clinical practice. This review offers an integrated and updated overview of the ultrasonographic evaluation of the ulnar nerve in cubital tunnel syndrome, detailing relevant anatomy, characteristic normal and pathological appearances, and key considerations in postoperative follow-up. The ulnar nerve may be compressed at several anatomical sites, including the arcade of Struthers, the retrocondylar groove, Osborne's ligament within the cubital tunnel, and the aponeurosis between the two heads of the flexor carpi ulnaris. Typical sonographic abnormalities include focal or segmental nerve enlargement, disruption or loss of the normal fascicular architecture, and changes in echogenicity. Dynamic maneuvers during ultrasound examination can further identify nerve subluxation, dislocation, or snapping over the medial epicondyle, all of which may contribute to clinical symptoms. Postoperative ultrasound evaluation is increasingly important for detecting complications or persistent compression following in-situ decompression, medial epicondylectomy, or anterior transposition. A standardized and reproducible ultrasound protocol is therefore essential for accurate diagnosis, appropriate management, and follow-up. Radiologists play a pivotal role in this multidisciplinary approach by providing detailed imaging assessments that guide surgical decision-making and help optimize patient outcomes.
    Keywords:  cubital tunnel syndrome; postoperative; ulnar nerve; ultrasound
    DOI:  https://doi.org/10.15557/jou.2026.0002
  2. Reg Anesth Pain Med. 2026 Mar 30. pii: rapm-2026-107633. [Epub ahead of print]
    Interventional treatments for sacroiliac joint pain: a systematic review and network meta-analysis.
    Ji-Hoon Park, Jae Ni Jang, Soyoon Park, Young-Soon Choi, Rakib Miah, Sukhee Park.
       BACKGROUND: Sacroiliac joint (SIJ) pain is a frequent cause of chronic low back pain, but the comparative effectiveness of available interventional treatments remains unclear.
    OBJECTIVE: We explored the therapeutic effects of interventional treatments on SIJ using a network meta-analysis.
    EVIDENCE REVIEW: A comprehensive systematic search of multiple databases was conducted to identify randomized controlled trials comparing conventional, cooled, and pulsed radiofrequency (RF) ablation; intra-articular steroid injections under different imaging guidance techniques; prolotherapy; platelet-rich plasma; sham procedures; and conservative management.
    METHODS: Primary outcomes were pain intensity and Oswestry Disability Index at 1, 3, and 6 months. Random-effects network meta-analysis estimated mean differences with 95% CIs, and P scores were used to rank treatments.
    RESULTS: 18 trials involving 1075 patients were included. RF-based interventions consistently outperformed steroid injections, sham, and conservative care. For pain relief, cooled RF ranked highest at 1 month, conventional RF at 3 months, and pulsed RF at 6 months, demonstrating significant superiority over most comparator treatments. For disability outcomes, pulsed RF provided the greatest improvement at 1 and 3 months, whereas CT-guided intra-articular steroid injection ranked highest at 6 months. However, the certainty of evidence was generally low to very low due to imprecision and study limitations.
    CONCLUSIONS: These findings support the overall effectiveness of RF techniques for SIJ pain while highlighting important evidence gaps that warrant further high-quality trials with longer follow-up.
    Keywords:  Injections, Spinal; Radiofrequency Ablation; Sacroiliac Joint
    DOI:  https://doi.org/10.1136/rapm-2026-107633
  3. J Orthop Res. 2026 Apr;44(4): e70200
    Supraspinatus Tendon Thickness Is Associated With Collagen Disorganization in Symptomatic and Asymptomatic Shoulders of Individuals With Unilateral Rotator Cuff Tendinopathy.
    M Chris Zipser, Oscar Vila-Dieguez, Sebastian Klich, Greg Bashford, Kira Chow, Lori A Michener.
      Rotator cuff (RC) tendinopathy is a common source of shoulder pain and is frequently linked to structural changes in the supraspinatus tendon of greater thickness and disrupted collagen organization. This study aimed to characterize differences in tendon thickness and collagen organization between individuals with unilateral symptomatic RC tendinopathy, their contralateral asymptomatic shoulder, and asymptomatic controls, and to examine the relationship between thickness (macro-morphology) and collagen organization (micro-morphology). This is a cross-sectional observational study of 64 participants diagnosed with RC tendinopathy compared to 64 asymptomatic controls. On ultrasound imaging of the tendon, thickness was measured, and collagen organization was quantified via spatial frequency analysis of peak spatial frequency radius (PSFR). Compared to controls, individuals with RC tendinopathy showed significantly greater tendon thickness on the involved side (4.3 ± 0.7 vs. 3.9 ± 0.5 mm, p = 0.0097), but no differences in PSFR. Participants with RC tendinopathy showed no significant differences between sides in tendon thickness or PSFR. In the RC tendinopathy group, tendon thickness and PSFR were inversely correlated on both the involved (r = -0.24, p = 0.060) and uninvolved (r = -0.32, p = 0.01) sides, indicating that increased tendon thickness was associated with decreased collagen organization-an association not observed in controls. Findings suggest tendon thickness reflects maladaptive structure in RC tendinopathy, and collagen organization alone may not sufficiently identify tendon pathology. The relationship between tendon thickness and collagen disorganization in RC tendinopathy indicates that tendon maladaptation differs from adaptive hypertrophy in healthy shoulders. Statement of Clinical Significance: Combined evaluation of tendon hypertrophy and collagen organization can enhance structural characterization in those with tendinopathy.
    Keywords:  peak spatial frequency radius; rotator cuff tendon; supraspinatus; tendinopathy; tendon hypertrophy; ultrasound
    DOI:  https://doi.org/10.1002/jor.70200
  4. J Orthop Sports Phys Ther. 2026 Apr;56(4): CPG1-CPG79
    Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Revision 2026.
    Mia Erickson, Marsha Lawrence, Melissa J Lazinski, Kylie Scott, RobRoy L Martin.
      APTA Orthopedics and APTA Hand and Upper Extremity Physical Therapy, Academies of the American Physical Therapy Association, have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for physical therapy management and prevention of upper extremity musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline is a revision of the 2019 CPG that focuses on hand pain and sensory deficits in carpal tunnel syndrome. J Orthop Sports Phys Ther 2026;56(4):CPG1-CPG79. Epub 12 February 2026. doi:10.2519/jospt.2026.0301.
    Keywords:  ICD; ICF; carpal tunnel syndrome; clinical practice guidelines; hand; nerve compression
    DOI:  https://doi.org/10.2519/jospt.2026.0301
  5. Disaster Med Public Health Prep. 2026 Apr 01. 20 e66
    Dysphagia Rehabilitation in Disaster-A Mechanistic Review.
    Syoichi Tashiro, Liang Zhang, Michiyuki Kawakami, Ayako Wada, Shin Yamada, Tetsuya Tsuji.
       OBJECTIVES: Researchers have revealed that the incidence of aspiration pneumonia (AP) increases following a disaster, not only due to the disaster itself but also due to environmental factors, which will propose dysphagia rehabilitation targets. We aimed to delineate the current status of dysphagia rehabilitation in disasters.
    METHODS: English literature was searched via scientific databases, representative journal homepages, trial registries, and gray literature.
    RESULTS: A total of 242 articles were reviewed in full text, and 31 were included in this review. Most hazards were earthquakes (19/31), and most reports originated from Japan (19/31). The reported issues were summarized according to the International Classification of Functioning, Disability, and Health (ICF) codes. Twenty-seven codes related to areas such as Swallowing, Caring for teeth, and Food were the most frequently reported. In addition, three additional items not formally listed in the ICF were considered: nutrition, oral hygiene, and denture.
    CONCLUSIONS: The mechanisms of emergency lifestyle-related aspiration pneumonia were identified, and approaches to prevent AP were proposed. We further discuss how to promote dysphagia rehabilitation in disasters. Nevertheless, multidisciplinary coordination is important, and more involvement of rehabilitation specialists is required.
    Keywords:  Deglutition disorders; dentistry; disaster rehabilitation; immobilization syndrome; nutrition
    DOI:  https://doi.org/10.1017/dmp.2026.10344
  6. Disabil Rehabil. 2026 Mar 29. 1-19
    Identification of International Classification of Functioning, Disability and Health categories in a multifaceted rehabilitation program for degenerative cerebellar ataxia: a descriptive analysis of real-world clinical practice.
    Yuichi Hiramatsu, Hiroaki Fujimoto, Hironori Otomune, Kenji Takamatsu, Hidetaka Shiina, Koji Takahashi, Megumi Hatakenaka, Hajime Yagura, Ichiro Miyai.
       PURPOSE: To identify the International Classification of Functioning, Disability and Health (ICF) categories addressed by multifaceted rehabilitation interventions for patients with degenerative cerebellar ataxia (DCA).
    MATERIALS AND METHODS: We retrospectively analyzed a short-term, intensive inpatient rehabilitation program in 55 patients with DCA, including spinocerebellar ataxia types 3, 6, 17, 31, and others. Rehabilitation interventions by physical, occupational, and speech therapists targeting functioning, contextual factors, and self-directed exercises were collected through a retrospective questionnaire completed by the treating therapists, with reference to medical records. Interventions were linked to the ICF and Deutsche Gesellschaft für Sozialmedizin und Prävention categories. Categories were analyzed based on the severity of ataxia using the Scale for the Assessment and Rating of Ataxia.
    RESULTS: Overall, 1,258 interventions were linked to 1,341 s-level ICF categories: 13 body functions, 23 activities and participation, 6 environmental, and 1 personal factor.　Activities and participation categories related to mobility and self-care were identified in severe cases, whereas no body function categories related to ataxia severity were identified.
    CONCLUSIONS: Multifaceted rehabilitation for DCA corresponds to multiple ICF domains.　Interventions targeting activity and participation vary with ataxia severity, suggesting that tailored combinations may improve specific activities of daily living.
    Keywords:  Degenerative cerebellar ataxia; ICF coding; ICF linking; descriptive analysis; multifaceted rehabilitation interventions
    DOI:  https://doi.org/10.1080/09638288.2026.2646108
  7. Rev Fac Cien Med Univ Nac Cordoba. 2026 03 11. 83(1): e48175
    From trauma to fibrosis: a case of ulnar nerve entrapment in Guyon’s canal
    Luan Nascimento Lázaro, Pedro Henrique de Oliveira Alvarenga, Ocacir de Souza Reis Soares, Márcio Luís Duarte.
      Guyon's canal syndrome is an uncommon distal ulnar neuropathy caused by compression within the wrist. We report a case of delayed ulnar nerve entrapment secondary to post-traumatic fibrosis, diagnosed nine years after wrist injury and surgery. High-resolution ultrasonography demonstrated focal nerve compression within Guyon's canal adjacent to fibrotic tissue. The patient presented with chronic sensory deficits and hypothenar atrophy. Conservative treatment led to partial symptom control. This case highlights delayed post-surgical fibrosis as a potential cause of Guyon's canal syndrome and underscores the diagnostic value of ultrasound in chronic compressive neuropathies.
    Keywords:  ultrasonography; ulnar nerve; ulnar nerve compression syndromes
    DOI:  https://doi.org/10.31053/1853.0605.v83.n1.48175
  8. Cureus. 2026 Feb;18(2): e104384
    Effectiveness of Dry Needling Versus Percutaneous Electrolysis in Achilles Tendinopathy: A Randomized Clinical Trial.
    Sara Delgado Álvarez, Roberto Méndez Sánchez, Luis Polo Ferrero, Isaac Rodríguez Fragua, Catalina Loaiciga Espeleta, Roberto González Raja, Zacarías Sánchez Milá, Jorge Velázquez Saornil.
       INTRODUCTION: Achilles tendinopathy (AT) is characterized by pain, inflammation, and functional limitations. It is also the most common cause of pain located at the back of the calcaneus. The Achilles tendon is among the most vulnerable tendons in the lower limb, and its pathology is one of the most common overuse injuries. Moreover, it is not an injury exclusive to athletes, as 65% of diagnosed Achilles tendinopathies are not related to sport.
    METHODS: Randomized, single-blind clinical trial with 60 patients, 30 in each group. All study participants were previously diagnosed with insertional AT, mid-portion tendinopathy, or both and were referred by an orthopedic surgeon. The short- and medium-term results of treatment with dry needling (DN) application to the gastrocnemius muscle trigger points (MTrPs) versus ultrasound-guided percutaneous electrolysis (PE) application to the Achilles tendon were observed in terms of pain intensity, pressure pain threshold, ankle dorsiflexion range of motion under load, quality of life, and ankle and foot function in patients with previously diagnosed AT.
    RESULTS: The visual analogue scale revealed that the time effect was statistically significant. Similarly, AT algometry revealed that the time effect was statistically significant, indicating that the pressure pain threshold assessed by algometry changed significantly over the course of the study. Moreover, quality of life and functionality showed statistically significant improvements from the third week of the study, whereas range of motion remained unchanged.
    CONCLUSION: Ultrasound-guided PE applied to the Achilles tendon is more effective than DN applied to the MTrPs of the gastrocnemius muscle in reducing pain intensity and improving quality of life and ankle and foot function in the short and medium term in patients with AT.
    Keywords:  achilles tendinopathy; algometry; dry needling; functionality; pain; physiotherapy; quality of life; range of motion; ultrasound-guided percutaneous electrolysis
    DOI:  https://doi.org/10.7759/cureus.104384
  9. J Hand Surg Am. 2026 Apr 03. pii: S0363-5023(26)00053-5. [Epub ahead of print]
    A Nationwide Propensity Score-Matched Analysis Identifying Preinjury Predictors of Complex Regional Pain Syndrome Following Distal Radius Fracture.
    Nirav K Mungalpara, William K Reiser, Logan Van Poucke, Gautam Malhotra, Alfonso Mejia, Mark H Gonzalez.
       PURPOSE: Complex regional pain syndrome (CRPS) is an uncommon but debilitating complication following distal radius fractures (DRFs). This study aimed to evaluate a broad set of preexisting comorbidities, including substance-use disorders, psychiatric conditions, compressive neuropathies, upper-limb traumatic nerve injuries, and cervical radiculopathy and determine their associations with CRPS development after DRF.
    METHODS: A retrospective analysis of the PearlDiver database (2010-2022) was performed. Patients with and without CRPS following DRF were matched 1:1 using propensity scores based on age, sex, fracture type, and DRF management (Current Procedural Terminology 25605-25609). Multivariable logistic regression evaluated the association between CRPS and 12 preexisting comorbidities. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) and P values were reported.
    RESULTS: Among 2,685,041 DRF patients, 3,796 developed CRPS (incidence 0.18%). In the matched cohort (n = 26,186), several strong associations emerged. Neuropathic conditions demonstrated the highest risk: upper-limb nerve injury (OR 3.20, 95% CI 2.42-4.30), radial nerve lesions (OR 2.43, 95% CI 1.72-3.50), cubital tunnel syndrome (OR 2.27, 95% CI 2.01-2.57), carpal tunnel syndrome (OR 2.01, 95% CI 1.88-2.14), and cervical radiculopathy (OR 1.80, 95% CI 1.68-1.94). Psychiatric conditions showed modest associations: anxiety disorders (OR 1.25, 95% CI 1.18-1.32), depression (OR 1.07, 95% CI 1.01-1.13), and fibromyalgia (OR 1.58, 95% CI 1.44-1.74). Substance-use factors demonstrated mixed effects: opioid use increased risk (OR 1.39, 95% CI 1.27-1.52), alcohol use decreased risk (OR 0.86, 95% CI 0.79-0.94), and tobacco/cannabis were not significant.
    CONCLUSIONS: Preexisting neuropathic disorders, particularly traumatic nerve injuries, compressive neuropathies, and cervical radiculopathy, are the strongest predictors of CRPS after DRF. Psychiatric conditions confer a smaller but consistent risk, while substance-related factors vary. Identifying preexisting neural vulnerability may improve risk stratification after DRF.
    TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis II.
    Keywords:  Complex regional pain syndrome; distal radius fracture; epidemiology; retrospective analysis
    DOI:  https://doi.org/10.1016/j.jhsa.2026.01.004
  10. Bioinformation. 2025 ;21(12): 4706-4710
    Fall risk after total hip replacement: A functional correlation study.
    Manoj Agnihotri, Ajit Dabholkar.
      Falls are a common issue among older adults after total hip arthroplasty (THA), with factors such as reduced mobility and fear of falling contributing. Therefore, it is of interest to examine recovery and fall-related concerns in patients following total hip arthroplasty (THA). It used measures such as the Harris Hip Score (HHS) and the Falls Efficacy Scale (FES) to assess progress. The study found that the Sit-to-Stand test (STS) was strongly linked to fall confidence, emphasising its value in monitoring recovery and fall risk. This study is the identification of key functional measures (such as the Sit-to-Stand test and Falls Efficacy Scale) in assessing recovery and fall risk in older adults post-total hip arthroplasty, emphasizing the role of physical and psychological factors in improving fall-related confidence and mobility.
    Keywords:  Total hip arthroplasty (THA); alternate step test; falls; geriatric rehabilitation; harris hip score; sit-to-stand; timed up and go
    DOI:  https://doi.org/10.6026/973206300214706
  11. J Pain Res. 2026 ;19 571167
    Optimizing Osteoarthritis Management - Therapeutic Efficacy and Evaluation of Intra-Articular Triamcinolone Acetonide Injection.
    Yongqing Wan, Lingchao Kong, Rende Ning.
      Osteoarthritis (OA) is a common degenerative joint disease that often leads to pain and diminished quality of life in patients. For end-stage osteoarthritis, surgical intervention remains the only effective treatment. However, for the majority of patients, surgery is not the initial consideration. The management of osteoarthritis primarily focuses on alleviating associated clinical symptoms, and rational non-surgical conservative treatment is the recommended approach for patients in the early to middle stages. Intra-articular injection therapy represents one of the most effective non-surgical treatment options, second only to oral analgesics and anti-inflammatory medications, with a lower incidence of systemic complications. Compared to surgery, it is more cost-effective and less invasive. Among these, intra-articular corticosteroid injection is a widely adopted non-surgical treatment by rheumatologists for osteoarthritis. Numerous studies have demonstrated that intra-articular corticosteroid injections can provide short-term pain relief in osteoarthritis. Triamcinolone Acetonide (TA) is one of the commonly used corticosteroids, valued for its notable anti-inflammatory and analgesic effects. It is extensively applied in intra-articular injections for osteoarthritis to alleviate pain and potentially delay disease progression. The purpose of this paper is to review the mechanism of action of Triamcinolone Acetonide, its current applications and efficacy in osteoarthritis, safety profile, and future directions, thereby providing a theoretical foundation and practical guidance for clinical management strategies in osteoarthritis.
    Keywords:  intra-articular injection; osteoarthritis; pharmacology; triamcinolone acetonide; ultrasound
    DOI:  https://doi.org/10.2147/JPR.S571167
  12. Asian Spine J. 2026 Apr 03.
    Impact of lumbar spinal canal stenosis on paravertebral muscle condition: an observational study in Japan.
    Jusei Kunimoto, Takahito Iga, Kazuki Takeda, Toshiki Okubo, Satoshi Suzuki, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe.
       Study Design: Retrospective cohort study.
    Purpose: To examine the impact of lumbar canal stenosis (LSS) severity on paraspinal muscles in patients undergoing surgery.
    Overview of Literature: LSS commonly causes back pain, leg pain, and sensory disturbances, and severe cases may result in muscle weakness. Dysfunction of the lumbar paraspinal muscles is linked to low back pain, and lower extremities muscle weakness is common in severe LSS. However, few studies have investigated the condition of paraspinal muscles in LSS patients. This study aimed to clarify the relationship between LSS severity and paraspinal muscle degeneration by comparing muscle area and fat content in surgical LSS cases.
    Methods: Seventy-eight patients with LSS (51 males, 27 females) who underwent posterior decompression or decompression with fusion were included. On preoperative T2-weighted magnetic resonance imaging, total muscle cross-sectional area, muscle cross-sectional area (MCSA), fat cross-sectional area, and fat percentage (FP) were measured for the multifidus, longissimus, and psoas muscles. Patients were categorized by stenosis count (single or multiple) and anatomical level (above L3/4, below L4/5, or extensive).
    Results: The MCSA of the multifidus and longissimus muscles was significantly smaller in the multiple stenosis group than in the single stenosis group (56.5±2.1 cm2 vs. 51.0±1.5 cm2, p=0.0384). FP was significantly higher in the multiple stenosis group (multifidus: 25.5%±1.4% vs. 30.3%±1.0%, p=0.0081; longissimus: 14.3%±0.9% vs. 17.2%±0.7%, p=0.0123) across all levels. No significant differences in MCSA were observed among different anatomical levels.
    Conclusions: An increased number of stenotic levels were associated with significant paraspinal muscle atrophy and fat infiltration, whereas the anatomical stenosis level showed minimal impact on muscle condition. Stenosis severity, rather than its location, may primarily contribute to paraspinal muscle degeneration in LSS patients.
    Keywords:  Fatty infiltration; Lumbar vertebrae; Muscle atrophy; Paraspinal muscles; Spinal stenosis
    DOI:  https://doi.org/10.31616/asj.2025.0381
  13. J Orthop Res. 2026 Apr;44(4): e70201
    Achilles Tendon Shear Wave Velocity Within a 1-Year Follow-Up After Non-Operatively Treated Rupture.
    Maria Sukanen, Ra'ad M Khair, Iida Laatikainen-Raussi, Aleksi Reito, Ville Ponkilainen, Neil J Cronin, Arto J Hautala, Taija Finni.
      The purpose of this study was to investigate changes in Achilles tendon (AT) shear wave velocity (SWV) during the first year after rupture. Additionally, we aimed to explore relationships between AT SWV and plantarflexion maximal voluntary torque (MVT), steps/day, patient-reported function, and tendon thickness. Participants (N = 27, 8 females, 41.5 ± 9.8 years) were measured for AT SWV at rest, accelerometer-monitored daily steps, and tendon thickness at 2-, 6-, and 12 months post-rupture. AT SWV was imaged from distal, middle, and proximal locations along the length of the tendon (ATdist, ATmid, ATprox). MVT was tested at 6- and 12 months. Achilles tendon total rupture score (ATRS) was inquired at 12 months. Pearson's correlation was used to assess the relationship between limb asymmetry (LSI, %) of ATmid SWV and the functional and structural outcomes. Linear mixed model was used to assess the effect of time, limb condition and imaging location on AT SWV. AT SWV LSI correlated with MVT LSI at 6- and 12 months after rupture (r = 0.500, p = 0.011; r = 0.653, p < 0.001, respectively). By 6 months, the injured tendon reached SWV level of the uninjured limb and at 12 months, ATprox SWV of the injured side was higher than the uninjured (mean difference 2.4 m × s⁻¹ (95% CI 0.9-3.7), p = 0.007. At 12 months, median ATRS was 91 points. Increase in SWV of the injured tendon may indicate an improvement in its material properties during recovery. This improvement may be associated with the ruptured tendon's ability to transfer loads and the muscle-tendon units' capacity to generate force.
    Keywords:  daily step count; diagnostic imaging; elastography; mechanical properties; muscle strength; patient function; tendon healing; ultrasound
    DOI:  https://doi.org/10.1002/jor.70201
  14. J Yeungnam Med Sci. 2026 ;43 26
    Median neuropathy after open reduction and internal fixation: when implant proximity is not the culprit.
    Berkay Yalçınkaya, Hilmi Berkan Abacıoğlu, Ahmet Furkan Çolak, Harun Kürşat Karademir, Murat Kara.
      
    DOI:  https://doi.org/10.12701/jyms.2026.43.26
  15. Clin Rheumatol. 2026 Mar 28.
    Ultrasound-based assessment of talar cartilage in individuals with chronic ankle instability: a systematic review.
    Amin Mohammadi, Saeed Eshghi, Iman Mohammadi, Patrick Wilson, Ryan McCann.
       PURPOSE: To systematically synthesize ultrasound (US) evidence on talar cartilage morphology and load-induced deformation in individuals with chronic ankle instability (CAI), and to map methodological approaches (acquisition, outcome definitions, loading paradigms, and normalization) to inform protocol standardization.
    METHODS: PubMed, Web of Science, and EBSCO were searched (March 31, 2025). Eligible studies reported quantitative US-derived talar cartilage morphology (e.g., thickness, cross-sectional area [CSA]) and/or deformation following standardized loading in CAI and comparison groups. Due to heterogeneity in imaging protocols, loading tasks, and outcome definitions, findings were synthesized narratively and organized by outcome domain.
    RESULTS: Across available cohorts, load-induced deformation was the most consistently differentiating signal: CAI groups generally demonstrated greater deformation than controls, with more frequent regional effects at the medial talar dome. Evidence for baseline (unloaded) morphological differences was mixed, with some studies reporting no group differences and others reporting larger CSA in CAI. Associations between deformation and neuromechanical measures (e.g., inversion laxity, postural control, hop biomechanics, ground reaction forces) were reported but were protocol- and cohort-dependent.
    CONCLUSIONS: Current evidence, limited by few unique cohorts, partial non-independence across publications, and heterogeneous acquisition/loading/normalization procedures, suggests that B-mode US can quantify talar cartilage morphology and detect load-induced deformation differences in CAI in research settings. Talar cartilage ultrasonography should be considered investigational until standardized acquisition and analysis procedures and longitudinal validity are established. Key Points • Ultrasound can quantify talar cartilage morphology and load-induced deformation in individuals with chronic ankle instability. • Load-induced talar cartilage deformation appears to be the most consistent ultrasound-derived feature differentiating chronic ankle instability from healthy controls. • Evidence for baseline talar cartilage morphology differences is mixed, likely reflecting heterogeneity in cohorts and imaging/loading protocols. • Standardized acquisition, loading, and analysis methods, along with independent longitudinal validation, are needed before clinical translation.
    Keywords:  Ankle injuries; Ankle sprain; Joint degeneration; Talar cartilage; Ultrasonography
    DOI:  https://doi.org/10.1007/s10067-026-08049-3
  16. Clin Rheumatol. 2026 Mar 29.
    Comparison of the effectiveness of extracorporeal shock wave therapy and high-intensity laser therapy in patients with knee osteoarthritis: a single-blind randomized clinical trial.
    Orge Fatos Demirtas, Ozlem Altindag, Mazlum Serdar Akaltun, Neytullah Turan, Elif Balbal, Ali Gur.
       OBJECTIVE: The aim of this single-blind randomized clinical trial was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) on clinical parameters in knee osteoarthritis.
    PATIENTS AND METHODS: A total of 60 patients aged between 40 and 75 years, diagnosed with primary knee osteoarthritis and admitted to the Department of Physical Medicine and Rehabilitation, Gaziantep University, were included in the study. Sixty patients were randomized into two groups using the envelope method. Group 1 received ESWT (3 sessions/week, total of 6 sessions), and Group 2 received HILT (5 sessions/week, total of 10 sessions) for a duration of 2 weeks. A standardized home exercise program was applied to all patients. Patients were evaluated before treatment, after treatment, and at the 6th week post-treatment using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne algofunctional knee index. Statistical analyses were performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA), including t-test, chi-square, ANOVA, and Pearson correlation; significance was set at p < 0.05.
    RESULTS: In both groups, compared to pre-treatment values, significant improvements were observed in VAS (p < 0.001), WOMAC pain, stiffness, and physical function (p < 0.001), as well as Lequesne index scores (p < 0.001) after treatment and at the 6th week post-treatment. No significant differences were found between the groups in intergroup comparisons.
    CONCLUSION: Both ESWT and HILT are effective and safe treatment methods for reducing pain, disease severity, and improving physical function in knee osteoarthritis. Our findings support broader clinical use of both treatments, though further comprehensive studies are required. Key Points • In both the ESWT and laser groups, significant improvements were observed in VAS, WOMAC pain, stiffness, and physical function and Lequesne index scores at 6 weeks post-treatment compared to pre-treatment values. • In patients with knee osteoarthritis receiving ESWT and HILT treatment, improvement was achieved in terms of pain and functionality, but our study showed that neither agent was superior to the other.
    Keywords:  Extracorporeal shock wave therapy; Laser therapy; Osteoarthritis of knee
    DOI:  https://doi.org/10.1007/s10067-026-08052-8
  17. J Pain Res. 2026 ;19 597243
    Hyperbaric Oxygen Therapy in Managing Chronic Pain Syndromes - A Systematic Review.
    Anna-Maria Leys, Guy Henri Hans, Vera Saldien, Davina Wildemeersch.
       Background: Chronic pain is a major global health problem for which current treatments often provide insufficient relief. Tissue hypoxia and redox imbalance may contribute to its pathophysiology, prompting interest in hyperbaric oxygen therapy (HBOT) as a potential adjunctive treatment. This review evaluates the therapeutic effects of HBOT in adults with chronic pain syndromes.
    Methods: A PRISMA-guided systematic review was conducted (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials; January 2000 - August 2025). Randomized controlled trials (RCTs) evaluating HBOT in adults with chronic pain were included. Primary outcomes were pain measures (intensity, distribution and sensitivity). Secondary outcomes included multidimensional pain-related outcomes (quality of life, functioning and psychological well-being), analgesic use, neuroimaging findings, and adverse events. Risk of bias was assessed using the Cochrane RoB 2 tool. Due to study heterogeneity, results were synthesized narratively.
    Results: Eleven RCTs (480 participants) were included, predominantly involving fibromyalgia (n=8), with additional studies in complex regional pain syndrome (CRPS) (n=1), idiopathic trigeminal neuralgia (n=1) and radiation-induced brachial neuropathy (n=1). Sample sizes ranged from 17 to 71 participants. Most trials showed some concerns or high risk of bias, mainly due to subjective outcomes and lack of blinding. In fibromyalgia, HBOT showed consistent within-group improvements in pain, functioning, and quality of life, with some studies demonstrating between-group benefits. Limited evidence in CRPS and trigeminal neuralgia suggested possible benefit, whereas the trial in radiation-induced brachial plexopathy showed no meaningful improvement. HBOT was generally well tolerated, with mostly mild adverse events.
    Conclusion: HBOT shows potential as an adjunctive intervention for selected chronic pain syndromes, particularly fibromyalgia. However, condition-specific effects, inconsistent superiority over controls, methodological limitations, protocol heterogeneity, and limited long-term follow-up constrain the strength of evidence. Larger, standardized trials with extended follow-up are needed before routine clinical implementation can be recommended.
    Keywords:  HBOT; chronic pain; complex regional pain syndrome; fibromyalgia; functional outcomes; trigeminal neuralgia
    DOI:  https://doi.org/10.2147/JPR.S597243
  18. Indian J Orthop. 2026 Mar;60(3): 599-611
    A Systematic Review on the Efficacy and Safety of Platelet-Rich Plasma in the Management of Achilles Tendon Rupture.
    Mohammed Alharbi.
       Background: The Achilles tendon is the most robust tendon in the human body; yet ruptures of the Achilles tendon are prevalent. Their prevalence is greatest among middle-aged individuals, perhaps due to the increased participation of this demographic in sports. There is a huge controversy regarding the treatment of Achilles tendon ruptures with platelet-rich plasma (PRP) and whether it is associated with improvement in outcomes or not; therefore, I conducted the current systematic review to investigate the evidence from published articles assessing the effectiveness of PRP in patients with Achilles tendon ruptures.
    Methods: This systematic review and meta-analysis was performed by searching for all eligible publications on PubMed, Web of Science, and Scopus from their creation to November 2024. A search strategy based on three primary keywords and their corresponding Medical Subject Headings (MESH) terms: "Platelet-rich plasma" AND "Achilles tendon" AND "Rupture." I systematically reviewed the included articles and a narrative synthesis of data was conducted to present the efficacy and safety parameters in addition to a summary of findings of the included studies.
    Results: After screening, eight articles were included in the present systematic review. The studies provide a range of findings on the effectiveness of PRP in the treatment of Achilles tendon ruptures, with most research suggesting limited clinical benefit. In contrast, Zou et al. offered a differing perspective, suggesting that PRP may serve as a biological augmentation in surgical repair, potentially improving short- and mid-term outcomes. Overall, while some studies suggest possible short-term benefits, the majority do not support PRP as a valuable addition to Achilles tendon rupture treatment protocols.
    Conclusion: From the systematic synthesis of the included studies, I observed controversial findings regarding the efficacy of PRP in the management of Achilles tendon ruptures with more data supporting no benefit. However, comprehensive data and strong evidence are still lacking to depend on in the use of PRP and its different types and constituents in the treatment process of Achilles tendon ruptures. This shows the importance of continued research to fill the gap in this area.
    Keywords:  Achilles tendon; Efficacy; Platelet-rich plasma; Rupture
    DOI:  https://doi.org/10.1007/s43465-025-01611-2
  19. Int J Chron Obstruct Pulmon Dis. 2026 ;21 580903
    Kinesiophobia in Patients with Chronic Obstructive Pulmonary Disease: A Concept Analysis.
    Huifang Yin, Rongrong Li, Yidan Hu, Lihua Huang.
       Background: Kinesiophobia (fear of movement) is a significant barrier to pulmonary rehabilitation and functional recovery in patients with Chronic Obstructive Pulmonary Disease (COPD). Despite its considerable impact on clinical outcomes, this concept currently lacks a unified definition and comprehensive theoretical framework.
    Objective: To clarify the concept of kinesiophobia in COPD by identifying its defining attributes, antecedents, and consequences, and to integrate these elements into a cohesive conceptual framework.
    Methods: A comprehensive literature search was performed in CNKI, Wanfang, VIP, Web of Science, PubMed, CINAHL, and Cochrane Library databases from inception to April 1, 2025. Following Rodgers' evolutionary methodology, two researchers independently screened studies and conducted a systematic thematic synthesis.
    Results: Twenty-nine studies met inclusion criteria. Kinesiophobia in COPD is characterized by four defining attributes: symptom hypervigilance, maladaptive cognition, complex emotional responses, and behavioral avoidance. These are influenced by sociodemographic, disease-related, and psychological antecedents, and lead to functional decline and reduced quality of life.
    Conclusion: This analysis synthesizes a unified conceptual framework that integrates dyspnea-related and pain-related kinesiophobia, addressing a critical gap in the literature. This framework provides the foundation for developing precise assessment tools and mechanism-based interventions tailored to specific fear subtypes, ultimately aiming to disrupt the debilitating cycle of fear and avoidance in COPD.
    Keywords:  activity avoidance; chronic obstructive pulmonary disease; concept analysis; fear of movement; kinesiophobia; pulmonary rehabilitation; symptom catastrophizing
    DOI:  https://doi.org/10.2147/COPD.S580903
  20. Front Rehabil Sci. 2026 ;7 1745671
    An ICF-based interdisciplinary case management improves functioning, participation, and well-being for people with disabilities in community rehabilitation: a protocol for a randomised controlled trial.
    Chi Keung Yeung, Ka Man Cheng, Ping Kin Wong, Shui Sang Wong, Hon Yee Cheng, Wai Yee Cheung, Wai Yan Wong, Choi Wa Ling, Chi Chung Lee.
       Background: Community-delivered rehabilitation (CDR) aims to empower people with disabilities and promote their social inclusion. However, conventional multidisciplinary approaches often lack integration and personalised coordination. The International Classification of Functioning, Disability and Health (ICF) offers a structured framework that facilitates interdisciplinary collaboration, case management and person-centred care. This trial aims to evaluate the effectiveness of an ICF-based interdisciplinary case management model in improving functioning, participation, and subjective well-being among adults with physical disabilities receiving home-based community rehabilitation, compared with usual multidisciplinary care.
    Methods: This is a six-month, single-blind, randomised controlled trial. Sixty participants will be recruited and randomly assigned via block randomisation to either an intervention group receiving structured ICF-based interdisciplinary case management or a control group receiving usual multidisciplinary care. The inclusion criteria were adults with physical disabilities eligible for CDR; exclusion criteria included severe cognitive impairment or inability to provide informed consent. The intervention consists of ICF-based assessments using the ICF Rehabilitation Set and Minimal Set of Environmental Factors, collaborative goal setting, monthly interdisciplinary case conferences, and coordinated care planning. The primary outcomes are functioning (WHO Disability Assessment Schedule 2.0, 36-item version) and well-being (Satisfaction with Life Scale). The secondary outcomes are changes in ICF qualifiers and therapist-related clinical outcomes (Australian Therapy Outcome Measures). Outcomes will be assessed at baseline and six months. Data will be analysed via intention-to-treat principles and generalised linear mixed models (GLMMs). Recruitment began in May 2025 and is expected to be completed by December 2025, with follow-up concluded by July 2026.
    Discussion: This trial will generate empirical evidence on the use of the ICF as a framework for structured interdisciplinary case management in CDR. The findings may inform service planning, interprofessional training, and policy development to promote holistic, person-centred disability care.Clinical Trial Registration: https://www.chictr.org.cn/hvshowprojectEN.html?id=284308&v=1.0.
    Keywords:  case management; community-based rehabilitation; interdisciplinary collaboration; international classification of functioning disability and health; people with disabilities; person-centred care; randomised control trial; social participation
    DOI:  https://doi.org/10.3389/fresc.2026.1745671
  21. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00449-8. [Epub ahead of print]46 109-116
    Intensive versus usual rehabilitation programs in stable chronic obstructive pulmonary disease (COPD) patients.
    Hala M Abd Elsabour Sabah, Rehab M Mohammed, Samia Mohamed Rashad.
       BACKGROUND: Pulmonary rehabilitation (PR) is a comprehensive, patient-customized, multifaceted, non-pharmacological, pivotal intervention designed to enhance the quality of life in patients with chronic obstructive pulmonary disease (COPD). Comorbidities and financial costs pose an important hindrance to long-term adherence to PR programs, and the optimal duration and intensity of a PR program are controversial. So, we conducted this study to assess the effect of 3-week PR program on COPD patients, and to compare the effectiveness of an intensive program with two sessions per day, to a usual program with one session per day.
    METHODS: A prospective interventional study enrolling 50 clinically stable COPD patients randomized into two groups. A three-week PR program was designed for both groups. Group I received one session/day while Group II received two sessions/day. Oxygen saturation(SPO2) modified Medical Research Councill(mMRC) dyspnea grade, COPD Assessment Test (CAT) score, Barthel scale, and 6-min walking test(6MWT) were all assessed at baseline and the end of the program.
    RESULTS: Fifty COPD patients, with a mean age of 60.06 ± 6.3 years. After three weeks of PR either with one or two sessions per day, both groups showed significant improvement in the dyspnea score, CAT score, Barthel score, SPO2, and 6minute walking distance (6MWD) (p-value˂0.05). Also, on comparing the resulting parameters between the two groups showed a non-significant difference.
    CONCLUSION: A three-week pulmonary rehabilitation with usual program is effective and comparable to an intensive program in increasing exercise capacity, improving dyspnea, and health-related quality of life in stable COPD Patients.
    Keywords:  COPD; Program; Pulmonary rehabilitation; Short term PR
    DOI:  https://doi.org/10.1016/j.jbmt.2025.10.055
  22. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00369-9. [Epub ahead of print]46 227-234
    A study investigating the impact of the 'rehabilitation-training integration' intervention strategy on elite weightlifters with chronic low back pain returning to competitive sports.
    Peng Liu, Qi Yan.
       OBJECTIVE: This study aimed to evaluate the efficacy of a 16-week integrated rehabilitation-training intervention for an elite female weightlifter with chronic low back pain (CLBP), focusing on optimizing biomechanical and clinical synergy to address pain-performance conflicts and restore her competitive capacity.
    METHODS: A case-study framework was employed with a structured three-phase protocol: pain modulation, neuromuscular re-education, and sport-specific loading. Multidimensional assessments were conducted throughout the intervention, including the Visual Analog Scale (VAS), Functional Movement Screen (FMS), Y-Balance Test (YBT), joint range of motion (ROM), isokinetic strength testing, and sport-specific performance metrics. Dynamic periodization was applied to ensure progressive adaptation, with an emphasis on core stability, strength symmetry, and kinetic chain efficiency.
    RESULTS: indicated substantial improvements: VAS scores reduced by 76 % (from 7.8 to 1.9), FMS scores increased by 28.6 % (from 14 to 19), YBT asymmetry normalized to <8 %, hip flexion symmetry restored to within 5°, and hip extension torque improved by 22.3 % (from 218 N to 266 N). The athlete returned to competition, surpassing her pre-injury total lift by 7 kg and winning a national championship.
    CONCLUSION: The rehabilitation-training integration strategy, combining biomechanical correction and neuromuscular optimization, effectively addressed the athlete's CLBP. By focusing on core stability, restoring strength symmetry, and improving movement patterns, the intervention facilitated pain reduction, tissue healing, and sport-specific performance restoration. This approach provides a validated framework for managing chronic injuries in strength sports, offering valuable insights for rehabilitation and performance enhancement in elite athletes.
    Keywords:  Chronic low back pain; Rehabilitation-training integration; Return to play; Weightlifters
    DOI:  https://doi.org/10.1016/j.jbmt.2025.09.022
  23. Skeletal Radiol. 2026 Apr 01.
    Insights into the complex relationship between pain and imaging-detected structural damage in knee osteoarthritis.
    David Ferreira Branco, C Kent Kwoh, Theresa Patzer, Marco L Loggia, Ali Guermazi, Mohamed Jarraya.
      Knee osteoarthritis (OA) is a leading cause of chronic pain and disability, yet the relationship between imaging-detected structural damage and clinical pain remains still unclear. This persistent pain-structure discordance limits the effectiveness of current treatments and poses major challenges for clinical trial design and the development of disease-modifying OA drugs. Advances in imaging particularly MRI-based scoring systems have improved characterization of cartilage, bone, synovial, and meniscal pathology, but morphologic imaging alone cannot capture the neurobiological processes that shape the pain experience. This review summarizes pathophysiological changes and pain mechanism related to OA, followed by a review of pain assessment tools, a summary of our current understanding of the association between structural damage and pain experience in knee OA. Finally, we discuss emerging imaging tools, including positron emission tomography, which may help visualize inflammatory and neurobiological processes in both the knee joint and the brain.
    Keywords:  Bone marrow lesions; Central sensitization; Knee osteoarthritis; Magnetic resonance imaging; Neuroinflammation; Pain mechanisms; Synovitis
    DOI:  https://doi.org/10.1007/s00256-026-05204-4
  24. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00504-2. [Epub ahead of print]46 442-455
    The Relationship between early and late stimulation of the deltoid muscle in patients undergoing reverse total shoulder arthroplasty. A systematic review with meta-analysis.
    Flávio Martins do Nascimento Filho, Talita Santos Andrade, Pedro Machado Menezes, Mayara Alves Menezes, Suziany Dos Santos Caduda, Igor Leonardo Alves Mendonça, Tarcísio Brandão Lima, Jader Pereira de Farias Neto, Walderi Monteiro da Silva Junior.
       OBJECTIVE: To evaluate the effects of early stimulation on deltoid functional performance in patients undergoing reverse total shoulder arthroplasty (RTSA).
    STUDY DESIGN: Systematic review with meta-analysis.
    METHODS: A comprehensive search was conducted in 12 databases. Two independent reviewers assessed the studies for inclusion and quality of evidence. Data were analyzed using meta-analysis when possible; otherwise, they were qualitatively synthesized. The outcomes evaluated were functional performance, pain, functional capacity, range of motion (ROM), muscle strength, and adverse effects. The quality of evidence was assessed using the GRADE approach.
    RESULTS: Four randomized controlled trials (RCTs) were included, of which three provided viable comparisons for meta-analysis. In the comparison between early and late stimulation, early stimulation demonstrated statistically significant improvements in ROM for flexion, abduction, and external rotation. Conversely, delayed stimulation resulted in better outcomes for internal rotation. Nevertheless, no significant differences were found between groups in functional performance, pain, or functional capacity.
    CONCLUSION: Although both groups showed improvements, early stimulation demonstrated superior ROM outcomes in specific movements. However, the evidence was classified as low to very low due to methodological limitations. To enhance clinical decision-making, further studies with greater methodological rigor are necessary.
    Keywords:  Arthroplasty; Rehabilitation; Shoulder; Systematic review
    DOI:  https://doi.org/10.1016/j.jbmt.2025.12.017
  25. Front Med (Lausanne). 2026 ;13 1757222
    Effectiveness of percutaneous electrolysis in subacute and early chronic medial gastrocnemius muscle injuries: a single-blinded randomized clinical trial.
    Carlos Vicente-Vega, Fausto José Barbero-Iglesias, Javier Martín-Vallejo, Sergio Varela-Rodríguez.
       Background: Chronic injuries of the medial gastrocnemius muscle are clinically relevant conditions that often result in persistent pain, functional limitations, and delayed return to activity. Although conservative management is usually prescribed, outcomes are not always satisfactory, and minimally invasive approaches such as percutaneous electrolysis (PE) have been proposed as potential therapeutic alternatives.
    Methods: This randomized clinical trial included 71 patients with medial gastrocnemius injuries of at least 3 weeks' duration. Participants were randomly allocated to high-intensity PE (n = 23), low-intensity PE (n = 23), or a sham control group (n = 25). Participants received three sessions, once per week for three consecutive weeks. Outcomes were pain during gait and contraction, fatigue, kinesiophobia, and ankle range of motion (ROM), assessed at baseline and after the intervention.
    Results: High-intensity PE produced significant reductions in pain during gait and contraction compared with the sham group (p < 0.05). Low-intensity PE was associated with a significant reduction in fatigue compared with sham (p = 0.024). No significant between-group differences were observed in kinesiophobia or range of motion. Within-group analyses showed improvements in several outcomes among patients treated with PE (all, p < 0.05).
    Conclusions: Percutaneous electrolysis may effectively reduce pain during gait and contraction, as well as fatigue, compared with a sham intervention in patients with subacute to early chronic medial gastrocnemius injuries.
    Clinical trial registration: https://clinicaltrials.gov/study/NCT06713200, identifier: NCT06713200.
    Keywords:  fibrosis; gastrocnemius injury; invasive physiotherapy; muscle scar tissue; percutaneous electrolysis; rehabilitation; tennis leg
    DOI:  https://doi.org/10.3389/fmed.2026.1757222
  26. J Ultrason. 2026 Apr;26(104): 20260003
    Aponeurotic expansion of the supraspinatus tendon: sonographic spectrum and proposed classifications.
    Saulius Rutkauskas.
       Aim: The aponeurotic expansion of the supraspinatus tendon is a recognized but underappreciated anatomical structure of the shoulder. Its sonographic appearance may mimic or coexist with pathology of adjacent tendons, particularly the long head of the biceps tendon, creating diagnostic challenges. Although described in prior literature, many atypical variants remain insufficiently documented. This study aimed to characterize atypical sonographic manifestations of the aponeurotic expansion of the supraspinatus tendon and to propose new classifications based on its relationship with the supraspinatus tendon, its position within the rotator interval, and its association with the long head of the biceps tendon.
    Material and methods: Between October 2018 and September 2025, a total of 3,600 shoulder ultrasound examinations were performed. Nineteen patients (15 women, four men; mean age 60.7 years, range 24-82 years) with pathologically altered aponeurotic expansions were retrospectively identified. Each case was evaluated for structural and positional changes in relation to the supraspinatus, long head of the biceps, and subscapularis tendons.
    Results: The most frequent supraspinatus-aponeurotic expansion relationship was minor intrasubstance tearing (31.6%), followed by complete supraspinatus tears with retraction (21.1%). At the rotator interval, subluxation was observed in 36.8% of cases. Regarding interactions with the long head of the biceps tendon, aponeurotic expansion dislocation with preserved intragroove biceps alignment was most common (31.6%). Several theoretical subtypes were not observed.
    Conclusions: Ultrasound enables detailed assessment of the aponeurotic expansion of the supraspinatus tendon. The proposed classifications provide a structured framework for clinical practice and may guide future research into the diagnostic and functional significance of this complex region.
    Keywords:  aponeurotic expansion of the supraspinatus tendon (AEST); biceps brachii; rotator cuff; tendons/pathology; ultrasonography
    DOI:  https://doi.org/10.15557/jou.2026.0003
  27. Front Med (Lausanne). 2026 ;13 1753968
    The efficacy of pulmonary rehabilitation on cognitive functions in patients with chronic obstructive pulmonary disease: systematic review.
    Shahad Alkandari, Shibili Nuhmani, Mohammad AlSubaiei, Turki Abualait.
       Background: Pulmonary rehabilitation (PR) program is an essential non-pharmacological management in patients with chronic obstructive pulmonary disease (COPD). COPD can lead to cognitive impairment (CI) for about 36%.in COPD patients.
    Objective: The aim of this study is to explore the efficacy of PR in improving cognitive functioning in patients with COPD.
    Method: Electronic searches of three databases: PubMed, Scopus, and Web of Science were performed. The included studies assessed at least one cognitive function in patients with COPD before and after participating in PR program. Study quality was evaluated by two reviewers independently using risk-of-bias tool (RoB 2) for randomized control trials (RCT) and Risk of Bias In Non-Randomized Studies - of Interventions (ROBIN-I) for non-RCT.
    Result: Eleven studies (six RCT and five non-RCT) were selected based on the inclusion criteria, representing ten components of PR intervention, and 25 cognitive tests (or subtests). The total number of participants was 864 patients with COPD. The age range was 48 to 76 years and both genders were included. The studies showed heterogeneity in the study design, PR intervention elements and cognitive tests. PR program showed significant improvement among COPD population in cognitive function in nine studies. The most frequent test used was Montreal Cognitive Assessment test and the most frequent PR component performed was aerobic exercise.
    Conclusion: PR programs possibly improve cognitive function among patients with COPD especially those suffering from cognitive impairment. Future studies need to unify the PR intervention elements and the neuropsychological battery tests used to enable a proper evaluation of the program efficacy and application.
    Systematic review registration: PROSPERO Registration ID: CRD42023471801.
    Keywords:  COPD; cognitive function; cognitive impairment; pulmonary rehabilitation; rehabilitation
    DOI:  https://doi.org/10.3389/fmed.2026.1753968
  28. PM R. 2026 Apr 02.
    Effects of exercise-induced hypoalgesia on pressure pain threshold in patients with chronic musculoskeletal pain: A systematic review and meta-analysis.
    Joaquín Salazar-Méndez, Fabiola Benavides-Méndez, Rodrigo Núñez-Cortés, Felipe Araya-Quintanilla, Nelson Viscay-Sanhueza, Sergio Sazo-Rodríguez, Felipe Díaz-Ramírez, Javier Meza-Carvajal, Síbila Floriano Landim, Jorge Fuentes.
       OBJECTIVE: To determine the effects of exercise programs on exercise-induced hypoalgesia in people with chronic musculoskeletal pain.
    LITERATURE SURVEY: This systematic review and meta-analysis included a search of MEDLINE, Web of Science, CINAHL, SCOPUS, and EMBASE databases from inception until May 18, 2025. Randomized controlled trials that examined aerobic or anaerobic exercise interventions in patients with chronic musculoskeletal pain and that assessed pressure pain thresholds were considered.
    METHODOLOGY: The Hartung-Knapp-Sidik-Jonkman random-effects method or Mantel-Haenszel fixed-effects method, depending on the heterogeneity, was applied to estimate the effects of exercise-induced hypoalgesia. The risk of bias was assessed with the risk of bias 2 tool and the certainty of the evidence was evaluated with Grading of Recommendations Assessment, Development, and Evaluation.
    SYNTHESIS: Nineteen articles were included. The meta-analysis found a small statistically significant difference in favor of other physical therapy treatments compared with isolated exercise for pressure pain thresholds in both individuals with chronic neck-shoulder pain and those with chronic low back pain pain, with low and very low certainty of the evidence, respectively. For the overall risk of bias, 2 studies had a low risk, 6 had some concerns, and 11 had a high risk.
    CONCLUSIONS: Isolated exercise in people with chronic neck and shoulder pain and those with chronic low back pain is not superior to other therapeutic modalities for improving pressure pain thresholds. Other physical therapy modalities generate higher pressure pain thresholds than isolated exercise with small effect size. These findings should be interpreted with caution due to the limited certainty of the evidence.
    DOI:  https://doi.org/10.1002/pmrj.70120
  29. Cureus. 2026 Feb;18(2): e104379
    Evaluating the Safety of Early Return to Play After Metacarpal or Scaphoid Fracture: A Systematic Review.
    Calvin Wang, Jason Daniels, Daniel Devine, Michael Simon, David Kirschenbaum, Brian M Katt.
      This review summarizes reported outcomes and complications associated with early versus standard return-to-play timelines in athletic patients. Specifically, we focus on athletes with metacarpal and scaphoid fractures to determine whether significant differences in complications and outcomes exist depending on the time of return. Return-to-play timing varies within sports medicine, and a focused review addressing metacarpal and scaphoid fractures currently does not exist. Therefore, this review seeks to synthesize existing studies to highlight the implications of early return to play.
    Keywords:  early return-to-play; fracture; metacarpal; scaphoid; union
    DOI:  https://doi.org/10.7759/cureus.104379
  30. Med J Aust. 2026 Apr;224(4): e70173
    Paediatric Injuries and E-Mobility Devices: A Call for Regulatory Reform in Queensland.
    Thomas Bradley.
      
    Keywords:  bone fractures; hand injuries; hip injuries; knee injuries; musculoskeletal abnormalities; musculoskeletal pain
    DOI:  https://doi.org/10.5694/mja2.70173
  31. Cureus. 2026 Feb;18(2): e104271
    Perineural Steroid Injections in Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis.
    Amaar A Ali, Zubayr Ali, Ahmed Eid, Rahul Kakkar, Minahil Arshad.
      Cubital tunnel syndrome (CuTS) is a prevalent mononeuropathy, although the role of perineural steroid injections (PSI) remains uncertain. This meta-analysis and systematic review sought to compile and evaluate all available evidence regarding the potential benefits of PSI. The performance of PSI was assessed objectively using ultrasound (US) and nerve conduction studies NCS), and evaluated clinically through patient-reported questionnaires. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed across PubMed, Embase, and Medline databases. Common outcomes and control groups were categorised together. Meta-analysis was performed where possible, while narrative synthesis was used for studies with substantial heterogeneity. A risk of bias assessment was also undertaken. The search yielded a total of 1751 papers. Nine studies met the inclusion criteria, encompassing 357 cases of CuTS. Clinically, patients who received PSI performed significantly better on clinical questionnaires and reported improved global symptom ratings. PSI was shown to be a useful adjunct compared with other treatment modalities, such as surgery and splinting. Steroid injections were also shown to be a reliable diagnostic tool in clinically uncertain cases of CuTS. No significant complication profile was identified with PSI. Meta-analysis of pooled results revealed no significant improvement in US findings or NCS. PSI was found to alleviate symptoms and signs of CuTS across a range of clinical tools and questionnaires. It represents a safe therapeutic modality that could serve a valuable adjunctive and diagnostic function. Objective improvement on imaging or electromyographic studies was not observed. Additional longitudinal studies with larger sample sizes are required. There is also a need for further comparisons between different treatment options.
    Keywords:  cubital tunnel; elbow joint; mononeuropathy; steroid injection; ulnar nerve
    DOI:  https://doi.org/10.7759/cureus.104271
  32. Pain Med. 2026 Mar 30. pii: pnag049. [Epub ahead of print]
    Spinal Cord Stimulation, Peripheral Nerve Stimulation, and Pulsed Radiofrequency in the Management of Herpes Zoster-Related Pain: A Network Meta-Analysis.
    Haneen Sabet, Abdallah Abbas, Johnson S Ho, Mohamed El-Moslemani, Dina Essam Abo-Elnour, Majed Aldehri, Ibrahim Alnaami, Ahmed M Raslan.
       BACKGROUND: Neuromodulation therapy is gaining importance in managing chronic neuropathic pain. This network meta-analysis aims to compare the efficacy and safety of spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), pulsed radiofrequency (PRF), and their combinations in the management of Herpes zoster (HZ)-related pain.
    METHODS: We searched Scopus, Cochrane CENTRAL, PubMed, and Web of Science from inception until August 27, 2025. Clinical trials and observational studies evaluating the efficacy and safety of SCS, PNS, PRF, or their combinations in HZ-related pain were included. Mean difference (MD) and risk ratio (RR) with corresponding 95% confidence intervals (CIs) were pooled.
    RESULTS: Eleven studies (1035 patients) were included. When compared to the reference group (PRF), SCS+PRF achieved the greatest reduction in pain intensity (MD: -3.58 points, 95% CI: [-5.05, -2.12]) and the highest treatment success rate (RR: 2.54 (95% CI: [1.45, 4.45]). PNS+PRF demonstrated the most significant improvement in Pittsburgh Sleep Quality Index (PSQI) score (MD: -1.75 points, 95% CI: [-3.24, -0.27]), while SCS alone showed the greatest reduction in pregabalin dose (MD: -36.58 mg, 95% CI: [-68.93, -4.24]), physical role (MD: 9.70 points, 95% CI: [6.21, 13.19]) and bodily pain (MD: 8.42 points, 95% CI: [2.10, 14.73]) domains of the Short Form-36 (SF-36) score, while no significant differences were observed among the interventions regarding the physical function domain.
    CONCLUSION: Combination neuromodulation therapies, particularly SCS+PRF, may provide superior pain relief. PNS+PRF and PNS also showed marked improvements in sleep quality, whereas SCS was most effective in reducing pregabalin use and enhancing SF-36 scores.
    Keywords:  Herpes zoster; Network meta-analysis; PNS; PRF; Peripheral nerve stimulation; Pulsed radiofrequency; SCS; Spinal cord stimulation; Systematic review
    DOI:  https://doi.org/10.1093/pm/pnag049
  33. Sci Rep. 2026 Mar 30. pii: 10649. [Epub ahead of print]16(1):
    Ultrasound-guided percutaneous electrolysis versus dry needling in patients with chronic low back pain a double-blind randomized clinical trial.
    Manuel Saavedra-Hernández, Inmaculada C Lara-Palomo, Cristian Sánchez-Ferre, Rubén Fernández-García, Juan José González-Gerez, Adelaida M Castro-Sánchez.
      
    Keywords:  Dry needling; Electrochemical techniques; Myofascial pain; Spine; Trigger point; Ultrasound imaging
    DOI:  https://doi.org/10.1038/s41598-026-45876-5
  34. J Orthop Surg Res. 2026 Apr 01. pii: 230. [Epub ahead of print]21(1):
    Retraction Note: A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA).
    Dan Du, Yuan Liang.
      
    DOI:  https://doi.org/10.1186/s13018-026-06838-9
  35. Foot Ankle Spec. 2026 Mar 28. 19386400261428877
    Treatment Strategies and Return-to-Sport Outcomes in High-Performance Athletes With Acute Achilles Tendon Rupture: Multicenter Retrospective Study.
    Shimpei Yano, Yasuhiko Takegami, Katsuhiro Tokutake, Kenichi Mishima, Hiroaki Nakashima, Shiro Imagama.
      IntroductionAcute Achilles tendon rupture (AATR) can challenge high-performance athletes, necessitating effective treatment strategies to facilitate their return to play (RTP). How treatment outcomes of non-surgical and surgical approaches affect RTP in high-level athletes remains unclear. Acute Achilles tendon rupture, considered a combination of age-related degeneration and high-energy trauma, suggests stratification based on athlete groups rather than simple age categorization to comprehend the reality of AATR in athletes.MethodsThis multicenter retrospective study included 64 athletes with AATR who underwent either non-surgical or surgical treatment. Athletes were categorized into elite (n = 18) and masters (n = 46) groups. Patient demographics, injury details, treatment, and RTP outcomes were collected. Intensity of Achilles tendon loading was assessed with the modified Halasi score (mHS). Complete RTP (cRTP) was defined as resuming the same sports discipline and competition level as before injury.ResultsIn the masters group, post-treatment mHS was significantly lower in the surgically treated versus non-surgically treated group (P = .0322). Complete RTP rate and Achilles tendon total rupture score were not significantly different between treatment groups in either elite or masters categories. In the masters group, the primary immobilization period was significantly longer in the surgical versus non-surgical group (P = .0435). Non-surgical masters patients not achieving cRTP had a significantly longer immobilization period (P < .001). (odds ratio = 0.91; 95% confidence interval = 0.56-1.48; P = .71).ConclusionSurgical treatment may decrease post-treatment physical activity intensity in masters athletes, and prolonged immobilization may negatively impact cRTP in non-surgical masters patients. Early functional mobilization is beneficial in both treatment modalities. Treatment strategies and duration of immobilization can potentially impact RTP outcomes in high-level athletes with AATR.
    Keywords:  Achilles tendon rupture; early mobilization; masters athletes; non-surgical treatment; return to play; surgical treatment
    DOI:  https://doi.org/10.1177/19386400261428877
  36. JSES Rev Rep Tech. 2026 May;6(2): 100683
    Risk factors for progression of supraspinatus tear size and fatty infiltration in nonsurgically treated rotator cuff tears.
    Yoshihiro Nakamura, Shin Yokoya, Yohei Harada, Chikara Watanabe, Shuhei Matsumura, Takahiko Hamasaki, Eisaku Fujimoto, Nobuo Adachi.
       Background: There is no clear information on structural changes of rotator cuff tears during nonsurgical management. In particular, the risk factors for the progression of tear size and fatty infiltration still remain poorly understood. Identifying such factors is essential for optimizing treatment strategies and follow-up planning.
    Methods: We retrospectively examined 80 shoulders (43 men, 37 women; mean age, 68.4 years) with partial- and full-thickness rotator cuff tears treated nonsurgically. All patients underwent initial and follow-up magnetic resonance imaging examinations at ≥12 months, with a mean follow-up of 22.2 ± 12.6 months. Progression of supraspinatus (SSP) tear size was defined as a mediolateral increase of ≥10 mm or ≥5 mm/yr, and progression of SSP fatty infiltration was defined as an increase in the modified Goutallier classification. Univariate analyses were conducted to determine potential risk factors, including age, sex, initial tear size, subscapularis (SSC) tear, infraspinatus (ISP) tear, initial fatty infiltration of SSC, SSP, and ISP, critical shoulder angle (CSA), and the presence of persistent pain at follow-up. Factors with significant associations were entered into multivariate logistic regression for determining independent predictors.
    Results: On follow-up magnetic resonance imaging, both SSP tear size and fatty infiltration demonstrated significant progression. Univariate analyses revealed a significant association between tear size progression and initial tear size (P < .001), SSC fatty infiltration (P = .004), and larger CSA (P = .013). SSP fatty infiltration progression was significantly associated with older age (P = .04), initial tear size (P = .01), SSC tear (P = .03), SSC fatty infiltration (P < .001), and larger CSA (P = .04). Multivariate logistic regression identified medium-sized tears (odds ratio [OR], 17.1; 95% confidence interval [CI], 4.3-68.3; P < .001) and SSC fatty infiltration grade ≥ 2 (OR, 8.1; 95% CI, 1.7-38.5; P = .009) as independent risk factors for SSP tear size progression, whereas CSA was not significant (OR, 1.1; P = .2). For fatty infiltration progression, SSC fatty infiltration grade ≥ 2 was an independent risk factor (OR, 10.4; 95% CI, 1.7-64.1; P = .01), whereas age (OR, 1.2; P = .05), medium-sized tears (OR, 3.3; P = .13), SSC complete tear (OR, 1.9; P = .5), and CSA (OR, 1.1; P = .41) were not significant.
    Conclusion: Progression of SSP tear size and fatty infiltration during nonsurgical treatment is closely associated with SSC fatty infiltration. Monitoring of SSC involvement may help identify patients at higher risk for progression of SSP tear size and fatty infiltration and support decisions.
    Keywords:  Conservative treatment; Fatty infiltration; Nonsurgical treatment; Risk factor; Rotator cuff tear; Subscapularis; Supraspinatus; Tear progression
    DOI:  https://doi.org/10.1016/j.xrrt.2026.100683
  37. J Trauma Inj. 2026 Apr 01.
    Complete avulsion of the proximal hamstring tendon in a young gymnast: a case report.
    Shreya Jaiwant Gudigar, Pavan Kumar A, P K Karthik Yelamarthy, S T Ramanuja Chari, Raghava Dutt Mulukutla, Preeti Shah.
      Proximal hamstring complex tears are uncommon injuries in gymnastics. This case report describes a rare instance of a 17-year-old female gymnast who sustained a complete avulsion of the proximal hamstring complex during exercise. The injury was diagnosed clinically and later confirmed by magnetic resonance imaging as a proximal hamstring tear, prompting surgical repair with suture anchors. The patient underwent a structured rehabilitation program with progressive milestones in weight-bearing, mobility, and strength training. By postoperative 26 weeks, she had regained functional strength and returned to competitive activity. This case highlights the importance of early diagnosis, timely surgical intervention, and a carefully managed rehabilitation protocol in achieving successful outcomes for young gymnasts. It also underscores the need for greater awareness and documentation of proximal hamstring complex tears in gymnastics, where such cases remain underreported. This report demonstrates the potential for full recovery and return to sport with appropriate treatment and rehabilitation, providing valuable insight into the management of this rare injury.
    Keywords:  Case reports; Hamstring muscles; Rehabilitation; Sutures; Tendon injuries
    DOI:  https://doi.org/10.20408/jti.2025.0121
  38. Clin Rheumatol. 2026 Mar 28.
    Combined effect of underwater ultrasound and custom-made insoles in rheumatoid arthritis: a randomized controlled trial.
    Ömer Faruk Özçelep, Ceren Demir, Elife Ceyda Okumuş, Mehmet Canlı, Halil Alkan.
       BACKGROUND: To investigate the effects of underwater ultrasound therapy alone and in combination with custom-made insoles in individuals with rheumatoid arthritis (RA).
    METHODS: This single-blind, randomized controlled trial included 75 patients with mild-to-moderate RA and foot pain, who were randomly allocated into three groups: control group (CG), underwater ultrasound group (UG), and underwater ultrasound plus custom-made foot insole group (IG). Interventions were applied over a 6-week period. Outcome measures included the Health Assessment Questionnaire (HAQ), Manchester-Oxford Foot Questionnaire (MOFQ), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Static Plantar Pressure Distribution (SPPD), Single Heel-Rise Test (SHRT), and ankle circumference (AC). Assessments were performed before and after the intervention period.
    RESULTS: Significant time effects were observed for most outcome measures, indicating overall improvements after the intervention period across all groups (p < 0.05), except for AC. A significant group × time interaction was found for HAQ (p = 0.002, η2 = 0.209) and selected SPPD parameters (RF, RB, and LB; p < 0.05), suggesting differential changes over time between groups. No significant group × time interactions were observed for MOFQ, TUG, BBS, SHRT, or AC, indicating comparable clinical improvements among groups. In contrast, SPPD demonstrated significant between-group differences, particularly in the group receiving custom-made foot insoles (p < 0.05).
    CONCLUSION: Underwater ultrasound therapy was associated with overall improvements in functional status, mobility, balance, and muscle performance in patients with rheumatoid arthritis. While clinical outcomes improved similarly across groups, the addition of custom-made insole mainly enhanced plantar pressure distribution, indicating a primary biomechanical benefit.
    TRIAL REGISTRATION: The study was registered on the Clinical Trials Registry (registration number: NCT06753552). Key Points • A six-week underwater ultrasound intervention resulted in significant improvements in functional status, mobility, balance, and plantar flexor muscle endurance in individuals with rheumatoid arthritis, regardless of treatment group. • The addition of custom-made foot insoles did not lead to superior clinical outcomes but provided distinct biomechanical advantages by significantly modifying Static Plantar Pressure Distribution. • Group-specific differences were primarily observed in plantar pressure parameters, indicating that insoles mainly influence biomechanical load redistribution rather than subjective clinical outcomes. • Underwater ultrasound may serve as a supportive therapeutic modality in rheumatoid arthritis, while the integration of custom-made foot insoles may offer additional biomechanical benefits, particularly in patients with foot involvement.
    Keywords:  Custom-made insole; Plantar pressure; Rheumatoid arthritis; Ultrasound
    DOI:  https://doi.org/10.1007/s10067-026-08076-0
  39. J Ultrasound Med. 2026 Mar 28.
    Application of Transperineal 3-Dimensional Ultrasound in Evaluating Levator Ani Muscle Contraction During Female Pelvic Floor Rehabilitation.
    Liting Yao, Shaoshan Cao, Qiongjun Deng, Shaojie Zhou, Azhi Li, Jingmian Zhou.
       OBJECTIVES: Pelvic floor disorders (PFD) and functional alterations are common among women and may affect quality of life. This study aimed to observe levator ani muscle (LAM) contraction by transperineal 3-dimensional ultrasound and to explore the relationship between ultrasound-derived pelvic floor muscle strength evaluation during contraction and clinical Oxford grading.
    METHODS: A total of 954 postpartum patients receiving pelvic floor rehabilitation at Xiamen Humanity Maternity Hospital from October 2022 to January 2025 were enrolled. Patients were categorized according to clinical Oxford muscle strength grade, and all underwent transperineal pelvic floor ultrasound. The ultrasound-derived relative strain parameters of the LAM-specifically, changes in hiatal area, muscle length, and anteroposterior diameter during contraction-were measured to evaluate the agreement between ultrasound assessment and clinical Oxford grading.
    RESULTS: A significant correlation was found between ultrasound-based assessments and clinical Oxford grading (p < .001). The change in LAM anteroposterior diameter during contraction showed the highest correlation with Oxford grade (ρ = 0.809), followed closely by changes in hiatal area and muscle length (ρ = 0.771 and ρ = 0.781, respectively).
    CONCLUSION: Transperineal 3-dimensional ultrasonography allows non-invasive and quantitative evaluation of pelvic floor anatomy. The strong correlations between dynamic parameters and the Oxford score demonstrate its ability to objectively assess pelvic floor muscle strength. This modality may therefore contribute to the objective characterization of pelvic floor muscle function and may inform future studies in postpartum pelvic floor rehabilitation.
    Keywords:  3‐dimensional ultrasonography; levator ani muscle; muscle strength evaluation; pelvic floor; postpartum rehabilitation
    DOI:  https://doi.org/10.1002/jum.70241
  40. Zhonghua Jie He He Hu Xi Za Zhi. 2026 Apr 12. 49(4): 403-416
    [Pulmonary rehabilitation interventions strategies for patients with chronic obstructive pulmonary disease complicated with anxiety and depression: a summary of best evidence].
    J C Niu, J H Xiang, C X Shi, L Dong, S Ding, Y Y Chen, L R Liang, Y R Jia.
      Objective: To systematically search, evaluate, and synthesize the best evidence on pulmonary rehabilitation intervention strategies for patients with chronic obstructive pulmonary disease (COPD) with comorbid anxiety and depression, and to provide evidence-based references for the rehabilitation and management of psychological comorbidities in COPD. Methods: Following the "6S" evidence pyramid model, a systematic top-down search was conducted across 24 domestic and international databases, guideline websites, and professional association websites from their inception to December 2024. Included literature comprised clinical decisions tools, guidelines, expert consensus statements, systematic reviews/meta-analyses, and randomized controlled trials related to pulmonary rehabilitation interventions for COPD patients with comorbid anxiety and depression. Two researchers trained in evidence-based nursing independently conducted literature screening, quality evaluation, and evidence extraction and synthesis. Results: A total of 32 studies were included, comprising 4 clinical decisions, 10 guidelines, 3 expert consensuses, 4 systematic reviews/meta-analyses, and 11 randomized controlled trials. Overall, 29 evidence items were synthesized from four aspects: status assessment, capacity enhancement, opportunity provision, and motivation promotion. The evidence indicates that pulmonary rehabilitation intervention strategies for COPD patients with comorbid anxiety and depression should embed continuous assessment throughout the entire rehabilitation process. These strategies should target psychological issues, integrating exercise training and psychological intervention to form the core of pulmonary rehabilitation. Furthermore, evidence integrated via the Capability, Opportunity, and Motivation-Behaviour (COM-B) model suggests that individualized interventions should be oriented toward the individual differences in patients' capability, opportunity, and motivation, with long-term assessment and management focusing on their psychological issues. Conclusions: This evidence summary synthesizes comprehensive and scientifically rigorous best evidence on pulmonary rehabilitation intervention strategies for COPD patients with comorbid anxiety and depression. It aims to promote the scientific and standardized management of psychological comorbidities in COPD, providing an evidence-based foundation for healthcare professionals to systematically implement pulmonary rehabilitation programs.
    DOI:  https://doi.org/10.3760/cma.j.cn112147-20251217-00799
  41. Exp Biol Med (Maywood). 2026 ;251 10907
    A novel platelet-rich plasma clinically induces reliable, rapid, long-term chronic peripheral neuropathic pain elimination.
    Damien P Kuffler, Onix Reyes, Ivan J Sosa, Christian A Foy.
      Peripheral nerve trauma results in 50%-84% of patients developing chronic neuropathic pain, which is eliminated when axons reinnervate targets. Autografts reduce pain by promoting target reinnervation. We hypothesized that applying a novel platelet-rich plasma (PRP) formulation to proximal stumps would permanently eliminate the pain. This prospective case series compared analgesia levels after bridging nerve gaps with an autograft (autograft repair) vs. a PRP-filled collagen tube (PRP repair). Autograft repairs were performed on 16 nerves with a 5.75-cm mean gap length, 2.0-year repair delay, 42.3-year age, and 8.6 chronic neuropathic pain. PRP repairs were performed on 10 nerves with a 6.0-cm gap length, 1-year repair delay, 36.7-year age, with 88% having 9.1 chronic neuropathic pain. For autograft repairs, the pain began to decrease when axons reinnervated targets, reaching a mean of 0.3 in 18.2% of patients, and was eliminated in 81.8%. Following PRP repairs, the pain reduction began within 2 weeks and was eliminated by 2 months. Thus, autografts contribute to pain reduction/elimination by promoting target reinnervation. However, PRP directly and rapidly induced long-term pain elimination in all patients, while axons were regenerating, and without target reinnervation. These results prove that platelet-released factors reliably and rapidly eliminate chronic neuropathic pain.
    Keywords:  PRP; autografts; chronic neuropathic pain; nerve regeneration; nerve trauma
    DOI:  https://doi.org/10.3389/ebm.2026.10907
  42. PM R. 2026 Apr 03.
    Comparison of the effects of Kinesio tape and high-intensity laser therapy applied in conjunction with physical therapy on pain, grip strength, and functional level in patients with lateral epicondylitis: A randomized controlled trial.
    Esin Akbaş, Abuzer Akbaş, Murat Ali Çınar, Serkan Usgu.
       BACKGROUND: Previous studies have demonstrated the effectiveness of various conventional treatments for lateral epicondylitis, but it is still unclear which treatment is most effective.
    OBJECTIVE: To compare the effects of Kinesio tape (KT) and high-intensity laser therapy (HILT), applied in conjunction with physical therapy (PT), on pain, hand grip strength, functional status, and pain sensitivity in chronic lateral epicondylitis.
    DESIGN: Randomized controlled trial.
    SETTING: Tertiary hospital physical medicine and rehabilitation clinic.
    PARTICIPANTS: Patients with chronic lateral epicondylitis.
    METHODS: A total of 53 patients with chronic lateral epicondylitis were included in this randomized controlled study and were randomly assigned into three groups: PT-only group (n = 17), HILT group (n = 18), and KT group (n = 18). The PT-only group received PT; the KT group received PT and KT; and the HILT group received PT and HILT. The treatment period was 2 weeks, with five sessions per week.
    MAIN OUTCOME MEASURES: The Visual Analog Scale (VAS), hand grip strength, Patient-Rated Tennis Elbow Evaluation (PRTEE), and pain sensitivity were assessed before treatment, at the end of treatment (week 2), and at week 6. Treatment effects were analyzed using a mixed-design analysis of variance.
    RESULTS: A statistically significant interaction between group and time was found for VAS and PRTEE scores (p < .001). The main effects of time revealed statistically significant differences in the mean values of VAS and PRTEE (p < .001). In all groups, VAS and PRTEE measurements at weeks 2 and 6 showed statistically and clinically significant improvements compared to pretreatment values. A statistically significant difference between week 2 and week 6 was found only in the HILT group (p = .024 and p < .001, respectively). There was no statistically significant interaction between group and time for hand grip strength and pain sensitivity.
    CONCLUSION: HILT with PT resulted in better outcomes in terms of pain and function compared to PT alone and PT combined with KT.
    DOI:  https://doi.org/10.1002/pmrj.70112
  43. J Integr Complement Med. 2026 Mar 30. 27683605251411152
    Does Adding a Pilates Exercise Program Enhance Recovery Outcomes for Sports Hernia? A Randomized Controlled Trial.
    Hany M Elgohary, Ahmed A Abdelrahim, Zizi M Ibrahim Ali, Olfat Ibrahim Ali, Alaa A Ahmed.
       BACKGROUND AND OBJECTIVES: Athletic pubalgia, commonly referred to as sports hernia, is a recognized cause of chronic groin pain in athletes. This study aimed to evaluate whether adding Pilates to a rehabilitation program that included low-level laser therapy (LLLT) and low-intensity ultrasound (LIUS) would provide superior outcomes in pain reduction and in functional mobility and hip function.
    MATERIALS AND METHODS: In this randomized controlled trial, 88 male participants (18-45 years) diagnosed with sports hernia were randomly assigned to either an experimental group (Pilates + LLLT + LIUS) or a control group (LLLT + LIUS). Both groups received treatment three times per week for 6 weeks. Pain (primary outcome) was assessed using the Visual Analog Scale (VAS), functional mobility and hip function (secondary outcomes) were evaluated with the Lower Extremity Functional Scale (LEFS) and the Harris Hip Score (HHS), respectively, at baseline, after 6 weeks of intervention, and at a 6-week follow-up.
    RESULTS: Both groups demonstrated significant improvements across all outcomes over time (p < 0.001). Compared with controls, the experimental group showed greater reductions in pain (VAS mean difference: -0.84; 95% CI: -1.26 to -0.42; p = 0.003); however, this did not exceed the minimal clinically important difference. In contrast, functional mobility (LEFS mean difference: +17.07; 95% CI: 14.88-19.26; p < 0.001) and hip function (HHS mean difference: +11.78; 95% CI: 9.10-14.46; p < 0.001) demonstrated both statistical and clinical significance in the experimental group compared with controls.
    CONCLUSIONS: Incorporating Pilates into rehabilitation programs resulted in modest additional pain relief, yielding clinically meaningful improvements in functional mobility and hip function. Pilates can be considered a valuable complement to conventional modalities in sports hernia rehabilitation.
    Keywords:  Pilates; low-intensity ultrasound; low-level laser therapy; rehabilitation; sports hernia
    DOI:  https://doi.org/10.1177/27683605251411152
  44. Med J Malaysia. 2026 Mar;81(2): 234-245
    Cytopeutics umbilical cord-derived mesenchymal stem cells are associated with earlier clinical improvement compared to bone marrow aspirate concentrate with scaffold in knee cartilage injury: A Phase 1 feasibility and Phase 2 randomized controlled trial.
    B A H Md Yusoff, N Mohamad, S P Chin, M N Ramlan, M S Zool Kipele, N S I Saffery, N A Mohd Nasir, A F Mohd Don, S K Lai, H Hussin, M F Yakop, S F Abdul Wahid, S K Cheong.
       INTRODUCTION: Despite advances in the development of mesenchymal stem cells (MSCs), the ultimate benefits of MSCs against current cell-based therapies are still limited. This study aimed to assess the safety, feasibility, and efficacy of Cytopeutics® umbilical cord-derived MSCs (Chondrocell-EX) in patients with knee cartilage injury.
    MATERIALS AND METHODS: The study was conducted in two parts: a phase I feasibility study (PI) followed by a phase II randomized controlled trial (PII). Both studies were approved by UKM Research Ethics Committee (PI: UKM PPI/111/8; PII: UKM PPI/111/8/JEP-2019-304). Six patients were involved in the PI study in which all patients received Chondrocell-EX and 28 patients in the following PII study, where 17 patients received Chondrocell-EX with Hyaluronic acid (HA) (Arm A) and 11 patients received commercially available cell-based therapy, which is Bone Marrow Aspirate Concentrate (BMAC) with Hyaluronic acid-based scaffold (HA-S) (Arm B). Safety was assessed based on the occurrence of adverse events, while clinical outcomes were assessed based on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Pain Visual Analog Scale (VAS). Second-look arthroscopy and histological assessment were performed to assess their structural outcomes at 12 months.
    RESULTS: In the PI feasibility study, significant pain reduction began at 3 months, with mean VAS decreasing from 6.83 ± 0.98 at baseline to 4.83 ± 1.17 (p < 0.01), 3.00 ± 0.00 at 6 months (p < 0.01), and 1.83 ± 0.75 at 12 months (p < 0.01). In the PII study, Arm A (Chondrocell-EX + HA) demonstrated significant VAS improvements at all follow-up points compared to baseline (p < 0.001), whereas Arm B (BMAC + HA-S) showed significant reductions only from 3 months onward. After adjustment for baseline age and VAS, Arm A achieved significantly lower pain scores than Arm B at 6 months (2.56 ± 1.41 vs 3.09 ± 1.22; p = 0.015) and 12 months (2.27 ± 1.49 vs 2.50 ± 1.35; p = 0.043), indicating earlier and sustained pain relief with Chondrocell-EX injection. Functional outcomes mirrored pain improvements. In PI, KOOS scores improved significantly from 3 months, reaching 85.83 ± 11.87 at 12 months (p < 0.01). In PII, KOOS increased significantly in both arms (p < 0.001), but Arm A demonstrated earlier gains at 3 months and significantly higher adjusted KOOS scores than Arm B at 6 (p = 0.009) and 12 months (p = 0.037). In KOOS subdomains analysis, it showed significantly greater improvements in Arm A, particularly in symptoms and stiffness, activity of daily living (ADL), pain, sport and recreation, and quality of life (QoL) at key time points.
    CONCLUSION: Chondrocell-EX+HA treatment is more convenient, feasible, and minimally invasive with the findings suggesting that it is associated with faster functional improvement and pain relief, along with demonstration of hyaline-like cartilage regeneration, compared to the BMAC+HA-S method.
  45. Bioinformation. 2025 ;21(12): 4409-4413
    Comparison between the outcomes of manipulation under anaesthesia versus intra-articular steroid injection in idiopathic adhesive capsulitis.
    Raju Manda, Ashoke Kumar Chanda, Sudipta Dasgupta, Gourav Naskar, Kousik Biswas.
      One of the most common causes of shoulder pain and restricted motion is frozen shoulder, or adhesive capsulitis, characterized by a thickened, contracted joint capsule with chronic inflammatory changes. Therefore, it is of interest to compare the outcomes of manipulation under anaesthesia (MUA) and intra-articular steroid injection in idiopathic adhesive capsulitis. A total of 60 patients were prospectively observed and treated at the Department of Orthopaedics, Calcutta National Medical College and Hospital, from April 2021 to September 2022. The mean time for resolution of symptoms was 11.30±0.41 weeks in the MUA group and 10.90±0.67 weeks in the steroid group, with a statistically significant difference (p=0.0073). Thus, MUA was found to be particularly effective for rapid functional restoration, providing quicker improvement in shoulder mobility and early pain relief.
    Keywords:  Steroid; frozen shoulder; manipulation under anaesthesia (MUA); shoulder; symptoms
    DOI:  https://doi.org/10.6026/973206300214409
  46. Front Med (Lausanne). 2026 ;13 1791881
    Comparison of two types of platelet-rich plasma in rotator cuff injury: study protocol for a randomized clinical trial.
    Yuxiu Ji, Bo Wang, Shengjian Wu, Xiaoqiao Chen, Yujie Xie, Xi Luo, Chi Zhang, Li Wang.
       Background: Platelet-rich plasma (PRP) has been widely used in the treatment of rotator cuff tendinopathy. Due to the lack of unified standards for PRP preparation and clinical instructions, its efficacy remains controversial.
    Purpose: We aimed to conduct a pragmatic comparison of two commonly used composite PRP formulations with different platelet (PLT) and leukocyte concentrations to provide clinical evidence for the optimal PRP formulation in the treatment of rotator cuff injury (RCI).
    Methods: A prospective, single-center, participant-blinded, outcome-assessor-blinded, and statistician-blinded randomized controlled trial with a 12-month follow-up investigating PRP in RCI will be conducted at Southwest Medicine University. Participants who choose PRP treatment will be randomly allocated in a 1:1 ratio to either group. Clinical assessments will be performed at baseline (2 days before PRP injection) and 1, 3, 6, and 12 months after the first injection. The primary outcomes include the Chinese version of the Constant-Murley Score (CMS) and the visual analog scale (VAS). Secondary outcomes include imaging changes assessed by magnetic resonance imaging (MRI) and ultrasound (US) scanning, serum cytokine measurements, the 12-Item Short Form (SF-12), and adverse events (AEs). Statistical analysis will be performed according to the intention-to-treat (ITT) principle.
    Implications: The results will provide new evidence for the optimal PRP formulation for RCI in clinical practice. Furthermore, we will investigate multiple outcomes, including clinical, functional, structural, and inflammatory changes after PRP injection.
    Trial registration: https://www.chictr.org.cn/searchproj.html?title=&officialname=&subjectid=&regstatus=&regno=ChiCTR2500113374&secondaryid=&applier=&studyleader=&createyear=&sponsor=&secsponsor=&sourceofspends=&studyailment=&studyailmentcode=&studytype=&studystage=&studydesign=&recruitmentstatus=&gender=&agreetosign=&measure=&country=&province=&city=&institution=&institutionlevel=&intercode=&ethicalcommitteesanction=&whetherpublic=&minstudyexecutetime=&maxstudyexecutetime=&btngo=btn, This study was registered in the Chinese clinical trial registry (ChiCTR2500113374).
    Keywords:  PRP; leukocyte; platelet-rich plasma; protocol; rotator cuff injury; tendinopathy
    DOI:  https://doi.org/10.3389/fmed.2026.1791881
  47. J Orthop Surg Res. 2026 Apr 03.
    Comparative analysis of postoperative outcomes in men and women following total hip replacement surgery.
    Sandra Ruta, Til Leander Riedl, Patrick Orth, Christian Götze, Filippo Migliorini, Julian Koettnitz.
       BACKGROUND: Total hip arthroplasty (THA) is a widely performed procedure to alleviate pain and restore function in patients with advanced hip osteoarthritis. Despite extensive research, the question of sex disparities remains inconclusive, with studies showing comparable or different clinical outcomes.
    METHODS: A prospective analysis was conducted on 167 patients who underwent total hip arthroplasty (THA) between 06/2022 and 06/2023 at a university hospital to analyses sex-specific outcomes. Demographic data, the mobility, the use of walking aids, pre- and postoperative range of motion, pain and the HHS (Harris Hip Score) after six months were collected and analysed. Data analyses were conducted with SPSS Version 29.0.
    RESULTS: The mean age of the patients was 66.9 ± 10.5 with a percentage of women (w) of 60.5%. After six months the range of motion between the sexes was significantly different with more motion deficits for men (m). For example, women revealed a significantly greater total range of motion (ranks: 70.8 vs. 92.6; p = 0.001) with a higher degree (°) of hip flexion ((w) 103.0° ± 7.5° vs. (m) 98.2° ± 7.4°; p = 0.001) and internal rotation ((w)13.3° ± 6.8° vs. (m) 8.9° ± 6.6°, p = 0.001). The pain in both sides was significantly reduced six months after surgery (rest: 2.2 ± 0.9 vs. 0.6 ± 1.5; movement: 7.3 ± 1.1 vs. 1.6 ± 2.4; for both p = 0.001) but no sex difference could be found. The gait pattern and stair climbing ability were better in men (p = 0.008; p = 0.037), but no significant differences in postoperative satisfaction or quality of life could be detected (p = 0.671; p = 0.409). The combination of a stem with a low offset and cups larger than 55 mm showed better results in the Harris Hip Score (HHS) (mean: 86.9 ± 10.7 vs. 95.3 ± 4.0; p = 0.001), what can be considered an advantage for men.
    CONCLUSIONS: This study shows sex differences in the range of motion and mobility in everyday life. Although the female sex showed better mobility, no differences in satisfaction or quality of life were found six months after surgery. However, the combination of stem and cup size seems to have a relevant influence on postoperative outcome, especially in men.
    Keywords:  Harris hip score; Quality of life; Satisfaction; Total hip arthroplasty; sex
    DOI:  https://doi.org/10.1186/s13018-026-06811-6
  48. Biomed Res Int. 2026 ;2026(1): e5591406
    Anatomical Mapping of the Masseter for Safe Botulinum Toxin Injection: A Cadaveric Study.
    Yuqi Zhao, Jinran Chen, Jinrui Jiang, Zechuan Wang, Houen Zhou, Wendi Xu, Bo Xue, Liujun Yong.
       BACKGROUND: Botulinum toxin (BTX) is commonly used in masseter injections to enhance facial contour. However, the injection may harm the surrounding structure due to insufficient research on the anatomical structure of the masseter region.
    OBJECTIVES: This study is aimed at providing anatomical evidence for facial injections in clinical practice by dissecting the superficial masseter structure and analyzing it by classifying the masseteric nerve and structure.
    METHODS: Select 24 adult gross specimens with intact facial characteristics and dissect the masseter regions to expose the surface structure of the masseter muscle. After that, draw a heatmap according to the frequency of occurrence of the above structures. Then, dissect and document the structure relationship of the masseteric nerves and each layer of the masseter.
    RESULTS: The masseter region has a safe triangular zone (△LMF). The course probability of the facial nerve, parotid gland, parotid duct, facial artery, and facial vein is the lowest in this region. The masseteric structure is classified into three types: overlapped type, juxtaposed type, and parallel type, of which the juxtaposed type is the most common. In the safe triangular zone, the small branches of the masseteric nerve are mainly distributed in the connection range of line LM.
    CONCLUSION: The three-point injection approach is presented after a comprehensive analysis incorporating the masseter injection's safe triangular zone and the masseter's internal structure. It provides a more accurate treatment strategy for the masseter microplastic injection.
    Keywords:  anatomical structure; botulinum toxin; masseter; triangular zone
    DOI:  https://doi.org/10.1155/bmri/5591406
  49. Pain Res Manag. 2026 ;2026(1): e4480549
    Patients' Experiences With Complex Regional Pain Syndrome (CRPS) and a Rehabilitation Program That Combines Graded Motor Imagery (GMI) and Tactile Desensitization (TD).
    Isak Furu Krogstad, Lena Danielsson, Louisa Palmi Danielsson, Gunnvald Kvarstein, Svein Bergvik.
      Complex regional pain syndrome (CRPS) is characterized by predominant pain in combination with sensory, trophic, motor, or autonomic changes. Comprehensive rehabilitation programs have demonstrated promising results, but the treatment protocols can be challenging to apply within clinical settings. Intensive rehabilitation programs require highly motivated and dedicated patients, and insight into patients' perspectives and experiences of the treatment is crucial for ensuring adherence and preventing drop-out. To our knowledge, no previous qualitative studies have explored the challenges underlying a comprehensive home rehabilitation program for patients with CRPS. This study presents a qualitative study of ten CRPS patients who received or had recently completed an individualized Graded Motor Imagery (GMI) and Tactile Desensitization (TD) treatment. Semistructured interviews were conducted using a phenomenological approach. The analysis followed a four-step process based on systematic text condensation (STC). Illness perception emerged as an overarching theme, and how patients perceived and understood their condition and the treatment appeared to impact the treatment and its outcome significantly. Four subthemes emerged: (1) illness comprehension; (2) regaining control; (3) altered perceptions of the affected limb; and (4) provider support. The participants described how their perception and comprehension of the condition and symptoms changed during treatment. Illness comprehension, regaining control, reintegrating the affected limb, and strong clinician support seemed vital to the positive change. These factors may help future clinicians implement a home-based treatment program for CRPS patients and increase the likelihood of adherence and successful treatment outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT02753335.
    Keywords:  adherence; complex regional pain syndrome; graded motor imagery; illness perception; pain; patient experiences; qualitative
    DOI:  https://doi.org/10.1155/prm/4480549
  50. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00457-7. [Epub ahead of print]46 80-98
    The impact of custom-made rocker sole shoes on biomechanical parameters of the lower limb during gait and running: A systematic review.
    Mokhtar Arazpour, Atefeh Aboutorabi, Monireh Ahmadi Bani, Mohammad Hadadi, Sobhan Sobhani, Shima Shirozhan, Maede Mahmoodi.
       AIM: The purpose of this systematic review was to investigate the effects of rocker sole shoes on temporal-spatial parameters, kinematics, kinetics, plantar pressure, and electromyography (EMG) activity during walking.
    METHOD: A systematic search was conducted in the PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. The search keywords included rocker sole, rocker bottom shoe, gait parameters, kinematics, kinetics, pressure, and EMG. The risk of bias in the included studies was assessed using a modified Downs and Black scale.
    RESULTS: Twenty-eight studies with low to moderate risk of bias were included. The included studies primarily assessed walking, and the evidence focused on temporal-spatial parameters and kinematics, with fewer studies analyzing kinetics and electromyography. The use of rocker sole shoes was associated with a significantly shorter stance phase duration and a greater cadence compared to conventional footwear. A primary finding was a reduction in ankle joint range of motion, while knee and hip joint kinematics remained largely unchanged.
    CONCLUSION: Custom-made rocker sole shoes induce specific biomechanical adaptations during gait, notably a reduced ankle range of motion and an increased cadence. These changes result in decreased ankle power generation during the late stance phase (push-off) and a shorter stride length.
    Keywords:  Biomechanical phenomena; Electromyography; Gait; Orthotic devices; Running; Shoes; Walking
    DOI:  https://doi.org/10.1016/j.jbmt.2025.11.007
  51. NPJ Digit Med. 2026 Mar 31.
    A randomized trial of a digitally delivered, home-based neuromodulation and mindfulness intervention for pain management in older adults with knee osteoarthritis.
    Juyoung Park, Chiyoung Lee, Lifeng Lin, Mindy J Fain, Ilknur Telkes, Stephen Dahmer, Lindsey Park, Jason Hoang, Hongyu Miao, Hyochol Ahn.
      Knee osteoarthritis (OA) is a major cause of chronic pain and disability in older adults, yet scalable home-based interventions remain limited, partly due to the lack of clinically effective digital solutions. This study is the first fully powered randomized, double-blind, sham-controlled trial to test a digitally delivered, home-based protocol combining transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM) for knee OA pain. A total of 208 participants were randomized to active tDCS + MBM, active tDCS + sham MBM, sham tDCS + active MBM, or double sham; they completed ten 20-min sessions over 2 weeks. Knee pain intensity was measured at baseline, post treatment, and monthly for 3 months. Although both active tDCS groups improved, the difference between the combined tDCS + MBM intervention and tDCS alone was not statistically significant. Benefits were not sustained at 3 months. These findings offer the first evidence that a remotely supervised, digitally delivered tDCS + MBM intervention can rapidly reduce knee OA pain, supporting future personalized and extended treatment studies. Clinical trial registration: ClinicalTrials.gov NCT04375072 (registered May 7, 2020).
    DOI:  https://doi.org/10.1038/s41746-026-02577-7
  52. Jt Dis Relat Surg. 2026 May 01. pii: jdrs.2026.2569. [Epub ahead of print]37(2): 565-571
    Total knee arthroplasty with "Collar Tightening Technique" for advanced knee osteoarthritis with concurrent chronic posterolateral knee dislocation and lateral patellar dislocation: A case report.
    Wen-Shuo Chang, Chi-Sheng Chien, Tsung-Mu Wu, Kin-Weng Wong.
      Chronic posterolateral knee dislocation with concurrent lateral patellar dislocation is a rare and challenging pathology. Without appropriate treatment, it invariably leads to advanced osteoarthritis, frequently necessitating total knee arthroplasty. However, achieving optimal patellofemoral tracking remains a primary challenge, and no consensus on a definitive surgical technique exists. In this article, we introduce a novel "Collar Tightening Technique" to address this complex clinical scenario. A 66-year-old male with a complex medical history, including prior right knee medial collateral ligament/posterior cruciate ligament reconstruction, presented with chronic right knee pain with difficulty in ambulation. Imaging revealed advanced osteoarthritis, posterolateral knee dislocation, and lateral patellar dislocation with a fixed 20-degree tibial external rotation deformity. The patient underwent total knee arthroplasty, during which the collar tightening technique was employed to restore patellofemoral stability. This technique consisted of three key components: (1) an extensive lateral release, (2) distal and lateral advancement of the quadriceps tendon, and (3) medialization of the patellar component. A hinged prosthesis was utilized to address the underlying global instability. Postoperatively, the patient could walk smoothly with single cane assistance. In conclusion, restoring stable patellofemoral tracking is of paramount importance in complex total knee arthroplasty. The collar tightening technique provides an effective solution by combining dynamic stabilization from muscle advancement with static stabilization from component positioning. This comprehensive approach warrants consideration when a simple lateral retinacular release is insufficient to achieve proper patellofemoral alignment.
    DOI:  https://doi.org/10.52312/jdrs.2026.2569
  53. Disabil Rehabil Assist Technol. 2026 Mar 31. 1-33
    Rehabilitation technology for hospitalised older adults: a scoping review.
    Claire Rockliff, Allison Hunder, Snaha Sunny, Kiran Parmar, Antonio Miguel Cruz.
       PURPOSE: There is limited information on rehabilitation technology and its ability to support hospitalised older adults. This review aims to examine the extent and types of rehabilitation technology used for hospitalised older adults, assess technology readiness levels (TRLs), identify outcome variables and evaluate the level of evidence.
    MATERIALS AND METHODS: A scoping review was conducted across six electronic databases (Medline, PsycInfo, EMBASE, CINAHL, Web of Science and Scopus) to evaluate studies investigating the use of rehabilitation technology among hospitalised older adults, in accordance with PRISMA-ScR guidelines.
    RESULTS: The search yielded 5310 records, with 23 meeting inclusion criteria and included for final analysis. Robotics were the most common rehabilitation technology, in six studies, followed by games in five studies, virtual reality in four studies and mobile applications in three studies. Rehabilitation technology mainly addressed functional mobility and physical performance, and functional independence and activities of daily living. Although the median TRL was high, with 8 studies achieving Level 1b evidence quality, variability in outcome measures, participants and intervention protocols limits the strength of available evidence.
    CONCLUSION: Rehabilitation technologies show promise for supporting hospitalised older adults; however, more research is needed to determine feasibility, cost-effectiveness and implementation in clinical practice.
    Keywords:  Scoping review; activities of daily living; assistive technologies; hospital rehabilitation; older adults; rehabilitation technology; technology readiness
    DOI:  https://doi.org/10.1080/17483107.2026.2642305
  54. PLoS One. 2026 ;21(3): e0344922
    Telemedicine for rotator cuff syndrome: Asynchronous exercise and remote follow-up in a randomized controlled study.
    Selkin Yilmaz Muluk, Nazlı Olcucu, Ozlem El.
       INTRODUCTION: Rotator cuff syndrome (RCS) is a common musculoskeletal condition that requires rehabilitation. Telemedicine involving asynchronous exercise video and remote follow-up has emerged as a potential alternative to conventional in-person rehabilitation, offering advantages in accessibility and cost-effectiveness. This study aimed to evaluate the effectiveness of telemedicine compared to conventional methods in the rehabilitation of RCS.
    METHODS: This randomized controlled trial was conducted at a public hospital physiatry clinic between November 2023 and June 2024. The telemedicine group (TG) received asynchronous exercise videos and remote video-call follow-ups; the control group (CG) received illustrated exercise brochures and in-person follow-ups. Outcomes were assessed at baseline, 15th day, and 6th month. The primary outcomes were pain (measured using the Visual Analog Scale, VAS) and functional levels (assessed using the Quick Disabilities of Arm, Shoulder, and Hand, QuickDASH). Secondary outcomes included exercise adherence, satisfaction, and travel burden. Data were analyzed using linear mixed-effects models.
    RESULTS: Trial included 90 patients (mean age 51.19 ± 7.07 years), randomly assigned to TG (n = 45) or CG (n = 45). Both groups demonstrated within-group improvements in VAS (mean change -1.88 [95% CI -2.56 to -1.20]) and QuickDASH (-15.6 [95% CI -21.0 to -10.2]) scores from baseline to 15th day (p < 0.001) and in VAS from baseline to 6th month (-4.82 [95% CI -5.50 to -4.13], p < 0.001). No between-group differences were found in pain reduction at 15th day (estimate = -0.27, 95% CI -1.44 to 0.89, p = 0.645) or at 6th month (estimate = -0.40, 95% CI -1.57 to 0.77, p = 0.499), nor in functional improvement at 15th day (estimate = -2.68, 95% CI -12.90 to 7.57, p = 0.607). The TG demonstrated higher exercise adherence (p = 0.027) and satisfaction (p < 0.001). Based on predefined minimal clinically important difference thresholds, all group differences fell within non-inferiority margins. The cost-effectiveness of telemedicine was 266.4 km and 1325.6 minutes saved per unit of VAS, and 11.34 km and 56.41 minutes saved per unit of QuickDASH improvement.
    CONCLUSION: Telemedicine is a viable alternative to traditional management of RCS, providing comparable pain relief, functional outcomes, and reduced travel burden. Future studies should assess long-term effects and broader populations.
    DOI:  https://doi.org/10.1371/journal.pone.0344922
  55. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00495-4. [Epub ahead of print]46 688-696
    Feasibility of neuromuscular electrical stimulation for knee osteoarthritis in older women: A double-blind randomized controlled trial.
    Jean Carlos Constantino Silva, Josiel Gomes Ribeiro, Walbert Menezes Bitar, Geovanna de Paula Martins de Souza, Rômulo de Oliveira Sena, Alex S Ribeiro, Ewertton de Souza Bezerra.
      This study examined the feasibility of using neuromuscular electrical stimulation (NMES)-specifically AUSSIE and functional electrical stimulation (FES) currents-for older women with knee osteoarthritis (OA). Primary outcomes included feasibility indicators such as recruitment rate, adherence, satisfaction, and safety, while secondary outcomes assessed pain and physical function. Participants were randomly assigned to three groups: AUSSIE current, pulsed FES current, or a control group without intervention. The intervention lasted four weeks, with three 20-min sessions per week. Feasibility was evaluated using recruitment and attendance records and post-intervention questionnaires. Pain was measured by the visual analog scale (VAS), and function was assessed using the Timed Up and Go (TUG) and 6-m walk tests. The recruitment rate was 13.9 % (25 of 180 screened). Adherence was high, with all intervention participants completing at least 80 % of sessions. Satisfaction was also high, as 100 % of participants rated the program as "excellent" or "very good," and no adverse events were reported. Although not powered for efficacy, exploratory analyses suggested that both NMES groups experienced pain reduction and improved physical function, with the FES group showing the greatest TUG improvement. These findings indicate that both AUSSIE and FES currents are feasible, safe, and well-accepted interventions for older women with knee OA. The results support the design of a larger randomized controlled trial to confirm the clinical efficacy of NMES in this population.
    Keywords:  Arthritis; Joint diseases; Knee; Osteoarthritis; Transcutaneous electric nerve stimulation
    DOI:  https://doi.org/10.1016/j.jbmt.2025.12.008
  56. J Electromyogr Kinesiol. 2026 Mar 25. pii: S1050-6411(26)00039-8. [Epub ahead of print]88 103143
    Differences in neuromechanics during walking in individuals with bilateral and unilateral chronic ankle instability.
    Minsub Oh, Hyunwook Lee, Seunguk Han, J Ty Hopkins.
       BACKGROUND: Although unilateral chronic ankle instability (CAI) is well studied, differences in joint kinematics and muscle activity during walking between bilateral and unilateral CAI remain unclear.
    PURPOSE: To investigate joint kinematics and muscle activation patterns during walking between individuals with bilateral and unilateral CAI.
    METHODS: Sixty participants were recruited: 20 bilateral CAI individuals (bilateral), 20 unilateral CAI individuals (unilateral), and 20 healthy controls (control). Joint kinematics and muscle activity were measured throughout the stance phase during 5 walking trials on a force plate.
    RESULTS: The bilateral group showed increased ankle dorsiflexion, inversion, knee valgus, hip flexion, and hip adduction angles compared to the unilateral and/or control groups. The unilateral group showed less ankle inversion, knee valgus, and hip flexion, but increased hip adduction angles compared to the control group. The bilateral group exhibited altered muscle activation in the lower extremity muscles compared to the unilateral and control groups. The unilateral group showed altered muscle activation patterns during walking compared to the control group.
    CONCLUSIONS: Joint angles and muscle activity during walking are altered in individuals with bilateral CAI compared with those with unilateral CAI and healthy controls, indicating distinct biomechanical and neurophysiological differences that reflect unique neuromuscular control strategies.
    Keywords:  Central nervous system; Gait analysis; Motor control; Muscle function
    DOI:  https://doi.org/10.1016/j.jelekin.2026.103143
  57. J Oral Rehabil. 2026 Apr 01.
    Evaluating the Reproducibility of Exercise Protocols in Temporomandibular Disorders Research: A Scoping Review.
    Patricia Crane, M Alex Haddad, Benjamin Brubaker, Sidmael Butler, Chelsey Geiger, Cody Marker, John Monroe, Thomas Obi-Tabot, Taylor Robinson, Kristian Spriggs, Mekhi Vance, Sarah Bauman.
       BACKGROUND: Temporomandibular disorder (TMD) is a common source of nondental orofacial pain. Exercise therapy is a recommended conservative treatment, yet inconsistent reporting of protocols limits reproducibility and clinical application.
    OBJECTIVES: The primary objective of this scoping review was to determine the reporting of exercise therapy interventions in randomised controlled trials for TMD using the Template for Intervention Description and Replication (TIDieR) checklist.
    METHODS: This scoping review assessed the completeness of exercise intervention reporting in randomised controlled trials (RCTs) for TMD using the TIDieR checklist. A comprehensive search across five databases and grey literature identified eligible RCTs. Data were extracted and analyzed using descriptive statistics and a Mann-Whitney U test.
    RESULTS: Seventy-five RCTs published between 1993 and 2024 were included. The mean TIDieR score was 7.98/12, with only 6.7% of studies reporting all checklist items. Frequently reported elements included intervention name, rationale and procedures. Tailoring, modifications, fidelity and adherence were underreported. No significant improvement in reporting quality was observed post-TIDieR publication.
    CONCLUSIONS: Reporting gaps persist in TMD exercise research, limiting reproducibility and clinical translation. Greater adherence to standardised reporting tools like TIDieR is needed to enhance transparency and evidence-based practice.
    Keywords:  TIDieR checklist; intervention reporting; jaw pain; oral rehabilitation; physical therapy
    DOI:  https://doi.org/10.1111/joor.70195
  58. Clin Physiol Funct Imaging. 2026 May;46(3): e70060
    The effect of inhaled dry salt on pulmonary mucociliary clearance in obstructive lung disease: A randomised, placebo-controlled, crossover study.
    Rie Skovly Thomsen, Clara Mikkelsen, Naja Enevold Olsen, Hrefna Sæunn Einarsdóttir, Mohamed Attauabi, Ronan M G Berg, Henrik Harboe, Jann Mortensen.
       BACKGROUND: Inhaled saline may improve mucus transport in respiratory diseases, for example, cystic fibrosis. This randomised, placebo-controlled, crossover study examined the effect of inhaled dry NaCl on mucociliary clearance in patients with chronic obstructive pulmonary disease (COPD).
    METHODS: Twenty-five patients with GOLD stage I-III COPD (72% with excess mucus) were tested on two separate days after inhalation from a dry powder inhaler containing either 40 mg dry NaCl or placebo (empty). Pulmonary mucociliary clearance was assessed using inhalation of a radioactive 99mTc-labelled nanocolloid tracer and gamma camera imaging. Clearance was measured for 2 h post-intervention. Co-primary outcomes were clearance after 1 and 2 h.
    RESULTS: The study was terminated early due to COVID-19 after enrolling 25 of 35 planned patients. No significant differences were observed in mucociliary clearance between NaCl and placebo after 1 h (11.3% ± 9.0% vs. 11.4% ± 7.0%, p = 0.97) or 2 h (15.3% ± 9.8% vs.16.1% ± 8.7%, p = 0.55). Normalised clearance based on initial radioaerosol deposition also showed no difference.
    CONCLUSIONS: Inhalation of 40 mg dry NaCl was well tolerated without acute adverse effects in COPD patients. However, early termination left the study underpowered, increasing the risk of type II error. Non-significant findings should not be interpreted as evidence of no effect. Larger, adequately powered trials are needed to clarify the impact of dry NaCl inhalation on mucociliary clearance in COPD.
    Keywords:  COPD; cough; mucociliary clearance; scintigraphy
    DOI:  https://doi.org/10.1111/cpf.70060
  59. Orthop J Sports Med. 2026 Mar;14(3): 23259671261419505
    Return to Sport Following Elbow Dislocation: A Systematic Review.
    Andrew S Albright, Andrew K Chow, Nicholas R Kiristis, Andrew S Cuthbert, Matthew S Smith, James R Satalich, John W Cyrus, J Brett Goodloe.
       Background: Elbow dislocation is the second most common large joint dislocation in athletes, frequently occurring in contact and high-impact sports such as football, wrestling, and gymnastics. While these injuries typically result from a fall onto an outstretched hand with the elbow in near full extension, both nonoperative and surgical treatments have demonstrated high success rates in restoring elbow function, enabling athletes to return to sport (RTS) with favorable functional outcomes.
    Purpose/Hypothesis: The purpose of this systematic review was to evaluate RTS rate, time to return, and functional outcomes in athletes following elbow dislocation. It was hypothesized that most athletes would successfully return to their sport regardless of treatment modality and that nonoperative treatment would be associated with a shorter recovery timeline compared with surgical intervention.
    Study Design: Systematic review; Level of evidence, 4.
    Methods: PubMed, Embase, Cochrane, and Web of Science were searched through March 20, 2025, for studies that investigated the management of elbow dislocation in athletes. Data were extracted on mechanism of injury, dislocation treatment, complications, follow-up duration, and outcome parameters, including RTS, return to the same level of play, time to return, and elbow outcome scores.
    Results: A total of 9 studies covering 970 athletes met the inclusion criteria for analysis. Across the studies that reported sex and age, 328 of 417 (78.7%) of the athletes were male, with a weighted mean age of 29.6 years. The mean follow-up was 72 months across the 5 studies that provided follow-up data. Across 8 of the 9 studies, 97 of 417 athletes with elbow dislocations (23.3%) underwent surgical treatment, while 320 received nonoperative management. Across 5 studies of 161 dislocations, only 18 cases (11.2%) resulted in complications. Return to any sporting activity, reported for 274 athletes across 7 studies, was observed in 99.3% of patients (n = 272/274) after a mean of 11.4 ± 7.7 weeks. On average, athletes treated nonoperatively returned sooner (8.95 weeks) than surgically treated athletes (16.3 weeks). Mayo Elbow Performance Score, Elbow Self-Assessment Score, and subjective elbow value scores demonstrated excellent elbow performance after injury.
    Conclusion: The results supported the hypothesis that athletes with elbow dislocation demonstrated excellent functional outcomes and high RTS rates, with most returning within 10 weeks. Most returned regardless of treatment, with nonoperative management generally associated with a shorter return timeline than surgical intervention.
    Keywords:  athletes; elbow dislocation; nonoperative treatment; return to sport; surgical management
    DOI:  https://doi.org/10.1177/23259671261419505
  60. Acta Orthop Belg. 2025 Dec;91(4): 429-438
    Surgical treatment for medial epicondyle tendinopathy: a systematic literature review.
    J T Poolton, J Minett, A Kazmi.
      Medial epicondyle tendinopathy is a pathology of the common flexor-pronator elbow tendon. Surgical intervention is indicated if conservative management modalities fail. This review aimed to determine if surgical intervention is an effective treatment for medial epicondyle tendinopathy in general population adults. Studies measuring pain, using the Visual Analogue Scale; grip strength, using a hand-held dynamometer; and/or function, using a validated quantitative tool, following surgical management of medial epicondyle tendinopathy in patients aged ≥18 years were searched for. Databases searched included Cochrane Library, MEDLINE, OpenGrey and PubMed. Study quality was assessed using the NICE quality appraisal checklist for quantitative studies reporting correlations and associations, and findings were presented in accordance with PRISMA guidelines. Four case series including a total of 105 (11 treated arthroscopically, 34 percutaneous and 60 open) patients with mean ages of 45-52.5 years met the inclusion criteria. All 4 studies measured validated quantitative outcomes, including MEPI (n=2), DASH (n=2) and VAS (n=2). One study observed significant improvements in VAS (P=0.006) and DASH (P=0.04), while another observed a significant improvement in MEPI (P<.0001). Post-operative complication rates for each approach were 18.18% (2/11) for arthroscopic, 0% (0/60) for open and 0% (0/34) for percutaneous. Study quality ranged from low (n=1) to medium (n=3) for internal validity, and medium (n=1) to high (n=3) for external validity. In conclusion, there is a small-sized (n=4) and weak recommendation for using surgical management of medial epicondyle tendinopathy in general population adults, owning to the limited and generally low-quality of evidence.
    DOI:  https://doi.org/10.52628/91.4.14595
  61. J Bodyw Mov Ther. 2026 Jun;pii: S1360-8592(25)00434-6. [Epub ahead of print]46 99-108
    Aquatic vs. hopping exercises: A novel comparison of their impacts on motor and sensorimotor rehabilitation in chronic ankle instability.
    Zahra Shahsanaei, Sajad Bagherian, Banafsheh Mohammadi.
       BACKGROUND: Chronic ankle instability (CAI) is a common condition characterized by recurrent instability, reduced proprioception, and impaired balance, increasing the risk of further injuries. While various rehabilitation strategies exist, evidence comparing the efficacy of aquatic and hopping exercises in improving motor and sensorimotor functions in individuals with CAI remains limited. This study aimed to address this gap.
    METHODS: In this quasi-experimental study, 53 women with unilateral CAI were allocated to control (n = 18), aquatic exercise (n = 17), or hopping exercise (n = 18) groups. Interventions lasted six weeks (three sessions/week, 45 min/session). Motor function (Fusionetics Scoring System: overhead and single-leg squats), dynamic balance (Y-Balance Test), static balance (Balance Error Scoring System), and proprioception (goniometric evaluation) were assessed pre- and post-intervention. Mixed-design ANOVA and Bonferroni post-hoc tests analyzed within- and between-group differences.
    RESULTS: Both interventions significantly improved all outcomes compared to the control group (P < 0.05). Proprioceptive errors in dorsiflexion and plantarflexion decreased by 19.69 % and 25.54 % (aquatic) and 24.62 % and 26.67 % (hopping). Dynamic balance improved by 4.39 % (aquatic) and 7.44 % (hopping). Hopping exercises showed superior benefits in single-leg squat performance (P < 0.05).
    CONCLUSIONS: Both exercise modalities effectively enhance motor and sensorimotor functions in individuals with CAI. Hopping exercises demonstrated greater improvements in dynamic balance and motor control, making them particularly beneficial for athletes or advanced rehabilitation stages. Future studies should explore long-term outcomes and diverse populations.
    Keywords:  Aquatic therapy; Hopping exercises; Motor function; Rehabilitation strategies
    DOI:  https://doi.org/10.1016/j.jbmt.2025.10.039
  62. BMC Pulm Med. 2026 Mar 29.
    Effects of inspiratory muscle training on exercise capacity, muscle oxygenation and strength, physical activity, and dyspnea in patients with post-COVID-19 syndrome and pulmonary involvement: a randomized controlled triple-blinded study.
    Başak Kavalcı Kol, Meral Boşnak Güçlü, Ece Baytok, Nilgün Yılmaz Demirci.
      
    Keywords:  COVID-19; Exercise tolerance; Muscle oxygenation; Muscle strength
    DOI:  https://doi.org/10.1186/s12890-026-04249-4
  63. Crit Care. 2026 Mar 31.
    Ultrasound assessment of muscle atrophy and its association with functional outcomes in critically ill patients: a systematic review and meta-analysis.
    Chen-Chun Lin, Yi-Jia Lin, Chi-Tsung Chen, Hsiao-Min Chou, Wei-Chun Hsu.
      
    Keywords:  Critical illness; Cross-sectional area; Echointensity; Intensive care unit–acquired weakness; Muscle atrophy; Muscle thickness; Pennation angle; Skeletal muscle ultrasound
    DOI:  https://doi.org/10.1186/s13054-025-05825-6
  64. Wilderness Environ Med. 2026 Apr 03. 10806032261435903
    Ultrasound Diagnosis of A2 Pulley Injuries: Landmark-Specific Tendon-Bone Distance and Flexor Tendon Curvature in a Cadaveric Study.
    Xeber Iruretagoiena, Volker Schöffl, Marc Blasi, Fernando Dávila, Ramón Balius, Xavier Sala, María-Teresa Iglesias-Gaspar, Javier de la Fuente.
      BackgroundA2 pulley ruptures are common in rock climbers, yet diagnosing partial ruptures remains challenging due to variability in tendon-bone distance (TBD) measurements in ultrasound assessments.ObjectiveThis study evaluated TBD at multiple anatomic landmarks to differentiate intact, partial, and complete A2 pulley ruptures; compared landmarks for optimal ultrasound diagnosis; and investigated flexor tendon curvature as an additional indicator.MethodsForty-two fingers from 14 fresh-frozen cadaveric arms were examined using high-frequency ultrasound. Fingers were assigned to 5 simulated groups: intact; low-grade partial (5 mm), medium-grade partial (10 mm), and high-grade partial (15 mm) ruptures; and complete ruptures (≥20 mm). TBD was measured at 4 anatomic landmarks: distal edge of A2 pulley (point A), 5 mm proximal to point A (point B), 10 mm proximal to point A (point C), and the midpoint of the proximal phalanx (MPP point). Analysis of variance and Bonferroni correction were used for statistical analysis.ResultsTBD significantly differed between intact, partial, and complete ruptures at most landmarks. Point C reliably differentiated high-grade partial ruptures from complete ruptures (P<0.05), whereas point A was most responsive to low-grade partial ruptures. The flexor tendon curvature correlated with increasing rupture severity, supporting its use in ultrasound diagnosis.ConclusionTBD provides an indirect, objective, and reproducible ultrasonographic sign for assessing A2 pulley injuries, whereas tendon curvature serves as a complementary direct sign. Using both improves diagnostic accuracy, refines injury classification, and supports clinical decision making. These findings may guide management and rehabilitation strategies for climbers and other athletes with finger pulley injuries.
    Keywords:  A2 pulley; anatomic landmarks; partial rupture; tendon-bone distance; ultrasound
    DOI:  https://doi.org/10.1177/10806032261435903
  65. Jt Dis Relat Surg. 2026 May 01. pii: jdrs.2026.2603. [Epub ahead of print]37(2): 431-441
    Irreducible metacarpophalangeal joint dislocations: Clinical characteristics, surgical approaches, and outcomes.
    Mehmet Şah Sakçı, Ersen Türkmen, Mümin Karahan, Ekrem Özdemir.
       OBJECTIVES: This study aims to evaluate the clinical characteristics, surgical management, and outcomes of irreducible metacarpophalangeal (MCP) dislocations.
    PATIENTS AND METHODS: Between August 2020 and August 2024, a total of 13 patients (7 males, 6 females; mean age: 29.2 ± 23.7 years; range, 7 to 78 years) with MCP dislocations who were surgically treated were retrospectively analyzed. Demographics, dislocation patterns, obstructing elements, operative approach, and postoperative complications were documented. Functional outcomes included MCP range of motion (ROM), extension lag, grip strength recovery compared to the contralateral hand, and patient-reported disability using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) questionnaire.
    RESULTS: The index finger was most frequently involved (53.8%), with dorsal dislocations predominating (76.9%). A dorsal approach was performed in 76.9%. Dorsal reconstruction resulted in greater MCP ROM (flexion 85.8° ± 7.5° vs. 78.4° ± 6.7°), smaller extension lag (-1.8° ± 3.7° vs. -4.2° ± 5.3°), and lower disability scores (QuickDASH 4.0 ± 4.7 vs. 8.8 ± 5.5). Volar reconstruction provided superior grip strength (107.5 ± 8.7% vs. 90.9 ± 12.3%), exceeding baseline. Return-to-sport was earlier after the dorsal approach (11.5 ± 2.9 vs. 14.4 ± 3.0 weeks). Although differences did not reach statistical significance, large effect sizes (d ≥ 0.8) highlighted clinical relevance. Transient postoperative hypoesthesia occurred in two volar cases.
    CONCLUSION: Timely operative management, tailored to dislocation type and obstructing anatomy, is essential. The dorsal approach optimizes MCP mobility, disability reduction, and athletic recovery, whereas the volar approach enhances grip strength. These complementary outcomes underscore the importance of individualized surgical selection and structured rehabilitation.
    DOI:  https://doi.org/10.52312/jdrs.2026.2603
  66. Front Neurol. 2026 ;17 1764795
    Consensus on key evaluation tools for stroke: a Delphi study protocol for the assessment of balance and gait.
    Chiara Castagnoli, Elisa Gervasoni, Davide Cattaneo, Marco Germanotta, Diego Longo, Massimiliano Gobbo, Joel Pollet, Rosa Pullara, Rebecca Cardini, Irene Giovanna Aprile, Marco Baccini, Francesca Cecchi.
       Background: Stroke is a leading cause of long-term disability, and gait and balance impairments significantly affect post-stroke independence and quality of life. Following rehabilitation, patients can regain walking and balance abilities. These gains may occur through true recovery, characterized by the restoration of pre-stroke motor patterns and underlying neural functions and structures, or through compensation, characterized by the use of alternative movement strategies and neural reorganization. Identifying outcome measures that describe gait and balance recovery and distinguish true recovery from compensation could greatly improve the accuracy of functional diagnosis and help tailor rehabilitation by guiding strategy selection. This protocol outlines a Delphi study to establish expert consensus on the most appropriate assessment tools for gait and balance in people with stroke and on their ability to differentiate between recovery and compensation across the International Classification of Functioning, Disability and Health (ICF) domains. The resulting tool set will support individualized, evidence-based rehabilitation strategies.
    Methods: The Delphi study employs a two-phase design comprising an initial expert focus group followed by a multi-round electronic Delphi process. The focus group will identify key constructs and candidate tools to assess either recovery or compensation. In the Delphi rounds, a panel of 30 to 50 international experts in stroke rehabilitation will rate the relevance of tools, including clinical scales, instrumented assessments of motor performance, and neural information, across the ICF domains. Consensus will be defined as ≥75% agreement, and iterative rounds will refine item selection based on panel feedback.
    Expected outcomes: The study will produce a consensus-based core set of assessment tools for evaluating post-rehabilitation gait and balance recovery after stroke, capable of distinguishing true recovery from compensation. These tools will facilitate more precise diagnosis, patient stratification, and targeted interventions. Additionally, the study will support the design of future research protocols, including cross-sectional and longitudinal studies of stroke rehabilitation outcomes.
    Discussion: This study aims to advance precision rehabilitation after stroke by identifying outcome measures that distinguish true recovery from compensatory strategies. A Delphi methodology will provide a rigorous, consensus-driven basis for selecting clinically meaningful tools, thereby enhancing assessment accuracy and potentially improving rehabilitation outcomes.
    Keywords:  neurological rehabilitation; precision medicine; rehabilitation; stroke; stroke rehabilitation
    DOI:  https://doi.org/10.3389/fneur.2026.1764795
  67. Respir Med. 2026 Mar 31. pii: S0954-6111(26)00168-X. [Epub ahead of print] 108800
    Capturing what people with COPD want: a systematic review of goal-oriented measurement instruments.
    Sara Souto-Miranda, Guilherme Rodrigues, Martijn A Spruit, Alda Marques.
       BACKGROUND: A core outcome set (COS) for chronic obstructive pulmonary disease (COPD) recommends measuring personal goal attainment following PR. However, the optimal method for this assessment remains unclear. This article provides a perspective on a review of existing patient-reported outcome measures (PROMs) and their measurement properties, in an attempt to identify the best PROM for assessing personal goals in individuals with COPD.
    METHODS: The review followed a two-phase approach. In the first phase, a systematic search of PubMed, ScienceDirect and Scopus was conducted to identify PROMs used to assess goal attainment in individuals with COPD after any intervention. In the second phase, measurement properties of the identified PROMs were reviewed using the Consensus-based Standards for the selection of health Measurement INstruments guidelines and search filter.
    RESULTS: Only one article, reporting on Goal Attainment Scaling, was included after full-text assessment. The Goal Attainment Scaling was used to measure the personal goals of individuals with COPD following a community pharmacist intervention. No studies on the measurement properties of Goal Attainment Scaling were found.
    CONCLUSION: This review highlights the lack of PROMs specifically developed and evaluated for assessing personal goals in COPD. Future research should focus on validating the use of Goal Attainment Scaling in the COPD and PR contexts or developing a new PROM to integrate into the COS.
    PROSPERO REGISTRATION ID: CRD42022313344.
    Keywords:  COPD; goal achievement; measurement instruments; patient empowerment; pulmonary rehabilitation; systematic review
    DOI:  https://doi.org/10.1016/j.rmed.2026.108800
  68. PLoS One. 2026 ;21(4): e0344749
    Five-year real-world outcomes of short-course leukocyte-poor PRP versus standard conservative therapy in early-stage knee osteoarthritis.
    Qiuping Yu, Chenghong Wen, Junli Liu.
       BACKGROUND: Platelet-rich plasma (PRP) is increasingly applied in knee osteoarthritis (KOA), but its long-term efficacy remains uncertain. This study assessed 5-year outcomes of intra-articular PRP compared with conventional therapy in early-stage KOA.
    METHODS: A retrospective cohort of 116 patients with bilateral KOA (Kellgren-Lawrence I-II) treated in 2019 was analyzed. Group A (n = 58) received standardized management plus three PRP injections, while Group B (n = 58) received standardized conservative management alone (NSAIDs and/or intra-articular hyaluronic acid), combined with education, exercise therapy, and weight management. Pain, function, and quality of life were evaluated by VAS, WOMAC, and SF-36 at baseline and 5 years.
    RESULTS: Both groups showed deterioration over 5 years. VAS increased from 4.64 ± 0.52 to 5.41 ± 1.17 in Group A and from 4.80 ± 0.59 to 5.44 ± 1.16 in Group B, without significant between-group difference (P = 0.849). WOMAC and SF-36 scores also worsened similarly, with no intergroup significance (P > 0.05). Intra-group analyses confirmed significant declines from baseline (P < 0.001).
    CONCLUSIONS: Although a short, single course of leukocyte-poor PRP did not yield sustained superiority over standardized conservative management at 5 years, this real-world study provides rare long-term comparative evidence that defines the temporal boundaries of PRP efficacy and underscores the need for maintenance or optimized dosing protocols in clinical practice.
    DOI:  https://doi.org/10.1371/journal.pone.0344749
This page is being maintained by Thomas Krichel. It was last updated on 2026‒04‒12 at 18:58.