bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2025–11–23
67 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Visualization of the Median Nerve When Snapping: Real-Time Dynamic Ultrasound Examination.
  2. Dynamic ultrasound examination for postoperative intermittent irritation of the infrapatellar branch of the saphenous nerve.
  3. Development and validation of a functional assessment tool for Chinese inpatient rehabilitation: insights from a Delphi study based on the International Classification of Functioning, Disability, and Health (ICF).
  4. Unexpected analgesic effect of omalizumab in a patient with chronic widespread pain.
  5. Tibialis anterior tendon variants: The forgotten risk in foot and ankle surgery.
  6. Rethinking Disability Assessment in Italy: Innovations and Challenges in the Medico-Legal Perspective of Type 2 Diabetes Mellitus.
  7. A patient-centred ICF-based comprehensive framework for rehabilitation in Austria: Development and implementation.
  8. Comparison of quadriceps and hamstring muscle size and strength between young athletes following knee surgery and healthy controls.
  9. Endoscopic dorsal medial branch nerve rhizotomy: A systematic review.
  10. Comment on Trigger Point Injection for Myofascial Pain Syndrome of the Low Back.
  11. Unexplained Groin Pain in the Elderly: Spontaneous Iliopsoas Tendon Rupture With Haematoma in a 90-Year-Old Woman.
  12. Functional Assessment of Peroneal Muscles Using Ultrasound Imaging in Chronic Ankle Instability.
  13. Short-Term Relief or Long-Term Repair: A Narrative Review of Corticosteroid and Platelet-Rich Plasma Injections in Rotator Cuff Tendinopathy.
  14. Tendon Sheath, Bursae, and Clinically Relevant Peritendinous Structures of the Hand and Wrist.
  15. Reframing exercise for musculoskeletal pain relief.
  16. Physical Activity in the Management of Diabetic Neuropathic Pain: A Narrative Review of Mechanisms, Evidence, and Clinical Perspectives.
  17. Unstable occult scaphoid fracture diagnosed by dynamic point-of-care ultrasound: a case report and review.
  18. Differential Diagnosis of Posterior Buttock Pain: A Conceptual Review Based on Topographic Localization of Pain, Is It Really the Sacroiliac Joint?
  19. Global Trends and Hotspots in Ultrasound Imaging for Rehabilitation Research: A Bibliometric and Visualization Analysis.
  20. Diagnostic Utility of 2L-IO Latency Difference in Carpal Tunnel Syndrome: An Electrophysiologic Perspective.
  21. Injuries to the Rectus Femoris: A Review of Evaluation, Management, and Return to Sport.
  22. Ultrasound-Guided External Trigger Point Injections for Female Patients With Myofascial Pelvic Pain: A Report of Two Cases.
  23. Efficacy of cycloid vibration therapy for arthrogenic muscle inhibition after anterior cruciate ligament reconstruction: a study protocol for a prospective, randomised controlled trial.
  24. A rare side effect after local corticosteroid injection for carpal tunnel syndrome: Acute horseshoe abscess.
  25. MR Imaging of Injury of the Extensor Mechanism of the Fingers.
  26. Pain Affirming Care in Older Adults with Marginalized Experiences: A New Framework for Care.
  27. MR Imaging of the Distal Radioulnar Joint.
  28. Efficacy and safety of platelet-rich plasma in the treatment of carpal tunnel syndrome: A meta-analysis.
  29. A commentary on "Outcome comparison of arthroscopic latissimus dorsi tendon transfer and muscle advancement for irreparable rotator cuff tear: a systematic review".
  30. Age- and sex-related differences in lumbar disc degeneration and multifidus muscle atrophy: a retrospective MRI study of 238 patients with chronic low back pain.
  31. Individualised exercise for patients with persistent low back pain and lateral abdominal muscle impairments: a randomised feasibility study.
  32. Correction: Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.
  33. Evidence for arthrogenic inhibition of the gluteus medius after anterior cruciate ligament injury: A systematic review.
  34. Digitally assisted vs conventional home-based rehabilitation after rotator cuff repair: A meta-analysis.
  35. The Use of Dual-Energy X-ray Absorptiometry (DEXA) in Evaluating Recovery After Musculoskeletal Injuries in Athletes: A Scoping Review.
  36. A step forward for knee osteoarthritis pain . . . and other research.
  37. Skeletal muscle index, grip strength, and physical performance as predictors of severe chemotherapy toxicity among older adults with malignancy.
  38. Diagnostic Accuracy of the SARC-CalF in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.
  39. Physical function and rehabilitation in patients with brain tumours: narrative review.
  40. The Benefit of Repairing the Deltoid Ligament in Unstable Ankle Fractures: Patient-Reported Functional Outcome and Radiological Stability Measurements; a Clinical Trial Protocol.
  41. Reliability of a Spinal Cord Injury-Specific Extension of the Work Rehabilitation Questionnaire (WORQ-SCI).
  42. [A mallet finger, and then?]
  43. Vitality in older adults: A state-of-the-science review.
  44. The moderating role of social support in the association between depressive symptoms and functional disability among older adults with HIV.
  45. External supports in carpal tunnel syndrome: Which works best? A double-blind randomized controlled trial.
  46. MR Imaging of Inflammatory, Crystalline-induced, and Infectious Arthritides of the Hand and Wrist.
  47. Suzetrigine for pain relief: Key considerations for nurses.
  48. Effectiveness of Ultrasound-Guided Hydrodissection for Atypical Anterior Cutaneous Nerve Entrapment Syndrome Presenting as Lower Back Pain Due to Retrograde Neuropathic Pain.
  49. Ultrasound measurements of pelvic floor and diaphragm muscles in chronic obstructive pulmonary disease patients with urinary incontinence.
  50. Early Multidisciplinary Rehabilitation Improves Swallowing and Speech Function in a Patient With Amyotrophic Lateral Sclerosis.
  51. Acute Low Back Pain: Diagnosis and Management.
  52. Smartphones: a useful option for the pulmonary rehab toolkit?
  53. When rehabilitation is not enough, how targeting metabolism can overcome the limited plasticity of skeletal muscle after traumatic injury.
  54. A 68-year-old man presenting with tingling pain in the medial aspect of the right forearm and hand.
  55. Botulinum toxin in focus: evolution, pharmacology, and it's expanding clinical impact.
  56. Treatment of Persistent Pectoralis Minor Hyperactivity and Compensatory Trapezius Hypertrophy Using Arthroscopic Release: A Case Report.
  57. Pain Management in the Older Adult with Opioid Use Disorder.
  58. Targeting the ROS-ferroptosis-inflammation cycle with a nanozyme-functionalized hydrogel for intervertebral disc repair.
  59. Atraumatic sacral fracture in a postpartum patient in the late postoperative period following lumbar decompression for disc herniation.
  60. Existential Well-Being and Suffering in the Context of Cardiac Rehabilitation: A Qualitative Interview Study.
  61. [Musculoskeletal disorders in patients with Parkinson's disease].
  62. Rehabilitation and Pain Management in Klippel-Feil Syndrome Associated With Caroli's Disease, Scoliosis, and Aphasia.
  63. Corticosteroid injection combined with a shoulder rehabilitation system for chronic rotator cuff injuries: a protocol for a randomised controlled trial.
  64. Does Suture Configuration Matter in Achilles Tendon Repairs?
  65. Promoting the Physical Activity of Older Adults in Institutional Long-Term Care: A Mixed-Method Case Study.
  66. Pregnancy-Related Carpal Tunnel Syndrome.
  67. Post-intensive care unit syndrome: the silent legacy of intensive care unit survival. Narrative review and strategies for its approach in intermediate respiratory care units.
  1. Muscle Nerve. 2025 Nov 20.
    Visualization of the Median Nerve When Snapping: Real-Time Dynamic Ultrasound Examination.
    Berkay Yalçınkaya, Ahmet Furkan Çolak, Hilmi Berkan Abacıoğlu, Levent Özçakar.
      
    Keywords:  flexor digitorum superficialis; forearm; movement; neuropathy; ultrasonography
    DOI:  https://doi.org/10.1002/mus.70076
  2. J Yeungnam Med Sci. 2025 ;42 74
    Dynamic ultrasound examination for postoperative intermittent irritation of the infrapatellar branch of the saphenous nerve.
    Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar.
      
    DOI:  https://doi.org/10.12701/jyms.2025.42.74
  3. PeerJ. 2025 ;13 e20280
    Development and validation of a functional assessment tool for Chinese inpatient rehabilitation: insights from a Delphi study based on the International Classification of Functioning, Disability, and Health (ICF).
    Jiahui Li, Guangxu Xu, Juan Jin, Na Li, Jianan Li, Shouguo Liu.
       Objectives: To develop and validate a functional assessment tool for inpatient rehabilitation in China using the International Classification of Functioning, Disability, and Health (ICF) Rehabilitation Set (ICF-RS) framework and the Delphi method.
    Methods: A three-round Delphi process engaged 15 experts to refine ICF-RS items via a 5-point importance questionnaire. Validation involved 2,574 inpatients assessed with a numerical rating scale. Reliability (Cronbach's alpha) and structural validity (factor analysis) were evaluated.
    Results: Through three rounds of Delphi meetings, 10, 2, and 1 ICF items with mean importance scores below the threshold were respectively removed, resulting in 17 ICF items achieving expert consensus for inclusion in the final assessment tool, named ICF-RS-17. Expert authority coefficient was 0.81. Cronbach's alpha exceeded 0.9. Factor analysis identified two factors explaining 68.86% (admission) and 73.25% (discharge) of variance, confirming structural validity.
    Conclusions: The study developed a 17-item functional assessment tool, ICF-RS-17, demonstrating strong reliability and validity for inpatient rehabilitation. These findings help promote the application of the ICF in clinical settings, enhance rehabilitation clinical management, and potentially support the further development of rehabilitation insurance policies.
    Keywords:  Delphi method; Functional assessment; ICF; Rehabilitation; Reliability; Validity
    DOI:  https://doi.org/10.7717/peerj.20280
  4. Clin Rheumatol. 2025 Nov 21.
    Unexpected analgesic effect of omalizumab in a patient with chronic widespread pain.
    Hasan Ocak, Alp Çetin.
      
    DOI:  https://doi.org/10.1007/s10067-025-07837-7
  5. Foot Ankle Surg. 2025 Nov 17. pii: S1268-7731(25)00260-7. [Epub ahead of print]
    Tibialis anterior tendon variants: The forgotten risk in foot and ankle surgery.
    Łukasz Olewnik, Ingrid C Landfald, Brion Benninger.
       PURPOSE: The tibialis anterior tendon (TAT) is a critical structure for foot dorsiflexion and medial arch stabilization. Despite its functional importance, the morphological variability of the TAT remains underrecognized in clinical and surgical settings. This review aims to present a comprehensive overview of TAT anatomical variants, their diagnostic imaging features, and implications for foot and ankle surgery.
    METHODS: We systematically analyze the current anatomical classifications of the TAT, with particular focus on the Olewnik et al. (2019) system, which integrates cadaveric dissection and high-resolution ultrasound findings. Comparative analysis with historical systems (Musiał, Brenner, Willegger) is included. Clinical risk stratification, imaging strategies (ultrasound, MRI), and type-specific surgical approaches are also discussed.
    RESULTS: Six distinct TAT types (I-VI) were identified, with Type VI detectable only via ultrasound. Variants involving single-band insertions (Types V and VI) pose the highest intraoperative risk due to limited insertional dispersion and altered fiber rotation. Incorporation of morphological typing into preoperative imaging protocols significantly improves surgical planning and minimizes iatrogenic injury. A clinical algorithm and rehabilitation guidelines tailored to each TAT variant are proposed.
    CONCLUSION: The morphological variability of the TAT has direct surgical, diagnostic, and rehabilitative implications. Integrating a type-based TAT classification into routine foot-and-ankle work flow sparticularly for procedures involving the medial cuneiform or first metatarsal may support preoperative planning; whether its use reduces complication or reoperation rates requires prospective validation. Multicenter prospective and biomechanical studies are needed to evaluate clinical impact and refine variant-based surgical planning.
    Keywords:  Anatomical variants; Foot surgery; Preoperative planning; Tendon classification; Tibialis anterior tendon; Ultrasound
    DOI:  https://doi.org/10.1016/j.fas.2025.11.006
  6. Clin Ter. 2025 Nov-Dec;176(6):176(6): 830-832
    Rethinking Disability Assessment in Italy: Innovations and Challenges in the Medico-Legal Perspective of Type 2 Diabetes Mellitus.
    G Migliozzi, F Orsini, A Santurione, M Salducci, M Lippi, F M Damato.
       Abstract: The recent reform of the Italian civil disability assessment system has introduced a new integrated evaluation framework grounded in the International Classification of Functioning, Disability and Health (ICF), the International Classification of Diseases (ICD), and the WHO Disability Assessment Schedule (WHODAS 2.0). This person-centered, context-sensitive model aims to transcend the limitations of a purely clinical evaluation. However, adopting new instruments and criteria presents significant challenges, particularly in medico-legal settings. This paper, through a narrative analysis of the paradigmatic case of Type 2 Diabetes Mellitus (T2DM), explores methodological innovations, potentials, and critical issues within the reform, emphasizing key concerns in documentation management, regulatory consistency, and the experimental implementation phase.
    Keywords:  Assessment report; Disability; Invalidity; Medico-legal evaluation; Type 2 diabetes mellitus; Welfare state
    DOI:  https://doi.org/10.7417/CT.2025.5305
  7. Clin Rehabil. 2025 Nov 19. 2692155251396107
    A patient-centred ICF-based comprehensive framework for rehabilitation in Austria: Development and implementation.
    Martina Honegger, Martin Skoumal, Christoph Pertinatsch, Britta Neubacher, Christof Kadane, Sonja Lindner-Rabl, Regina Roller-Wirnsberger.
      ObjectiveAustria's rehabilitation system lacked personalisation, alignment with the International Classification of Functioning, Disability, and Health (ICF), and measurable quality indicators. To address these gaps, a unified change management approach aligned with international standards and the biopsychosocial model was developed. The resulting Comprehensive Framework for Rehabilitation Standards, Practices, and Services aimed to establish a patient-centred, evidence-informed model integrating policy, quality, and practice.Local contextRehabilitation in Austria is provided by social insurance institutions, including the Pension Insurance Austria, which defines medical and therapeutic specifications for rehabilitation services. Historically, these were disease-centred, heterogeneous, and lacked individualisation.MethodsThe development followed a co-creation process involving focus groups with interdisciplinary staff from rehabilitation centres. Implementation in 17 centres across Austria required process and information technology adaptations as well as capacity building. Thirteen key performance indicators were established for monitoring, evaluation, and benchmarking.ResultsAfter three quarters of implementation, all centres adhered to six key performance indicators, including staff and patient satisfaction, functional status assessment, quality of life screening, work-related rehabilitation needs, and follow-up rehabilitation referrals. Challenges included consistent ICF application, individual goal-setting, and therapy planning tailored to impairment severity. Implementation problems mirrored those reported internationally. Strong leadership, interdisciplinary collaboration, and early information technology engagement were key enablers.ConclusionThe framework operationalised international rehabilitation standards into a scalable national model. Its ICF-based design demonstrated that large-scale, patient-centred, participation-oriented rehabilitation is achievable through structured change management. Future evaluations should assess long-term outcomes and adaptability across health systems with varying digital maturity.
    Keywords:  Biopsychosocial model; comprehensive framework; participation (WHO ICF); patient-centred care; rehabilitation
    DOI:  https://doi.org/10.1177/02692155251396107
  8. PeerJ. 2025 ;13 e20330
    Comparison of quadriceps and hamstring muscle size and strength between young athletes following knee surgery and healthy controls.
    Christopher J Cleary, Isaiah G Roepe, Christopher D Bernard, Traci Smiley, John K Veazey, Kyle A Martin, Megan Bechtold, Bryan G Vopat, Ashley A Herda.
       Objectives: This study compared the size and strength of the quadriceps and hamstring muscles in young athletes who had undergone previous knee surgery (POST) to sex- and age- matched, healthy controls (SAM).
    Methods: A total of 18 (nine POST and nine SAM) participants volunteered to participate in the study's procedures. Of the nine POST participants, six had underwent anterior cruciate ligament reconstruction, two underwent medial patellofemoral ligament reconstruction and one had undergone patellar tendon repair. Maximal voluntary isometric contractions assessed absolute strength (MVICABS) of the quadriceps and hamstrings. Muscle size was quantified as muscle cross-sectional area (mCSA) from panoramic ultrasound images. Relative strength (MVICREL) was calculated as a ratio of strength to muscle size. Separate 2-way mixed-factorial analyses of variance leg (operative or non-dominant (O-ND) vs. non-operative or dominant (NO-D)) and group (POST vs. SAM) assessed statistical differences at p ≤ 0.05.
    Results: There were no significant two-way interactions (p-range: 0.142-0.74) for any variables. Further, there were no significant main effects for the quadriceps (p-range: 0.127-0.605) nor was there a main effect for leg in any hamstrings variables (p-range: 0.126-0.367). However, the POST group had greater MVICABS and MVICREL than SAM for the hamstrings by 69.8 ± 30.7 N (p = 0.037) and 2.21 ± 1.02 N cm-2 (p = 0.045).
    Conclusions: These findings indicate that there was no difference in quadriceps muscle strength or size between the POST and SAM groups. However, the POST group had greater hamstrings strength than SAM yet no differences in muscle size. These results suggest that the rehabilitation program may have been effective in restoring quadriceps function and enhancing hamstrings strength in young athletes following knee surgery. However, future studies should continue to elucidate the physiological effects of knee surgeries in larger, more diverse samples to attenuate the negative musculoskeletal outcomes experienced even after successful surgery and rehabilitation. Yet, these results can be considered as preliminary findings that demonstrate the feasibility of the inclusion of ultrasound imaging in return-to-sport evaluation in a small sample.
    Keywords:  Injury; Rehabilitation; Sports medicine; Surgery; Ultrasound
    DOI:  https://doi.org/10.7717/peerj.20330
  9. J Orthop. 2026 Jan;71 107-112
    Endoscopic dorsal medial branch nerve rhizotomy: A systematic review.
    William J Hlavinka, Ayesha A Sayyed, Sudha Ramakrishnan, Joseph Chavarria, Jason Alder, Ioannis Avramis, James Rizkalla.
       Background/purpose: Chronic low back pain is a leading cause of disability worldwide, with lumbar facet joint syndrome accounting for a significant proportion of cases. While percutaneous radiofrequency ablation is the current standard of care for patients refractory to conservative therapy, endoscopic rhizotomy has emerged as a promising alternative with potential for improved precision and durability. This systematic review aims to evaluate the efficacy of endoscopic rhizotomy and compare the clinical outcomes with percutaneous ablation in the management of lumbar facet-mediated low back pain.
    Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Ovid were searched to identify studies evaluating endoscopic rhizotomy or directly comparing endoscopic rhizotomy to percutaneous ablation. Inclusion criteria encompassed prospective or retrospective cohort studies, randomized controlled trials, and case series reporting on postoperative outcomes. Primary outcomes included changes in pain scores, functional outcomes, need for repeat procedure, and adverse events. A total of 10 studies met inclusion criteria for analysis.
    Results: Endoscopic rhizotomy demonstrated significant and sustained reductions in pain scores, with several studies reporting decreases of over 70 % maintained up to 24 months post-procedure. Comparative studies revealed that endoscopic rhizotomy was associated with greater pain relief and functional improvement than percutaneous ablation at nearly all follow-up intervals, including 6, 12, and 24 months. The rate of repeat interventions was lower in endoscopic rhizotomy cohorts compared to percutaneous ablation. Functional outcomes favored endoscopic rhizotomy with multiple studies showing 50 % or greater improvement from baseline.
    Conclusion: Endoscopic rhizotomy appears to be a safe and effective intervention for chronic lumbar facetogenic pain, offering longer-lasting pain relief and greater functional recovery than percutaneous ablation in selected patients.
    Keywords:  Dorsal medial branch nerve; Endoscopic spine surgery; Endoscopy; Facet; Facet pain syndrome; Facetogenic back pain; Rhizotomy
    DOI:  https://doi.org/10.1016/j.jor.2025.08.020
  10. Ann Emerg Med. 2025 Dec;pii: S0196-0644(25)01051-0. [Epub ahead of print]86(6): 703
    Comment on Trigger Point Injection for Myofascial Pain Syndrome of the Low Back.
    Alper Mengi.
      
    DOI:  https://doi.org/10.1016/j.annemergmed.2025.06.624
  11. Cureus. 2025 Oct;17(10): e94601
    Unexplained Groin Pain in the Elderly: Spontaneous Iliopsoas Tendon Rupture With Haematoma in a 90-Year-Old Woman.
    Praveenraja Shanmugam, Sona Murugan, Felix Saka.
      Hip and groin pain are frequent presenting complaints among elderly patients. These symptoms are most commonly related to fractures, which are usually identifiable on X-rays. Spontaneous iliopsoas tendon injury, however, is a rare and under-recognised cause of atraumatic hip or groin pain in this population. We report the case of a 90-year-old woman with a history of multiple comorbidities on long-term warfarin for atrial fibrillation who presented with dull left groin pain radiating to the lower back and marked limitation of mobility in the absence of recent trauma. On admission, the international normalised ratio (INR) was 3.98 (reference range, 2-3) and warfarin was held; haemoglobin (Hb) was 87 g/L (reference range, 115-165 g/L), which is the patient's baseline with no fall on serial checks. Examination revealed severe pain on resisted hip movement and groin tenderness, while pelvic X-rays excluded fracture. CT imaging demonstrated bulky soft tissue tracking along the left iliacus muscle extending to the lesser trochanter, consistent with spontaneous iliopsoas tendon rupture with intramuscular haematoma. Orthopaedics recommended conservative management with analgesia, mobilisation as tolerated, and inpatient rehabilitation. MRI was not pursued as it would not have altered the management. The patient remained haemodynamically stable without any drop in haemoglobin levels. This case highlights the importance of considering spontaneous iliopsoas tendon rupture in elderly patients who present with atraumatic hip or groin pain and have non-diagnostic X-rays. Timely cross-sectional imaging is often key to making the diagnosis. Early diagnosis allows appropriate conservative management and is associated with favourable functional outcomes.
    Keywords:  atraumatic hip pain; conservative management; elderly female; iliopsoas haematoma; iliopsoas tendon rupture; spontaneous tendon injury; warfarin therapy
    DOI:  https://doi.org/10.7759/cureus.94601
  12. J Foot Ankle Res. 2025 Dec;18(4): e70088
    Functional Assessment of Peroneal Muscles Using Ultrasound Imaging in Chronic Ankle Instability.
    Abbis Jaffri.
       BACKGROUND: Lateral ankle sprains (LAS) result in chronic ankle instability (CAI), causing ongoing instability. Although peroneal muscle weakness is documented in CAI, surface electromyography shows similar activation patterns between CAI and healthy individuals, suggesting structural rather than neural deficits. Ultrasound imaging (USI) uniquely enables noninvasive assessment of muscle morphology and quality through cross-sectional area and echogenicity measurements. However, previous USI studies examined peroneals only in nonweight-bearing positions, potentially missing functional deficits. This study examines peroneal muscle characteristics in CAI versus healthy individuals specifically during weight-bearing functional positions using USI.
    METHODS: A case-control study was conducted with 58 participants (29 CAI and 29 healthy controls), aged 18-30 years. Cross-sectional area (CSA), echogenicity (grayscale analysis where higher values indicate fatty infiltration/fibrosis), and functional activation ratio (FAR) of the peroneal muscles were assessed using USI in nonweight-bearing (side lying) and weight-bearing (bilateral-leg standing (BLS) and single-leg standing (SLS)) positions. CSA images were averaged from three measurements for each position.
    RESULTS: The CAI group had significantly smaller CSA in BLS (p < 0.01) and SLS (p < 0.01) but not lying (p = 0.06), higher echogenicity indicating poorer muscle quality (69.7 ± 10.3 vs. 61.3 ± 7.0, p < 0.01), and lower FAR in both BLS (0.99 ± 0.13 vs. 1.13 ± 0.16, p < 0.01) and SLS (1.01 ± 0.17 vs. 1.12 ± 0.22, p = 0.03) compared to healthy controls.
    CONCLUSION: Individuals with CAI showed reduced peroneal muscle CSA, lower activation, and poorer muscle quality specifically in weight-bearing positions compared to healthy controls. These findings suggest altered muscle function in CAI especially in functional weight-bearing positions. This demonstrates the need to assess peroneals in functional weight-bearing position compared to resting.
    Keywords:  muscle activation; rehabilitation; weight‐bearing
    DOI:  https://doi.org/10.1002/jfa2.70088
  13. Cureus. 2025 Nov;17(11): e97271
    Short-Term Relief or Long-Term Repair: A Narrative Review of Corticosteroid and Platelet-Rich Plasma Injections in Rotator Cuff Tendinopathy.
    Olive Kyaw, Chan Khin.
      Rotator cuff tendinopathy is a common cause of shoulder pain and disability in adults over 40. Corticosteroid injections provide short-term pain relief but may impair tendon healing with repeated use. Platelet-rich plasma (PRP) aims to promote tissue repair; however, comparative evidence remains heterogeneous. We conducted a narrative review of comparative studies of corticosteroid versus PRP injections for rotator cuff tendinopathy. Ovid MEDLINE, Embase, and PubMed were searched for English-language studies (2010-25). Eligible designs included randomised controlled trials (RCTs), prospective comparative studies, and systematic reviews/meta-analyses. Of 263 records, 60 full texts were screened, and 17 studies were included. Reviews/meta-analyses consistently found corticosteroids superior for short-term relief (<3 months), with several suggesting PRP may be favoured for mid- to long-term outcomes (6-12 months), though results were inconsistent. Among RCTs, early evidence showed no benefit of PRP over placebo, whereas more recent trials reported improved pain and function with PRP versus corticosteroids; other RCTs found no difference. Prospective studies generally suggested more sustained outcomes with PRP. Heterogeneity in PRP preparation and protocols limits comparability. Corticosteroids remain useful for rapid symptom control, but benefits wane and repeated use may pose risks. PRP may offer more durable improvements for selected patients, albeit with variable effect sizes across studies and higher cost.
    Keywords:  corticosteroid injection; platelet-rich plasma; randomised controlled trial; rotator cuff tendinopathy; shoulder pain; systematic review; tendon healing
    DOI:  https://doi.org/10.7759/cureus.97271
  14. Magn Reson Imaging Clin N Am. 2026 Feb;pii: S1064-9689(25)00074-1. [Epub ahead of print]34(1): 103-116
    Tendon Sheath, Bursae, and Clinically Relevant Peritendinous Structures of the Hand and Wrist.
    Áurea V R Mohana-Borges, Karen Cheng, Mario Moreno, Christine B Chung.
      Imaging is essential for evaluating tenosynovitis, bursitis, and pulley lesions. Both ultrasound (US) and MR imaging detect fluid accumulation and synovial thickening, key for diagnosing tenosynovitis and bursitis. They also reveal A1 pulley thickening in trigger fingers and A2-A4 pulley strain or tears in closed flexor pulley injuries (climber's fingers). US enables dynamic assessments in real-time and detects hypervascularity, while MR imaging provides detailed insights into the extent of inflammation in the soft tissues and bone through fluid-sensitive sequences and contrast enhancement. These complementary modalities enhance diagnostic accuracy, providing better guidance for treatment and interventional procedures.
    Keywords:  Bursitis; Climber’s finger; Imaging; MR imaging; Stenosing tenosynovitis; Tenosynovitis; Trigger finger; Ultrasound
    DOI:  https://doi.org/10.1016/j.mric.2025.08.006
  15. Br J Sports Med. 2025 Nov 17. pii: bjsports-2025-110336. [Epub ahead of print]
    Reframing exercise for musculoskeletal pain relief.
    Justin Martino.
      
    Keywords:  Exercise Therapy; Pain Management; Physical Therapy; Physical Therapy Modalities; Rehabilitation
    DOI:  https://doi.org/10.1136/bjsports-2025-110336
  16. Cureus. 2025 Oct;17(10): e94960
    Physical Activity in the Management of Diabetic Neuropathic Pain: A Narrative Review of Mechanisms, Evidence, and Clinical Perspectives.
    Jaouher Dhouibi, Houda Migaou, Amr Chaabeni, Amine Kalai, Sana Salah, Soumaya Boudokhane, Zohra Ben Salah Frih, Anis Jellad.
      Diabetic neuropathic pain (DNP) is a common and debilitating complication of diabetes mellitus, resulting from complex metabolic, vascular, and neuroinflammatory mechanisms. Pharmacological treatments provide limited relief, highlighting the need for adjunctive therapies. This review aimed to summarize current understanding of the pathophysiology of DNP and to evaluate the efficacy and mechanisms of physical activity (PA) in its management. A narrative synthesis of recent preclinical and clinical studies investigating the impact of exercise on DNP was conducted. Studies suggested that PA may improve insulin sensitivity, reduce oxidative stress, enhance microvascular blood flow, modulate neuroinflammation, and promote nerve regeneration. Clinical evidence demonstrates that aerobic, resistance, and multimodal exercise programs reduce pain severity, improve nerve conduction, and enhance functional outcomes. PA remains a safe and effective means in addition to pharmacological treatment in DNP. Tailored supervised exercise programs are recommended to optimize benefits. High-quality studies are still needed to establish standardized exercise protocols and long-term outcomes.
    Keywords:  diabetes mellitus; diabetic neuropathies; exercise; neuralgia; pain
    DOI:  https://doi.org/10.7759/cureus.94960
  17. Front Med (Lausanne). 2025 ;12 1711119
    Unstable occult scaphoid fracture diagnosed by dynamic point-of-care ultrasound: a case report and review.
    Yong-Hyun Yoon, Jihyo Hwang, King Hei Stanley Lam, Jeimylo Cristobal De Castro, Teinny Suryadi, Anwar Suhaimi, Chun Wei Kang, Howon Lee, Hyeongjik Kim, Seungbeom Kim, Daniel Chiung-Jui Su.
       Background: The scaphoid is the most frequently fractured carpal bone, yet its diagnosis remains a significant clinical challenge. A substantial percentage of non-displaced fractures are missed on initial radiographs, leading to delays in treatment and an increased risk of serious long-term complications such as non-union and avascular necrosis. While advanced imaging like CT and MRI are highly accurate, they are associated with higher costs, radiation exposure (CT), and limited immediate availability. High-resolution musculoskeletal ultrasound has emerged as a rapid, non-invasive, and cost-effective alternative. Its unique ability to perform dynamic, real-time assessment of fracture stability offers a significant advantage over static imaging modalities.
    Case presentation: A 29-year-old woman presented to our outpatient clinic with acute left wrist pain following a traction-fall injury. An initial four-view radiographic series of the wrist revealed no definitive evidence of a fracture. Despite the negative imaging, clinical suspicion remained high due to persistent, exquisite point tenderness over the anatomical snuffbox. A point-of-care musculoskeletal ultrasound examination was performed, which revealed a clear hypoechoic cortical breach at the scaphoid waist. To assess mechanical stability, a dynamic stress maneuver-defined as a gentle, controlled "heel-toe" probe rocking that applies focal pressure across the fracture-was performed under real-time sonographic visualization. Gentle probe pressure combined with passive ulnar deviation of the wrist demonstrated visible gapping and micromotion at the fracture site, confirming it as mechanically unstable. Based on this definitive finding, the diagnosis was revised to an unstable occult scaphoid waist fracture, and the management plan was immediately upgraded to a rigid thumb spica splint. Long-term follow-up over 2 years showed radiographic and sonographic evidence of a stable fibrous union.
    Conclusion: This case report highlights the pivotal role of dynamic musculoskeletal ultrasound as an adjunct in the diagnostic algorithm for acute wrist trauma. It demonstrates its ability not only to identify a radiographically occult scaphoid fracture but, more critically, to provide immediate functional information about mechanical stability. This information is paramount for guiding appropriate and timely management to mitigate the risk of long-term complications. We advocate for the broader integration of dynamic ultrasound into the initial assessment of suspected scaphoid fractures.
    Keywords:  dynamic ultrasonography; fracture stability; occult fracture; point-of-care ultrasound; scaphoid fracture; wrist injury
    DOI:  https://doi.org/10.3389/fmed.2025.1711119
  18. Int J Spine Surg. 2025 Nov 18. pii: 8821. [Epub ahead of print]
    Differential Diagnosis of Posterior Buttock Pain: A Conceptual Review Based on Topographic Localization of Pain, Is It Really the Sacroiliac Joint?
    W Carlton Reckling, David W Polly.
      Diagnosis and management of musculoskeletal pain in the lower back, buttock, and hip can be complex due to the multilayered muscular anatomy in this region. Each structure or functional group (ie, hip abductors) may present as a local pain syndrome. Pain may arise from osseous, intra-articular, ligamentous, musculotendinous, myofascial, neural, or vascular sources. Diagnosis is challenging due to overlapping innervation and referred pain patterns, particularly sclerotomal referral from osseous and ligamentous structures. Effective treatment requires accurate diagnosis. A regionalized approach categorizing pain syndromes into 6 anatomic zones-above the iliac crest, the iliac crest, the lateral hip, the gluteal region, sciatic nerve related, and the ischial tuberosity-may improve diagnostic clarity and guide treatment. A regionalized, 6-zone framework for posterior buttock pain may enhance diagnostic accuracy and guide individualized management.
    Keywords:  SI joint dysfunction; pain; pain management; sacroiliac joint
    DOI:  https://doi.org/10.14444/8821
  19. J Multidiscip Healthc. 2025 ;18 7423-7441
    Global Trends and Hotspots in Ultrasound Imaging for Rehabilitation Research: A Bibliometric and Visualization Analysis.
    Xuanzhu Qian, Yuen-Lim Ching, Wenxun Li, Yixiao Wang, Fangshuo Zhang, Jiali Liu, Kuo Gao, Yiran Huang.
       Objective: As a non-invasive, convenient and real-time imaging tool, ultrasound has provided new imaging evidence for rehabilitation and scientific research in recent years. As the volume and scope of studies grow, analyzing the innovative applications and research trends of ultrasound in rehabilitation is essential. This study employs bibliometric methods to map global research collaboration networks in ultrasound for rehabilitation, explore research dynamics, and predict future research themes based on emerging trends.
    Methods: We performed a bibliometric analysis of 8346 articles from the Web of Science (WoS) Core Collection (1990-2024) using CiteSpace and VOSviewer.
    Results: A total of 8346 articles were included. Annual publication volumes have a surge in the past five years. Western countries dominate research output, while institutions in China are emerging as significant contributors. Levent Ozcakar and Paul W. Hodges lead in publication volume and citation impact, respectively. Musculoskeletal ultrasound, intelligent algorithms, and skill education are key citation clusters and emergent topics. High-frequency keywords include ultrasound examination, exercise and efficacy validation emerging recently.
    Conclusion: Ongoing research is likely to continue focusing on the reliability of ultrasound for diagnosing various diseases, musculoskeletal quantification through novel ultrasound technologies in physical therapy, and ultrasound monitoring and biofeedback in respiratory and postpartum rehabilitation. Additionally, musculoskeletal examination evidence, real-time training monitoring, and systematic review evaluation are gaining increasing attention. These emerging areas may serve as guiding themes for future research, providing a foundation for continued innovation in the application of ultrasound in rehabilitation.
    Keywords:  bibliometric; rehabilitation; ultrasonography
    DOI:  https://doi.org/10.2147/JMDH.S553547
  20. J Clin Neurophysiol. 2025 Nov 17.
    Diagnostic Utility of 2L-IO Latency Difference in Carpal Tunnel Syndrome: An Electrophysiologic Perspective.
    Canan Duman İlki, Zerin Özaydın Aksun, Hüseyin Özden Şener.
       PURPOSE: This study aimed to evaluate the diagnostic value of the second lumbrical-interosseous distal motor latency (2L-IO distal motor latency [DML]) difference in the diagnosis of carpal tunnel syndrome, and to assess its utility across different stages of the disease.
    METHODS: A total of 145 carpal tunnel syndrome-affected hands from 89 patients and 52 hands from 31 healthy volunteers were evaluated between January and August 2023. In addition to standard electrophysiologic tests, the DML difference between the 2L and interosseous muscles was recorded. Carpal tunnel syndrome severity was classified according to the Bland scale. The diagnostic sensitivity and specificity of the 2L-IO DML difference were analyzed using receiver operating characteristic analysis.
    RESULTS: The 2L-IO DML difference was significantly prolonged in the carpal tunnel syndrome group compared with healthy controls (1.85 ± 1.41 ms vs. 0.25 ± 0.28 ms; P < 0.001). With a cutoff value of 0.45 ms, the sensitivity and specificity of the method were calculated as 98.6 and 98.1%, respectively. Although the diagnostic accuracy of conventional tests was 84%, it increased to 98% with the 2L-IO DML difference. Diagnosis was achieved in 85% of early stage (Grade 0-1) cases and in 90% of advanced cases in which the abductor pollicis brevis response was absent.
    CONCLUSIONS: The 2L-IO DML difference offers high diagnostic value in carpal tunnel syndrome, serving as a complementary test in early stages and a decisive tool in advanced stages. Preferentially recording from the 2L muscle instead of the abductor pollicis brevis may facilitate electrophysiologic evaluation, especially in challenging cases.
    Keywords:  Carpal tunnel syndrome; Distal motor latency; Electrophysiology; Lumbrical muscle; Median nerve; Motor nerve conduction studies
    DOI:  https://doi.org/10.1097/WNP.0000000000001225
  21. J Am Acad Orthop Surg. 2025 Nov 12.
    Injuries to the Rectus Femoris: A Review of Evaluation, Management, and Return to Sport.
    Scott Mullen, Bryan G Vopat, Richard McEntee, John Paul Schroeppel.
      Injuries to the rectus femoris (RF) are an infrequently reported injury and can range from mild muscle strains to full tears, including injuries to the proximal and distal tendons of the RF. Patients often present with anterior thigh pain sustained after kicking or sprinting and describe a sudden "pop" in their thigh. Magnetic resonance imaging is the preferred modality for diagnosing the location, type, and severity of pathology. To date, there is no current treatment algorithm developed for managing these injuries. Nonsurgical management consists of rest, stretching, anti-inflammatory medications, gradual strengthening, and progressive functional rehabilitation before returning to activity. Injection therapy is sometimes used as well. Surgical treatment has typically been reserved for full-thickness muscle tears and tendon avulsions in high-level athletes. The literature has demonstrated that elite athletes have a high return to sport rate and do not have long-term effects. This review seeks to discuss the epidemiology, pathology, and outcomes of injuries to the RF muscle. Injuries to the quadriceps muscle in general are outside of the scope of this review.
    DOI:  https://doi.org/10.5435/JAAOS-D-25-00061
  22. Case Rep Anesthesiol. 2025 ;2025 7853542
    Ultrasound-Guided External Trigger Point Injections for Female Patients With Myofascial Pelvic Pain: A Report of Two Cases.
    Sophie E Smith, Alopi Patel.
      Trigger point injections (TPIs) are used to relieve myofascial pain via injection with local anesthetics. External TPIs are commonly used to treat surface muscle groups such as the trapezius, while internal transvaginal or external pelvic TPIs may be used for pelvic pain in female patients. This case series discusses two female patients with histories of myofascial pelvic pain due to high-tone pelvic floor disorder (HTPFD) who received ultrasound-guided external TPIs for pain relief. Patient 1 had previously received internal TPIs with no relief, while Patient 2 had previously tried botulinum toxin injections and a pudendal nerve block with some relief. In both cases, ultrasound-guided external TPIs provided pain relief for a period of time and were repeated. This case highlights the importance of ultrasound-guided external TPIs as part of the arsenal of treatment options for pelvic floor dysfunction treatment.
    Keywords:  female pelvic floor dysfunction; high-tone pelvic floor disorder; hypertonicity; myofascial pelvic pain; ultrasound-guided trigger point injections
    DOI:  https://doi.org/10.1155/cria/7853542
  23. BMJ Open. 2025 Nov 04. 15(11): e105424
    Efficacy of cycloid vibration therapy for arthrogenic muscle inhibition after anterior cruciate ligament reconstruction: a study protocol for a prospective, randomised controlled trial.
    Wei Cao, Cuiyun Sun, Ke Hu, Xiaofeng Han, Wei Jin, Rong Xu.
       INTRODUCTION: Arthrogenic muscle inhibition (AMI) is a neuromuscular control disorder that occurs following joint injuries such as ligament tears, joint inflammation or postoperative conditions. It is characterised primarily by reflexive inhibition of the muscles surrounding the affected joint, substantially impeding rehabilitation. After anterior cruciate ligament reconstruction (ACLR), effective rehabilitation is essential to restore joint function, facilitate a return to preinjury activity levels and reduce the risk of reinjury. Vibration therapy may mitigate AMI by modulating somatosensory input to joint and cutaneous mechanoreceptors, thereby activating neuromuscular pathways through stimulation of mechanoreceptors in the skin, articular structures and musculotendinous tissues. Accordingly, this study employs cycloid vibration therapy (CVT) to evaluate its efficacy and safety in the management of AMI post-ACLR. The findings aim to determine whether integrating CVT into postoperative rehabilitation can effectively mitigate AMI, thereby optimising recovery of neuromuscular control and functional outcomes in ACLR patients.
    METHODS AND ANALYSIS: This prospective, single-centre, randomised controlled trial will enrol 44 patients with AMI who have undergone ACLR. Participants will be randomly allocated in a 1:1 ratio to either an experimental group, receiving CVT plus conventional rehabilitation or a control group, receiving conventional rehabilitation alone. All participants will complete an 8-week rehabilitation programme consisting of 24 sessions. Outcome measures will be assessed at baseline, at a 4-week interim evaluation and immediately postintervention at week 8. These assessments will include surface electromyography parameters, ultrasonographic muscle thickness, range of motion, knee joint proprioception, Visual Analog Scale pain scores, Lysholm Knee Scoring Scale, Holden Functional Classification and adverse event rates. A follow-up study will evaluate patient satisfaction and long-term outcomes, while all adverse events will be monitored and documented throughout the trial.
    ETHICS AND DISSEMINATION: The Medical Ethics Committee of Drum Tower Hospital, affiliated with Nanjing University School of Medicine, approved this study (2024-1022-02). The results will be submitted for publication in a peer-reviewed medical journal.
    TRIAL REGISTRATION NUMBER: ChiCTR2500096882.
    Keywords:  Clinical Protocols; Knee; Musculoskeletal disorders; Physical Therapy Modalities; Rehabilitation medicine
    DOI:  https://doi.org/10.1136/bmjopen-2025-105424
  24. Turk J Phys Med Rehabil. 2025 Sep;71(3): 406-410
    A rare side effect after local corticosteroid injection for carpal tunnel syndrome: Acute horseshoe abscess.
    Gülşah Çelik, Ahmet Bal, Hanife Hale Hekim.
      Local corticosteroid injections are commonly used for carpal tunnel syndrome. Rarely, hand infections can occur after injection. This report presented a 60-year-old female patient who developed a horseshoe abscess after corticosteroid injection for carpal tunnel syndrome. Early surgical intervention, intravenous antibiotics, and early mobilization led to successful management. Proper sterilization is crucial to prevent complications. Understanding hand anatomy is essential for prompt diagnosis and treatment of infections.
    Keywords:  Carpal tunnel syndrome; corticosteroid; horseshoe abscess; infection; injection.
    DOI:  https://doi.org/10.5606/tftrd.2025.15536
  25. Magn Reson Imaging Clin N Am. 2026 Feb;pii: S1064-9689(25)00075-3. [Epub ahead of print]34(1): 117-128
    MR Imaging of Injury of the Extensor Mechanism of the Fingers.
    Lukas Meadows, Tetyana Gorbachova.
      Extensor mechanism injuries of the hand are common in clinical practice and may lead to significant functional impairment. Understanding the complex anatomy and functional role of different extensor mechanism components in the fingers is critical for accurate imaging interpretation. We provide a brief overview of relevant anatomy and extensor zone injuries classification. Critical points for image acquisition optimization are included. Important imaging findings of extensor tendon injuries and their complications including mallet finger, swan neck and boutonniere deformities, and sagittal band injuries are reviewed. Clinical pearls regarding treatment, potential imaging pitfalls, and mimickers of these injuries are also discussed.
    Keywords:  Boutonniere deformity; Extensor tendon injury; Finger MR imaging; Mallet finger; Sagittal band injury; Swan neck deformity
    DOI:  https://doi.org/10.1016/j.mric.2025.08.007
  26. Clin Geriatr Med. 2026 Feb;pii: S0749-0690(25)00063-1. [Epub ahead of print]42(1): 1-13
    Pain Affirming Care in Older Adults with Marginalized Experiences: A New Framework for Care.
    Staja Star Booker, Janiece L Taylor.
      Chronic pain is and will continue to be a persisting chronic health condition as the population rapidly ages. In older adults, a moderate-to-large proportion experience both chronic pain and high-impact chronic pain that leads to difficulties with mood regulation, functional mobility, and social engagement. In racially/ethnically diverse and underrepresented older adults, chronic pain and its management are even more challenging not only because of its severity but also because they experience unequal care consequent to their intersectional identities. To counter the compounding effects of ageism, racism, and ableism, pain affirming care is introduced as new approach/philosophy for equitable pain care.
    Keywords:  Ageism; Chronic pain; Disability; Older adult; Pain affirming care; Pain assessment; Pain management; Race/ethnicity
    DOI:  https://doi.org/10.1016/j.cger.2025.08.002
  27. Magn Reson Imaging Clin N Am. 2026 Feb;pii: S1064-9689(25)00073-X. [Epub ahead of print]34(1): 83-101
    MR Imaging of the Distal Radioulnar Joint.
    Alvaro Cerezal, Ana Canga, Luis Cerezal.
      MR imaging plays a critical role in evaluating the pathology of the distal radioulnar joint (DRUJ), particularly in assessing the integrity of the triangular fibrocartilage complex (TFCC). High-resolution MR imaging and MR arthrography, especially with DRUJ compartment injection, improve the detection of subtle peripheral and foveal TFCC tears. Accurate identification and classification of both Palmer and non-Palmer lesions are essential for guiding arthroscopic treatment and assessing joint stability. Additionally, MR imaging helps evaluate posttraumatic deformity, degenerative changes, and inflammatory arthropathy, all of which may alter DRUJ biomechanics and influence therapeutic decision-making.
    Keywords:  CT; DRUJ instability; Distal radioulnar joint; MR imaging; Triangular fibrocartilage complex; Wrist fractures
    DOI:  https://doi.org/10.1016/j.mric.2025.08.005
  28. Medicine (Baltimore). 2025 Oct 31. 104(44): e45010
    Efficacy and safety of platelet-rich plasma in the treatment of carpal tunnel syndrome: A meta-analysis.
    Yali Du, Xuebing Jiang, Kaifei Fu, Chengwen Cui.
       BACKGROUND: To evaluate the efficacy and safety of platelet-rich plasma (PRP) in the treatment of CTS by meta-analysis.
    METHODS: Wanfang database, CNKI, VIP database, China Biological Literature Database, PubMed, Embase and Cochrane were searched for RCTS about PRP in the treatment of patients with CTS published up to October 2024. The PRP treatment group was treated with PRP on the basis of conventional treatment for CTS. The control group was treated with conventional conservative treatment of CTS. The main evaluation index of meta-analysis was BCTQ severity score. The secondary outcome measures were cross-sectional area of the median nerve, SNCV, DML, and VAS of pain.
    RESULTS: A total of 7 studies involving 365 patients were included in this meta-analysis. There were 183 patients in PRP group and 182 patients in control group. The results of meta-analysis showed that compared with the conventional treatment group, the PRP group had significant reductions in the symptom severity scale at 1, 3, and 6 months and the functional status scale at 3 and 6 months (P < .05). Compared with the conventional treatment group, PRP group increased the cross-sectional area of median nerve at 1 month but decreased the cross-sectional area of median nerve at 3 and 6 months, and the differences were not statistically significant (P > .05). The Sensory nerve conduction velocity of PRP treatment group was lower than that of conventional control group at 1 (P < .0001), 3 (P = .35) and 6 (P = .69) months after treatment. Compared with the conventional treatment group, the PRP treatment group increased distal motor latency at 1, 3, and 6 months, but the difference was not statistically significant. Compared with the conventional control group, the PRP treatment group decreased the visual analogue scale of pain at 1 (P = .56) and 3 (P = .02) months. There were no serious adverse reactions after PRP treatment in the 4 studies which recorded adverse reactions.
    CONCLUSION: PRP is a safe and effective treatment for patients with CTS. PRP can improve the subjective efficacy of patients with CTS but has little effect on the cross-sectional area of median nerve, SNCV, and DML.
    Keywords:  carpal tunnel syndrome; meta-analysis; platelet-rich plasma
    DOI:  https://doi.org/10.1097/MD.0000000000045010
  29. Int J Surg. 2025 Nov 20.
    A commentary on "Outcome comparison of arthroscopic latissimus dorsi tendon transfer and muscle advancement for irreparable rotator cuff tear: a systematic review".
    Jie Guan, Yimin Chen, Liming Zhu.
      
    DOI:  https://doi.org/10.1097/JS9.0000000000003711
  30. BMC Musculoskelet Disord. 2025 Nov 19. 26(1): 1059
    Age- and sex-related differences in lumbar disc degeneration and multifidus muscle atrophy: a retrospective MRI study of 238 patients with chronic low back pain.
    Manman Tian, Bonuo Qi, Jingjing Zeng, Jiashan Chen, Min Lin.
      
    Keywords:  Age-related differences; Fat infiltration ratio; Magnetic resonance imaging (MRI); Multifidus muscle degeneration; Pfirrmann grading
    DOI:  https://doi.org/10.1186/s12891-025-09296-2
  31. Pilot Feasibility Stud. 2025 Nov 15. 11(1): 144
    Individualised exercise for patients with persistent low back pain and lateral abdominal muscle impairments: a randomised feasibility study.
    Caitlin Lauren Siobhan Prentice, Carol Ann Flavell, Nicola Massy-Westropp, Steve Milanese.
       BACKGROUND: This parallel randomised control trial assessed feasibility of an exercise intervention for individuals with low back pain and maladaptive changes in lateral abdominal muscle contraction. Feasibility was assessed considering participant retention, program adherence and a preliminary evaluation of intervention efficacy.
    METHODS: Sixty adults (40 female, 20 male, average 54.2 years of age) with persistent low back pain and maladaptive changes in lateral abdominal muscle contraction were randomly assigned to fully or partially individualised versions of the 12-week program. All participants received motor control and graded activity exercise individualised to their low back pain symptoms, impairments and functional goals. Additionally, participants in the fully individualised group were asked what types of exercise they enjoy, and this informed the graded activity prescription. Lateral abdominal outcome measures included endurance and ultrasound imaging (muscle thickness at rest and during contraction, transversus abdominis slide), manual palpation and pressure biofeedback unit measures of contraction. Clinical outcomes included pain intensity (Numeric Rating Scale), disability (Roland Morris Disability Questionnaire), function (Pain Specific Functional Scale), physical activity (International Physical Activity Questionnaire) and lumbar instability (Lumbar Instability Questionnaire). Outcomes were measured at baseline, at the end of the intervention and clinical outcomes were measured again three months after the intervention concluded. Linear mixed effects models were used to compare the effects of the intervention within and between groups.
    RESULTS: Retention and exercise compliance rates were 81% and > 85% (86% control group, 87% experimental group) respectively. Participants in both groups achieved improved lumbar instability, disability, pain intensity, function, physical activity, lateral abdominal muscle endurance and contraction post intervention. The fully individualised group demonstrated greater between group improvements in function (mean [95%CI]: - 2.577 [- 3.239, - 1.915] 12 weeks, - 2.592 [- 3.254, - 1.930] 3 months) and physical activity (mean [95%CI]: - 790.834 [- 1712.05, 130.382] 12 weeks, - 1080.748 [- 2001.964, - 159.532] 3 months).
    CONCLUSIONS: The intervention demonstrated improvements in clinical outcomes, and acceptable exercise compliance. However, the intervention did not meet retention feasibility criteria to proceed to an adequately powered trial. Modifications to improve retention including incorporating group activities are required. Following modifications, an adequately powered trial is required to determine the efficacy of the intervention.
    TRIAL REGISTRATION: This trial was prospectively registered on the Australian and New Zealand Clinical Trial Registry (ACTRN12622001284752 30 September 2022).
    Keywords:  Lumbar; Motor control; Physical activity
    DOI:  https://doi.org/10.1186/s40814-025-01723-4
  32. PLoS One. 2025 ;20(11): e0337031
    Correction: Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.
    PhysAgeNet
      [This corrects the article DOI: 10.1371/journal.pone.0297348.].
    DOI:  https://doi.org/10.1371/journal.pone.0337031
  33. J Exp Orthop. 2025 Oct;12(4): e70551
    Evidence for arthrogenic inhibition of the gluteus medius after anterior cruciate ligament injury: A systematic review.
    Jean Tarchichi, Jad Zalaket, Nicolas Graveleau, Pierre Laboudie, Nicolas Bouguennec.
       Purpose: Arthrogenic muscle inhibition (AMI) is a reflex inhibition following joint injury or surgery affecting periarticular muscles. While AMI has been extensively studied in the quadriceps after anterior cruciate ligament (ACL) injury, its potential impact on the gluteus medius remains unclear. Given the muscle's critical role in pelvic and lower limb control, clarifying this relationship may have important implications for rehabilitation strategies after ACL injury. The purpose of this study is to search for a relation between ACL injuries and arthrogenic inhibition of the Gluteus medius in the ipsilateral hip.
    Methods: A structured review of 12 peer-reviewed studies was conducted, assessing Gluteus medius or hip muscle function after ACL injury or reconstruction. Eligible studies evaluated muscle activation, strength and neuromuscular adaptations using electromyography (EMG), dynamometry or biomechanical motion analysis. Data were summarised to evaluate the presence and clinical significance of AMI affecting the gluteus medius.
    Results: Among the included studies, two reported clear signs of gluteus medius inhibition after ACL injury or reconstruction. Several demonstrated reduced activation and weakness of the gluteus medius, suggesting a potential inhibitory mechanism. Specifically, EMG-based findings in two studies supported altered neuromuscular recruitment patterns, while three others identified movement strategies with compensation or abductor weakness. However, some other studies reported no significant deficits, highlighting interstudy variability due to differing methods, population characteristics or time since injury. Despite these differences, a general trend towards proximal neuromuscular adaptation appears relevant.
    Conclusion: There is emerging evidence that suggests the presence of gluteus medius dysfunction suggestive of AMI following ACL injury in certain individuals. While not universally observed, this inhibition may impair dynamic hip stability and functional recovery. Future research should explore whether targeted hip muscle training can reduce persistent neuromuscular deficits after ACL injury.
    Level of Evidence: Level III.
    Keywords:  ACL; AMI; arthrogenic muscle inhibition; gluteus medius; weakness
    DOI:  https://doi.org/10.1002/jeo2.70551
  34. World J Clin Cases. 2025 Nov 16. 13(32): 109464
    Digitally assisted vs conventional home-based rehabilitation after rotator cuff repair: A meta-analysis.
    Maryam Salimi, Alireza Keshtkar, Seyedarad Mosalamiaghili, Arash Sharafatvaziri, Brian T Feeley.
       BACKGROUND: Rotator cuff tears are a chief cause of shoulder pain and disability, and surgical repair is often required when conservative management fails. As digital health technologies have expanded, especially since the coronavirus disease 2019 pandemic, digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.
    AIM: To determine if digitally assisted rehabilitation could be as practical, or even more effective, than the traditional methods most patients currently follow.
    METHODS: Six electronic databases, including PubMed, Scopus, Cochrane Library, Google Scholar, EMBASE, and Web of Science, were searched to find articles that compare digital-based rehabilitation and conventional treatment. Outcomes of interest were Disabilities of the Arm, Shoulder and Hand (DASH) score and range of motion. The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.
    RESULTS: Three randomized controlled trial studies were enrolled in this study, including 195 cases. We did not find any significant differences between the two groups in terms of DASH score, flexion range of motion, and external rotation range of motion. There was a significant difference between the two groups for abduction range of motion.
    CONCLUSION: Digital home-based rehab seems to be a strong alternative to traditional methods, offering similar results for people recovering from rotator cuff surgery. This approach might also make rehab more accessible and engaging for patients. That said, further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.
    Keywords:  Arthroscopic rotator cuff repair; Digital therapeutic; Home-based rehabilitation; Shoulder rehabilitation
    DOI:  https://doi.org/10.12998/wjcc.v13.i32.109464
  35. Orthop J Sports Med. 2025 Nov;13(11): 23259671251387342
    The Use of Dual-Energy X-ray Absorptiometry (DEXA) in Evaluating Recovery After Musculoskeletal Injuries in Athletes: A Scoping Review.
    Robert DiCesare, Umair Tahir, Atefeh Noori, Norah F Matthies, Jaskarndip Chahal, Ryan A Paul, Andrea H W Chan.
       Background: Dual-energy x-ray absorptiometry (DEXA) is a widely used imaging modality in sports medicine and orthopaedics due to its accuracy in assessing bone mineral density (BMD) and body composition. Tracking these parameters provides valuable insights into the recovery process after musculoskeletal injuries, which are prevalent among athletes.
    Purpose: To evaluate how DEXA imaging has been used to guide rehabilitation in both recreational and competitive athletes by monitoring changes in BMD and body composition after musculoskeletal injuries.
    Study Design: Scoping review; Level of evidence, 4.
    Methods: A comprehensive literature search was conducted in Ovid MEDLINE, EMBASE, Cochrane Central, and SportDISCUS databases (2000-2024). Studies were included if they used DEXA to measure BMD or body composition changes in athletes after musculoskeletal injuries. Titles, abstracts, and full texts were screened independently by 2 reviewers, with discrepancies resolved through discussion. Data were synthesized qualitatively, and major trends were reported and identified.
    Results: Of 1132 unique records, 12 studies met inclusion criteria, involving 319 athletes (34% female) with injuries such as anterior cruciate ligament (ACL) tears, lumbar stress fractures, femoroacetabular impingement, and Achilles tendon ruptures. Athletes represented a range of sports, including soccer, basketball, cricket, and triathlon, at both competitive and recreational levels. DEXA identified significant BMD declines after injury, particularly in the affected limb. For instance, up to a 7% BMD reduction was observed in surgical limbs after ACL reconstruction, persisting for up to 2 years in some cases. Rehabilitation strategies incorporating blood flow restriction therapy or combined running and isometric exercises better preserved lean mass and BMD compared with conventional programs focused solely on closed and open kinetic chain exercises.
    Conclusion: The review demonstrated that DEXA imaging is a promising tool in orthopaedic sports medicine for assessing injury-related changes in BMD and body composition. It provides detailed insights into recovery processes and aids in tailoring rehabilitation strategies and return-to-sport decisions. Some studies incorporated advanced rehabilitation methods such as blood flow restriction therapy, which appeared to accelerate recovery as measured by DEXA outcomes. Future studies should explore integrating DEXA findings into athlete-specific rehabilitation protocols with validated thresholds for return to play.
    Keywords:  DEXA; body composition; dual-energy x-ray absorptiometry; rehabilitation; return-to-play
    DOI:  https://doi.org/10.1177/23259671251387342
  36. BMJ. 2025 Nov 20. 391 r2364
    A step forward for knee osteoarthritis pain . . . and other research.
    Tom Nolan.
      
    DOI:  https://doi.org/10.1136/bmj.r2364
  37. PLoS One. 2025 ;20(11): e0336968
    Skeletal muscle index, grip strength, and physical performance as predictors of severe chemotherapy toxicity among older adults with malignancy.
    Efthymios Papadopoulos, Dmitry Rozenberg, Andy Kin On Wong, Sharon Hiu Ching Law, Sarah Costa, Angela M Cheung, Shabbir M H Alibhai.
       BACKGROUND: Skeletal muscle index (SMI), grip strength, and physical performance have been shown to predict clinically relevant outcomes in geriatric oncology. However, their predictive ability for chemotherapy toxicity is poorly understood. We examined whether SMI, grip strength, or physical performance are independently associated with severe toxicity among older adults receiving chemotherapy.
    METHODS: Older adults (≥65y) who had received chemotherapy at an academic cancer center between June 2015 and June 2022 were included in the analysis. SMI prior to chemotherapy was determined via computed tomography (CT), using the entire cross-sectional area of the muscle (cm2) at the third lumbar vertebra (L3) divided by the square of patient height in meters. Grip strength and lower extremity physical performance were measured prior to chemotherapy. Multivariable logistic regression was used to examine the independent associations between SMI, low grip strength, and low physical performance with severe (grade≥3) chemotherapy toxicity.
    RESULTS: Of the 115 older adults in the study, 71.3% were males. The most common disease site was genitourinary (53.9%) and most participants received chemotherapy with palliative intent (67.8%). A total of 69 (60.0%) participants experienced at least one grade ≥3 toxicity during the study. In multivariable analyses, low grip strength per the Sarcopenia Definitions and Outcomes Consortium (SDOC) definition was significantly associated with grade ≥3 toxicity (adjusted odds ratio (OR): 2.77, 95%CI: 1.03-7.45, p = 0.044). SMI either as a continuous (OR: 1.03, 95%CI: 0.97-1.09, p = 0.40) or categorical variable (OR: 1.17, 95%CI: 0.47-2.89, p = 0.74) was not predictive of grade ≥3 toxicity. Similarly, low physical performance did not have significant associations with grade ≥3 toxicity (OR: 2.06, 95%CI: 0.86-4.95, p = 0.11).
    CONCLUSION: Low grip strength may predict grade ≥3 toxicity among older adults receiving chemotherapy. Integrating grip strength into geriatric assessment may help clinicians identify older adults who might be at greater risk for severe chemotherapy toxicity.
    DOI:  https://doi.org/10.1371/journal.pone.0336968
  38. Gerontologist. 2025 Nov 21. pii: gnaf258. [Epub ahead of print]
    Diagnostic Accuracy of the SARC-CalF in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.
    Eun-Jung Kim, Soomin Hong, Da-Young Kim, Youn-Jung Son.
       BACKGROUND AND OBJECTIVES: The Sarcopenia and Calf Circumference (SARC-CalF) tool has been proposed to enhance the detection of sarcopenia. A comprehensive systematic review evaluating the diagnostic performance of the SARC-CalF could support its broader adoption as a valid screening instrument. Thus, this study aimed to assess the diagnostic accuracy of the SARC-CalF in detecting sarcopenia risk among older adults.
    RESEARCH DESIGN AND METHODS: A systemic review was conducted in six electronic databases and Google Scholar. The values of sensitivity, specificity, and area under the curve were estimated simultaneously using a bivariate model. Evaluation of the quality of individual studies included in this review was conducted with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
    RESULTS: Our systematic review included 18 studies, with 10,367 older adults. The pooled sensitivity and specificity of the SARC-CalF were 53.3% (95% confidence interval [CI], 0.46-0.60) and 87.3% (95% CI, 0.84-0.90), respectively. The pooled diagnostic odds ratio was 7.34 (95% CI, 5.87-9.19), and the area under the curve was 0.78 (95% CI, 0.73-0.81), indicating moderate diagnostic accuracy. Subgroup analyses revealed variations based on reference standards and calf circumference cut-off values.
    DISCUSSION AND IMPLICATIONS: This study highlights the SARC-CalF as a practical, cost-effective screening scale for sarcopenia of older people in community settings. Further research is required to establish optimal calf circumference cut-off values and validate its utility in various clinical environments. Combining the SARC-CalF scale with other functional measures may be useful and optimal tools for sarcopenia among older adults.
    Keywords:  Aging; Diagnostic Techniques and Procedures; Sarcopenia
    DOI:  https://doi.org/10.1093/geront/gnaf258
  39. BMJ Support Palliat Care. 2025 Nov 20. pii: spcare-2025-005761. [Epub ahead of print]
    Physical function and rehabilitation in patients with brain tumours: narrative review.
    Masahiko Kusaba, Takuro Sakurai, Takuya Fukushima.
      Patients with brain tumours experience a variety of symptoms and side effects due to treatment, which can seriously affect their physical function and activities of daily living. These patients also face a greater physical burden than that experienced by patients with other cancers, and rehabilitation interventions are important. However, thus far, there have been no sufficient investigations of how rehabilitation interventions contribute to improving patients' physical function, activities of daily living and prognosis. Therefore, a narrative review was conducted to explore physical function and its influence on the prognosis of patients with brain tumours, as well as to investigate the effects of rehabilitation interventions in these patients. Patients with brain tumours experience a decline in physical function and physical activity, which are related to prognosis, over a long period of time. The effects of rehabilitation interventions for patients with brain tumours have been reported in randomised clinical trials and before-and-after studies. Patients with brain tumours experience long-term declines in physical function and activity; therefore, long-term rehabilitation interventions are important for these patients. Furthermore, although the effectiveness of these interventions in randomised clinical trials has been reported, most research is limited to patients with gliomas, and future investigation is required.
    Keywords:  Brain; Prognosis; Rehabilitation
    DOI:  https://doi.org/10.1136/spcare-2025-005761
  40. Foot Ankle Orthop. 2025 Oct;10(4): 24730114251386735
    The Benefit of Repairing the Deltoid Ligament in Unstable Ankle Fractures: Patient-Reported Functional Outcome and Radiological Stability Measurements; a Clinical Trial Protocol.
    Esten Konstad Haanæs, Frede Jon Frihagen, Greger Lønne, Aksel Paulsen, Jostein Skorpa Nilsen, Martin Greger Gregersen, Marius Molund.
       Background: Suturing the deep posterior deltoid ligament in unstable ankle fractures is novel to established treatment. Some cadaveric and clinical trials support that adding deltoid ligament repair to plating of the lateral fracture will improve stability restoration.
    Objectives: We will investigate the effects of deep deltoid ligament repair on patient-reported function, radiologic stability parameters, and the incidence of ankle osteoarthritis and the possible side effects from this additional procedure. The medial ankle injury patterns found will be described.
    Study design: A randomised controlled nonblinded multicentre trial.
    Methods: A total of 120 patients with Lauge Hansen SER 4B ankle fractures will be randomised (1:1 ratio) to conventional plating of the lateral malleolus only or additional suture of the deep deltoid ligament. The primary end point was patient-reported function measured in Olerud-Molander Ankle Score (OMAS) at 1 and 2 years. The secondary end points included Self-Reported Foot and Ankle Score (SEFAS), Ankle Fracture Outcome of Rehabilitation Measure (A-FORM), VAS pain, and EuroQol-5D-5L scores; rates of treatment-related adverse events, reoperations, and incidence of posttraumatic arthritis; and comparison of side-to-side differences in tibiotalar medial clear space from bilateral weightbearing ankle radiographs and gravity stress on group level.
    Keywords:  Outcome studies; ankle fractures; deltoid ligament; posttraumatic arthritis; randomised controlled trial; research protocol; sports; trauma; weightbearing radiographs
    DOI:  https://doi.org/10.1177/24730114251386735
  41. J Occup Rehabil. 2025 Nov 21.
    Reliability of a Spinal Cord Injury-Specific Extension of the Work Rehabilitation Questionnaire (WORQ-SCI).
    Anouk L C Veenhuysen, Renée van Dinter, Ellen H Roels, Michiel F Reneman.
       PURPOSE: The Work Rehabilitation Questionnaire (WORQ), an International Classification of Functioning, Disability, and Health (ICF)-based questionnaire, was developed to assess work-related functioning of persons with a range of health conditions. The WORQ has shown limitations in its applicability to persons with spinal cord injury (SCI). The purpose of this study was to investigate internal consistency, test-retest reliability, and agreement of the WORQ-SCI, a newly developed extension to the WORQ for use in persons with SCI.
    METHODS: A cross-sectional and test-retest reliability study was performed in eight Dutch rehabilitation centers specialized in SCI rehabilitation. Persons with SCI with first inpatient rehabilitation between 2015 and 2022 and work participation as a goal, completed the WORQ-SCI twice. Internal consistency (Cronbach's alpha), test-retest reliability (intra-class correlation, ICC), and agreement between measurement points (Bland-Altman plot) were analyzed.
    RESULTS: A total of 175 participants completed the WORQ-SCI questionnaire at baseline (T1), of whom 59 completed the WORQ-SCI questionnaire a second time, with 52 reporting no changes in health or work status. Internal consistency for the WORQ-SCI was: 0.93 (23 items, N = 175). Test-retest reliability for the subgroup with no changes was ICC = 0.91 (95%-CI 0.84-0.95, N = 52). Bland-Altman plot for agreement between WORQ-SCI T1 and T2 (retest) suggested no systematic bias, with a mean difference of - 1.5 (SD 15.2) and 95% limits of agreement: ± 29.7.
    CONCLUSION: The WORQ-SCI showed good internal consistency and test-retest reliability. The test-retest results provide insight into measurement error, emphasizing the robustness of the instrument over time. The WORQ-SCI could be used reliably to assess work-related functioning in persons with SCI, although limits of agreement suggest caution when interpreting change at the level of the individual.
    Keywords:  Employment; Questionnaire; Test–retest reliability; Vocational rehabilitation
    DOI:  https://doi.org/10.1007/s10926-025-10341-z
  42. Ned Tijdschr Geneeskd. 2025 Oct 14. pii: D8434. [Epub ahead of print]169
    [A mallet finger, and then?]
    Patrick Krastman, Mark de Vries, Jos Runhaar, Gerald Kraan.
      Mallet finger (hammer finger) predominantly results from trauma causing injury to the terminal extensor tendon at the level of the distal phalanx. It remains unclear whether radiography provides additional value in all patients with a mallet finger, which warrants further investigation. We recommend obtaining radiographs in primary care only for mallet fingers resulting from high-energy trauma. The purpose of radiography should not be to distinguish between tendinous and bony mallet fingers, but rather to assess whether surgical intervention may be indicated.
  43. Arch Gerontol Geriatr. 2025 Nov 02. pii: S0167-4943(25)00329-2. [Epub ahead of print]141 106072
    Vitality in older adults: A state-of-the-science review.
    Ilana I Logvinov, Victoria Loerzel.
      Vitality is increasingly recognized as a multidimensional biophysiological state influenced by physical, emotional, cognitive, social, and subjective factors. However, there is no consensus on its definition, and existing nursing theories and related constructs, such as quality of life and functional status, fail to fully capture its complexity. This state-of-the-science review synthesized findings from 35 research studies to examine how vitality is defined, assessed, and influenced in older adults. The review identified significant variability in measurement tools, with most instruments assessing only one or two domains of vitality. Key findings indicate that low-intensity physical activities, psychological well-being, social engagement, and good physical health enhance vitality, while chronic illness, isolation, and mental health challenges diminish it. Notable gaps include the lack of culturally inclusive research and inadequate integration of older adults' perspectives. These findings underscore the need for a unified conceptual framework and comprehensive assessment tools that reflect the perceptions and experiences of older adults and support person-centered interventions to promote healthy aging.
    Keywords:  Aging; Healthy aging; Psychological well-being; Vitality
    DOI:  https://doi.org/10.1016/j.archger.2025.106072
  44. AIDS Care. 2025 Nov 17. 1-17
    The moderating role of social support in the association between depressive symptoms and functional disability among older adults with HIV.
    Norman Chong, Win Min Han, Jonathan King, Zachary Collier, Syaza Hisham, Jessica Loh Seh Min, John Son Lim, Sazali Basri, Tan Xin Woen, Chong Meng Li, Reena Rajasuriar, Pui Li Wong.
      The co-occurrence of depression and functional disability is prevalent among older people with HIV (PWH). Research suggests social support could enhance resilience and buffer the impact of depression on health outcomes in PWH. This study examined whether social support moderates the relationship between depressive symptoms and functional disability in older PWH. From September 2020 to August 2022, we recruited 213 participants from Universiti Malaya Medical Center, Malaysia. We received participants' socio-demographic and clinical information, including measures evaluating depressive symptoms, social support, and functional disability. Our structural equation models suggest that social support moderated the association between depressive symptoms and functional disability [B(SE) = 1.93 (0.18), p = <0.001]. Moderating effects varied by domain; significantly in communication and understanding [B(SE) = -0.03 (0.01), p = 0.026], getting around [B(SE) = -0.03 (0.01), p = 0.025), life activities [B(SE) = -0.03 (0.01), p = 0.007) and participation in society [B(SE) = -0.04 (0.01), p = 0.002). At low social support, the depressive symptoms-functional disability associations strengthened across all domains. At higher social support levels, this association weakened in communication and understanding, getting along with people, and participation in society. Strengthening social support may improve mental health and functioning in older PWH.
    Keywords:  Good health and well-being; depression; functional status; older adults; social support
    DOI:  https://doi.org/10.1080/09540121.2025.2586249
  45. J Hand Ther. 2025 Nov 17. pii: S0894-1130(25)00180-2. [Epub ahead of print]
    External supports in carpal tunnel syndrome: Which works best? A double-blind randomized controlled trial.
    Sefa Dongaz, Asalet Aybüke Güp, Özge İpek Dongaz, Hüseyin Aydoğmuş, Emrah Emre Deveci, Kılıçhan Bayar.
       BACKGROUND: The effectiveness of conservative treatments in carpal tunnel syndrome is controversial.
    PURPOSE: Comparing the effects of rigid tape, kinesio tape, and splint on pain intensity, symptom severity, functional status, and grip strength in the patients with carpal tunnel syndrome.
    STUDY DESIGN: This was a prospective, double-blinded, randomized-controlled trial.
    METHODS: A total of 40 patients who were diagnosed with mild/moderate carpal tunnel syndrome were divided into four intervention groups: rigid taping group, kinesio taping group, splinting group, control group. The participants were assessed with the Visual Analog Scale, Boston Carpal Tunnel Questionnaire, hand dynamometer, and pinch meter at baseline and 2 weeks later with tapes or splint removed.
    RESULTS: All groups showed significant improvements in pain intensity (p = 0.005, ES = 0.88), symptom severity (p = 0.005, ES = 0.88), functional status (p = 0.005, ES = ranged between 0.79 and 0.88), grip strength (p = 0.005, ES = 0.88), and pinch strength (p = 0.004-0.006, ES ranged between 0.87 and 0.92). Between-group comparisons revealed greater pain reduction in the control group compared to the rigid taping group (p = 0.001, ES = 0.24). The rigid taping group showed the highest increase in grip strength, with both rigid and kinesio taping groups showing superiority over the control group (p < 0.001, ES = 0.37). Lateral and three-point pinch strengths improved significantly in the rigid taping group compared with the control group (p = 0.007, ES = 0.27; p = 0.003, ES = 0.30, respectively).
    CONCLUSIONS: The rigid taping group demonstrated the most consistent benefits, particularly in grip strength, while the kinesio taping group improved pain intensity and grip strength. However, external supports did not show superiority in pain relief, as the control group had better outcomes. Symptom severity and functional status improvements were similar among groups.
    Keywords:  Conservative treatment; Median nerve; Orthosis; Rehabilitation
    DOI:  https://doi.org/10.1016/j.jht.2025.09.006
  46. Magn Reson Imaging Clin N Am. 2026 Feb;pii: S1064-9689(25)00077-7. [Epub ahead of print]34(1): 143-157
    MR Imaging of Inflammatory, Crystalline-induced, and Infectious Arthritides of the Hand and Wrist.
    Huw Walters, Mark Kong, James Teh.
      This review highlights the pivotal role of MR imaging in the evaluation of inflammatory, crystalline-induced, and infectious arthritides affecting the hand and wrist. MR imaging offers superior sensitivity over other imaging modalities for detecting early pathologic changes, including synovitis, osteitis, bone erosion, and tenosynovitis. It assists in differentiating between the different types of arthritides by identifying characteristic imaging patterns. Early use of MR imaging enables timely, targeted intervention, minimizing the risk of irreversible joint damage. Familiarity with MR imaging findings should improve diagnostic accuracy and facilitate optimal clinical management, improving patient outcomes in complex cases of hand and wrist arthropathy.
    Keywords:  CPPD; Crystals; Gout; Hand arthritis; Hydroxyapatite; Infection; Inflammatory arthritis
    DOI:  https://doi.org/10.1016/j.mric.2025.08.009
  47. Nursing. 2025 Dec 01. 55(12): 47-50
    Suzetrigine for pain relief: Key considerations for nurses.
    Hanna Reker, Dan Sheridan.
       ABSTRACT: Suzetrigine (JOURNAVX) is a novel oral medication approved in January 2025 for the treatment of moderate-to-severe acute pain in adults. It works by selectively inhibiting NaV1.8 voltage-gated sodium channels, which play a key role in pain transmission through peripheral sensory neurons. This targeted mechanism offers potential advantages over current pain management options. Clinical trials have demonstrated efficacy in reducing pain intensity following surgical procedures, making it a promising alternative to opioids. For nurses, suzetrigine represents an important addition to multimodal pain management strategies. Nurses play a key role in educating patients about its use, monitoring for adverse effects, and ensuring adherence to proper dosing guidelines. As suzetrigine becomes more widely available, health care professionals need to understand its benefits, risks, and proper use. This article provides an overview of its mechanism of action, adverse effects, dosing guidelines, cost considerations, and potential role in pain management.
    Keywords:  JOURNAVX; acute pain; pain management; suzetrigine
    DOI:  https://doi.org/10.1097/NSG.0000000000000266
  48. Cureus. 2025 Oct;17(10): e94871
    Effectiveness of Ultrasound-Guided Hydrodissection for Atypical Anterior Cutaneous Nerve Entrapment Syndrome Presenting as Lower Back Pain Due to Retrograde Neuropathic Pain.
    Tsuyoshi Yoshinaga, Tetsuya Koga, Hiroaki Koga.
      This case report describes an atypical presentation of anterior cutaneous nerve entrapment syndrome (ACNES). A male patient with refractory lower back pain without typical abdominal symptoms exhibited localized tenderness in the abdominal wall. The patient's back pain was reproduced by compression of the tender point. Color Doppler ultrasonography revealed a pulsating perforating artery directly beneath the tender point. Ultrasound-guided hydrodissection was performed at the site, resulting in resolution of Carnett's sign and significant improvement in both pain and motor function. This case suggests that retrograde neuropathic pain (RNP) may arise from entrapment of the anterior cutaneous nerve, manifesting as referred pain in the lower back. Even in the absence of abdominal symptoms, a positive Carnett's sign should prompt the consideration of abdominal wall nerve entrapment and associated RNP in the differential diagnosis of refractory low back pain.
    Keywords:  abdominal wall peripheral nerve; anterior cutaneous nerve entrapment syndrome; carnett’s sign; hydrodissection; low back pain; rectus abdominis; retrograde neuropathic pain
    DOI:  https://doi.org/10.7759/cureus.94871
  49. Ir J Med Sci. 2025 Nov 21.
    Ultrasound measurements of pelvic floor and diaphragm muscles in chronic obstructive pulmonary disease patients with urinary incontinence.
    Mehtap Balaban, Elif Sena Dusgun, Hifziye Pervin Nur, Nida Lalecan, Umran Ozden Sertcelik, Seyda Toprak Celenay.
       BACKGROUND: The precise manner in which morphological properties of pelvic floor muscles (PFMs) and diaphragm muscle in Chronic Obstructive Pulmonary Disease (COPD) patients with Urinary Incontinence (UI) are affected remains unclear.
    AIM: This study aimed to compare the ultrasound measurements of PFMs and diaphragm muscle in COPD patients with and without UI.
    METHODS: Thirty COPD patients with UI [UI group, age: 61.00 (42.00-70.00) years, body mass index: 27.86 (20.20-54.69) kg/m2] and thirty COPD patients without UI [N-UI group, age: 64.00 (47.00-70.00) years, body mass index: 27.11 (20.30-35.94) kg/m2] were included. The PFMs contaction assessment and diaphragm muscle morphological properties were evaluated using the Logiq S7/Expert ultrasound device. The percentage of change in thickness of diaphragm muscle, known as the diaphragm thickening fraction index (DTFI), was also calculated.
    RESULTS: It was found that the PFMs contraction (p = 0.018) and DTFI (p = 0.016) values were significantly lower in the UI group compared to the N-UI group. No significant differences were observed in the diaphragm thickness score during the inspiration (p = 0.973) and expiration (p = 0.233) between the groups.
    CONCLUSIONS: Patients with COPD and UI exhibited diminished the PFMs contaction severity and DTFI compared to those with COPD but no UI. It should be considered that UI comorbidity in COPD may negatively affect PFMs contaction severity and diaphragm muscle morphological properties.
    Keywords:  Chronic obstructive pulmonary disease; Diaphragm; Pelvic floor muscle; Urinary incontinence
    DOI:  https://doi.org/10.1007/s11845-025-04180-3
  50. Clin Case Rep. 2025 Nov;13(11): e71486
    Early Multidisciplinary Rehabilitation Improves Swallowing and Speech Function in a Patient With Amyotrophic Lateral Sclerosis.
    Yue Hu, Yun Lu, Danmei Lan.
      Amyotrophic lateral sclerosis (ALS) is a chronic, progressive neurodegenerative disease for which there is a lack of effective treatment. This case report describes a 49-year-old male with ALS who presented with dysphagia, dysarthria, dyskinesia, sleep disorders, anxiety, and depression. Following 45 days of early multidisciplinary rehabilitation, the patient demonstrated significant improvement in swallowing and speech function, alleviation of non-motor symptoms, and maintenance of motor function. Notably, he retained the ability to consume soft foods at a two-year follow-up. This case highlights the vital role of early multidisciplinary rehabilitation in the comprehensive management of ALS.
    Keywords:  amyotrophic lateral sclerosis; dysarthria; dysphagia; multidisciplinary rehabilitation; video fluoroscopic swallowing study
    DOI:  https://doi.org/10.1002/ccr3.71486
  51. Am Fam Physician. 2025 Nov;112(5): 526-536
    Acute Low Back Pain: Diagnosis and Management.
    J Scott Earwood, Nancy A Doles, Raedeen S Russell.
      Acute low back pain falls into two causal categories: specific and nonspecific. Specific causes can be intrinsic to the spine, from systemic disease, or referred pain from other organs. However, acute low back pain typically is nonspecific. Aside from recent trauma, most patients with acute low back pain do not require imaging unless history reveals red flag findings. Those with red flag findings require immediate evaluation and treatment, including imaging and specialty referral or consultation. For patients with nonspecific low back pain, first-line treatment involves maintaining activity, use of heat therapy, and other nonpharmacologic treatments (eg, dry needling, transcutaneous electrical nerve stimulation, acupuncture). Pharmacotherapy options include nonsteroidal anti-inflammatory drugs, trigger point injections, and possibly systemic corticosteroids for radicular low back pain. Drugs that should not routinely be used include benzodiazepines, gabapentin, pregabalin, opioids, and acetaminophen. Physicians should address comorbid conditions that increase the risk of acute low back pain becoming chronic. Patients with pain persisting beyond 8 weeks despite appropriate therapy should be considered for imaging and laboratory evaluation to identify specific causes.
  52. Thorax. 2025 Nov 20. pii: thorax-2025-224148. [Epub ahead of print]
    Smartphones: a useful option for the pulmonary rehab toolkit?
    Christine F McDonald.
      
    Keywords:  Exercise; Pulmonary Rehabilitation
    DOI:  https://doi.org/10.1136/thorax-2025-224148
  53. Exp Physiol. 2025 Nov 20.
    When rehabilitation is not enough, how targeting metabolism can overcome the limited plasticity of skeletal muscle after traumatic injury.
    Sarah M Greising, Jarrod A Call.
      There is a category of large-scale neuromusculoskeletal injuries that result in long-term functional disabilities, and one such injury is volumetric muscle loss (VML) injury. In addition to the clinical outcomes related to long-term dysfunction, co-morbidities and reduced mobility and physical activity, this review addresses several underexplored physiological limitations of VML at both the whole-body level and within the injured muscle. Our objectives with this review are to provide: (1) critical understanding of the pathophysiological limitations related to VML injury; (2) evidence for emerging treatment options that target the VML-induced metabolic dysregulation; and (3) early functional data on metabolic treatments as a component of regenerative rehabilitation. We highlight new attempts to intervene in this unique pathophysiology, in addition to current unanswered questions for the field.
    Keywords:  neuromusculoskeletal injury; rehabilitation; skeletal muscle injury; β2‐adrenergic receptor agonist
    DOI:  https://doi.org/10.1113/EP093074
  54. J Yeungnam Med Sci. 2025 ;42 77
    A 68-year-old man presenting with tingling pain in the medial aspect of the right forearm and hand.
    Jiwoo Shin, Min Cheol Chang.
      
    DOI:  https://doi.org/10.12701/jyms.2025.42.77
  55. Expert Rev Clin Pharmacol. 2025 Nov 21.
    Botulinum toxin in focus: evolution, pharmacology, and it's expanding clinical impact.
    Hira Bakhtiar Khan, Pragnitha Chitteti, Mehwash Nadeem.
       INTRODUCTION: Botulinum toxin (BoNT), recognized for its distinctive pharmacological properties, has become a highly effective therapeutic agent with a wide range of clinical applications. Among its serotypes, botulinum toxin A (BoNT A) is the most extensively used, with established roles in conditions such as limb spasticity, overactive bladder and neuropathic pain. Despite its broad utility, careful consideration is required to minimize adverse outcomes, underscoring the importance of multidisciplinary collaboration to ensure patient safety.
    AREAS COVERED: This expert review is developed through the evaluation of experimental studies and systematic reviews, which were integrated to generate a practice-oriented expert perspective. Although we have provided an overview of all BoNTs, our primary focus has been BoNT A. We have particularly focused on key considerations for the use of BoNT, including immunogenicity and it's utility in special populations such as pregnant patients, individuals with pulmonary compromise, older adults, and children.
    EXPERT OPINION: Despite the practical challenges of prescribing BoNT A, it is generally regarded as an effective therapy. Its use requires careful risk vs benefit evaluation and strict adherence to guidelines to reduce adverse outcomes. Non-response and immunogenicity remain important barriers, although ongoing research and engineered toxins point toward a future with more precision-based applications.
    Keywords:  Botulinum toxin (BoNT-A); Chemodenervation; Strabismus; detrusor overactivity; snare protein
    DOI:  https://doi.org/10.1080/17512433.2025.2594489
  56. JBJS Case Connect. 2025 Oct 01. 15(4):
    Treatment of Persistent Pectoralis Minor Hyperactivity and Compensatory Trapezius Hypertrophy Using Arthroscopic Release: A Case Report.
    Tobias Gruber, Verena Edler, Markus Scheibel.
       CASE: We report on a 20-year-old male patient with shoulder pain and severely altered scapulothoracic kinematics due to pectoralis minor muscle hyperactivity and compensatory trapezius hypertrophy. After failed conservative treatment, an isolated arthroscopic release of the pectoralis minor tendon was performed, resulting in substantial pain relief and improved range of motion in the 6-week follow-up and sustained benefits 6 years later.
    CONCLUSION: Persistent pectoralis minor hyperactivity may be the cause of altered scapulothoracic movement, resulting in pronounced hypertrophy of the trapezius muscle. It can be safely treated with an isolated arthroscopic detachment of the pectoralis minor tendon.
    Keywords:  pectoralis minor STAM; pectoralis minor release
    DOI:  https://doi.org/e25.00391
  57. Clin Geriatr Med. 2026 Feb;pii: S0749-0690(25)00069-2. [Epub ahead of print]42(1): 175-189
    Pain Management in the Older Adult with Opioid Use Disorder.
    Rebecca Ellis, Rebecca Rodin.
      Increasing prevalence of addiction poses challenges to pain management in older adults, a population already facing high rates of chronic pain and medical and psychosocial complexity. Little guidance exists on the management of pain in older adults with opioid misuse and opioid use disorder, in whom heightened pain sensitivity, comorbid mental health disorders, and potential harms from prescribed analgesic medications complicate treatment. This article will explore diagnostic and treatment strategies for older adults with opioid misuse and opioid use disorder, with special attention to the use of buprenorphine and methadone for comorbid pain and addiction.
    Keywords:  Buprenorphine; Geriatrics; Opioid misuse; Opioid use disorder; Opioids; Pain; Substance use disorder
    DOI:  https://doi.org/10.1016/j.cger.2025.08.008
  58. Nat Commun. 2025 Nov 20.
    Targeting the ROS-ferroptosis-inflammation cycle with a nanozyme-functionalized hydrogel for intervertebral disc repair.
    Yanqiu Wang, Lu Tan, Yi Yang, Hongli Duan, Chao Liu, Jing Zhao, Yue Zhou, Changqing Li, Minghan Liu.
      Intervertebral disc degeneration is a major cause of low back pain and is driven by a vicious cycle of reactive oxygen species (ROS), ferroptosis, and inflammation, afflicting millions of people worldwide. Breaking this cycle represents a significant therapeutic challenge. Here, we develop a ROS-responsive hydrogel loading a resident nanozyme system composed of nucleus pulposus cell membrane-coated black phosphorus@cerium oxide to disrupt this degenerative cascade. Specifically, the nanozyme exhibits a self-sustaining cerium redox cycle due to the incorporation of black phosphorus nanosheets into cerium oxide, conferring durable antioxidant capacity for scavenging ROS. Furthermore, it suppresses the inflammatory cytokine IL6 by inhibiting HuR-mediated mRNA stabilization, thereby blocking the pro-inflammatory and pro-ferroptotic IL6/STAT3 axis. Together, this dual mechanism enables our nanozyme-functionalized hydrogel to break the ROS-ferroptosis-inflammation feedback loop, thus effectively promoting structural and functional disc repair.
    DOI:  https://doi.org/10.1038/s41467-025-66116-w
  59. Einstein (Sao Paulo). 2025 ;pii: S1679-45082025000100526. [Epub ahead of print]23 eRC1630
    Atraumatic sacral fracture in a postpartum patient in the late postoperative period following lumbar decompression for disc herniation.
    Edgar Santiago Valesin Filho, Mariano Tamura Vieira Gomes, Guilherme Pianowski Pajanoti, Ariel Filipe Wuerges de Aquino, Mario Lenza, Luciano Miller Reis Rodrigues.
      Stress fractures of the sacrum are extremely rare differential diagnoses for persistent low back pain in pregnant and postpartum women. The common occurrence of low back pain due to mechanical overload on the spine, coupled with challenges in obtaining imaging studies during this phase of a woman's life, often delays and compromises the accurate diagnosis of sacral fatigue fractures. We report the rare case of a postpartum patient who underwent surgery for lumbar disc herniation one year and one month earlier and was diagnosed with an atraumatic sacral fracture.
    DOI:  https://doi.org/10.31744/einstein_journal/2025RC1630
  60. Scand J Caring Sci. 2025 Dec;39(4): e70156
    Existential Well-Being and Suffering in the Context of Cardiac Rehabilitation: A Qualitative Interview Study.
    Birgit Rasmussen, Thomas Maribo, Bente Skovsby Toft.
       AIMS AND OBJECTIVES: This study explores how individuals with ischemic heart disease (IHD) experience well-being and suffering in the early post-discharge period and how these experiences influence their perspectives on cardiac rehabilitation (CR).
    METHODOLOGICAL DESIGN: A phenomenological-hermeneutic approach was applied. Semi-structured interviews explored participants' lived experiences. The COREQ guideline was followed.
    ETHICAL ISSUES AND APPROVAL: The study is registered in the Internal Directory of Research Projects in the Central Denmark Region (reg. no. 1-16-02-232-19). It adheres to ethical principles for qualitative research, and all participants gave verbal and written informed consent.
    METHODS: We conducted semi-structured interviews with 17 patients recently discharged following hospitalisation for IHD. Interviews were analysed using a five-step meaning condensation process, guided by existential theory on dwelling-mobility.
    RESULTS: The overarching theme 'The ambiguity of being mortal and living well' captures the paradox of existential 'homelessness' and possibilities for well-being. Three themes emerged: (1) Existential concerns and considering the severity of the disease-facing uncertainty and struggling to trust in the body; (2) Confidence in returning to a normal everyday life-regaining control through social support and familiar activities; (3) Existential possibilities and appreciation of life-a renewed outlook marked by gratitude and motivation for meaningful change. CR is perceived as a source of reassurance and support, but must feel personally relevant.
    CONCLUSION: Patients' existential experiences shortly after discharge influence their engagement with CR. A person-centred conversation about CR that integrates existential concerns can support well-being, foster confidence and enhance CR participation.
    Keywords:  cardiac rehabilitation; existential; homecoming; ischemic heart disease; lived experience; qualitative research; well‐being and suffering
    DOI:  https://doi.org/10.1111/scs.70156
  61. Zh Nevrol Psikhiatr Im S S Korsakova. 2025 ;125(11. Vyp. 2): 6-10
    [Musculoskeletal disorders in patients with Parkinson's disease].
    I G Smolentseva, T Abdullaeva, O S Levin.
      Parkinson's disease (PD) is a progressive neurodegenerative disorder that causes posture alterations with trunk anteflexion and the flexion of the hip and knee joints, leading to changes in the musculoskeletal system (MS). MS disorders in Parkinson's Disease (PD) are linked to two primary mechanisms: they can be a direct result of the motor symptoms of PD and may also serve as early indicators of the disease. On one hand, clinically significant manifestations such as camptocormia, Pisa syndrome, anterocollis, and hand dystonia can lead to postural alterations and deformities of the fingers as the disease progresses. On the other hand, patients with Parkinson's disease may also develop primary musculoskeletal disorders, including adhesive capsulitis and rotator cuff tendinopathy, which can result in partial tendon ruptures. Additionally, they are at risk for conditions like rheumatoid arthritis, osteoarthritis, osteoporosis, and pathological fractures. MS disorders are a significant disabling factor in PD patients, requiring an interdisciplinary approach. This approach involves neurologists, orthopedic traumatologists, and rehabilitation therapists to prevent disabling deformities, ensure early diagnosis, and provide optimal therapy. Therefore, it is essential to evaluate orthopedic symptoms in patients with Parkinson's disease and conduct multicenter studies to develop management strategies.
    Keywords:  Parkinson’s disease; musculoskeletal system; osteoarthritis; osteoporosis
    DOI:  https://doi.org/10.17116/jnevro20251251126
  62. Cureus. 2025 Oct;17(10): e94535
    Rehabilitation and Pain Management in Klippel-Feil Syndrome Associated With Caroli's Disease, Scoliosis, and Aphasia.
    Amine Achraf Majit, Araj Aymane, Ahmed Amine El Oumri.
      Klippel-Feil syndrome (KFS) is often underdiagnosed. Medical imaging studies suggest that its incidence may be higher than currently recognized. Although surgical treatment has been extensively studied, non-surgical approaches, such as physiotherapy, rehabilitation, and pain management, receive comparatively less attention. We report the case of an 18-year-old girl being treated for a malformation syndrome consisting of a rare condition, Caroli's disease with aphasia, who was referred for movement limitations associated with scoliosis and cervicobrachial neuralgia. The main objective of this article is to present a case of malformation syndrome associated with KFS, Caroli's disease, and scoliosis in an aphasic patient, as well as the difficulty of medical management, mainly rehabilitation and pain management outside of surgery.
    Keywords:  caroli’s disease; congenital spine deformity; kfs; klippel-feil syndrome; motor aphasia; pain management; scoliosis ; spine rehabilitation
    DOI:  https://doi.org/10.7759/cureus.94535
  63. BMJ Open. 2025 Nov 21. 15(11): e101474
    Corticosteroid injection combined with a shoulder rehabilitation system for chronic rotator cuff injuries: a protocol for a randomised controlled trial.
    Zifu He, Jing Xu.
       INTRODUCTION: The main clinical symptoms of patients with chronic rotator cuff injuries (CRCI) include pain and/or limitation of movement, which severely reduce the function of the shoulder joint. Local injection of corticosteroid with local anaesthetics can control the inflammatory response and effectively relieve patients' pain in the short term. In addition, rehabilitation exercises are considered an important tool for improving shoulder function. However, due to the presence of pain or substandard execution of movements, it is often difficult for patients to achieve the desired therapeutic effect. Although there are many options for digital rehabilitation, relatively few purely conservative treatments have been used for patients with CRCI. And even fewer studies have addressed how to improve exercise accuracy in such patients.
    METHODS AND ANALYSIS: This protocol comprises three phases. First, shoulder active motion data will be collected from patients with CRCI and analysed using K-means clustering to define distinct clinical rehabilitation stages based on movement patterns and biomechanical principles. The clinical stages will be validated using one-way analysis of variance (ANOVA) and cross-tabulation to evaluate interstage functional differences and clinical consistency. Second, a shoulder rehabilitation system with real-time feedback will be developed, and its usability evaluated through a pilot study incorporating the System Usability Scale, Simulator Sickness Questionnaire and semistructured interviews. Finally, a randomised controlled trial will be conducted. 60 participants will be randomly allocated to either G1 (corticosteroid injection+digital rehabilitation) or G2 (corticosteroid injection+traditional home rehabilitation). The primary outcome is the Constant-Murley Score. Secondary outcomes include range of motion, Numerical Rating Scales, University of California at Los Angeles Shoulder Score, movement accuracy and exercise attitude questionnaire. Between-group comparisons will use independent t-tests or Mann-Whitney U tests, and within-group changes will be analysed with repeated measures ANOVA or Friedman test, with post hoc Bonferroni-adjusted comparisons.
    ETHICS AND DISSEMINATION: The protocol was approved by the Medical Ethics Committee of Gongli Hospital, Pudong New Area, Shanghai (number: GLYY1s2024-031). All participants will provide informed consent prior to enrolment. The study findings will be disseminated through publication in a peer-reviewed journal or presentations at relevant national and international academic conferences.
    TRIAL REGISTRATION NUMBER: ChiCTR2500097903.
    Keywords:  Chronic Pain; Digital Technology; Musculoskeletal disorders; Pain management; REHABILITATION MEDICINE; Shoulder
    DOI:  https://doi.org/10.1136/bmjopen-2025-101474
  64. Cureus. 2025 Oct;17(10): e94982
    Does Suture Configuration Matter in Achilles Tendon Repairs?
    Nathan Benner, Hana Keller, Grant Branam, Scott Telfer, Kenneth Chin.
       BACKGROUND: The human Achilles tendon is functionally important for dynamic activities and is a common site of tendon rupture, resulting in pain, weakness, and removal from sport. While treatment options vary and the opinions regarding optimal management are not uniform, percutaneous repair through commercially available guides is one option that has been used in the United States.
    HYPOTHESIS/PURPOSE: The purpose of this study was to test the mechanical properties of four common suture configurations in the repair of Achilles tendon ruptures.
    STUDY DESIGN: This biomechanical study utilized porcine toe flexor tendons as an analogue for the human Achilles tendon.
    METHODS: Simulated rupture was performed, and tendons were repaired using a percutaneous guide. The technique was uniform with predetermined allotment into one of four groups based on suture configuration (single or double locked) and type (round or flat), with a total of 10 specimens in each group. Specimens then underwent a static creep test, a dynamic load creep test, and finally a load-to-failure test. An analysis of variance was performed to test for differences between the variables, followed by pairwise comparisons using independent t-tests to assess inter-group differences if significant effects were found, adjusted for multiple comparisons.
    RESULTS: No significant differences were seen between conditions for the creep tests. The suture configuration used was determined to have a significant effect on the maximum load to failure of the constructs (p = 0.018) and maximum stress in the construct during the load-to-failure test (p = 0.019). Double tape had a significantly greater load to failure than the single round and single conditions and reached greater stresses before failure (respectively). No significant differences were found between the double tape and double round techniques, nor between the double round and either of the single techniques for any of the load-to-failure variables.
    CONCLUSION: The results of this study, using a porcine model to simulate a minimally invasive technique for Achilles tendon repairs, suggest that the use of a double-locked tape suture configuration leads to a stronger overall construct.
    Keywords:  achilles tendon; achilles tendon repair; sports medicine of the foot and ankle; sports problems; tendon biomechanics
    DOI:  https://doi.org/10.7759/cureus.94982
  65. Int J Older People Nurs. 2025 Nov;20(6): e70053
    Promoting the Physical Activity of Older Adults in Institutional Long-Term Care: A Mixed-Method Case Study.
    Noora Narsakka, Riitta Suhonen, Johanna Finskas, Minna Stolt.
       INTRODUCTION: Older adults living in institutional long-term care benefit from engaging in physical activity adapted to their functioning. Despite evidence of solutions to promote physical activity, recurrent evidence shows that older adults spend their time sedentary. More in-depth knowledge is needed about the current state of promoting the physical activity of older adults in institutional long-term care for improved practice in the future. We aimed to increase the understanding of older adults' physical activity promotion in institutional long-term care by investigating how, how much and by whom older adults' physical activity is promoted.
    METHODS: This is a concurrent mixed-method case study using data from a larger research project performed in an institutional, full-time, long-term care unit in Finland. Thirteen older adults and 12 staff members participated. Data were collected through focus groups, interviews, patient record transcripts and actigraphy between May and October 2023. A mixed-method analysis was conducted using the framework 'Following a thread'. Separate analyses of datasets were conducted, including analyses of qualitative and quantitative data using reflexive thematic analysis and descriptive statistics. Analytical questions were identified and further explored using all datasets to synthesise findings.
    RESULTS: Four themes were developed: (1) lack of physical activity, (2) plans for physical activity promotion, (3) nurses' role in activity promotion and (4) accessibility and freedom of movement.
    CONCLUSION: Current activity promotion is not sufficient for older adults to achieve the benefits of physical activity for their health and functioning. Improvements are needed in delivering sufficient physical activities. Nurses' role in activity promotion should be developed to include care-integrated activities, spontaneous and organised activities and instrumental activities of daily living for older adults. Interprofessional work to promote activity could be used more. Stimulating elements in the physical environment and increasing freedom of movement could produce improvements in physical activity. Improvements in activity promotion can potentially be achieved with simple strategies and low additional costs.
    Keywords:  environment; health promotion; long‐term care; nursing care; nursing homes; older adults; physical activity
    DOI:  https://doi.org/10.1111/opn.70053
  66. Cureus. 2025 Oct;17(10): e94652
    Pregnancy-Related Carpal Tunnel Syndrome.
    Filip Georgiew, Jakub Florek, Adam Bębenek, Pawel Florek, Grzegorz Sobanski.
      Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder during pregnancy. Symptoms are often mild, and only a minority of affected women seek medical attention. Although symptoms typically resolve after delivery, they may persist through breastfeeding or beyond in some cases. Given this course, conservative management is recommended. This article aims to review pregnancy-related carpal tunnel syndrome (PRCTS), with particular emphasis on indications for available conservative treatment modalities. In this narrative review, a computer-based search was conducted on PubMed, Scopus, The Cochrane Library, and Web of Science databases for the relevant literature. Studies published between 2005 and 2025 were included. The search strategy included a combination of the following search terms: carpal tunnel syndrome, pregnancy, conservative treatment, hand, and pain. No specific limitations were imposed on study selection criteria. In PRCTS, the primary treatment goal is to reduce intracarpal pressure. First-line measures include wrist immobilization, pharmacologic and anti-edema therapies, and techniques to mobilize or stretch the transverse carpal ligament. Initiation of pharmacologic treatment during pregnancy should be carefully weighed because of potential maternal and fetal adverse effects. Commonly used physiotherapy procedures in the treatment of CTS, including high-intensity laser therapy and extracorporeal shock wave therapy, are contraindicated during pregnancy. Therapeutic ultrasound and phonophoresis are generally avoided or used only with caution. Surgical intervention is infrequently required and is reserved for cases with severe symptoms and functional impairment, failure of nonsurgical measures, and electrophysiological evidence of marked nerve compression.
    Keywords:  carpal tunnel syndrome; conservative treatment; hand; pain; pregnancy
    DOI:  https://doi.org/10.7759/cureus.94652
  67. Monaldi Arch Chest Dis. 2025 Nov 11.
    Post-intensive care unit syndrome: the silent legacy of intensive care unit survival. Narrative review and strategies for its approach in intermediate respiratory care units.
    Emilio García Díaz, María Barca Hernando, Demetrio González Vergara, Javier Toral Marín, María Andrea Jaimes Castaño, Carlos Carrera Cueva, Sergio López Ruz.
      Advances in intensive care have increased survival rates among critically ill patients but revealed a new challenge: post-intensive care syndrome (PICS). This syndrome, affecting patients' physical, cognitive, and psychological well-being, also impacts their quality of life (QoL). Recognized in the early 21st century, PICS is now a research and clinical priority, particularly in specialized units like intermediate respiratory care units (IRCUs). This review aims to examine the evolution, clinical impact, and management strategies of PICS. A narrative review approach was utilized. A systematic search was conducted in biomedical databases (PubMed, Scopus, and Google Scholar), identifying relevant studies on PICS, its manifestations, risk factors, and therapeutic strategies. The review included original articles and clinical guidelines published between 2010 and 2024. The findings are organized into emerging themes: clinical manifestations, risk factors, diagnostic tools, management strategies, and the role of IRCUs. Each theme was analyzed to identify recurring patterns and gaps in the current knowledge base. IRCUs offer an ideal setting to address PICS-related sequelae, improving patients' QoL and facilitating their social reintegration. However, ongoing research is essential to optimize therapeutic strategies and develop more effective care models.
    DOI:  https://doi.org/10.4081/monaldi.2025.3594
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