Search Results (6,119)

Background: Musculoskeletal disorders (MSDs) are a significant health problem associated with performing professional activities. The occurrence of pain often determines the type of work undertaken. Healthcare workers and public administration employees are occupational groups at risk of developing musculoskeletal disorders. The aim of this study was to compare the incidence and location of MSDs between two professional groups—healthcare and administrative workers—and to assess their impact on professional functioning. Methods: The study included 339 employees, comprising 188 healthcare workers and 151 administrative workers. An extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E) was used. Results: Healthcare workers experienced MSDs significantly more often than administrative workers, both in the past and in the last 12 months. MSDs in healthcare workers more often led to absenteeism, changes in duties, use of healthcare services, and medication use. The observed differences were statistically significant, particularly in the upper and lower limbs. Conclusions: Musculoskeletal disorders (MSDs) are a significant health problem among healthcare and administrative workers, but they affect healthcare staff much more frequently, especially in the upper and lower limbs. This results in higher sick leave rates, the need to modify duties, and more frequent use of treatment and painkillers. These differences may result from varying working conditions, age, and education, highlighting the need to implement preventive measures tailored to the specific characteristics of each professional group. Full article

Ulnar collateral ligament (UCL) injuries are a major concern in baseball because of repetitive valgus stress from overhead throwing, often leading to surgical intervention. In recent years, UCL reconstruction has become increasingly frequent. Although this procedure has a high success rate, revision surgery is often required. This systematic review and meta-analysis examined the incidence of UCL surgery and revision procedures in baseball players, explored potential risk factors, and identified areas for future research. A comprehensive search of PubMed, Google Scholar, CINAHL, Embase, and SportDiscus databases was conducted for studies published between 2014 and 2024. Studies reporting the incidence of primary and revision UCL reconstructions in baseball players were included. The quality of the included studies was assessed using the Methodological Index for Non-randomized Studies (MINORS). A meta-analysis using RevMan 5.4 software calculated the pooled proportions and 95% confidence intervals for UCL surgery and revision rates. Six studies met the inclusion criteria, including data from 27,366 baseball players. The pooled incidence of UCL surgery was 4.52% (95% CI: 4.20–4.84%), and the pooled incidence of revision surgery was 8.42% (95% CI: 5.49–11.35%). Statistical analyses showed high heterogeneity (I² = 100%, p < 0.00001). Sensitivity analyses were performed to assess the robustness of the results, both in the incidence of surgery and in the revision surgery. UCL surgery is a common procedure in baseball, and a notable proportion of athletes require revision. Further research is necessary to identify the risk factors and develop preventive strategies to reduce UCL injury rates. Full article

Understanding neuromuscular adaptations resulting from specific training modalities is crucial for optimizing athletic performance and injury prevention. This in silico proof-of-concept study aimed to computationally model and predict neuromuscular adaptations induced by strength and plyometric training, integrating musculoskeletal simulations and machine learning techniques. A validated musculoskeletal model (OpenSim 4.4; 23 DOF, 92 musculotendon actuators) was scaled to a representative athlete (180 cm, 75 kg). Plyometric (vertical jumps, horizontal broad jumps, drop jumps) and strength exercises (back squat, deadlift, leg press) were simulated to evaluate biomechanical responses, including ground reaction forces, muscle activations, joint kinetics, and rate of force development (RFD). Predictive analyses employed artificial neural networks and random forest regression models trained on extracted biomechanical data. The results show plyometric tasks with GRF 22.1–30.2 N·kg⁻¹ and RFD 3200–3600 N·s⁻¹, 10–12% higher activation synchrony, and 7–12% lower moment variability. Strength tasks produced moments of 3.2–3.8 N·m·kg⁻¹; combined strength + plyometric training reached 3.7–4.2 N·m·kg⁻¹, 10–16% above strength only. Machine learning predictions revealed superior neuromuscular gains through combined training, especially pairing back squats with high-intensity drop jumps (50 cm). This integrated computational approach demonstrates significant practical potential, enabling precise optimization of training interventions and injury risk reduction in athletic populations. Full article

Background: Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular disorder that is characterized by progressive muscle weakness, musculoskeletal limitations, and pulmonary involvement, with cardiomyopathy and cardiovascular complications being a primary cause of morbidity and mortality. With advances in respiratory care, cardiac involvement has become the leading cause of death. There is growing interest in systemic inflammatory indices as potential predictors of cardiovascular involvement. This study aimed to evaluate the prognostic value of inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and pan-immune inflammation value (PIV)—in children with DMD and to explore their association with cardiac findings. Methods: In this retrospective study, 25 male patients diagnosed with DMD and 25 age-matched healthy male controls were evaluated between January 2021 and July 2024. Demographic and clinical data, hematologic and biochemical parameters, and inflammatory indices were recorded. Cardiovascular involvement was assessed using electrocardiography (ECG) and transthoracic echocardiography (TTE). Group comparisons were performed using independent t-tests, while ROC and Pearson correlation analyses were used for diagnostic performance and associations. Results: Pathological Q waves were the most frequent ECG abnormality (24%), and 16% of patients had echocardiographic abnormalities. While most systemic inflammatory indices (NLR, MLR, SIRI, SII, PIV) did not significantly distinguish cardiovascular involvement, PLR demonstrated a strong positive correlation with Pro-BNP levels (r = 0.86, p < 0.05), suggesting a potential link between systemic inflammation and subclinical cardiac stress. Conclusions: Although the overall diagnostic utility of inflammatory indices in predicting cardiovascular complications in DMD was limited, PLR showed a correlation with Pro-BNP in our cohort. However, given the small sample size and limited number of patients with ventricular dysfunction, this finding should be interpreted with caution. PLR may warrant further investigation as a potential marker of cardiovascular involvement in DMD, but larger prospective studies are needed to validate its clinical significance. Full article

Fractional laser (FL) and fractional radiofrequency (FRF) are effective treatments for atrophic acne scars, yet comparative data in Asian populations with darker skin types remain limited. This retrospective cohort study compared the clinical effectiveness and safety of FL and FRF in Thai patients aged 18–60 years with Fitzpatrick skin types III–IV who underwent at least two treatment sessions between 2012 and 2023. Baseline characteristics were balanced using propensity score stratification, and missing data were addressed through multiple imputation with chained equations. The primary endpoint was the proportion of patients achieving ≥25% improvement in scarring at 6 months, with equivalence testing performed using a 20% margin. A total of 397 patients (254 FL, 143 FRF) were included, with balanced baseline characteristics after stratification. At 6 months, 88.1% of FRF-treated and 71.9% of FL-treated patients achieved the primary endpoint. FRF showed numerically greater mean improvement at all time points, though differences were not statistically significant. FL met the non-inferiority criterion but not equivalence. FRF was associated with significantly higher pain scores (p < 0.001), while adverse events, including post-inflammatory hyperpigmentation, were rare and similar between groups. Both modalities demonstrated meaningful clinical benefit and acceptable safety, although statistical equivalence could not be established and FRF was associated with greater procedural discomfort. Full article

The effectiveness of breathing interventions on postural alignment, pain reduction, and functional improvement in patients with forward head posture (FHP) and chronic neck pain remains uncertain. Previously conducted randomized controlled trials (RCTs) that involved breathing interventions were identified through searches of the PubMed, Cochrane Library, Web of Science, and Scopus databases. Studies were included if they applied diaphragmatic breathing, breathing muscle training, or feedback breathing exercises for at least 2 weeks to chronic neck pain (duration ≥ 3 months) and/or forward head posture. The craniovertebral angle (CVA), the visual analog scale (VAS), and the neck disability index (NDI) were the primary outcome measures. The results showed that breathing interventions had a moderate effect size in terms of improving the CVA. Limited effects were observed for pain reduction, and improvements in neck disability approached statistical significance. However, despite these positive findings, the overall evidence was rated as ‘very low certainty’ in the GRADE assessment, primarily due to high heterogeneity among studies, limited sample sizes, and the potential for unit-of-analysis errors in diagnosis-based subgroup analyses. Consequently, their overall effectiveness in chronic neck pain was limited. Future research is needed to explore a multidisciplinary approach to neck pain using standardized protocols and larger samples. Full article

Adolescent idiopathic scoliosis (AIS) is a multifactorial disease with environmental and genetic components. AIS clinical management is complicated by the lack of reliable predictive markers of progression. Recent studies have highlighted a potential role for epigenetic mechanisms in disease progression. However, most findings derive from peripheral blood analyses, with little data available on musculoskeletal tissues directly affected by AIS. Given the tissue-specific nature of epigenetic regulation, validating blood-based biomarkers in disease-relevant tissues is essential. We performed a comparative multi-gene RT-qPCR analysis, arranged in a custom array format, to assess the local expression of candidate epigenetically regulated genes associated with AIS progression across bone, paravertebral muscle, spinal ligament, and peripheral blood, all collected from the same patients. Tissue- and gene-specific expression patterns were observed, supporting the presence of local regulatory mechanisms. Peripheral blood expression of HAS2, PCDH10, H19, ADIPOQ, ESR1, GREM1, SOX9, FRZB, LRP6, and FBN1 resembled bone expression, while PITX1, CRTC1, APC, CTNNB1, FZD1, and AXIN1 reflected muscle and ligament; WNT1 reflected only muscle. In contrast, GREM1 and SOX9 were expressed only in muscle and ligament and FGF4 and NPY only in muscle, suggesting limited systemic biomarker potential. Compared to non-AIS tissues, AIS samples showed downregulation of PCDH10 and FBN2 in bone and CRTC1, FRZB, LRP6, and MSTN in muscle. WNT1 and WNT10 were upregulated in muscle and FBN1 in ligament. In conclusion, the results highlight differential gene expression across AIS tissues, supporting tissue-specific regulation in some of the genes analyzed. Only a subset of markers exhibited blood expression patterns that reflected those in specific tissues, suggesting that certain blood biomarkers may act as surrogates for distinct tissue compartments. These results lay the groundwork for future DNA-based studies to confirm the epigenetic nature of this regulation and to identify reliable biomarkers for AIS progression. Full article

Background and Objectives: Musculoskeletal pain is a global public health issue. Eight Constitution Medicine (ECM), a type of East Asian Traditional Medicine, offers personalized, minimally invasive treatment through Eight Constitution Acupuncture (ECA) and Eight Constitution Lifestyle Intervention (ECLI). Despite its clinical use, scientific evidence supporting ECM’s effectiveness remains limited. This study aimed to evaluate the effectiveness in treating musculoskeletal pain in primary care settings. Materials and Methods: This retrospective study analyzed medical records from three ECM clinics (Gangnam-Shingwang, Yeson, and Yebon) between January 2018 and August 2023. A total of 163 patients were included, with 44 providing follow-up data. Pain intensity, quality of life, and functional outcomes were assessed using validated instruments including the PainDETECT questionnaire, Korean Cancer Pain Assessment Tool (KCPAT) somatic pain scores, EuroQol 5-Dimension 5-Level (EQ-5D-5L), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Pre- and post-treatment scores were statistically analyzed. Results: Significant decreases were observed in KCPAT somatic pain scores (11.77 ± 4.77 to 9.77 ± 5.32) and significant improvements in EQ-5D-5L scores (0.74 ± 0.12 to 0.80 ± 0.07). WOMAC and ODI scores also showed significant improvements. However, the changes in the NDI, SPADI, and PainDETECT scores were not statistically significant. No adverse events were reported. Conclusions: ECM, through ECA and ECLI, may offer effective personalized treatment for musculoskeletal pain, improving both pain intensity and quality of life. Despite its small sample size and retrospective design, this study offers valuable preliminary evidence for ECM. Further large-scale prospective studies are needed to confirm these findings. Full article

Background/Objectives: Fructooligosaccharides (FOS) and dried tart cherry (TC) are examples of simple and complex (i.e., within a food matrix) prebiotics that have demonstrated promising osteoprotective activity. In this study, we examined how dietary supplementation with TC or FOS shapes the gut-bone axis to promote bone accrual in young adult mice, and the role of the gut microbiota in mediating these responses. Methods: Studies were performed using 10-wk-old female C57BL/6 mice (n = 10–12/group) fed a control diet or control diet supplemented with 10% TC or FOS for 10 wks alone or in combination with an antibiotic/anti-fungal cocktail to suppress the gut microbiota. The bone phenotype was characterized by dual-energy X-ray absorptiometry, micro-computed tomography and static and dynamic bone histomorphometry. The gut-microbiota was profiled and short chain fatty acids (SCFA) were assessed based on 16S rRNA profiling and gas chromatographic techniques, respectively. Results: FOS and TC enhanced bone structure, with FOS yielding more pronounced benefits across cortical and trabecular compartments. These skeletal improvements with FOS occurred in the absence of systemic changes in bone turnover markers but were accompanied by increases in local bone formation, osteoblast and osteocyte numbers, and bone mineralization in the femur. Both diets altered gut microbiota composition and increased fecal concentrations of the most abundant SCFAs (i.e., acetate, propionate and butyrate), but the response was greater with FOS. Suppression of the gut microbiota and fecal SCFAs with the antibiotic/anti-fungal cocktail inhibited the effects of FOS and TC on cortical bone, but induced unexpected improvements in the trabecular bone. Conclusions: These findings demonstrate differential effects of simple and complex prebiotics on the gut-bone axis in young adult female mice and support a role for SCFA in the cortical bone response, but not in the trabecular bone response with this model of gut microbiota suppression. Full article

Although the relationship between risk factors and disease patterns still remains poorly understood, arterial hypertension in climacteric women is a substantial risk factor for multimorbidity. This cross-sectional study analyzed data from 1003 women aged ≥40 years attending Brazilian Basic Health Units to assess multimorbidity (≥2 chronic conditions) and its patterns (cardiometabolic, musculoskeletal, and neuropsychological). An adjusted logistic regression revealed that postmenopausal status (OR: 2.17; 95% CI: 1.05–4.48) and an age of ≥70 years (OR: 2.85; 95% CI: 1.16–6.99) were key risk factors for multimorbidity. Notably, 86% of hypertensive women had multimorbidity, most frequently dyslipidemia (50%), type 2 diabetes (37%), and thyroid disorders (18%). The cardiometabolic pattern (86% prevalence) was strongly associated with hypertension, especially among women aged ≥50 years (OR: 2.10; 95% CI: 1.10–3.98) and those with obesity grade I+ (OR: 2.30; 95% CI: 1.36–3.89). Musculoskeletal disorders were associated with postmenopausal status (OR: 2.41; 95% CI: 1.05–5.51) and obesity (OR: 1.92; 95% CI: 1.08–3.43), while neuropsychological diseases showed no significant associations. These findings highlight that hypertensive climacteric women—especially postmenopausal, older, or those with obesity—face elevated risks of cardiometabolic and musculoskeletal multimorbidity, underscoring the need for targeted preventive strategies in this population. Full article

Background/Objectives: Previous meta-analyses on vitamin D (VitD) supplementation for fall prevention have mixed different populations and doses. This study aimed to evaluate whether VitD supplementation reduces fall risk in community-dwelling adults aged ≥65 years. Methods: Randomized clinical trials (RCTs) including adults ≥65 years living in the community and receiving supplemental VitD were identified through the MEDLINE and EMBASE databases (January 2005–July 2024), and independent reviewers selected studies reporting fall risk, extracted data, and assessed risk of bias. Outcomes were pooled using the inverse variance method. Heterogeneity and publication bias were assessed with I², Egger’s test, and the trim-and-fill method. Results: The analysis dataset was 23,211 participants from 10 RCTs. Most studies had minimal risk of bias. Overall, VitD supplementation was not associated with a reduction in fall risk, as no statistically significant or consistent trend was observed (OR = 0.99; 95%CI: 0.95–1.03; I² = 31%). In women, no significant association was found (OR = 0.97; 95%CI: 0.92–1.02; I² = 31.2%), and in men, no significant association was observed (OR = 1.08; 95%CI: 0.98–1.20; I² = 0%) when analyzed separately. Supplementation with doses ≤1000 IU/day showed no significant association with fall risk (OR = 0.96; 95%CI: 0.90–1.02; I² = 39.5%), as did durations ≤12 months (OR = 0.96; 95%CI: 0.90–1.02; I² = 56.2%) and daily administration (OR = 0.97; 95%CI: 0.92–1.03; I² = 37.2%). Doses >1000 IU/day, intermittent dosing (both OR = 1.02; 95%CI: 0.96–1.09; I² = 0%), and durations >12 months (OR = 1.01; 95%CI: 0.96–1.07; I² = 0%) all showed no significant association. Although evidence of publication bias was detected, adjustment did not alter the results. Conclusions: This meta-analysis shows that VitD supplementation has no effect on the risk of falls in community-dwelling adults ≥65 years, yet its main interest lies in ensuring population homogeneity found in previous analyses of mixed settings. Full article

Work-related musculoskeletal disorders (WMSDs) have a significant impact on healthcare professionals. The aim of this study was to conduct an umbrella review and meta-analysis to examine the overall body area prevalence of WMSDs by continents, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Mendeley, PubMed/Medline, Science.gov, ScienceDirect, and Google Scholar were screened without date limitation to identify relevant meta-analyses. The selection, quality appraisal, and data extraction process were performed independently by two reviewers. Ten meta-analyses were included from the 3853 unique records, for a total of 100,211 participants, including dentists, nurses, surgeons, and mixed healthcare professionals. High heterogeneity (Cochran’s Q test and I² statistic) was observed. The largest number of meta-analyses was performed among nurses. Subgroup analysis by continent revealed an imbalance in the number of works, with Asia being the most documented. The analysis of prevalence rates was complete in Asia (overall and nine body areas), and partial in Europe (neck, shoulder, wrist) and Africa (lower back only). A ranking of the most exposed areas by continent was proposed. The lower back was the most exposed area (Africa: 54.5%; Asia: 56.6%). It would be relevant in future work to consider the numerous cross-sectional studies in order to improve subgroup analyses by continent and, thus, complete and strengthen the initial results presented in this first umbrella review. Full article

The barbell back squat, a prevalent lower-limb resistance exercise characterized by a closed kinetic chain and multi-joint movement, results in the greatest knee joint range of motion. Variations in thigh and shank lengths and their ratios may influence knee joint mechanics. This study investigated the effects of thigh and shank lengths and their ratios on knee kinematics and kinetics during the barbell back squat. Fifty resistance-trained adult men participated. Kinematic and kinetic data were collected using an eight-camera motion capture system and two force plates. Correlation and simple linear regression analyses were conducted to evaluate the relationships between thigh and shank length parameters and knee joint mechanics. Greater thigh length was significantly associated with increased anterior knee displacement and knee extension moment. Additionally, longer shank length and a higher shank-to-thigh ratio were associated with greater knee abduction and internal rotation angles. Consequently, increased thigh length may contribute to greater anterior knee displacement, while increased shank length may be associated with increased knee abduction and internal rotation. Accordingly, trainers and trainees should evaluate individual thigh and shank lengths. For participants with relatively longer shank and thigh segments, compensatory knee movements should be closely monitored to mitigate the risk of musculoskeletal injuries. Full article

Background and Objectives: Chronic ankle instability (CAI), a prevalent injury among female volleyball players, can negatively affect functional performance and increase the risk of further injury. The aim of this study was to compare functional movement quality, dynamic balance, vertical jumping performance, hip muscle strength, and risk of injury between adolescent female volleyball players with unilateral CAI and those without CAI. Materials and Methods: This cross-sectional study included 46 adolescent female volleyball players, divided into CAI (n = 23) and control (n = 23) groups based on predefined criteria. Functional movement quality was assessed using the Functional Movement Screen (FMS), and dynamic balance was evaluated with the Y-Balance Test (YBT). Maximal isometric strength of the hip muscles (flexors, extensors, abductors, adductors, and internal and external rotators) was measured using hand-held dynamometry, and vertical jumping performance was assessed using countermovement jump tests. Injury risk was classified based on established cut-off values for the FMS-composite and YBT-anterior reach asymmetry scores. Results: The CAI group demonstrated significantly lower FMS-composite scores (p = 0.007), reduced anterior reach on the YBT (p = 0.004), and decreased strength in the hip flexors (p = 0.007) and hip adductors (p = 0.044), supported by moderate effect sizes. No significant group differences were observed in the other YBT directions, vertical jump tests, or the other hip muscles (p > 0.05). A greater proportion of athletes in the CAI group were classified as high risk for injury based on both FMS-composite (p = 0.022) and YBT-anterior reach asymmetry (p = 0.001) cut-off values, supported by moderate and relatively strong effect sizes, respectively. Conclusions: Adolescent female volleyball players with unilateral CAI showed impaired movement quality, balance deficits, hip muscle weakness, and increased injury risk. These results highlight the importance of targeted interventions and broader investigations into CAI in adolescent athletes. Full article

Background: Several studies have examined the prevalence of musculoskeletal pain (MSP) among university students internationally. We aimed to assess the prevalence, pattern, and potential risk factors for MSP among Majmaah University students in Saudi Arabia. Methods: A cross-sectional questionnaire was administered to students from different faculties at Majmaah University. We collected data via the validated Arabic versions of the Standardized Nordic Musculoskeletal Questionnaire, the International Physical Activity Questionnaire, and the Perceived Stress Scale. Bivariate and multivariate logistic regression analyses were performed to explore associations between MSP and demographic, ergonomic, lifestyle, and psychosocial variables. Results: A total of 257 students (n = 195, 75.9% female; n = 62, 24.1% male) were included in this study. The 12-month prevalence of MSP was 225 (87.5%), with the lower back (n = 119, 46.3%) and neck (n = 113, 44.0%) regions being the most affected. Compared with male students, female students reported a higher MSP prevalence (90.3% vs. 79.0%, p = 0.035). The multivariable model was significant (likelihood-ratio χ² = 26.042, df = 7, p < 0.001), accounted for Nagelkerke R² = 0.182 of variance, and showed good calibration (Hosmer–Lemeshow χ² = 8.505, df = 8, p = 0.386). Perceived stress was the only independent predictor of 12-month MSP (β = 0.084, adjusted OR = 1.087, 95% CI 1.034–1.143, Wald χ² = 10.732, p = 0.001), while sex, smoking, academic workload, and sleep duration were non-significant (all p > 0.127). Conclusions: MSP appears to be prevalent among Majmaah University students, with psychological stress emerging as a key independent risk factor. Preventive strategies should include stress management prioritization and ergonomic and physical activity education to support university student well-being. Full article