Treatment Of Musculoskeletal Disorders Research Articles

Effectiveness of Laser Acupuncture for Reducing Pain and Increasing Mouth Opening Range in Individuals with Temporomandibular Disorder: A Systematic Review and Network Meta-Analysis.

Laser acupuncture (LA) demonstrates promising results in the treatment of musculoskeletal disorders. However, its effects on temporomandibular disorder (TMD) are not yet fully understood. Thus, the aim of this systematic review and network meta-analysis was to assess the effectiveness of LA on pain intensity and maximum mouth opening range (MMO) related to TMD. A search was carried out in 11 electronic databases and references of included studies to locate randomized clinical trials (RCTs) that evaluated LA as a primary treatment for TMD. The risk of bias was assessed using the RoB 2 tool. Network meta-analysis was conducted on the MetaInsight platform, considering the pain intensity and counseling (C) as the outcome of reference. The GRADE system was used to assess the certainty of the evidence. Five studies evaluated pain intensity, four with a high risk of bias and one with a low risk. Two studies evaluated pain intensity on palpation (one with high and one with low risk of bias), and one study with high risk of bias evaluated MMO. Laser parameters were: 690-810nm, 40-150 mW, and 7.5-112.5J/cm2. Occlusal splint (OS) [- 2.47; CI 95% - 3.64, - 1.30] and Physiotherapy (PT) [-2.64; CI 95% - 3.94, - 1.34] reduced pain intensity compared to C. The ranking of treatments in order of effectiveness was PT > OS > LA > C > CR (craniopuncture). The certainty of the evidence was very low or low. The data do not support the indication of LA for the treatment of TMDs and new placebo-controlled RCTs must be conducted to demonstrate its effectiveness more precisely.

A Systematic Review on Musculoskeletal Disorders among Workers in Unorganized Sector

Musculoskeletal Disorders (MSDs) are a group of medical conditions that affect the musculoskeletal systems, which include muscles, tendons, ligaments, and nerves, that support the body and allow movement. In the context of workers in the unorganized sector, due to the nature of their profession, MSDs are expected, which often involve repetitive motions, heavy lifting, awkward postures, and other physical demands. Loss of money, decreased productivity, and a decline in quality of life are all possible consequences for the workers. Therefore, it is crucial to prevent and manage MSD among workers in the unorganized sector such as improving working conditions, providing training on safe work practices, and promoting early detection and treatment of MSD. The study aims to identify the variables that affect informal worker’s quality of life. The researcher gathered the available data and suggested a few guidelines. The condition of employees may be improved with certain adjustments to the workplace, work tools, worker health, work duties, and work management.

EVALUATION OF ANTI-INFLAMMATORY ACTIVITY OF SIDDHA HERBOMINERAL FORMULATION RATHINAGARA RASA MEZHUGU IN ANIMAL MODEL

The usage of Nonsteroidal and steroidal drugs in the treatment of Musculoskeletal disorders often results in adverse effects such as renal damage, gastric irritation, etc. Alternative therapies with less or no side effects are the need of the hour. Siddha system offers a lot of Anti-inammatory drugs that are polyherbal or Herbo-mineral in nature and devoid of the above-mentioned adverse effects. This research work deals with the Anti-inammatory screening of a Siddha Herbo-mineral Formulation Rathinagara rasa mezhugu (RNM) documented in classic Siddha literature Anuboga vaidhaya naveneetham Part 5 indicated for inammatory disease conditions. Anti-inammatory activity was evaluated by Carrageenan-induced paw edema in Wistar rats. Indomethacin (10 mg/kg, orally) was used as standard. The formulation in doses of 20mg/kg, 45mg/kg, and 90 mg/kg showed 56%, 61.53%, and 90.47% inhibition of paw edema, respectively at the end of 5 h. The result of the study showed that RNM at all dose levels signicantly(p<0.5) reduced the inammation in a dose-dependent manner when compared to the control. RNM at 90mg/kg was found to be signicant (**p<0.01) and effective in the reduction of paw edema after 5hrs.From the results, it can be concluded that Rathinagara rasa mezhugu (RNM) was found to exhibit high anti-inammatory potential which conrmed the traditional use of the drug.

Potential and Limitations of Induced Pluripotent Stem Cells-Derived Mesenchymal Stem Cells in Musculoskeletal Disorders Treatment.

The burden of musculoskeletal disorders (MSK) is increasing worldwide. It affects millions of people worldwide, decreases their quality of life, and can cause mortality. The treatment of such conditions is challenging and often requires surgery. Thus, it is necessary to discuss new strategies. The therapeutic potential of mesenchymal stem cells (MSC) in several diseases has been investigated with relative success. However, this potential is hindered by their limited stemness and expansion ability in vitro and their high donor variability. MSC derived from induced pluripotent stem cells (iPSC) have emerged as an alternative treatment for MSK diseases. These cells present distinct features, such as a juvenile phenotype, in addition to higher stemness, proliferation, and differentiation potential than those of MSC. Here, we review the opportunities, challenges, and applications of iPSC as relevant clinical therapeutic cell sources for MSK disorders. We discuss iPSC sources from which to derive iMSC and the advantages and disadvantages of iMSC over MSC as a therapeutic approach. We further summarize the main preclinical and clinical studies exploring the therapeutic potential of iMSC in MSK disorders.

LC-MS/MS Evaluation of Pyrrolizidine Alkaloids Profile in Relation to Safety of Comfrey Roots and Leaves from Polish Sources.

Comfrey (Symphytum officinale L.) has a long tradition of use in the treatment of musculoskeletal disorders. However, due to hepatotoxic pyrrolizidine alkaloids (PAs), the EMA restricts the use of comfrey root (CR) to external use only and for short periods of time. Recent studies indicate a low permeability of PAs across the skin, calling into question the safety of topical application of products containing comfrey preparations. The aim of our work was to develop and validate an HPLC method enabling the separation of isomeric PAs from comfrey and, on this basis, to assess the potential toxicity of CR and comfrey leaf (CL) obtained from various Polish sources. The qualitative and quantitative analysis of PAs via HPLC-MS/MS was performed in MRM mode. The results obtained confirmed a lower content of PAs in CL than in CR and showed a wide variation in the composition of PAs in CR, with a much more stable profile of PAs in CL. Factor analysis confirmed that CRs and CLs differ in PA content, which is influenced by the growth conditions and geographical origin. The determined concentrations of PAs prove that in some CRs available on the Polish herbal market, the content of PAs may exceed the daily dose considered safe.

Local injection therapy in the complex treatment of musculoskeletal disorders: principles of application, evidence base, safety

Local injection therapy (LIT)  is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT.  LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.

High-Sensitive Double-Clad Fiber Bragg Grating Sensors for Real-Time Monitoring of Body Posture and Movement State

Musculoskeletal disorders (MSD) are prevalent in society and currently lack effective treatments. The incidence of MSD appears to be increasing as the worldwide population ages and sedentary lifestyles. Real-time monitoring of the body posture and movement state may be an effective strategy for the prevention and treatment of MSD. We proposed a real-time monitoring system based on a wearable high-sensitive double-clad fiber Bragg grating (FBG) sensors and an integrated demodulation device to recognize the body posture and movement state. The results demonstrate that the double-clad FBG sensors exhibit a high measurement sensitivity of approximately 36 pm/° in elbow joint static tests and 7.5 pm/° in knee joint static tests, which is almost 1.4 times higher than that of a single-mode FBG. Furthermore, a dataset of six gestures was created based on time and wavelength information obtained from six double-clad FBG sensors monitoring subtle deformations of muscles of the arm. The accuracy of recognizing simple and complex gestures was close to 100% and about 88%, respectively. The static and dynamic measurements demonstrate that the double-clad sensors have high accuracy, improved sensitivity, excellent flexibility and good repeatability, and this work is expected to a reliable assessment tool for clinical trials of MSD.

Stem Cells and Regenerative Medicine in the Treatment of Musculoskeletal Disorders

Regenerative medicine is a field of medicine focused on the repair or replacement of damaged or diseased cells, tissues, and organs through the use of various medical technologies. These technologies include stem cell therapy, tissue engineering, and gene therapy, among others. Millions across the globe are plagued with musculoskeletal disorders (MSD) with ranging debilitating effects that are detrimental to the functionality of one's life. The healing process of MSD can be arduous and sometimes worse than the injury itself. The various methods of treatment including stem-cell based therapy and the origin and composition of these stem cells has been reviewed in this paper, in order to present a way in which the natural healing process of MSD can be amplified and catalyzed.

A mini-review on the emerging role of nanotechnology in revolutionizing orthopedic surgery: challenges and the road ahead.

An emerging application of nanotechnology in medicine currently being developed involves employing nanoparticles to deliver drugs, heat, light, or other substances to specific types of cells (such as cancer cells). As most biological molecules exist and function at the nanoscale, engineering and manipulating matter at the molecular level has many advantages in the field of medicine (nanomedicine). Although encouraging, it remains unclear how much of this will ultimately result in improved patient care. In surgical specialties, clinically relevant nanotechnology applications include the creation of surgical instruments, suture materials, imaging, targeted drug therapy, visualization methods, and wound healing techniques. Burn lesion and scar management is an essential nanotechnology application. Prevention, diagnosis, and treatment of numerous orthopedic conditions are crucial technological aspects for patients' functional recovery. Orthopedic surgery is a specialty that deals with the diagnosis and treatment of musculoskeletal disorders. In recent years, the field of orthopedics has been revolutionized by the advent of nanotechnology. Using biomaterials comprised of nanoparticles and structures, it is possible to substantially enhance the efficacy of such interactions through nanoscale material modifications. This serves as the foundation for the majority of orthopedic nanotechnology applications. In orthopedic surgery, nanotechnology has been applied to improve surgical outcomes, enhance bone healing, and reduce complications associated with orthopedic procedures. This mini-review summarizes the present state of nanotechnology in orthopedic surgery, including its applications as well as possible future directions.

Work-Related Musculoskeletal Disorders of Teaching Staff in Higher Education

Abstract Work-related musculoskeletal disorders are among the most common disorders of the musculoskeletal system. The aim of this paper is to determine the prevalence of the musculoskeletal disorders (MSD) for the teachers in higher education. Examinees and methods: 100 teachers (66% men and 34% women with average age of 38.8 ± 13.1) were included in the prospective study. The information about the state of the teachers’ musculoskeletal system was gathered using a questionnaire for the MSD analysis. Potential risk factors for MSD were analyzed. MSD was observed in 74 (74%) teachers and associates (68.9% male and 31.1% female, p˂0.05). 32% Teachers had pain within the first five years of teaching work, while the rest of MSD occurred after that period. 73% of teachers were diagnosed with rigor in the lower back, 62% were diagnosed with neck pain, 45.9% were diagnosed with upper back pain, while 27% had pain in their ankles/feet. Lower pain prevalence was noticed in wrist, hands, hips and elbows. The prevalence of the musculoskeletal disorders for teachers is 74% and it is higher for men than for women. MSD, whose samples are multifactorial, are the most common in the lower back, neck, upper back and shoulders. Ergonomics and ergonomic education are the primary factors in the prevalence and treatment of MSD.

Local cryotherapy investigation on the biotissue phantom

BACKGROUND: Local cryotherapy (LC) is a physiotherapeutic method for the treatment of various diseases, including musculoskeletal disorders. The physician relies on his experience and the data from the LC equipment manufacturer for the given method and exposure modes. This is not sufficient to determine the correct dosing and to understand the effect of the various treatment parameters on the biotissue to have precise control over the effects of the treatment on the biotissues. Hence, it is imperative to conduct a study of different LC methods and modes to perform effective and safe treatments. The surface temperature of the biotissue is a convenient measurable quantity to ensure efficiency and safety. Previous studies show that the target temperature is 10 2 C, with a lower limit of 0 C. If the temperature drops below 0 C, then tissue damage is possible.
 AIM: Experimental comparison and identification of the most suitable modes in two methods of contactless local cryotherapy.
 MATERIALS AND METHODS: An experimental installation was developed and created. A series of experiments were carried out on a model medium with thermophysical properties close to those of the biotissues. The comparison of liquid nitrogen and air cooling was performed. The temperature was measured with resistance thermometers (Pt100) on a surface and inside of a model medium.
 RESULTS: When cooled by liquid nitrogen vapors from a distance of 10 and 15 cm from the surface, the accepted average target temperature of 10 C was reached in 1.8 and 4.4 min, and at a depth of 8 mm, the temperature was 26.4 and 23.7 C, respectively. When cooled with air from a distance of 10 cm from the surface with maximum and minimum flow, the target temperature was reached in 2.5 and 13.3 min, at a depth of 8 mm, the temperature was 22.9 and 16.0 C, respectively. Although air cooling from a distance of 15 cm was not possible to lower the temperature down to the target value, the less intense flow made it possible to lower the internal temperature in the model medium more strongly while having a weaker effect on the surface. This effect can potentially be positive in the treatment of musculoskeletal disorders, mainly joints.
 CONCLUSIONS: Among those tested, the most suitable modes of the considered methods that meet the requirements of efficiency, safety, and convenience of practical implementation were identified. For cooling using liquid nitrogen vapors, this is a mode spraying at a distance of 15 cm with a stable technique with a possible exposure time of 4.4 to 15 minutes. For air cooling, this is a mode with a stable technique with a constant flow with the nozzle fixed relative to the surface of the model medium at a distance of 10 cm with a minimum flow rate (350 l/min) with a possible exposure time of 13.3 to 21.5 min.

High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = -1.3 cm; confidence interval (CI) 95%: -1.6 to -1.0) and an improvement in functionality (standardized mean difference (SMD) = -1.0; CI95%: -1.4 to -0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias.

Global trends of traditional Chinese exercises for musculoskeletal disorders treatment research from 2000 to 2022: A bibliometric analysis.

Traditional Chinese exercise has been shown to be effective in relieving long-term chronic pain, physical dysfunction, decreased ability to participate in society and decreased quality of life in musculoskeletal diseases. In recent years, there has been a steady increase in publications on the treatment of musculoskeletal disorders by traditional Chinese exercises. The purpose of this study is to review the characteristics and trends of Chinese traditional exercise studies on musculoskeletal diseases published since 2000 through bibliometric analysis, and identify current research hotspots, so as to guide the direction of future research. Publications regarding traditional Chinese exercises for musculoskeletal disorders from 2000 to 2022 were downloaded from the Web of Science Core Collection. VOSviewer 1.6.18 and CiteSpace V software were used for bibliometric analyses. Bibliometric visualization and comparative analysis were conducted for authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords. A total of 432 articles were obtained, with an upward trend over time. The most productive countries and institutions in this field are the USA (183) and Harvard University (70). Evidence-based Complementary and Alternative Medicine (20) was the most prolific journal, Cochrane Database System Review (758) was the most commonly cited journal. Wang Chenchen published the largest number of articles (18). According to high frequency keywords, the hot spot musculoskeletal disorder and the type of traditional Chinese exercise are knee osteoarthritis and Tai Chi. This study provides a scientific perspective for the research of traditional Chinese exercises for musculoskeletal disorders and provides valuable information for researchers to discover the current research status, hot spots and new trends of future research.

Phototherapy techniques for the management of musculoskeletal disorders: strategies and recent advances.

Musculoskeletal disorders (MSDs), which include a range of pathologies affecting bones, cartilage, muscles, tendons, and ligaments, account for a significant portion of the global burden of disease. While pharmaceutical and surgical interventions represent conventional approaches for treating MSDs, their efficacy is constrained and frequently accompanied by adverse reactions. Considering the rising incidence of MSDs, there is an urgent demand for effective treatment modalities to alter the current landscape. Phototherapy, as a controllable and non-invasive technique, has been shown to directly regulate bone, cartilage, and muscle regeneration by modulating cellular behavior. Moreover, phototherapy presents controlled ablation of tumor cells, bacteria, and aberrantly activated inflammatory cells, demonstrating therapeutic potential in conditions such as bone tumors, bone infection, and arthritis. By constructing light-responsive nanosystems, controlled drug delivery can be achieved to enable precise treatment of MSDs. Notably, various phototherapy nanoplatforms with integrated imaging capabilities have been utilized for early diagnosis, guided therapy, and prognostic assessment of MSDs, further improving the management of these disorders. This review provides a comprehensive overview of the strategies and recent advances in the application of phototherapy for the treatment of MSDs, discusses the challenges and prospects of phototherapy, and aims to promote further research and application of phototherapy techniques.

Effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle: A meta-analysis based on current evidence.

Craniosacral therapy (CST) has remained controversial in the treatment of musculoskeletal disorders. To our knowledge, there is no larger sample size of research to demonstrate the effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle. To study whether the CST in the human suboccipital region could have a remote effect on the flexibility of the hamstring muscles, the Cochrane Library, Medline/Pubmed, CNKI, Embase, and Google Scholar were searched. Clinical trials assessing the effects of CST in short hamstring syndrome patients were eligible. Mean differences (MD) and 95% confidence intervals (CI) were calculated for the straight leg raise test (primary outcomes). The quality of the included studies was assessed using the Newcastle-Ottawa Scale. RevMan 5.3 software was used for data analysis. Five controlled trials with a total of 238 participants were included. CST could effectively relieve the symptoms of short hamstring syndrome patients [the overall MD -9.47, 95% confidence interval (CI) -15.82 to -3.12, P < .000001]. The CST was better than the proprioceptive neuromuscular facilitation technique (MD 3.09, 95% CI 1.48-4.70, P = .0002). Sensitivity analysis shows that the frequency of treatment and who did the experiment might be the main sources of impact results. CST could change the flexibility of the hamstring muscles. CST had a better curative effect when compared to proprioceptive neuromuscular facilitation technique on the hamstring muscles.

The prevalence and severity of sick-leaves due to musculoskeletal disorders among workers in water supply; sewerage, waste management and remediation activities

The aim of this study was to analyse the nationwide data on sick leaves (SL) due to work-related musculoskeletal disorders among Slovenian workers in section E “water supply; sewerage, waste management and remediation activities” from NACE Rev2 classification. We report both, SL frequency (ie, number of cases) and SL severity (ie, average SL duration), stratified by body region, gender, age and divisions within the section. In addition, trends in SL data (year 2015–2019 difference) were analyzed. Throughout the analysed years, ∼9,000 workers were employed in the section, with male to female ratio at ∼ 4:1. The major findings are as follows: (i) low back disorders were by far the most prevalent, however, the mean SL duration was the highest for lower limb disorders; (ii) older age was associated with increased SL frequency and duration, irrespective of gender; (iii) male gender was consistently associated with larger SL duration, while the data on SL frequency is inconclusive, as older females had more frequent SL than older males; (iv) the effect of division was relatively minor and the comparisons are limited due to large discrepancies regarding the number of workers across divisions; (v) a slight increasing trend for both SL frequency and duration was observed from 2015 to 2019. In conclusion, particular attention in terms of early diagnosis and treatment of musculoskeletal disorders should be given to male workers and older workers in general in section E.

Faktor-Faktor Yang Berhubungan Dengan Musculoskeletal Disorders Pada Pekerja Pembuat Batu Bata Di Desa Kajhu Kecamatan Baitussalam Aceh Besar Tahun 2022

Occupational health and safety is an important part of the protection of the health of workers, especially to overcome the problem of work-related diseases. MSDs disorders are a group of disorders that affect the bones, joints, muscles and the body's connective tissues. This study aims to determine the factors associated with Musculoskeletal Disorders Health in Brick Making Workers in Kajhu Village, Baitussalam District, Aceh Besar in 2022. This research is an analytical descriptive with a cross sectional design. Data collection was carried out by interviewing using a questionnaire. The population in this study were brick making workers in Kajhu Village, Baitussalam District, Aceh Besar in 2022 with a total of 40 respondents. The sample is determined by using total sampling technique. The statistical test used is Chi Square. The results showed that there was no relationship between tenure (p = 0.431), and there was a relationship between length of work (p = 0.42), history of MSDs (p = 0.010) and gender (p = 0.048) with musculoskeletal disorders. The conclusion of this study is that the length of service is not related to MSDs complaints in brick makers. Meanwhile, length of work, history of MSDs and gender are related to complaints of health. also increase awareness of the prevention and treatment of musculoskeletal disorders.

Treatment of Musculoskeletal Disorders- Scientific Review of the Literature

Purpose of the article: The purpose of the article is to present a paper about treatment of musculoskeletal disorders from review of literature. Materials and methods: In March and April 2019 were searched various biomedical databases such as PubMed, Research Gate and Academia.edu using the keywords "Work Related Musculoskeletal Disorders", "Musculoskeletal Injuries", "Work Injuries", "Physiotherapists", "Occupational health", “Treatment”, on the basis of which the presentation of the data obtained in the found research was done. Results: By reviewing 50 references, we presented the principles of treatment of musculoskeletal disorders. For many patients, clinical treatment decisions are often focused on a specific region of the body without much recourse to the potential impact of prognostic factors or other coexisting pain problems. It is difficult to obtain a more holistic view because examinations and systematic examinations usually focus on the specific site of musculoskeletal pain, comparing only two or three treatment options. Conclusion: Exercise therapy is beneficial for pain, function, and quality of life. Current research evidence shows significant positive effects in exercise programs on pain, function, quality of life, and work-related results in the short and long term for all manifestations of musculoskeletal pain (compared to subjects without exercise). Manual therapy has little or no clinically relevant effect on pain intensity, functional status, global improvement or return to work in patients with acute, subacute or chronic back pain with or without sciatica. TENS was no more effective in reducing placebo pain in chronic back pain, neck pain, shoulder pain, knee pain, and chronic musculoskeletal pain in general. Ultrasound and shock wave therapy do not significantly improve the clinical outcomes of acute and chronic lower back pain.

Risk Factor Analysis for Predicting the Onset of Rotator Cuff Calcific Tendinitis Based on Artificial Intelligence.

Background Symptomatic rotator cuff calcific tendinitis (RCCT) is a common shoulder disorder, and approaches combined with artificial intelligence greatly facilitate the development of clinical practice. Current scarce knowledge of the onset suggests that clinicians may need to explore this disease thoroughly. Methods Clinical data were retrospectively collected from subjects diagnosed with RCCT at our institution within the period 2008 to 2020. A standardized questionnaire related to shoulder symptoms was completed in all cases, and standardized radiographs of both shoulders were extracted using a human-computer interactive electronic medical system (EMS) to clarify the clinical diagnosis of symptomatic RCCT. Based on the exclusion of asymptomatic subjects, risk factors in the baseline characteristics significantly associated with the onset of symptomatic RCCT were assessed via stepwise logistic regression analysis. Results Of the 1,967 consecutive subjects referred to our academic institution for shoulder discomfort, 237 were diagnosed with symptomatic RCCT (12.05%). The proportion of women and the prevalence of clinical comorbidities were significantly higher in the RCCT cohort than those in the non-RCCT cohort. Stepwise logistic regression analysis confirmed that female gender, hyperlipidemia, diabetes mellitus, and hypothyroidism were independent risk factors for the entire cohort. Stratified by gender, the study found a partial overlap of risk factors contributing to morbidity in men and women. Diagnosis of hyperlipidemia, diabetes mellitus, and hypothyroidism in male cases and diabetes mellitus in female cases were significantly associated with symptomatic RCCT. Conclusion Independent predictors of symptomatic RCCT are female, hyperlipidemia, diabetes mellitus, and hypothyroidism. Men diagnosed with hyperlipidemia, diabetes mellitus, and hypothyroidism are at high risk for symptomatic RCCT, while more medical attention is required for women with diabetes mellitus. Artificial intelligence offers pioneering innovations in the diagnosis and treatment of musculoskeletal disorders, and careful assessment through individualized risk stratification can help predict onset and targeted early stage treatment.

Effectiveness of neural mobilization on pain intensity, disability, and physical performance in adults with musculoskeletal pain-A protocol for a systematic review of randomized and quasi-randomized controlled trials and planned meta-analysis.

Recent studies show that musculoskeletal conditions contribute significantly to years lived with disability considering the entire global population. Pain and functional disability are the main problems that people with these conditions suffer. Neural mobilization has been shown to be an effective intervention in the treatment of musculoskeletal pain within individual trials, also contributing to improved functionality. Some systematic reviews have been carried out during the last years with the aim of synthesizing the scientific evidence on the use of neural mobilization techniques in the treatment of musculoskeletal disorders. However, they varied a lot in the methodological approaches and, consequently, in the findings and conclusions. Thus, this document is a planned protocol of a comprehensive systematic review with meta-analysis that we intend to carry out to review the scientific literature regarding up-to-date evidence on the use of neural mobilization in the management of people suffering from musculoskeletal pain disorders. The study designs that we will consider as inclusion criteria will be randomized and quasi-randomized clinical trials. The target population will be adults and older adults with musculoskeletal pain. Any controlled trial using any neural mobilization technique as an intervention in one of the trial groups will be included. The main outcomes of interest will be pain, functional status, and physical performance tests (muscle strength, flexibility, and balance). There will be no restrictions on follow-up time or type of setting. The risk of bias of the included studies will be assessed by the RoB 2 tool and the certainty of the evidence will be evaluated using the comprehensive Assessment, Development and Assessment of Assessment Recommendation (GRADE) approach. We intend to present the findings through narrative descriptions and, if possible, through meta-analytic statistics.Trial registration: PROSPERO registration number. CRD42021288387.