Treatment Of Musculoskeletal Disorders Research Articles

Machine learning insights into scapular stabilization for alleviating shoulder pain in college students

Abstract Non-specific shoulder pain is a common musculoskeletal condition, especially among college students, and it can have a negative impact on the patient’s life. Therapists have used scapular stabilization exercises (SSE) to enhance scapular control and mobility. This study investigates the prediction of the impact of scapular stability exercises in treating non-specific shoulder pain, leveraging advanced machine learning techniques for comprehensive evaluation and analysis. Using a diverse range of regression models, including Gamma Regressor, Tweedie Regressor, Poisson Regressor, and others, the study examines the relationship between the effectiveness of various exercises and their impact on shoulder pain management. Furthermore, the study employs optimization techniques, such as Hyperopt, scikit-optimize, optunity, GPyOpt, and Optuna, to fine-tune the exercise protocols for optimal outcomes. The results reveal that scapular stabilization exercises, when optimized using machine learning algorithms, significantly contribute to reducing shoulder pain in college students. Among the optimization techniques, scikit-optimize demonstrated the best performance, resulting in a mean squared error of 0.0085, a mean absolute error of 0.0712, and an impressive R2 score of 0.8501. This indicates that the scikit-optimize approach yielded the most accurate predictions and effectively captured the relationship between the exercises and shoulder pain management. The findings highlight the critical role of scapular stabilization exercise interventions in ameliorating non-specific shoulder pain and underscore the potential of machine learning techniques in optimizing therapeutic strategies for musculoskeletal health management. The utilization of scikit-optimize, in particular, showcases its effectiveness in fine-tuning the exercise protocols for optimal outcomes. The study’s results serve as a crucial stepping stone in developing personalized rehabilitation programs for non-specific shoulder pain, emphasizing the importance of integrating machine learning methodologies in the assessment and treatment of musculoskeletal disorders among college students.

Evaluation of a Novel Mechanical Device for the Production of Microfragmented Adipose Tissue for Veterinary Regenerative Medicine: A Proof-of-Concept.

Therapies based on mesenchymal stromal cells (MSCs) have become one of the most significant advancements in veterinary regenerative medicine. The isolation of MSCs is usually performed by enzymatic digestion and requires variable times for cell expansion. In addition, these procedures need to be performed in specialized laboratory facilities. An alternative approach to in vitro-expanded MSC therapy is the use of microfragmented adipose tissue (microfat), which is a rich source of cells and growth factors from the stromal vascular fraction. Recent clinical studies support its safety and efficacy in the treatment of musculoskeletal disorders and wound healing. The aim of the present work was to characterize the microfragmented adipose tissue obtained by a new mechanical device, which provides sterile tissue that is ready for use in the clinic by the veterinarian, avoiding the need for specialized laboratory facilities. Microfat-derived MSCs were compared with enzymatically isolated MSCs in terms of their phenotypic characterization, growth rate and differentiation potential. Conditioned medium derived from microfat culture was evaluated for its ability to promote MSC vitality. No differences were observed between MSCs obtained through mechanical fragmentation and those derived from collagenase digestion of adipose tissue, suggesting that the device could serve as a practical source of microfragmented adipose tissue for use in veterinary clinics.

Generation of musculoskeletal cells from human urine epithelium-derived presomitic mesoderm cells

BackgroundNumerous studies have shown that somite development is a necessary stage of myogenesis chondrogenesis and osteogenesis. Our previous study has established a stable presomitic mesoderm progenitor cell line (UiPSM) in vitro. Naturally, we wanted to explore whether UiPSM cell can develop bone and myogenic differentiation.ResultsSelective culture conditions yielded PAX3 and PAX7 positive skeletal muscle precursors from UiPSM cells. The skeletal muscle precursors undergo in vitro maturation resulting in myotube formation. MYOD effectively promoted the maturity of the skeletal myocytes in a short time. We found that UiPSM and MYOD mediated UiPSM cell-derived skeletal myocytes were viable after transplantation into the tibialis anterior muscle of MITRG mice, as assessed by bioluminescence imaging and scRNA-seq. Lack of teratoma formation and evidence of long-term myocytes engraftment suggests considerable potential for future therapeutic applications. Moreover, UiPSM cells can differentiate into osteoblast and chondroblast cells in vitro.ConclusionsUiPSM differentiation has potential as a developmental model for musculoskeletal development research and treatment of musculoskeletal disorders.

Identifying the risk of exercises, recommended by an artificial intelligence for patients with musculoskeletal disorders

Musculoskeletal disorders (MSDs) impact people globally, cause occupational illness and reduce productivity. Exercise therapy is the gold standard treatment for MSDs and can be provided by physiotherapists and/or also via mobile apps. Apart from the obvious differences between physiotherapists and mobile apps regarding communication, empathy and physical touch, mobile apps potentially offer less personalized exercises. The use of artificial intelligence (AI) may overcome this issue by processing different pain parameters, comorbidities and patient-specific lifestyle factors and thereby enabling individually adapted exercise therapy. The aim of this study is to investigate the risks of AI-recommended strength, mobility and release exercises for people with MSDs, using physiotherapist risk assessment and retrospective consideration of patient feedback on risk and non-risk exercises. 80 patients with various MSDs received exercise recommendations from the AI-system. Physiotherapists rated exercises as risk or non-risk, based on patient information, e.g. pain intensity (NRS), pain quality, pain location, work type. The analysis of physiotherapists’ agreement was based on the frequencies of mentioned risk, the percentage distribution and the Fleiss- or Cohens-Kappa. After completion of the exercises, the patients provided feedback for each exercise on an 11-point Likert scale., e.g. the feedback question for release exercises was “How did the stretch feel to you?” with the answer options ranging from “painful (0 points)” to “not noticeable (10 points)”. The statistical analysis was carried out separately for the three types of exercises. For this, an independent t-test was performed. 20 physiotherapists assessed 80 patient examples, receiving a total of 944 exercises. In a three-way agreement of the physiotherapists, 0.08% of the exercises were judged as having a potential risk of increasing patients' pain. The evaluation showed 90.5% agreement, that exercises had no risk. Exercises that were considered by physiotherapists to be potentially risky for patients also received lower feedback ratings from patients. For the ‘release’ exercise type, risk exercises received lower feedback, indicating that the patient felt more pain (risk: 4.65 (1.88), non-risk: 5.56 (1.88)). The study shows that AI can recommend almost risk-free exercises for patients with MSDs, which is an effective way to create individualized exercise plans without putting patients at risk for higher pain intensity or discomfort. In addition, the study shows significant agreement between physiotherapists in the risk assessment of AI-recommended exercises and highlights the importance of considering individual patient perspectives for treatment planning. The extent to which other aspects of face-to-face physiotherapy, such as communication and education, provide additional benefits beyond the individualization of exercises compared to AI and app-based exercises should be further investigated.Trial registration: 30.12.2021 via OSF Registries, https://doi.org/10.17605/OSF.IO/YCNJQ.

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.

Effect of structural parameters, knotting methods, and wet state on the tensile properties of sutures for orthopedic surgery

With the popularity of sports and fitness, the chances of sports injuries for people have increased. Orthopedic sutures play an important role in the treatment of musculoskeletal disorders. Ultra-high molecular weight polyethylene (UHMWPE) yarns, with excellent tensile, compressive, impact strength, abrasion resistance, and chemical stability, are competitive materials for the preparation of sutures, but the tensile properties of sutures in knotted and wet environments are more informative in practical applications. In this paper, the effects of different structural parameters, knotting methods, and environments on the physical properties of nonabsorbable UHMWPE sutures, including appearance, breaking force, and breaking elongation, were investigated. The results showed that sutures with circular cross-sections had the best tensile properties; the loop knot gave the suture the greatest breaking strength, but also the smallest elongation, and the more complex the knot, the greater the elongation of the suture; dry and wet conditions have a significant effect on the mechanical properties of sutures. It is expected that this study will provide theoretical support for the optimal design of sutures and provide a basis for doctors to choose the knotting method.

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.