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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 48364

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Special Issue Editors

Dr. Carolina Fernández-Lao

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Guest Editor

1. Department of Physiotherapy, University of Granada, Granada, Spain
2. Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain
3. “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
Interests: cancer related physical impairments; cancer related musculoskeletal disorders; chronic pain; central sensitization processes

Dr. Francisco Artacho-Cordon

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Guest Editor

Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
Interests: women health; chronic pain; physical fitness; functional impairments; endometriosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal disorders are very common, and their consequences make an important contribution to disability. The current lifestyle promotes a lack of movement associated to a wide range of related physical and psycho-social disorders. On the other hand, there are multiple pathologies that can affect muscles, bones, and joints in a primary or secondary way, either permanently or temporarily. The resulting economic burden is considerable, with a continuous rise as the population ages. Physical rehabilitation is a holistic approach with physical and psycho-social applications in people with acute and chronic conditions, such as musculoskeletal and neurological disorders, amputations, pelvic organ disorders, cardiorespiratory issues, cancer, disability pain and dysfunction, among others. The aim of this Special Issue is to explore all the aspects of the prevention, diagnosis and management of musculoskeletal disorders and physical rehabilitation processes through a multidisciplinary point of view. The Editor’s interest lies in providing a platform for the publication of high-quality papers documenting new developments and recent advantages in all fields, including repetitive motion injuries, trauma disorders, occupational disorders, overuse syndromes, neurological issues, cardiorespiratory diseases and soft tissue disorders.

Submissions on other topics are welcome and can be discussed with the Guest Editors.

Dr. Carolina Fernández-Lao
Dr. Francisco Artacho-Cordon
Guest Editors

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Keywords

rehabilitation
musculoskeletal diseases
chronic disease
neurological issues
cardiorespiratory issues
cancer
occupational disorders
rheumatologic disorders
bone fractures
disability
dysfunction

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Published Papers (11 papers)

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Research

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12 pages, 1449 KiB

Open AccessArticle

Impact of Different Isokinetic Movement Patterns on Shoulder Rehabilitation Outcome

by Martin Missmann, Katrin Gollner, Andrea Schroll, Michael Pirchl, Vincent Grote and Michael J. Fischer

Int. J. Environ. Res. Public Health 2022, 19(17), 10623; https://doi.org/10.3390/ijerph191710623 - 25 Aug 2022

Viewed by 2255

Abstract

Shoulder pain is regularly associated with limited mobility and limitations in activities of daily living. In occupational therapy, various interventions, including active isokinetic training with a Baltimore Therapeutic Equipment (BTE) Work Simulator, help the patient improve shoulder mobility and alleviate pain. This randomized controlled cohort study aims to evaluate the impact of different isokinetic movement patterns on the DASH score, pain, and objective performance measures, such as range of motion (ROM) and hand grip strength. Patients that participated in a specific 3-week inpatient orthopedic rehabilitation were divided into two groups. The first group (UNI-group, n = 9) carried out uniplanar exercises for shoulder flexion, abduction, and external rotation. The patients in the second group (ADL-group, n = 10) imitated multiplanar everyday movements, such as climbing on a ladder, loading a shopping cart, and raising a glass to their mouth. Compared to the UNI-group, the ADL-group improved significantly in DASH scores (mean −10.92 ± 12.59 vs. −22.83 ± 11.31), pain (NPRS −1.11 ± 2.37 vs. 3.70 ± 2.00), and shoulder abduction (+2.77 ± 15.22 vs. +25.50 ± 21.66 degrees). In conclusion, the specific BTE exercise program with multiplanar movement patterns contributed considerably to the therapeutic improvement. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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12 pages, 1508 KiB

Open AccessArticle

The Kinematic and Kinetic Responses of the Trunk and Lower Extremity Joints during Walking with and without the Spinal Orthosis

by Chenyan Wang, Xiaona Li, Yuan Guo, Weijin Du, Hongmei Guo and Weiyi Chen

Int. J. Environ. Res. Public Health 2022, 19(11), 6952; https://doi.org/10.3390/ijerph19116952 - 6 Jun 2022

Cited by 3 | Viewed by 2852

Abstract

Spinal orthoses are an effective option for restoring the spine to its original position and controlling poor posture. However, the effects of poor posture and spinal orthoses on the kinematics and kinetics of trunk and lower extremity joints remain unclear. A six-camera Vicon motion capture system and two AMTI force plates were employed to collect gait parameters, including joint angle (spine, thorax, hip, knee, and ankle), range of motion (ROM), and ground reaction forces (GRFs). Furthermore, joint moments and joint reaction forces (JRFs) were calculated using a full-body musculoskeletal model in OpenSim. One-way repeated-measures ANOVA (p < 0.05) was used to compare significant differences among three trial conditions. These three conditions were walking in a normal posture, poor posture, and spinal orthosis. The results showed that spine ROM in the coronal and transverse plane was significantly lower when walking with a spinal orthosis compared to walking in normal and poor posture (p < 0.05). Compared to normal posture, the lumbar moments and back compressive forces were significantly increased when walking in poor posture (p < 0.05). However, when walking with a spinal orthosis, there was a significant decrease in trunk moments and reaction forces compared to walking in poor posture (p < 0.05). Individuals with poor posture could potentially induce instability and disorders, as evidenced by an increase in trunk moments and JRF compared to the normal posture. Spinal orthosis not only restricts spine ROM but also reduces the load on the spine and thus increases balance and stability. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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11 pages, 990 KiB

Open AccessArticle

Associations between Patient-Reported and Clinician-Reported Outcome Measures in Patients after Traumatic Injuries of the Lower Limb

by Walter Bily, Jakob Jauker, Helena Nics, Vincent Grote, Michael Pirchl and Michael J. Fischer

Int. J. Environ. Res. Public Health 2022, 19(5), 3140; https://doi.org/10.3390/ijerph19053140 - 7 Mar 2022

Cited by 8 | Viewed by 2702

Abstract

Both clinician-reported outcome measures (CROMs) measures and patient-reported outcome measures (PROMs) are applied to evaluate outcomes in rehabilitation settings. The previous data show only a low to moderate correlation between these measures. Relationships between functional performance measures (Clinician-Reported Outcome Measures, CROMs) and Patient-Reported Outcome Measures (PROMs) were analysed in rehabilitation patients with traumatic injuries of the lower limb. A cohort of 315 patients with 3 subgroups (127 hip, 101 knee and 87 ankle region) was analysed before and after 3 weeks of inpatient rehabilitation. All three groups showed significant improvements in PROMs with low to moderate effect sizes. Moderate to high effect sizes were found for CROMs. Correlation coefficients between CROMs and PROMs were low to moderate. The performance consistency between PROMs and CROMs ranged from 56.7% to 64.1%. In this cohort of rehabilitation patients with traumatic injuries, CROMs showed higher effect sizes than PROMs. When used in combination, patient-reported outcome and performance measures contribute to collecting complementary information, enabling the practitioner to make a more accurate clinical evaluation of the patient’s condition. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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16 pages, 2203 KiB

Open AccessArticle

Development of Clinical Prediction Rules for One-Year Postoperative Functional Outcome in Patients with Intertrochanteric Fractures: The Intertrochanteric Fracture Ambulatory Prediction (IT-AP) Tool

by Nath Adulkasem, Phichayut Phinyo, Jiraporn Khorana, Dumnoensun Pruksakorn and Theerachai Apivatthakakul

Int. J. Environ. Res. Public Health 2022, 19(1), 177; https://doi.org/10.3390/ijerph19010177 - 24 Dec 2021

Cited by 7 | Viewed by 3190

Abstract

Individualized prediction of postoperative ambulatory status for patients with intertrochanteric fractures is clinically relevant, during both preoperative and intraoperative periods. This study intended to develop clinical prediction rules (CPR) to predict one-year postoperative functional outcomes in patients with intertrochanteric fractures. CPR development was based on a secondary analysis of a retrospective cohort of patients with intertrochanteric fractures aged ≥50 years who underwent a surgical fixation. Good ambulatory status was defined as a New Mobility Score ≥ 5. Two CPR for preoperative and intraoperative predictions were derived using clinical profiles and surgical-related parameters using logistic regression with the multivariable fractional polynomial procedure. In this study, 221 patients with intertrochanteric fractures were included. Of these, 160 (72.4%) had good functional status at one year. The preoperative model showed an acceptable AuROC of 0.77 (95% CI 0.70 to 0.85). After surgical-related parameters were incorporated into the preoperative model, the model discriminative ability was significantly improved to an AuROC of 0.83 (95% CI 0.77 to 0.88) (p = 0.021). The newly-derived CPR enable physicians to provide patients with intertrochanteric fractures with their individualized predictions of functional outcome one year after surgery, which could be used for risk communication, surgical optimization and tailoring postoperative care that fits patients’ expectations. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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11 pages, 944 KiB

Open AccessArticle

Prevalence and Factors Associated with Musculoskeletal Disorders among Secondary Schoolteachers in Hail, Saudi Arabia: A Cross-Sectional Survey

by Omar W. Althomali, Junaid Amin, Wael Alghamdi and Daria Hussain Shaik

Int. J. Environ. Res. Public Health 2021, 18(12), 6632; https://doi.org/10.3390/ijerph18126632 - 20 Jun 2021

Cited by 16 | Viewed by 4138

Abstract

Musculoskeletal disorders (MSDs) are one of the most common occupational health hazards and serious health concerns among teachers. About 39% to 95% of teachers suffer from musculoskeletal pain that can lead to a decline in their performance, frequent sick leaves and early retirement, and can have a negative impact on their quality of life. The aim of this study was to investigate the prevalence of and risk factors for MSDs among secondary schoolteachers in Hail, Saudi Arabia. A cross-sectional study was conducted through an electronic survey. A self-reported and validated Arabic version of the Nordic Musculoskeletal Questionnaire (NMQ) was used. Participants were recruited randomly through a two-stage sampling technique. A total of 251 respondents (57.8% males and 42.2% females) returned the questionnaire. The overall prevalence of MSDs was 87.3%. Female teachers (95.3%) suffered more than their male counterparts (81.4%). The most common site was the lower back (62.55%), followed by the shoulders (53.39%) and knees (41.04%). Most of the participants (72.7%) reported MSDs in multiple sites. Binomial logistic regression predicted that smoking is a significant risk factor for lower back disorders (p < 0.05). A high prevalence of MSDs can be due to a substantial lack of awareness and practice of ergonomics, which warrant the development of preventive strategies and educational programs. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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10 pages, 712 KiB

Open AccessArticle

Risk of Mortality and Readmission among Patients with Pelvic Fracture and Urinary Tract Infection: A Population-Based Cohort Study

by Ying-Cheng Chen, Cheng-Hsun Chuang, Ming-Hong Hsieh, Han-Wei Yeh, Shun-Fa Yang, Chiao-Wen Lin, Ying-Tung Yeh, Jing-Yang Huang, Pei-Lun Liao, Chi-Ho Chan and Chao-Bin Yeh

Int. J. Environ. Res. Public Health 2021, 18(9), 4868; https://doi.org/10.3390/ijerph18094868 - 3 May 2021

Cited by 1 | Viewed by 2768

Abstract

Patients with pelvic fractures could encounter various complications during or after treatments. This cohort study investigated the risk of mortality and readmissions in patients with pelvic fractures, with or without urinary tract infections (UTIs), within 30 days following the pelvic fractures. This retrospective cohort study examined claim records from the Longitudinal Health Insurance Database 2000 (LHID2000). We selected patients hospitalized with pelvic fractures between 1997 and 2013 for study. Patients who had index data before 2000 or after 2010 (n = 963), who died before the index date (n = 64), who were aged <18 years (n = 94), or who had a pelvic injury (n = 31) were excluded. In total, the study cohort comprised 1623 adult patients; 115 had UTIs, and 1508 patients without UTIs were used as a comparison cohort. Multivariate analysis with a multiple Cox regression model and Kaplan–Meier survival analysis were performed to analyze the data. Our results showed that the 1-year mortality rate (adjusted hazard ratio [HR]: 2.32; 95% CI: 1.25–4.29) and readmission rate (adjusted HR: 1.72; 95% CI: 1.26–3.34) of the UTI group were significantly higher than those of the non-UTI group. Moreover, the Kaplan–Meier curve for the 1-year follow-up indicated that the UTI group had a higher cumulative risk of both mortality and hospital readmission compared with the non-UTI group. In conclusion, among patients with pelvic fracture, patients with UTI were associated with increased risks of mortality and readmission. Physicians must pay more attention to such patients to prevent UTIs among patients with pelvic fractures during hospitalization and conduct a follow-up after discharge within at least 1 year. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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12 pages, 536 KiB

Open AccessArticle

Association of Self-Reported Physical Fitness with Pregnancy Related Symptoms the GESTAFIT Project

by Nuria Marín-Jiménez, Milkana Borges-Cosic, Olga Ocón-Hernández, Irene Coll-Risco, Marta Flor-Alemany, Laura Baena-García, José Castro-Piñero and Virginia A. Aparicio

Int. J. Environ. Res. Public Health 2021, 18(7), 3345; https://doi.org/10.3390/ijerph18073345 - 24 Mar 2021

Cited by 3 | Viewed by 2478

Abstract

We explored the association of physical fitness (PF) with pregnancy-related symptoms, at the 16th and 34th gestational weeks (g.w.). The International Fitness Scale and the Pregnancy Symptoms Inventory were employed to assess self-reported PF and pregnancy-related symptoms, respectively. At the 16th g.w. greater self-reported overall PF was associated with lower incidence of urinary frequency (p = 0.020); greater overall PF, cardiorespiratory fitness (CRF), muscular strength and speed-agility were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater overall PF and speed-agility were associated with lower incidence of poor sleep (both, p < 0.05); greater CRF and flexibility were associated with lower limitations by tiredness-fatigue (both, p < 0.05); and greater flexibility was associated with lower limitations by poor sleep (p = 0.021). At the 34th g.w. greater self-reported overall PF, CRF and muscular strength were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater CRF was associated with lower incidence of poor sleep (p = 0.019); and, greater flexibility was associated with lower incidence of increased vaginal discharge (p = 0.023). Adequate levels of PF, especially CRF, may help women to cope with the most endorsed pregnancy-related symptoms and its limitations, especially tiredness-fatigue and poor sleep. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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Review

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15 pages, 3682 KiB

Open AccessReview

Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time

by Laura Ortega-Hombrados, Guadalupe Molina-Torres, Alejandro Galán-Mercant, Eduardo Sánchez-Guerrero, Manuel González-Sánchez and María Ruiz-Muñoz

Int. J. Environ. Res. Public Health 2021, 18(3), 1074; https://doi.org/10.3390/ijerph18031074 - 26 Jan 2021

Cited by 28 | Viewed by 11376

Abstract

Background: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: “Amyotrophic lateral sclerosis”, “Physical Therapy”, and “Physical and Rehabilitation Medicine”. The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. Results: 10 clinical trials were analyzed, with an internal validity of 5–7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. Conclusions: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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16 pages, 627 KiB

Open AccessStudy Protocol

‘Physio-EndEA’ Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis

by María del Mar Salinas-Asensio, Olga Ocón-Hernández, Antonio Mundo-López, Carolina Fernández-Lao, Francisco M. Peinado, Carmen Padilla-Vinuesa, Francisco Álvarez-Salvago, Paula Postigo-Martín, Mario Lozano-Lozano, Ana Lara-Ramos, Manuel Arroyo-Morales, Irene Cantarero-Villanueva and Francisco Artacho-Cordón

Int. J. Environ. Res. Public Health 2022, 19(3), 1738; https://doi.org/10.3390/ijerph19031738 - 2 Feb 2022

Cited by 8 | Viewed by 7862

Abstract

Aim: The ‘Physio-EndEA’ study aims to explore the potential benefits of a therapeutic exercise program (focused on lumbopelvic stabilization and tolerance to exertion) on the health-related quality of life (HRQoL) of symptomatic endometriosis women. Design: The present study will use a parallel-group randomized controlled trial design. Methods: A total of 22 symptomatic endometriosis women will be randomized 1:1 to the Physio-EndEA or usual care groups. The ‘Physio-EndEA’ program will consist of a one-week lumbopelvic stabilization learning phase followed by an eight-week phase of stretching, aerobic and resistance exercises focused on the lumbopelvic area that will be sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. The primary outcome measure is HRQoL. The secondary outcome measures included clinician-reported outcomes (pressure pain thresholds, muscle thickness and strength, flexibility, body balance and cardiorespiratory fitness) and patient-reported outcomes (pain intensity, physical fitness, chronic fatigue, sexual function, gastrointestinal function and sleep quality). Discussion: Findings of this study will help to identify cost-effective non-pharmacological options (such as this exercise-based intervention) that may contribute to the improvement of HRQoL in symptomatic endometriosis women. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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26 pages, 3162 KiB

Open AccessSystematic Review

Effect of Myofascial Therapy on Pain and Functionality of the Upper Extremities in Breast Cancer Survivors: A Systematic Review and Meta-Analysis

by Inmaculada Carmen Lara-Palomo, Adelaida María Castro-Sánchez, Marta María Córdoba-Peláez, Manuel Albornoz-Cabello and Lucía Ortiz-Comino

Int. J. Environ. Res. Public Health 2021, 18(9), 4420; https://doi.org/10.3390/ijerph18094420 - 21 Apr 2021

Cited by 6 | Viewed by 4062

Abstract

(1) Objective: The purpose was to analyze the effectiveness of myofascial therapy on musculoskeletal pain and functionality of the upper extremities in female breast cancer survivors, and to evaluate the changes in range of motion, quality of life, and mood state of these patients. (2) Methods: Systematic searches were performed on the MEDLINE/PubMed, Web of Science, Scopus, and Physiotherapy Evidence Databases for articles published until October 2020, in order to identify randomized controlled trials which analyzed the effectiveness of myofascial therapy as compared to a control group, passive treatment, placebo, or another intervention, and allowed co-interventions on female breast cancer survivors. Two reviewers examined the sources individually, calculated the risk of bias and extracted the data (PROSPERO number CRD42020215823). (3) Results: A total of eight RCTs were included. The results suggested that myofascial therapy does not have a greater statistically significant immediate effect on pain intensity (SMD: −0.15; 95% CI −0.48, 0.19), functionality (SMD: −0.17; 95% CI −0.43, 0.09) and range of motion in flexion (SMD: 0.30; 95% CI −0.13, 0.74) than an inactive, passive treatment or another intervention. However, a statistically significant result was observed for the abduction shoulder in favor of the experimental group (SMD: 0.46; 95% CI 0.05, 0.87; p = 0.03). (4) Conclusion: In general, although we found greater overall effects in support of the intervention with myofascial therapy than other control groups/types of interventions, the subgroup analysis revealed inconsistent results supporting myofascial therapy applied to breast cancer survivors. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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7 pages, 309 KiB

Open AccessStudy Protocol

Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

by Antonio Jose Martin-Perez, María Fernández-González, Paula Postigo-Martin, Marc Sampedro Pilegaard, Carolina Fernández-Lao, Eduardo Castro-Martín, Lydia Martín-Martín and Mario Lozano-Lozano

Int. J. Environ. Res. Public Health 2021, 18(8), 3991; https://doi.org/10.3390/ijerph18083991 - 10 Apr 2021

Viewed by 3113

Abstract

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Rehabilitation and Health)

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