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Musculoskeletal Injuries, Rehabilitation and Impact on Public Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 35539

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Dr. Domiziano Tarantino

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Department of Public Health, Rehabilitation Unit, University of Naples Federico II, Via Sergio Pansini nr. 5, 80131 Naples, Italy
Interests: rehabilitation medicine; physical therapy; musculoskeletal disorders; sports injuries; injury prevention; public health
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Dr. Bruno Corrado

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Guest Editor

Department of Public Health, Rehabilitation Unit, University of Naples Federico II, 80131 Naples, Italy
Interests: physical medicine and rehabilitation; musculoskeletal rehabilitation; neurological rehabilitation; sports rehabilitation; musculoskeletal ultrasound; ultrasound-guided injections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal injuries can affect any part of the human body, including bones, joints, cartilage, ligaments, tendons, muscles, and other soft tissues.

Musculoskeletal injuries are rapidly increasing due to both increased participation in sports and recreational activities, as well as population growth and aging. Musculoskeletal injuries can be traumatic or non-traumatic, and require a correct diagnosis and appropriate treatment. At present, advances in conservative and surgical treatments provide patients the best care to reduce pain and restore functionality.

The rehabilitation of musculoskeletal injuries plays a key role in a proper model of care. The goal of a correct rehabilitation is to restore abilities, functions and autonomy after a musculoskeletal injury. The timing of rehabilitation represents a core concept in the management of musculoskeletal injuries.

According to the WHO, musculoskeletal conditions are the highest contributor to the global need for rehabilitation, and account for approximately two-thirds of all adults in need of rehabilitation, representing an important burden for public health.

In this Special Issue, we are pleased to invite researchers in the field of musculoskeletal injuries and their rehabilitation to submit high-quality articles or reviews related to the issues in these research areas.

Dr. Domiziano Tarantino
Dr. Bruno Corrado
Guest Editors

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Keywords

musculoskeletal injuries
sports injuries
rehabilitation medicine
physical therapy
injury prevention
orthopedic rehabilitation
musculoskeletal surgery
conservative treatment of musculoskeletal injuries
infiltrative treatment
musculoskeletal injuries impact on public health

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Published Papers (9 papers)

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Research

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9 pages, 354 KiB

Open AccessCommunication

Increased Barefoot Stride Variability Might Be Predictor Rather than Risk Factor for Overuse Injury in the Military

by Darja Nesterovica-Petrikova, Normunds Vaivads and Ainārs Stepens

Int. J. Environ. Res. Public Health 2023, 20(15), 6449; https://doi.org/10.3390/ijerph20156449 - 26 Jul 2023

Viewed by 1334

Abstract

Footwear usage could be a promising focus in reducing musculoskeletal injury risk in lower extremities commonly observed among the military. The goal of this research was to find potential gait-related risk factors for lower leg overuse injuries. Cases (n = 32) were active-duty infantry soldiers who had suffered an overuse injury in the previous six months of service before enrolling in the study. The control group (n = 32) included infantry soldiers of the same age and gender who did not have a history of lower leg overuse injury. In the gait laboratory, individuals were asked to walk on a 5-m walkway. Rearfoot eversion, ankle plantar/dorsiflexion and stride parameters were evaluated for barefoot and shod conditions. Barefoot walking was associated with higher stride time variability among cases. According to the conditional regression analysis, stride time variability greater than 1.95% (AUC = 0.77, 95% CI (0.648 to 0.883), p < 0.001) during barefoot gait could predict lower leg overuse injury. Increased barefoot gait variability should be considered as a possible predictive factor for lower leg overuse injury in the military, and gait with military boots masked stride-related differences between soldiers with and without lower leg overuse injury. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

13 pages, 626 KiB

Open AccessArticle

Analysis and Report of the Physical and Rehabilitation Medicine Evaluation Activity in Patients Admitted to Acute Care Setting: An Observational Retrospective Study

by Andrea Bernetti, Marco Ruggiero, Pierangela Ruiu, Martina Napoli, Rossella D’Urzo, Annalisa Mancuso, Flavio Mariani, Luigi Tota, Francesco Agostini, Massimiliano Mangone and Marco Paoloni

Int. J. Environ. Res. Public Health 2023, 20(11), 6039; https://doi.org/10.3390/ijerph20116039 - 2 Jun 2023

Viewed by 1713

Abstract

Background. Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for rehabilitation early. Although access to rehabilitation services varies from country to country, it should always be governed by a PRM prescription. Objective. The aim of the present observational retrospective study is to describe consultancy activity performed by PRM specialists in a university hospital in terms of requests’ typology, clinical questions, and rehabilitation setting assignment. Methods. Multiple parameters were analyzed (clinical condition, patient’s socio-family background, and rehabilitation assessment scale scores) and a correlation analysis was performed between the analyzed characteristics and both the different clinical conditions and the assigned rehabilitation setting. Results. PRM evaluations of 583 patients from 1 May 2021 to 30 June 2022 were examined. Almost half of the total sample (47%) presented disability due to musculoskeletal conditions with a mean age of 76 years. The most frequently prescribed settings were home rehabilitation care, followed by intensive rehabilitation and long-term care rehabilitation. Conclusions. Our results suggest the high public health impact of musculoskeletal disorders, followed by neurological disorders. This is, however, without forgetting the importance of early rehabilitation to prevent other types of clinical conditions such as cardiovascular, respiratory, or internal diseases from leading to motor disability and increasing costs. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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11 pages, 1609 KiB

Open AccessArticle

Radial or Focal Extracorporeal Shock Wave Therapy in Lateral Elbow Tendinopathy: A Real-Life Retrospective Study

by Raffaello Pellegrino, Angelo Di Iorio, Serena Filoni, Paolo Mondardini, Teresa Paolucci, Eleonora Sparvieri, Domiziano Tarantino, Antimo Moretti and Giovanni Iolascon

Int. J. Environ. Res. Public Health 2023, 20(5), 4371; https://doi.org/10.3390/ijerph20054371 - 28 Feb 2023

Cited by 6 | Viewed by 2554

Abstract

Lateral elbow tendinopathy (LET) is characterized by pain, poor muscle strength of the wrist ex-tensors, and disability. Among the conservative rehabilitative approaches, focal as well as radial extracorporeal shock wave therapy (ESWT), are considered effective in LET management. The objective of this study was to compare the safety and effectiveness of focal (fESWT) and radial (rESWT) in terms of LET symptoms and the strength of wrist extensors, taking into account potential gender differences. This is a retrospective longitudinal cohort study of patients with LET treated with ESWT that had received a clinical and functional evaluation, including visuo-analogic scale (VAS), muscle strength using an electronic dynamometer during Cozen’s test, and the patient-rated tennis elbow evaluation (PRTEE) questionnaire. Follow-ups were carried out weekly in four visits after enrollment, and at 8 and 12 weeks. During the follow-ups, the VAS score decreased in both treatments, even if patients receiving fESWT reported early pain relief compared to those treated with rESWT (time for treatment p-value < 0.001). Additionally, peak muscle strength increased independently of the device used, and again more rapidly in the fESWT group (time for treatment p-value < 0.001). In the stratified analysis for sex and for the type of ESWT, rESWT appears to be less effective in female participants in terms of mean muscle strength and PRTEE scores, without differences according to the type of device used. The rESWT group reported a higher rate of minor adverse events (i.e., discomfort, p = 0.03) compared to fESWT. Our data suggest that both fESWT and rESWT might be effective in improving LET symptoms, even if the higher rate of painful procedures were reported in patients treated with rESWT. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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11 pages, 1401 KiB

Open AccessArticle

Effects of 8-Week Electromyostimulation Training on Upper-Limb Muscle Activity and Respiratory Gas Analysis in Athletes with Disabilities

by Jongbin Kim, Joonsung Park, Jeongok Yang, Youngsoo Kim, Inhyung Kim, Himchan Shim, Changho Jang, Mincheol Kim, Myeongcheol Kim and Bomjin Lee

Int. J. Environ. Res. Public Health 2023, 20(1), 299; https://doi.org/10.3390/ijerph20010299 - 24 Dec 2022

Cited by 1 | Viewed by 2348

Abstract

This study was aimed at verifying the efficacy of EMS training by investigating the changes in upper-limb muscle functions and energy expenditure in athletes with disabilities after an 8-week intervention of EMS training. We compared variations in muscle activity, respiratory gas, and symmetry index (SI) after an 8-week intervention in eight professional male athletes with disabilities wearing an electromyostimulation (EMS) suit (age: 42.00 ± 8.67 years, height: 1.65 ± 0.16 m, weight: 64.00 ± 8.72 kg, career length: 11.75 ± 3.83 years). For EMS training, each participant wore an EMS suit. EMS was applied to the upper-limb muscles pectoralis major and triceps at 40 °C water temperature, with a 25 Hz frequency (duty cycle 10%) for 15 min, followed by a 5 Hz frequency (duty cycle 5%) for 5 min. The pre- and post-intervention measurements were taken in the same way at a pre-set time (for 1 h, twice a week) for 8 weeks. Training involved a seated chest press, and the muscle activity (pectoralis major, triceps, and antebrachial muscles), upper-limb SI, and respiratory gas variables (maximal oxygen consumption (VO₂), carbon dioxide output (VCO₂), respiratory quotient (RQ), metabolic equivalents (METs), and energy expenditure per min (Energy expended per minute; EEm)) were analyzed. Variations pre- and post-intervention across the measured variables were analyzed. Regarding the change in muscle activity, significant variations were found in the pectoralis major right (p < 0.004), pectoralis major left (p < 0.001), triceps right (p < 0.002), and antebrachial right (p < 0.001). Regarding left-to-right SI, a positive change was detected in the pectoralis major and triceps muscles. Additionally, respiratory gas analysis indicated significant variations in VO₂ (p < 0.001), VCO₂ (p < 0.001), METs (p < 0.001), and EEm (p < 0.001). EMS training improved muscle strength and respiratory gas variables and is predicted to contribute to enhanced muscle function and rehabilitation training for athletes with disabilities. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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11 pages, 717 KiB

Open AccessArticle

Could the Improvement of Supraspinatus Muscle Activity Speed up Shoulder Pain Rehabilitation Outcomes in Wheelchair Basketball Players?

by Giacomo Farì, Marisa Megna, Maurizio Ranieri, Francesco Agostini, Vincenzo Ricci, Francesco Paolo Bianchi, Ludovica Rizzo, Eleonora Farì, Lucrezia Tognolo, Valerio Bonavolontà, Pietro Fiore and Victor Machado Reis

Int. J. Environ. Res. Public Health 2023, 20(1), 255; https://doi.org/10.3390/ijerph20010255 - 24 Dec 2022

Cited by 9 | Viewed by 2723

Abstract

Shoulder pain (SP) is a common clinical complaint among wheelchair basketball (WB) players, since their shoulders are exposed to intense overload and overhead movements. The supraspinatus tendon is the most exposed to WB-related injuries and it is primarily responsible for SP in WB athletes. In these cases, SP rehabilitation remains the main treatment, but there is still a lack of specific protocols which should be customized to WB players’ peculiarities and to the supraspinatus muscle activity monitor, and the improvement of rehabilitation outcomes is slow. Thus, the aim of this study was to verify if the improvement of supraspinatus muscle activity, monitored in real time with surface electromyography (sEMG) during the execution of therapeutic exercises, could speed up SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled. They were divided into two groups. Both groups underwent the same shoulder rehabilitation program, but only the Exercise Plus sEMG Biofeedback Group executed therapeutic exercises while the activity of the supraspinatus muscles was monitored using sEMG. Participants were evaluated at enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), using the following outcome measures: supraspinatus muscle activity as root mean square (RMS), Wheelchair User’s Shoulder Pain Index (WUSPI), shoulder abduction, and external rotation range of motion (ROM). The Exercise Plus sEMG Biofeedback Group improved more and faster for all the outcomes compared to the Exercise Group. The monitoring and improvement of supraspinatus muscle activity seems to be an effective way to speed up SP rehabilitation outcomes in WB players, since it makes the performance of therapeutic exercise more precise and finalized, obtaining better and faster results in terms of recovery of shoulder function. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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Review

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9 pages, 333 KiB

Open AccessReview

Intra-Articular Collagen Injections for Osteoarthritis: A Narrative Review

by Domiziano Tarantino, Rosita Mottola, Stefano Palermi, Felice Sirico, Bruno Corrado and Rossana Gnasso

Int. J. Environ. Res. Public Health 2023, 20(5), 4390; https://doi.org/10.3390/ijerph20054390 - 1 Mar 2023

Cited by 9 | Viewed by 5673

Abstract

Osteoarthritis (OA) is the most frequent degenerative progressive joint disease worldwide, with the hand, hip, and knee being the most-affected joints. Actually, no treatment can alter the course of OA, and therapy is directed at reducing pain and improving function. The exogenous administration of collagen has been investigated as a possible symptomatic adjuvant or stand-alone treatment for OA. The aim of this review is to assess if intra-articular collagen administration can be considered as a valid and safe therapeutic option for OA. A search in the main scientific electronic databases to identify the available scientific articles about the effects of intra-articular collagen as an OA treatment was performed. The results of the seven included studies showed that the intra-articular administration of collagen may stimulate chondrocytes to produce hyaline cartilage and hinder the normal inflammatory response leading to fibrous tissue formation, reducing symptoms, and improving functionality. The use of type-I collagen as an intra-articular treatment for knee OA was found not only to be effective, but also safe with negligible side effects. The reported findings are strongly promising, highlighting the need for further high-quality research to confirm the consistency of these findings. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

11 pages, 2615 KiB

Open AccessReview

Ultrasound Imaging and Guidance for Cervical Myofascial Pain: A Narrative Review

by Vincenzo Ricci, Kamal Mezian, Ke-Vin Chang, Domiziano Tarantino, Orhan Güvener, Fabrizio Gervasoni, Ondřej Naňka and Levent Özçakar

Int. J. Environ. Res. Public Health 2023, 20(5), 3838; https://doi.org/10.3390/ijerph20053838 - 21 Feb 2023

Cited by 12 | Viewed by 5018

Abstract

Cervical myofascial pain is a very common clinical condition in the daily practice of musculoskeletal physicians. Physical examination is currently the cornerstone for evaluating the cervical muscles and identifying the eventual presence of myofascial trigger points. Herein, the role of ultrasound assessment in precisely localizing them is progressively mounting in the pertinent literature. Moreover, using ultrasound, not only the muscle tissue but also the fascial and neural elements can be accurately located/evaluated. Indeed, several potential pain generators, in addition to paraspinal muscles, can be involved in the clinical scenario of cervical myofascial pain syndrome. In this article, the authors extensively reviewed the sonographic approach for cervical myofascial pain in order to better diagnose or guide different procedures that can be performed in the clinical practice of musculoskeletal physicians. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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18 pages, 762 KiB

Open AccessReview

Risk Factors to Persistent Pain Following Musculoskeletal Injuries: A Systematic Literature Review

by Othman Alkassabi, Lennard Voogt, Pamela Andrews, Ahmad Alhowimel, Jo Nijs and Hana Alsobayel

Int. J. Environ. Res. Public Health 2022, 19(15), 9318; https://doi.org/10.3390/ijerph19159318 - 29 Jul 2022

Cited by 9 | Viewed by 3558

Abstract

Background: Musculoskeletal (MSK) injury is one of the major causes of persistent pain. Objective: This systematic literature review explored the factors that lead to persistent pain following a MSK injury in the general population, including athletes. Methods: A primary literature search of five electronic databases was performed to identify cohort, prospective, and longitudinal trials. Studies of adults who diagnosed with a MSK injury, such as sprains, strains or trauma, were included. Results: Eighteen studies involving 5372 participants were included in this review. Participants’ ages ranged from 18–95 years. Most of the included studies were of prospective longitudinal design. Participants had a variety of MSK injuries (traumatic and non-traumatic) causing persistent pain. Multiple factors were identified as influencing the development of persistent pain following a MSK injury, including high pain intensity at baseline, post-traumatic stress syndrome, presence of medical comorbidities, and fear of movement. Scarcity of existing literature and the heterogeneity of the studies made meta-analysis not possible. Conclusions: This systematic review highlighted factors that might help predict persistent pain and disability following MSK injury in the general population, including athletes. Identification of these factors may help clinicians and other health care providers prevent the development of persistent pain following a MSK injury. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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Other

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15 pages, 5419 KiB

Open AccessSystematic Review

Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis

by Zhengze Yu, Yikun Yin, Jialin Wang, Xingxing Zhang, Hejia Cai and Fenglin Peng

Int. J. Environ. Res. Public Health 2023, 20(4), 2850; https://doi.org/10.3390/ijerph20042850 - 6 Feb 2023

Cited by 10 | Viewed by 9007

Abstract

Background: Chronic low back pain (CLBP) is a common health problem. Pilates is a unique exercise therapy. This meta-analysis aims to evaluate the efficacy of Pilates on pain, functional disorders, and quality of life in patients with chronic low back pain (CLBP). Methods: PubMed, Web of Science, CNKI, VIP, Wanfang Data, CBM, EBSCO, and Embase were searched. Randomized controlled trials of Pilates in the treatment of CLBP were collected based on the inclusion and exclusion criteria. The meta-analysis was performed using RevMan 5.4 and Stata 12.2. Results: 19 randomized controlled trials with a total of 1108 patients were included. Compared with the controls, the results showed the following values: Pain Scale [standard mean difference; SMD = −1.31, 95%CI (−1.80, −0.83), p < 0.00001], Oswestry Disability Index (ODI) [mean difference; MD = −4.35, 95%CI (−5.77, −2.94), p < 0.00001], Roland–Morris Disability Questionnaire (RMDQ) [MD = −2.26, 95%CI (-4.45, −0.08), p = 0.04], 36-item Short-Form (SF-36) (Physical Function (PF) [MD = 5.09, 95%CI (0.20, 9.99), p = 0.04], Role Physical (RP) [MD = 5.02, 95%CI (−1.03, 11.06), p = 0.10], Bodily Pain (BP) [MD = 8.79, 95%CI (−1.57, 19.16), p = 0.10], General Health (GH) [MD = 8.45, 95%CI (−5.61, 22.51), p = 0.24], Vitality (VT) [MD = 8.20, 95%CI(−2.30, 18.71), p = 0.13], Social Functioning (SF) [MD = −1.11, 95%CI (−7.70, 5.48), p = 0.74], Role Emotional (RE) [MD = 0.86, 95%CI (−5.53, 7.25), p = 0.79], Mental Health (MH) [MD = 11.04, 95%CI (−12.51, 34.59), p = 0.36]), Quebec Back in Disability Scale (QBPDS) [MD = −5.51, 95%CI (−23.84, 12.81), p = 0.56], and the sit-and-reach test [MD = 1.81, 95%CI (−0.25, 3.88), p = 0.09]. Conclusions: This meta-analysis reveals that Pilates may have positive efficacy for pain relief and the improvement of functional disorders in CLBP patients, but the improvement in quality of life seems to be less obvious. Registration: PROSPERO CRD42022348173. Full article

(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)

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