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Musculoskeletal assessment
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Musculoskeletal as an adjective describes aspects of, or involving, both the musculature and the skeleton of the body. There are more than 150 musculoskeletal conditions or disorders affecting the locomotor system. These conditions are burdensome, typically associated with pain, exhibit relatively high prevalence (> 21%; World Health Organization [WHO], 2021) and significantly limit mobility, dexterity and overall level of functioning (Cieza et al., 2020). Conditions range from those arising acutely (fractures, sprains, strains) to ones involving life-long persistence affecting joints (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), bones (osteoporosis, osteopenia, traumatic and fragility fractures), muscles (sarcopenia), spine (back and neck pain) and multiple areas and systems involving regional or widespread pain disorders and inflammatory diseases affecting connective and vascular tissue.
Musculoskeletal health in the community
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Musculoskeletal complaints are often experienced by the elderly, and they place negative impacts on the quality of life with ageing. Degraded articular cartilage, loss of bone and degenerated, narrowed intervertebral discs are usually observed in an ageing skeleton, and all these conditions together contribute to pain and the loss of mobility (Roberts et al., 2016). The most common musculoskeletal disorders found in older adults are osteoporosis, sarcopenia, tendinopathies and arthritis (Minetto et al., 2020). These conditions interfere with general wellbeing, add risk of developing chronic diseases, as well as increase all-cause mortality. They also represent a threat to healthy ageing and are expected to become more significant in the coming decades, leading to a growing public health and socio-economic burden to the community.
Introduction
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Other factors that have been shown to be predictors of higher postoperative pain reports are younger age (pain decreases as age increases), the presence of preoperative pain, and preoperative opioid use. Preoperative anxiety and depression or negative affect and pain catastrophizing may also correlate with higher postoperative opioid requirements and/or pain intensity as well as a higher risk of developing chronic pain after surgery (Chapter 13) and persistent postdischarge opioid use (Chapter 16) (Schug et al, 2020). These factors have also been associated with more widespread reports of pain and persistence of pain after acute musculoskeletal trauma.
Comorbid conditions as predictors of mortality in severe COPD – an eight-year follow-up cohort study
Published in European Clinical Respiratory Journal, 2023
Gabriella Eliasson, Christer Janson, Gunnar Johansson, Kjell Larsson, Anders Lindén, Claes-Göran Löfdahl, Thomas Sandström, Josefin Sundh
At baseline, information was collected by the responsible physician from history and medical record review on sex, age, smoking history, body weight and height, current pharmacological treatment, number of exacerbations the recent year, the phenotype of chronic bronchitis and comorbid conditions in terms of cardiovascular disease, diabetes, impaired kidney function, malnutrition, musculoskeletal symptoms, osteoporosis or depression. An exacerbation was defined as worsening of symptoms of dyspnea and sputum beyond normal day-to-day variation, requiring increased maintenance treatment, courses of antibiotics or oral steroids or an emergency visit or hospitalization [22]. The phenotype of chronic bronchitis was defined as productive cough of more than three months occurring within the span of two years [2]. All the comorbid conditions were defined as recorded doctor´s diagnoses with ongoing in need of pharmacological or non-pharmacological treatment. Cardiovascular disease included any of the diagnoses of ischemic heart disease, heart failure, atrial fibrillation or flutter or cerebrovascular disease. Impaired kidney function denoted chronical renal impairment and not transient renal failure with normalized kidney function. Musculoskeletal problems included any condition with symptoms of muscle weakness, pain or joint diseases including rheumatic diseases, osteoarthritis as well as arthrosis.
Validation of the international classification of functioning, disability, and health (ICF) core sets for musculoskeletal conditions in a primary health care setting from physiotherapists’ perspective using the Delphi method
Published in Disability and Rehabilitation, 2023
Hector Hernandez-Lazaro, Maria Teresa Mingo-Gómez, Luis Ceballos-Laita, Ricardo Medrano-de-la-Fuente, Sandra Jimenez-del Barrio
In clinical practice, the diagnosis of musculoskeletal conditions can be performed according to the International Classification of Diseases (ICD). This classification includes more than 150 diagnoses related to this type of pathology. The most frequent are osteoarthritis, spinal pain (cervicalgia and low back pain), fragility fractures, traumatic injuries, and some systemic inflammatory diseases (such as rheumatoid arthritis) [2]. In 2019, musculoskeletal conditions constituted the second leading cause of disability worldwide, accounting for 17% of years lived with disability [1]. These disorders are one of the main reasons for consultation in primary care, accounting for up to 18% of all general practitioner consultations [4]. Despite their relevance, these professionals have shown low accuracy in the diagnosis and suboptimal management of musculoskeletal conditions [5–7]. Instead, some authors have proposed that musculoskeletal conditions could be addressed by physiotherapists rather than general practitioners, including triage and direct-access services [4,8–10]. Although the evidence is limited, many studies suggest that physiotherapists can achieve clinical outcomes similar to those of general practitioners but with lower healthcare consumption [11–13]. Therefore, primary care physiotherapists could be determinant to improve the functioning and the quality of life of people suffering from musculoskeletal conditions.
A novel Home Exercise Assessment Tool (HEAT) to assess recall and performance: A reliability study
Published in Physiotherapy Theory and Practice, 2023
Joshua Halfpap, Christopher Allen, Daniel I. Rhon
Exercise is an effective, low-risk treatment for a variety of musculoskeletal disorders (Chou et al., 2017; Escolar-Reina et al., 2010; Qaseem et al., 2020; Uthman et al., 2014). While designs of exercise programs vary, most physical therapy interventions include some variation of an independent, unsupervised exercise regimen most often referred to as a home exercise plan. One of the biggest challenges to Physical Therapy practice is ensuring patients adhere to prescribed exercises while they are unsupervised as adherence is thought to be at or below 50% of prescribed levels (Escolar-Reina et al., 2010; Medina-Mirapeix et al., 2009). A systematic review by Essery, Geraghty, Kirby, and Yardley (2017) found that non-adherence to physical rehab programs, specifically for home-based programs is particularly high. Clinicians estimate only 64% of patients adhere to recommendations in the short term and 23% in the long term (Sluijs, Kok, and van der Zee, 1993). Similar to poor adherence to medication regimens (de Sousa Oliveira, José, and Caldas, 2017; Gokoel et al., 2020), poor exercise adherence poses a barrier to understanding the effectiveness of treatments and translating empirically validated interventions to clinical practice (Aitken, Buchbinder, Jones, and Winzenberg, 2015; Escolar-Reina et al., 2010; Medina-Mirapeix et al., 2009).