Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Feb 2019
GLA:D® Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study.
Reassuring patient education and exercise therapy are widely recommended interventions for back pain in clinical guidelines. However, many patients are offered non-guideline endorsed options, and strategies for effective implementation of guideline-based care have not yet been developed. This protocol outlines the evaluation of a strategy for nationwide implementation of standardised patient education and exercise therapy for people with persistent or recurrent back pain in a hybrid implementation-effectiveness design. The strategy and the evaluation were planned using the framework of the Behaviour Change Wheel. ⋯ This implementation-effectiveness study is designed to evaluate the process of implementing an evidence-based intervention for back pain. It will inform the development of strategies for implementing evidence-based care for musculoskeletal pain conditions, it will enhance the understanding of mechanisms for developing patient self-management skills, and it will demonstrate the outcomes that are achievable in everyday clinical practice.
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Bmc Musculoskel Dis · Feb 2019
Randomized Controlled Trial Multicenter StudyEffect of Vitamin D supplementation on synovial tissue volume and subchondral bone marrow lesion volume in symptomatic knee osteoarthritis.
Data from a recent clinical trial of vitamin D therapy in knee OA suggests that, compared to placebo, vitamin D therapy may be associated with a reduction in effusion-synovitis. Our aim was, using contrast-enhanced (CE) magnetic resonance imaging (MRI), to examine the effect of vitamin D therapy on synovial tissue volume (STV) and also subchondral bone marrow lesion (BML) volume in men and women with symptomatic knee OA. ⋯ Vitamin D supplementation does not appear to have an effect on synovitis or BML volume in patients with symptomatic knee OA.
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Bmc Musculoskel Dis · Feb 2019
Does isolated greater trochanter implication affect hip abducent strength and functions in intertrochanteric fracture?
A fracture in the isolated greater trochanter is an infrequent type of femoral intertrochanteric fracture. The gluteus medius and gluteus minimus are abducent muscle groups with attachments located on the greater trochanter. Thus, a fracture of the greater trochanter could cause avulsion injury of these attachment points and eventually affect the abducent function of the hip joint and cause chronic pain. Despite these prospects, the impact of a greater trochanter fracture on abducent strength and hip joint function have yet to be investigated. ⋯ Results from this investigation suggest that an isolated greater trochanter fracture attenuates the abducent strength of the hip joint, which may be related to injuries of the ligaments and muscles around the greater trochanter. The surgical skills and methods of addressing isolated greater trochanter fractures merit further investigation.
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Bmc Musculoskel Dis · Feb 2019
Randomized Controlled TrialIntegrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.
Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge. ⋯ The health coaching physical activity approach trialed here is feasible and well accepted by participants and may reduce care-seeking in patients with low back pain after treatment discharge, although further evaluation with an adequately powered trial is needed.
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Bmc Musculoskel Dis · Feb 2019
Case ReportsLengthening of free fibular grafts for reconstruction of the residual leg length discrepancy.
We evaluated our results of lengthening of free vascularized fibular grafts using a unilateral external fixator in patients with residual leg length discrepancy after free vascularized fibular graft for lower limb reconstruction. ⋯ This study shows that lengthening of free vascularized fibular grafts with an external fixator is an effective treatment for massive residual leg shortening after vascularized free fibular graft surgery.