Global prevalence of musculoskeletal pain in rural and urban populations. A systematic review with meta-analysis. Musculoskeletal pain in rural and urban populations.

INTRODUCTION: To systematically compare the global prevalence of musculoskeletal pain and care-seeking in rural and urban populations. METHODS: A systematic review with meta-analysis of observational studies reporting a direct comparison of rural and urban populations was conducted worldwide and included back, knee, hip, shoulder, neck pain and a broad diagnosis of 'musculoskeletal pain'. A search strategy combining terms related to 'prevalence', 'musculoskeletal pain' and 'rural' was used on the following databases: MEDLINE, Embase, CINAHL, Scopus, and rural and remote health from their inception to 1 June 2022. Random-effects meta-analysis was used to pool the data. Results were presented as odds ratios (OR) along with 95% confidence intervals (95% CI). RESULTS: A total of 42 studies from 24 countries were included with a total population of 489 439 participants. The quality scores for the included studies, using the modified Newcastle Ottawa Scale tool, showed an average score of 0.78/1, which represents an overall good quality. The pooled analysis showed statistically greater odds of hip (OR = 1.62, 95% CI = 1.23-2.15), shoulder (OR = 1.42, 95% CI = 1.06-1.90) and overall musculoskeletal pain (OR = 1.26, 95% CI = 1.08-1.47) in rural populations compared to urban populations. Although the odds of seeking treatment were higher in rural populations this relationship was not statistically significant (OR = 0.76, 95% CI = 0.55-1.03). CONCLUSION: Very low-certainty evidence suggests that musculoskeletal, hip and shoulder pain are more prevalent in rural than urban areas, although neck, back and knee pain, along with care-seeking, showed no significant difference between these populations. Strategies aimed to reduce the burden of musculoskeletal pain should consider the specific needs and limited access to quality evidence-based care for musculoskeletal pain of rural populations.

Effectiveness of an eHealth-Delivered Program to Empower People With Musculoskeletal Pain in Rural Australia: A Randomized Controlled Trial.

OBJECTIVE: Our objective was to evaluate the effectiveness of a three-month physiotherapist-delivered eHealth physical activity program compared with usual care to improve function in adults with low back pain or knee osteoarthritis in rural Australia. METHODS: This was a parallel, two-group, pragmatic, superiority, randomized controlled trial involving three- and six-month posttreatment follow-ups. There was a total of 156 adults with chronic nonspecific low back pain (n = 97) or knee osteoarthritis (n = 59) from rural Australia. The intervention involved an eHealth physical activity and an exercise program that included five to eight teleconsultations with a physiotherapist (primary time point three months) or usual care (eg, general practitioner, physiotherapy, and pain medication). The primary outcome was the Patient-Specific Functional Scale (0-30), with a three-point difference between groups being considered the minimum clinically important difference. RESULTS: Participants receiving the eHealth intervention (n = 78) reported significantly greater and clinically worthwhile improvements in function (mean between-group difference 3.6; 95% confidence interval [CI] 1.3-5.9) compared to participants receiving usual care (n = 78). Small but statistically significantly greater improvements in disability (7.2 of 100; 95% CI 2.1-12.3) and quality of life (4.5 of 100; 95% CI 0.0-9.0) also favored the eHealth group. No clinical or statistical differences between groups were found for the secondary outcomes of pain, coping skills, and physical activity levels. CONCLUSION: A physiotherapist-delivered eHealth intervention is effective and provides clinically meaningful improvements in function compared to usual care for people with musculoskeletal pain in rural communities. These findings highlight the potential for eHealth-based programs to improve access to evidence-based exercise interventions for people with musculoskeletal pain in rural communities.

Facilitating Access to Current, Evidence-Based Health Information for Non-English Speakers.

Scientific communication is crucial for the development of societies and the advancement of knowledge. However, many countries, and, consequently, their researchers, clinicians and community members, lack access to this information due to the information being disseminated in English rather than their native language. In this viewpoint, we aim to discuss the impacts of this problem and also outline recommendations for facilitating non-English speakers' access to current, evidence-based health information, thus extending the impact of science beyond academia. First, the authors discuss the barriers to accessing scientific health information for non-English speakers and highlight the negative impact of imposing English as a predominant language in academia. Next, the authors discuss the impacts of reduced access to clinical information for non-English speakers and how this reduced access impacts clinicians, clients, and health systems. Finally, the authors provide recommendations for enhancing access to scientific communication worldwide.

Implementation of physiotherapy telerehabilitation before and post Covid-19 outbreak: A comparative narrative between South American countries and Australia.

The continuous development in telecommunication tech-nologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These tech-nological advances, along with the demographic and social characteristics of each country, have made the implementa-tion of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Ocea-nia and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.

Prótesis de pivote medial y ultra-congruente: satisfacción y resultados clínicos. Serie de casos / Medial and ultra-congruent pivot designed prosthesis: satisfaction and clinical results. case series

Introducción La artroplastia total de rodilla es un procedimiento exitoso que mejora significativamente la calidad de vida de los pacientes disminuyendo el dolor e incrementando su capacidad funcional. Sin embargo, la literatura reporta hasta 25% de pacientes insatisfechos. El objetivo de este estudio es presentar los resultados clínicos y la satisfacción de un grupo de pacientes operados con implantes de tipo pivote medial y ultra-congruente. Materiales y métodos Se realizó un estudio observacional retrospectivo. Se revisaron las historias clínicas de todos los pacientes operados con los sistemas mencionados con mínimo 12 meses post-operatorios. Se analizaron resultados de 100 rodillas (96 pacientes) que completaron los cuestionarios, con una media de seguimiento de 33.5 meses. Se aplicaron los cuestionarios KSS, KOOS y WOMAC. Se estudiaron diferencias en dolor y función entre la etapa pre-operatoria y el último seguimiento. Se analizó la satisfacción de los pacientes con respecto al dolor y la capacidad funcional. Se evaluaron complicaciones presentadas. Resultados Todos los criterios presentaron una mejora estadísticamente significativa entre la etapa pre-operatoria y el último seguimiento. 97% de los pacientes reportaron estar satisfechos con los resultados. Las medias de los cuestionarios fueron entre 83.97 y 95.3. Se presentó 1 caso de revisión por infección peri-protésica. Discusión Las prótesis de pivote medial y ultra-congruente constituyen opciones eficaces y seguras para el tratamiento de artrosis de rodilla. Es necesario realizar estudios prospectivos y comparativos que generen evidencia de más alto nivel para confirmar los beneficios de estos diseños.

Background Total knee arthroplasty is a successful procedure that improves patient quality of life by reducing pain and increasing their functional capacity. However, literature reports up to 25% dissatisfaction in patients. The objective of the study is to present the clinical results and satisfaction of a group of patients operated on using ultra-congruent medial pivot-type implants. Methods A retrospective observational study was carried out. The medical records of all the patients who underwent knee arthroplasty surgery with a specific system were reviewed, including patients with a minimum of 12 months follow up. An analysis was performed on the results of 100 knees (96 patients) that had completed questionnaires. There was a mean follow-up of 33.5 months. The KSS, KOOS, and WOMAC questionnaires were used. Differences in pain and function between the pre-surgical stage and the last follow-up were studied. An analysis was made on patient satisfaction with regard to pain and functional capacity. Specific complications were evaluated. Results All evaluation criteria showed a statistically significant improvement between the pre-surgical stage and the last follow-up. Almost all (97%) of patients reported being satisfied with the results. The means of the questionnaires were between 83.97 and 95.3. One case of revision due to peri-prosthetic infection was presented. Discussion Medial pivot and ultra-congruent prostheses designs are effective and safe options for the treatment of osteoarthritis of the knee. Prospective and comparative studies that generate higher level evidence are necessary to confirm the benefits of these designs.