Research Articles and Resources

At Osteopathy Australia, our aim is to build a strong evidence base for the work of osteopaths. This involves reviewing the available literature to highlight relevant research for members, particularly with regard to its significance in clinical practice. We also have a range of research-related information sheets available to members on common research topics such as data analysis, grant writing, writing manuscripts and case reports, and choosing journals.

December 2022

Person-centered care for musculoskeletal pain. The importance of person-centered care cannot be ignored. It remains an important aspect of contemporary care and focuses on building positive and beneficial therapeutic relationships between patients and practitioners. A masterclass published in the Journal of Musculoskeletal Science and Practice has provided clinicians with advice on how to overcome some of the obstacles associated with the care model, and practical recommendations for putting the principles of person-centered care into practice.
^{_{Hutting, N., Caneiro, J. P., Ong'wen, O. M., Miciak, M., & Roberts, L. (2022). Person-centered care for musculoskeletal pain: Putting principles into practice. Musculoskeletal Science and Practice, 102663.}}

Perspective: Re-examining non-specific low back pain (NSLBP). A recent perspective published in The Spine Journal has looked into non-specific low back pain, noting the misconceptions that may have arisen and how different views may impede on progress, care, and understanding. The paper more specifically discusses how the term may inevitably result in the use of non-specific treatment options and/or diagnostic research seeking to identify specific causes (which is of no significant value). The authors further suggested that while the term is of use and should continue to be used in current terms, it may not be the way forward.
_{^{Han, C. S., Hancock, M. J., & Maher, C. G. (2022). Reconsidering non-specific low back pain: where to from here? The Spine Journal. 22 (12), 1927-1930.}}

November 2022

Pandemic impacts on psychosocial work factors and emotional exhaustion among Dutch healthcare workers. Unfavourable and stressful working conditions have been associated with poor mental health among healthcare workers with more recent research showing that the COVID-19 pandemic was associated with a steep increase in adverse working conditions. A recent paper in the journal of Occupational & Environmental Medicine has looked at the impact of the COVID-19 pandemic among Dutch healthcare workers. The authors utilised a battery of questionnaires to assess emotional exhaustion and psychosocial working conditions pre-pandemic and during the Covid pandemic, grouping workers on those working with Covid patients, those working with other patients, and those not working with patients. Surprisingly, the team found no changes in emotional exhaustion but did note that psychosocial working conditions deteriorated among healthcare workers who worked with Covid patients.
^{_{van Elk, F., Robroek, S. J., Burdorf, A., & Hengel, K. M. O. (2022). Impact of the COVID-19 pandemic on psychosocial work factors and emotional exhaustion among workers in the healthcare sector: a longitudinal study among 1915 Dutch workers. Occupational and Environmental Medicine.}}

Commercial wearable activity trackers for the clinical monitoring – what are the limitations? Commercial wearable activity trackers, such as FitBits and Apple watches, are affordable, easy to use, and patients may already use them for lifestyle advice so their value in clinical intervention has become of interest. Curtis and team have looked at the feasibility of using these commercial devices to monitor patients remotely. They recruited 43 participants who wore a device every day for four months. Following data analysis, the team noted that compliance was not of concern but data loss due to sync errors were. Such limitations would impact the feasibility of using commercially available devices and should be considered if using them for medical/research purposes in future.
^{_{Curtis, O. (2022). 5 The limitations of using commercial wearable activity trackers, such as FitBits, for the clinical monitoring of patient activity levels. BMJ Health & Care Informatics}}

FIBROWALK multicomponent therapy for fibromyalgia (protocol - On&Out study). A recent protocol in the journal Frontiers in Physiology has outlined the new On and & Out study that focuses on the effectiveness, cost, and physiology of FIBROWALK therapy (online and outdoors) for fibromyalgia. While FIBROWALK has been shown to be effective short term, no long-term investigation has been completed. As such, the authors will recruit over 200 participants to complete a comprehensive assessment on functional impairment, pain, fatigue, mental health, physical function, and sleep – with results to be published post-trial.
_{^{Serrat, M., Ferrés, S., Auer, W., Almirall, M., Lluch, E., D’Amico, F., ... & Feliu-Soler, A. (2022). Effectiveness, cost-utility and physiological underpinnings of the FIBROWALK multicomponent therapy in online and outdoor format in individuals with fibromyalgia: Study protocol of a randomized, controlled trial (On&Out study). Frontiers in Physiology, 2335.}}

October 2022

Statistical approaches to musculoskeletal injury risk. Predictor models are common in research and there are many aimed at accurately predicting which individuals are at higher risk for injury, particularly musculoskeletal injury. However, a study by Rhon and team in BMJ Open Sport & Exercise Medicine noted that many of those studies tend to dichotomise continuous-level predictors or will select predictors based on their magnitude in univariate analysis. This remains an issue due to oversimplification which results in including or excluding relevant predictors and changing predictive values which in turn may limit the validity of the models. Their replication study found that an original dichotomised model showed poorer performance compared to continuous models suggesting that while more difficult, proper statistical approaches may provide a better individualised risk profile.
^{_{Rhon, D. I., Teyhen, D. S., Collins, G. S., & Bullock, G. S. (2022). Predictive models for musculoskeletal injury risk: why statistical approach makes all the difference. BMJ open sport & exercise medicine, 8(4), e001388.}}

A review of 3D digital applications in manual therapy. Teaching physical assessment and palpation skills in manual therapy remains challenging for both students and educators. But with the use of digital technology for education in health streams on the rise, 3D digital technologies such as VR, or AR may help address this challenge. However, a review in the International Journal of Osteopathic Medicine has found that no AR, VR, or mixed application options were available to serve the needs of manual therapy education for joint assessments but that some already available applications may be used or adapted to help with tissue palpation skills. The findings highlight a shortage of educational tools available for manual therapy and a need to develop such tools.
_{^{Sampath, K. K., Arumugam, A., & Jull, G. (2022). The role of 3D digital applications in Manual therapy education–a scoping review. International Journal of Osteopathic Medicine}}.

Lower Limb OMT in young professional football players. A recent study in the Journal of Bodywork and Movement Therapies has looked at the effect of OMT on lower limb function in young football players. The team recruited 38 players and assigned them to either an OMT or control group and noted that OMT (specifically of the pivots) was able to improve players' range of motion in a sit-and-reach measure and improved their postural control. However, no difference was seen in cervical range of movement or upper and lower limb strength between the two groups. While the initial findings were somewhat favourable, only a single post-treatment evaluation was completed.
^{_{Thomas, E., Petrucci, M., Barretti, M., Messina, G., Cavallaro, A. R., & Bianco, A. (2022). Effects of osteopathic manipulative treatment of the pivots on lower limb function in young professional football players. Journal of Bodywork and Movement Therapies.}}

September 2022

The relationship between physician and patient. The New England Journal of Medicine has published an online interview perspective from Dr. Arthur Derse. The interview covers topics such as physician-patient challenges and the duties that physicians owe their patients. While the interview focuses primarily on medical doctors, it’s relevance to health professionals in general still exists.
_{^{Derse., A. (2022). The physician-patient relationship. New England Journal of Medicine, 387:669-672}}

August 2022

Inclusion and whole-body treatment for regaining function. An editorial published in the Journal of Osteopathic Medicine has discussed the relationship between inclusion and the whole-body approach when treating individuals to regain function (in relation to paralympic golf movement). The article covers the osteopathic approach to rehabilitation and its inclusion of an individual’s physical, mental, and social recovery including community re-integration through recreational activities such as golf. 
^{_{De Luigi, A. J. (2022). Paralympic golf movement: the links between inclusion and treating the whole person to regain function. Journal of Osteopathic Medicine.}}

Practice data for osteopathic practice in the UK. Changes to healthcare provisions and the addition of osteopathy as a recognised part of the allied health community in the UK in 2012 may have resulted in changes to practice activity. A study in PLOS ONE has now retrospectively analysed practice data from 500 osteopaths to provide an updated look at practice activity compared to a previous study run in 2009. When compared, patient characteristics had remained largely unchanged as did practice profiles with osteopaths predominantly treating musculoskeletal conditions in a private practice setting. It was also suggested that osteopaths may utilise care ‘packages’ where in addition to treatment they also provide information on self-management options. 
_{^{Plunkett, A., Fawkes, C., & Carnes, D. (2022). Osteopathic practice in the United Kingdom: A retrospective analysis of practice data. Plos one, 17(7), e0270806.}}

Persistent pain and its impact on absenteeism, health status and employment after workplace injury or illness. Workplace related illness and injury remain common and can easily result in persistent pain even after recovery and their subsequent return to work. A study in the BMJ journal Occupational and Environmental Medicine has looked at the prevalence of persistent pain among adults who experience workplace injury or illness as well as outcomes 18 months post injury. The authors assessed over 1000 workers for the study and found that at over half of the respondents reported persistent mild to significant pain and that those who did were also less likely to be working 18 months post injury. The study highlights the importance of understanding the longer-term impacts of workplace injury/chronic pain and what it means for employers and their employees (though lengthier longitudinal assessments are still needed). 
^{_{Dobson, K. G., Mustard, C., Carnide, N., Furlan, A., & Smith, P. M. (2022). Impact of persistent pain symptoms on work absence, health status and employment 18 months following disabling work-related injury or illness. Occupational and environmental medicine, oemed-2022-108383. Advance online publication.}}

Insights, Methods, and Applications in Exercise Physiology. Frontiers in Physiology have published two editorials discussing insights, methods, and applications in the exercise physiology. The first discusses various insights into cardiovascular exercise, molecular adaptations, injury, recovery, and pollution. The second showcases the various advances being made to methods and techniques used in research and practice – specifically covering aspects of cardiorespiratory testing, athletics, and heath monitoring. The two articles make up part of a special issue (of 12 articles) highlighting ‘insights in exercise in physiology’.
_{^{D'Antona, G., & Burtscher, M. (2022). Insights in exercise physiology: 2021. Frontiers in Physiology, 13, 975731.
Hunt, A., & Mack, G. (2022). Methods and applications in exercise physiology. Frontiers in Physiology, 13, 970615.}}

July 2022

Journal Focus: International Journal of Osteopathic Medicine

The Modified Back Beliefs Questionnaire for beliefs on back pain. There is an array of measures that can be used to assess practitioner’s beliefs on lower back pain, but they often don’t assess general beliefs about care and imaging. However, the Modified Back Beliefs Questionnaire (MBBQ) does cover these aspects. As such, a study by Fernandez and team in the International Journal of Osteopathic Medicine has specifically translated and adapted the MBBQ into Brazilian Portuguese and have also looked at various measurement properties of the adapted measure (possibly being the first study to do so). Measurement properties were acceptable; showing good internal consistency and test-retest reproducibility (Cronbach alpha 0.80) and had minimal detectable changes of 5.1 and 6.7 points for the inevitability and composite scores respectively.
^{_{Fernandes, D. A., Freire, A. P. C., Santos, J. M., Lemes, I. R., Diniz, L. M., Franco, M. R., ... & Pinto, R. Z. (2022). The Modified Back Beliefs Questionnaire as a tool to screen for incorrect beliefs regarding back pain: Cross-cultural adaptation and measurement properties. International Journal of Osteopathic Medicine.}}

Avoiding mistakes, misinterpretation, misrepresentation, and misinformation in evidence. A masterclass published in the International Journal of Osteopathic Medicine has highlighted and covered the importance of understanding evidence to help osteopaths make sense of research. It further discusses the importance of translating evidence into practice and more specifically may help an osteo decide on how and when to use research as part of their clinical practice. The chapters also go over case reports, trials, reviews, and qualitative research while discussing misinformation and cognitive biases.
^{_{Draper-Rodi, J., Vaucher, P., Hohenschurz-Schmidt, D., Morin, C., & Thomson, O. P. (2022). 4 M's to make sense of evidence–Avoiding the propagation of mistakes, misinterpretation, misrepresentation and misinformation. International Journal of Osteopathic Medicine.}}

Adjunctive osteopathic therapy for hospitalized COVID-19 patients: A feasibility-oriented chart review study with matched controls. A recent study in the International Journal of Osteopathic Medicine has looked at osteopathic manipulative therapy for respiratory distress related to COVID-19. Participants were those already hospitalised with COVID=19 and respiratory distress who were then allocated into treatment group and control group with the former receiving daily treatments of rib raising, abdominal diaphragm doming, thoracic pump, and pedal pump. While the treatment group reported high satisfaction and no adverse events, no significance difference between the treatment group and control group were found. Further limitations to the study were the retrospective observational design with only a small number of participants in the treatment group, however, the treatment group did trend towards fewer hospital days compared to controls.
_{^{Lennon, R. P., Dong, H., Zgierska, A. E., Demetriou, T., Croad, J., Livelsberger, C., ... & Rabago, D. (2022). Adjunctive osteopathic therapy for hospitalized COVID-19 patients: A feasibility-oriented chart review study with matched controls. International Journal of Osteopathic Medicine.}}

Movement analysis for lumbo-pelvic functional behaviour patterns during osteopathic motion tests. Choosing and correctly interpreting functional/manual tests remains difficult. However, motion tests may increase a practitioner’s understanding of different functional behaviours used by patient’s during complex functions. It thus becomes important to explore what distinct functional behaviours appear when emulating a new complex motor task and whether this behaviour is repeated. A study by Menard and team has explored this with 29 athletes using two motion tests (the one-sided tilt test and a modified version of this test limiting the trunk axial rotation). The team identified four classes of potential movement combinations that may help understand somatic dysfunction. The authors noted that rather than using tests to only identify joint mobility limitations, tests that assess biomechanical function may more broadly identify functional behaviours, allowing a personalised approach to active motion.
^{_{Ménard, M., Couvertier, M., Awai, L., Esteves, J. E., Bideau, B., & Vaucher, P. (2022). Exploring lumbo-pelvic functional behaviour patterns during osteopathic motion tests: A biomechanical (en) active inference approach to movement analysis. International Journal of Osteopathic Medicine.}}

June 2022

Diagnostic labelling and management intentions for low back pain. When scoping the literature, diagnostic labelling has its advantages and disadvantages and may have an influence on how clinicians go about treatment. A study in the European journal of pain has looked at the effect of labelling on low back pain management – focusing on primarily on beliefs such as imaging, second opinions, surgery, and seriousness. With over 1300 participants included in the study, the authors noted that specific labels such as “Episode of back pain”, “lumbar sprain” and “non-specific LBP” reduced the need for imaging, surgery and second opinion when compared to labels such as “arthritis”, “degeneration” and “disc bulge”. The results suggested that diagnostic labelling may be most relevant among individuals who are more at risk of poor outcomes such as participants suffering from low back pain who also have a history of seeking care.
^{_{O'Keeffe, M., Ferreira, G. E., Harris, I. A., Darlow, B., Buchbinder, R., Traeger, A. C., Zadro, J. R., Herbert, R. D., Thomas, R., Belton, J., & Maher, C. G. (2022). Effect of diagnostic labelling on management intentions for non-specific low back pain: a randomised scenario-based experiment. European journal of pain (London, England), 10.1002/ejp.1981. Advance online publication.}}

High-load compared vs low-load strengthening exercise on hypermobile shoulders. An RCT published in the British Journal of Sports Medicine has looked at the short-term effectiveness of high vs low-load strengthening exercise on hypermobile shoulders. 93 participants completed the trial which consisted of two groups who completed either a high or low load exercise program over four months. The authors noted significant between-group differences which favoured the high load exercise group with the high load group also showing improved symptoms (though not significant). The authors also noted more muscle soreness in the high load exercise group. The findings suggest that high load exercise may be used in primary care to treat patients with hypermobile shoulders although more research is needed to confirm this finding and assess its efficacy over a longer time frame.
^{_{Liaghat, B., Skou, S. T., Søndergaard, J., Boyle, E., Søgaard, K., & Juul-Kristensen, B. (2022). Short-term effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a randomised controlled trial. British journal of sports medicine, bjsports-2021-105223.}}

May 2022

A guide to the management of geriatric osteoporosis. Osteoporosis is a common musculoskeletal disease, more so in elderly individuals, and is often characterised by a loss of bone density and fragility. Allied health professionals play an important role in supporting and managing patients who suffer from this musculoskeletal condition. An article in the International Journal of Osteopathic Medicine has provided a clinician’s guide (for allied health professionals) to managing osteoporosis in elderly patients. The detailed article covers an array of key factors such as pathophysiology, screening, risk factors, management guidelines, and referral information.
^{_{Feehan, J., Tripodi, N., Fleischmann, M., Zanker, J., & Duque, G. (2022). A clinician's guide to the management of geriatric musculoskeletal disease: Part 1 - Osteoporosis. International Journal of Osteopathic Medicine, (43) 53-62.}}

A guide to the management of geriatric sarcopenia. Sarcopenia is more recently identified condition associated with the loss of muscle mass and strength. The condition is also commonly seen in aging populations. As a continuation of the masterclass article on geriatric musculoskeletal conditions published in the International Journal of Osteopathic Medicine (above) – this article provides a clinician’s guide (for allied health professionals) to managing sarcopenia in elderly patients. The detailed article similarly covers various topics such as pathophysiology, risk factors, and management options.
^{_{Tripodi, N., Wright, B., Lawton, A., Zanker, J., Feehan, J. (2022). A clinician's guide to the management of geriatric musculoskeletal disease: Part 2 – Sarcopenia. International Journal of Osteopathic Medicine, In Press.}}

Greater work physical activity linked to higher risk of knee osteoarthritis. A study published in the journal of Occupational and Environmental Medicine has suggested that individuals who have more physically active occupations may at an increased risk of suffering from knee osteoarthritis. The longitudinal study included 951 patients with over 2800 observations and noted that those with more physical roles, especially those who worked while standing or that involved some walking were more at risk when compared to those with mainly sedentary roles.
^{_{Lo, G. H., Richard, M. J., McAlindon, T. E., Park, C., Strayhorn, M. T., Harkey, M. S., Price, L. L., Eaton, C. B., & Driban, J. B. (2022). Increased risk of incident knee osteoarthritis in those with greater work-related physical activity. Occupational and environmental medicine, oemed-2022-108212.}}

Osteopathy in conjunction with physiotherapy for fatigue in long COVID: Study protocol. Long COVID is often characterised by ongoing symptoms such as respiratory and cardiovascular issues and more commonly, fatigue. A study protocol recently published in the International Journal of Osteopathic Medicine thus aims to compare the effectiveness of osteopathic manipulative treatment combined with physio when compared to physio alone on fatigue and functional limitations in adults with long COVID. The study is to be conducted in a public health primary-to-tertiary setting using an assessor-blinded, pragmatic randomized controlled superiority trial.
^{_{Certain Curi, A. C., Antunes Ferreira, A. P., Calazans Nogueira, L. A., Mello Meziat Filho, N. A., & de Sá Ferreira, A. (2022). Osteopathy and physiotherapy compared to physiotherapy alone on fatigue in long COVID: Study protocol for a pragmatic randomized controlled superiority trial. International journal of osteopathic medicine: IJOM, 10.1016/j.ijosm.2022.04.004. Advance online publication.}}

Low back pain and related disability in non-care-seeking adults. A study in the journal Musculoskeletal Science and Practice has explored the occurrence and extent of low back pain and its related disability in adults who are not seeking care. 101 adults were included in study and completed a range of questionnaires on back pain and disability. Over 70% of participants showed some level of disability and nearly half reported some level of pain. As the individuals assessed were not seeking care in any form, the authors suggested that some level of disability and pain associated with lower back pain may be manageable or perhaps just considered normal.
^{_{Vraa, M., Pascoe, S., Maddox, D., Rhon, D. I., Cleland, J. A., & Young, J. L. (2022). Prevalence and extent of low back pain and low back-related disability in non-care-seeking working-age adults. Musculoskeletal Science and Practice, 102572.}}

Pain experience and the Emergency Department. With an overall reduction in opioid prescribing in line with various practice recommendations, some individuals who seek acute pain relief may be left with unrelieved pain. Punches and team have explored ED patients’ beliefs and experiences on pain and emergency care. The study used semi structed interviews and subsequent framework analysis to gather information and determine key themes. Interestingly, patients that were interviewed reported unrelieved pain on ED discharge and an interest in seeking opioids from non-medical sources - strongly emphasising the disconnect between patients and emergency care providers. The study hopes to increase the information available for the development of future psychosocial interventions which must focus on balancing acute pain management needs with opioid exposure risks.
^{_{Punches, B. E., Brown, J. L., Soliman, S., Johnson, K. D., Freiermuth, C. E., Walker, Q., ... & Lyons, M. S. (2022). Patient Pain Experiences and the Emergency Department Encounter: A Qualitative Analysis. Pain Management Nursing.}}

April 2022

Study mapping of the 2021 NICE guidelines for assessment and management of chronic pain against a community sample. A recent study published in the British Journal of Pain has looked at common pain management strategies among adults in the UK and has compared them to the recent NICE guidelines (NG-193) for the management of chronic pain. Using an online survey, the researchers collected information on pain severity, interference, sleep, and mental health. The authors noted that respondents often used strategies such as exercise, physical therapy, psychological therapy, and pharmacological therapy – mostly in line with the NICE guidelines with the exception of pharmacological use where a number of participants still reported the use of opioids.
^{_{Zambelli, Z., Halstead, E. J., Iles, R., Fidalgo, A. R., & Dimitriou, D. (2022). The 2021 NICE guidelines for assessment and management of chronic pain: A cross-sectional study mapping against a sample of 1,000* in the community. British Journal of Pain, 20494637221083837.}}

Systematic Review Protocol: pain sensitisation for low back pain. Low back pain remains one of the most common disabilities worldwide and while many non-operative treatments remain available for the condition, there is little conclusive evidence on their respective effectiveness. A recent systematic review registered with PROSPERO looks to evaluate the safety and effectiveness of nonoperative treatment for pain sensitization for low back pain by reviewing original RCTs of nonoperative interventions. See the link below for more information about the review protocol.
^{_{Nopsopon, T., Suputtitada, A., Lertparinyaphorn, I., & Pongpirul, K. (2022). Nonoperative treatment for pain sensitization in patients with low back pain: protocol for a systematic review. Systematic Reviews, 11(1), 1-7.}}

Neck extensor muscle exercises for women with chronic idiopathic neck pain. Individuals with neck pain may show structural and functional impairments of the cervical extensor muscles and while global nonspecific neck exercises have shown improvements in neck pain and functionality, specific exercises have not been as readily assessed. Giménez-Costa and team from the University of Alcalá, Spain have conducted an RCT with 43 women comparing the effect of lower deep neck extensor exercises to general neck extensor exercises on neck pain and disability. Both groups showed improvements and reductions in disability at short term and long term follow up – suggesting that the two exercises had comparable outcomes, but the study could not determine if one exercise treatment option was more beneficial than the other.
^{_{Costa, M. G., Schomacher, J., Murillo, C., Sentandreu, T., Falla, D., & Lluch, E. (2022). Specific versus non-specific exercises for the neck extensor muscles in women with chronic idiopathic neck pain: A randomized controlled trial. Musculoskeletal Science and Practice, 102561.}}

An epidemiological study on early onset scoliosis. While the understanding of early onset scoliosis (classified as any curved deformity of the spine for children under 10) is growing, the knowledge of its prevalence and incidence is lacking. A study published in The Spine Journal by AlNouri and team has undertaken a multicentre retrospective cohort study to address this lack of information. They noted an annual incidence of .019% and prevalence of .077% with neuromuscular related scoliosis being the most common, followed by idiopathic, syndromic, and congenital. The findings support the current evidence suggesting that early onset scoliosis is rare and further notes the importance of early diagnosis and intervention.
^{_{Al Nouri, M., Wada, K., Kumagai, G., Asari, T., Nitobe, Y., Morishima, T., ... & Ishibashi, Y. (2022). The Incidence and Prevalence of Early-Onset Scoliosis: A Regional Multicenter Epidemiological Study. The Spine Journal.}}

MARCH 2022

Headache knowledge among UK osteopaths. The popularity of complementary and alternative medicine for headache sufferers continues to increase as people seek alternatives to the usual pharmaceutical route. With increase in mind, a survey of 383 osteopaths published in the International Journal of Osteopathic Medicine has assessed the existing knowledge of headache disorders among registered osteopaths practising in the UK. While mean knowledge scores were good, existing knowledge relied on prior headache education. Further themes identified that osteopaths acknowledged gaps in their knowledge and desired more headache education which if achieved, may improve patient care.
_{^{Huzzey-Cunningham, E., McWilliam, M., Mahtani, V., Bridge, H., Breukel, C., Schytz, H. W., & Draper-Rodi, J. (2022). Study to assess existing knowledge of headache disorders among registered osteopaths practising in the UK: A cross-sectional survey. International Journal of Osteopathic Medicine.}}

Musculoskeletal adaptations to training and sport performance. Both coaches and researchers can benefit from improving their knowledge and understanding of training and body adaptations. As such, an editorial in the Frontiers inn Physiology (Exercise Psyhsiology) has covered musculoskeletal adaptations to training focusing primarily on the connection between training practices and sports performance. The editorial covers areas ranging from the general trainability to specific athlete responses to new tools with physiological, biochemical, and even molecular insights.
^{_{Marinho D., Ferraz R., Toubekis A., Neiva H. (2022). Editorial: Musculoskeletal Adaptations to Training and Sports Performance: Connecting Theory and Practice. Frontiers in Physiology. 13 10.3389/fphys.2022.866895}}

Musculoskeletal and sports ultrasound terminology. Various streams and specialities of musculoskeletal and sports medicine have seen a steep rise in use of ultrasounds for guidance and diagnostic imaging. However, the lack of consensus around standardised terminology can easily lead to confusion between clinicians and even researchers when conveying information. A consensus statement published in the British Journal of Sports Medicine has utilised a Delphi based consensus statement on the issue, providing a point of reference to improve clarity and consistency for communicating. The expert panel consisted of 18 members from multiple specialty societies in musculoskeletal and sports ultrasound.
^{_{Hall, M. M., Allen, G. M., Allison, S., Craig, J., DeAngelis, J. P., Delzell, P. B., ... & Tagliafico, A. (2022). Recommended musculoskeletal and sports ultrasound terminology: a Delphi-based consensus statement. British Journal of Sports Medicine, 56(6), 310-319.}}

Osteopathic treatment in addition to standard care for GERD. A study by Lynen and Team in the Journal of Bodywork and Movement Therapies has conducted a RCT on the effectiveness of osteopathy (in addition to standard care) for patients with Gastroesophageal Reflux Disease (GERD) (known more commonly as acid reflux). 70 patients were randomly assigned into an osteopathic treatment group and a controlled untreated group with a mix of outcomes measures used to gather data on medication use, gastrointestinal symptoms, reflux, and quality of life. While medication use decreased and quality of life improved for the treatment group, reflux symptoms appeared to decrease however, there is uncertainty around this decrease due to participants completing the questionnaire incorrectly.
^{_{Lynen, A., Schömitz, M., Vahle, M., Jäkel, A., Rütz, M., & Schwerla, F. (2022). Osteopathic treatment in addition to standard care in patients with Gastroesophageal Reflux Disease (GERD)–A pragmatic randomized controlled trial. Journal of Bodywork and Movement Therapies, 29, 223-231.}}

FEBRUARY 2022

The No Worries Trial – an emotional recovery program for people living with chronic pain. Chronic pain affects around 1 in 5 Australians, impacting their daily lives and often causing various forms of distress. Researchers from NeuRA and UNSW have developed an online emotional recovery program aimed at people who live with chronic pain. Published in the Journal of Pain, the program was shown to reduce pain intensity by teaching users how to regulate difficult and intense emotions. The program is delivered online which also allows for greater accessibility.
^{_{Norman-Nott, N., Wilks, C. R., Hesam-Shariati, N., Schroeder, J., Suh, J., Czerwinski, M., & Gustin, S. M. (2021). The No Worries Trial: Efficacy of Online Dialectical Behaviour Therapy Skills Training for Chronic Pain (iDBT-Pain) Using a Single Case Experimental Design. The Journal of Pain.}}

A continued look at pain during COVID-19. COVID-19 continues to affect healthcare delivery in almost every aspect. With ongoing delays to healthcare access, interest has been building regarding the effect of COVID-19 on pain management. Chatkoff and team have explored the pandemics impact on chronic the pain experience, surveying over 400 patients with musculoskeletal, neuropathic, or postsurgical pain. The results noted that patients’ perceptions and experiences of chronic pain were negatively affected by the pandemic and that there was a pandemic related worsening of the chronic pain experience. The clinical implications are clear, suggesting that patients who suffer from chronic pain may need additional support and guidance while the pandemic is still ongoing.
^{_{Chatkoff, D. K., Leonard, M. T., Najdi, R. R., Cruga, B., Forsythe, A., Bourgeau, C., & Easton, H. (2022). A Brief Survey of the COVID-19 Pandemic's Impact on the Chronic Pain Experience. Pain Management Nursing, 23(1), 3-8.}}

Differentiating early-stage spondylolysis from nonspecific low back pain in adolescents. Acute low back pain in adolescents can often be caused by early-stage spondylolysis (ESS). While accurate diagnosis of ESS is of key importance for providing appropriate treatment options, differentiating ESS from other forms of lower back pain/lower back disorders is difficult when looking for physical signs alone – yet a physical marker is often needed for further MRI imaging. As such, a study published in the journal Musculoskeletal Science and Practice has aimed to determine common characteristics for motion-provoking lower back pain in patients with ESS. After assessing 112 adolescents, the results suggested that lateral bending was the greatest motion-provoking characteristic of lower back pain for patients with ESS.
^{_{Sugiura, S., Aoki, Y., Toyooka, T., Shiga, T., Otsuki, K., Aikawa, E., Oyama, T., Kitoh, K., Chikako, S., Takata, Y., Ishizaki, T., Omori, Y., Kiguchi, Y., Takata, A., Kote, A., Nakanishi, Y., Matsushita, Y., Suzuki, T., Mori, C., Takahashi, K., … Nishikawa, S. (2015). Characteristics of low back pain in adolescent patients with early-stage spondylolysis evaluated using a detailed visual analogue scale. Spine, 40(1), E29–E34.}}

PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science. Systematic review reporting has become ever more transparent due to the use of standardised reporting guides which allow readers of a systematic review to understand what was done, why it was done, and how it was done. But while standardised reporting exists, it is not universally used and as such, poor reporting of systematic reviews remains an issue. A consensus statement published in the British Journal of Sports Medicine has provided implementation guidance for using PRISMA in systematics reviews for sport and exercise medicine, musculoskeletal rehabilitation, and sports science. Ardern and team utilised a mix of content and methodology experts to identify strong examples of systematic review reporting in the aforementioned fields resulting in PERSiST – a guide for implementing PRISMA to improve transparency and reporting of systematic reviews in exercise, rehabilitation, sport medicine and sports science.
_{^{Ardern, C. L., Büttner, F., Andrade, R., Weir, A., Ashe, M. C., Holden, S., ... & Winters, M. (2022). Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. British journal of sports medicine, 56(4), 175-195.}}

JANUARY 2022

A look at novice athletes and injury rates. Physical activity is a clear cornerstone in everyday health and wellbeing. With many individuals living a more sedentary lifestyle, public health initiatives often focus on getting active. While these initiatives are magnificent, injuries incurred by those new to fitness may have long term negative effects. A study by Kemler and team in BMJ Open Sport and Exercise Medicine has explored whether there has been an increase in novice athletes and their injury rates. As may be expected, the team noted that injury risk was higher in novice athletes when compared to experienced athletes regardless of the fitness activity. The results enforce that attention must be paid to injury prevention in newer athletes to prevent drop-out rates and ensure safe exercise practices.
^{_{Kemler, E., Valkenberg, H., & Verhagen, E. (2022). More people more active, but there is a counter site. Novice athletes are at highest risk of injury in a large population-based retrospective cross-sectional study. BMJ Open Sport & Exercise Medicine, 8(1), e001255.}}

Pain management during COVID-19. An editorial in the Journal of Pain Management Nursing has explored how pain has been managed during the COVID-19 pandemic. The authors looked at various article’s from countries such as Spain, China, and the United States – with research ranging from pain among those with COVID, those who suffer from pain during COVID, and the effect of the pandemic on pain care.
_{^{Quinlan-Colwell, A., & Schreier, A. (2022). Pain Management during the COVID-19 Pandemic. Pain Management Nursing, 23(1), 1-2.}}

Practitioner attitudes and lower back pain. Lower back pain remains a common problem, affecting over 2 billion people around globally. A study in Musculoskeletal Science and Practice has explored the lower back pain attitudes of physical therapists. The team surveyed 420 therapists and noted several factors associated with lower back pain attitudes such as post grad training, fellowship training, and practice type (e.g., private practice). The findings suggested that therapists who had certifications in orthopaedics or sports, greater pain knowledge, and who worked in hospital settings were tended to have more helpful attitudes towards lower back pain.
^{_{Rufa, A., Dolphin, M., Adams, K., & Brooks, G. (2022). Factors associated with the low back pain-related attitudes and beliefs of physical therapists. Musculoskeletal Science and Practice, 102518.}}

A feasibility RCT on the use of osteopathic treatment for neck-shoulder pain. Computer use and computer-based tasks are commonplace worldwide for social, recreational, and work-related activities. It is also a common source of pain, more often from poor posture during use. A study in the journal of Complementary Therapies in Clinical Practice has outlined a feasibility RCT to assess the effect of osteopathic care on neck-shoulder pain in computer users. The trial consisted of 30 adults who were daily computer users. The feasibility RCT objectives were met, suggested that a larger scale RCT would be feasible in the future. Furthermore, the PPT results suggested that osteopathic treatment increased pain thresholds compared to sham treatments and usual care – increasing the evidence supporting the use of osteopathic treatments for musculoskeletal pain.
^{_{Santiago, R. J., Esteves, J. E., Baptista, J. S., Magalhães, A., & Costa, J. T. (2022). Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users. Complementary Therapies in Clinical Practice, 46, 101507.}}