Profiling and Association over Time between Disability and Pain Features in Patients with Chronic Nonspecific Neck Pain:A Longitudinal Study

Objectives: To longitudinally investigate the relationships between neck/arm disability and pain profile measures in individuals with chronic nonspecific neck pain (NSNP) at baseline, one month, and six months after a standardized physiotherapy intervention. A secondary aim was to compare pain sensitivity of individuals with chronic NSNP at baseline to healthy controls. Methods: A total of sixty-eight individuals with chronic NSNP and healthy controls were recruited. Neck disability index (NDI), the 11-item disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), temporal summation (TS), pressure pain thresholds (PPTs), pain intensity and pain extent were assessed in individuals with chronic NSNP. For the cross-sectional assessment, TS and PPTs were compared to healthy controls. Results: After following a standardized physiotherapy intervention, local and distal PPTs to the neck region decreased at one and six month follow-ups, respectively. Pain extent decreased at one and six months. Furthermore, a positive correlation between neck/arm disability and pain intensity was found at baseline, whereas moderate positive correlations (e.g., between NDI and pain extent) at baseline, one and six month follow-ups and negative correlations at six months (e.g., between arm disability and PPTs) were found. Discussion: Overall, these findings indicate that pain sensitivity can worsen following treatment despite reduced pain extent and unchanged neck disability and pain intensity scores over a six-month period in individuals with chronic NSNP

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Awareness of myths and realities about low back pain among spanish physiotherapists:which procedures do they consider to be of high value

Background and aims: Low back pain (LBP) is the most prevalent musculoskeletal disorder worldwide and physiotherapists are among the primary healthcare professionals assessing and managing the condition. As part of an evidence-based approach, physiotherapists must stay up-to-date with the evidence. However, scientific knowledge of LBP management amongst physiotherapists is largely unknown. This study aimed to evaluate the level of evidence-based knowledge regarding the management of LBP amongst Spanish physiotherapists.Methods: Physiotherapists working in Spain enrolled in an e-learning course that provided state-of-the-art knowledge of LBP management. Before starting the course, all participants had to complete an online test focusing on evidence-based knowledge about LBP (22 questions, true or false), comprehending socio-economic impact, characteristics, rehabilitation goals, the role of psychosocial factors, and high- and low-value interventions.Results: A total of 913 physiotherapists completed the initial test. More than 55% of responders reported that imaging diagnosis was essential before starting any physiotherapy treatment and that glucocorticoids were recommended for persistent LBP. In addition, almost half of the responders considered ergonomic adjustments based on maintaining an upright back posture to be fundamental interventions in managing persistent LBP.Conclusions: Despite considerable knowledge from the research literature, there are considerable gaps in the evidence-based knowledge of physiotherapists in Spain that may compromise the quality of the assessment and treatment of LBP patients. Promoting actions that favour the continuous learning and training of Spanish physiotherapists would improve the quality of LBP treatment