To examine the association between type 2 diabetes (T2D) and pain severity in people with localized osteoarthritis (OA) and to explore the association between glycemic control, measured by hemoglobin A1c (HbA1c) level, and pain severity in people with localized OA and T2D. Retrospective study. A tertiary medical center. Data from 819 patients (mean age = 65.08±9.77 years, 54.3% women) were used. Patients were grouped to localized OA only (N = 671) and localized OA+T2D (N = 148) based on diagnosis codes. An index date was set as the first diagnosis date of localized OA and linked to pain severity, measured by numeric rating scale from 0 to 10. HbA1c values were obtained for patients with T2D within six months of the index date. Multiple linear regression was used. After controlling for age, gender, body mass index (BMI); diagnoses of depression, hypertension, dyslipidemia; OA locations; and medication list (+/- 90 days of the index date), T2D was significantly associated with increased pain severity (B = 1.07, 95% confidence interval [CI] = 0.25 to 1.88, P = 0.014). For patients with T2D and localized OA with available data for HbA1c (N = 87), the results showed that an increased HbA1c value was significantly associated with higher pain severity (B = 0.36, 95% CI = 0.036 to 0.67, P = 0.029) after controlling for age, gender, BMI, medications, and OA locations. T2D was associated with higher pain severity in people with localized OA, and poor glycemic control was associated with higher pain severity in people with localized OA+T2D. Clinicians should emphasize that better HbA1c control might help with pain management in people with T2D and OA.

Background: Low back pain as a symptom affects many individuals around the globe regardless of their economic status or sociodemographic characteristics. During the 2019 COVID-19 pandemic, students found themselves obligated to sit down for long periods of time. The aim of this current study is to investigate the impact of these prolonged periods of sitting down in front of computers on developing a new episode of low back pain. Methods and Materials: This research adopted an observational cross-section study design. Students who are currently enrolled or had experienced distance learning classes in the last 6 months were eligible to participate. An online-based questionnaire was developed by the investigators through reviewing the literature with relevant objectives. McNemar’s test was used to compare certain variables between two periods before and during online distance learning. We used paired t-tests to compare pain intensity before, during, and after online learning, while a chi-square test was used to investigate correlations between factors influencing low back pain. Results: A total of 84 students participated in the study—46 (54.8%) females and 38 (45.2%) males. Before online distance learning, only 42.9% of participants reported low back pain, while only 20% had a back injury. The mean pain scores before, during, and after online distance learning were (2.85 ± 2.16, 4.79 ± 2.6, and 4.76 ± 2.7), respectively. The pain scores before online learning were significantly lower than pain scores during and after online distance learning (p < 0.05), respectively. Conclusion: The study findings suggested that low back pain prevalence increased among students during the COVID-19 pandemic. Future research should study participants’ behavior during the online learning and assess the long-run impact of distance learning among high-school and undergraduate students.

Background. The use of online learning methods has expanded considerably in many countries since the declaration of COVID-19 as a global pandemic by the World Health Organization. Smartphones are widely used for voice and text messaging, checking emails, and distance learning. The aim of this study was to investigate the relationship between using smartphones and text neck syndrome. Material and methods. A cross-sectional study was conducted among university students in Jordan between February and March 2023. All undergraduate students were invited to participate. A self-administered online (Google forms) questionnaire was distributed by posting the link to the questionnaire on students’ groups through social media websites such as Facebook, Twitter, and WhatsApp. Results. A total of 171 students responded to the survey. The participants included 103 (60%) females and 68 (40%) males. Approximately 79% of the participants were less than 22 years old. Almost half of the participants reported pain at neck (54%) and shoulder (51%), while about 61% of participants suffered from upper back pain. Conclusions. 1. Smartphones are widely becoming essential in educational technology, and more concern should be expended to increase the awareness about optimal and healthy usage of smartphones by restricting usage duration in order to reduce neck and shoulder pain and associated poor functioning in daily living activities. 2. Poor patterns of smartphone use increase the likelihood of neck pain. 3. Neck movement limitations are not associated with age or gender. 4. Students who did not report limitation in neck movement were less likely to have difficulty with reading.

Background: Individuals with prolonged symptoms after a mild traumatic brain injury (mTBI) report requiring more effort to complete complex and sustained activities. However, the relationship between cognitive workload and patient-reported symptoms is unclear. Objective: To compare the cognitive workload between middle-aged and older adults with persistent symptoms after mTBI and controls during a sustained visual attention task and to examine the relationship between workload and patient-reported symptoms. Methods: In this cross-sectional study, 48 adults (24 with persistent symptoms after mTBI (mean age = 54.92 ± 9.1 years) and 24 age-matched controls (mean age = 55.00 ± 8.7 years) completed the Dot Cancellation (DC) test. Outcome measures included performance measured by time to completion and number of errors on the test, objective workload measured by the Index of Cognitive Activity (ICA), subjective workload measured by the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and patient-reported outcomes of symptom severity measured by the Post-Concussion Symptom Scale (PCSS), and mental fatigue measured by the Mental Fatigue Scale (MFS). Results: Individuals with mTBI symptoms took longer to complete the DC test ( P = .002) and had higher scores on the NASA-TLX (mTBI = 37.5 [20.4, 50.8] compared to controls 10.4 [5, 27.5], P < .001). No differences in ICA were noted between the groups after accounting for DC time. Moderate correlations were observed between NASA-TLX and PCSS (ρ = .58, P < .001) and NASA-TLX and MFS (ρ = .58, P < .001). Conclusions: Individuals with persistent symptoms following mTBI exhibit greater subjective cognitive workload and take longer to complete a sustained visual attention task compared to age-matched controls. However, objective measures of cognitive workload did not differ significantly once task duration was controlled. Perceived cognitive workload experienced by this population is influenced by symptom severity and mental fatigue.

Background: Despite the global burden of chronic pain, gaps in pain education persist in healthcare programs. This study evaluated pain knowledge, attitudes, and beliefs among final-year physiotherapy (PT) and occupational therapy (OT) students in Jordan, compared these competencies between disciplines, examined the relationship between pain knowledge and beliefs, and explored significant predictors of pain knowledge. Methods: A descriptive, cross-sectional study was conducted using an online survey of final-year PT and OT students from three public universities in Jordan. Pain knowledge was assessed using the Revised Neurophysiology of Pain Questionnaire (RNPQ), and attitudes and beliefs toward pain and disability were measured with the modified Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS). Students also reported perceived sources of pain knowledge. Data analysis involved non-parametric tests for group comparisons, Spearman correlations to assess the RNPQ-HC-PAIRS association, and multiple linear regression to identify predictors of RNPQ scores. Results: A total of 216 students completed the survey (PT: n=149; OT: n=67). PT students demonstrated higher RNPQ scores and lower HC-PAIRS scores than OT students (both p< 0.001), indicating a better understanding of pain neurophysiology and more adaptive pain beliefs. Across the total sample, RNPQ and HC-PAIRS scores were inversely correlated (ρ = – 0.334, p< 0.001). Regression analysis identified discipline (PT vs OT), endorsing university courses as a primary pain knowledge source, and HC-PAIRS scores as significant predictors of RNPQ scores (adjusted R² = 0.855, p< 0.001). A significant interaction showed that PT students derived greater pain knowledge gains from university courses than OT students. Conclusion: Final-year PT and OT students in Jordan exhibited limited pain knowledge and persistent biomedical beliefs, with PT students outperforming OT students. University courses were the strongest predictor of pain knowledge, underscoring the need for integrating evidence-based pain curricula with a biopsychosocial focus in both disciplines. Plain Language Summary: Chronic pain is a common problem worldwide. Future health care providers such as physiotherapists and occupational therapists need to have a sound understanding of modern pain concepts to provide care to people with pain. A key point is that pain is affected by our body, mind, and surroundings, not just tissue injury. In our study, we surveyed 216 physiotherapy and occupational therapy students in their final year of training in Jordan. We also assessed their pain knowledge and attitudes and beliefs when caring for people with chronic pain. We found that physiotherapy students had better knowledge and more positive beliefs about pain than occupational therapy students. We also found that students who viewed their university courses as a main source of pain knowledge tended to have higher scores on pain knowledge assessment. This connection was strongest for physiotherapy students. Our findings show a clear opportunity to better prepare future health professionals for modern pain care by updating pain education curricula, especially occupational therapy programs. Improving pain education now will eventually lead to more effective and empathetic care in future.

The International Knee Documentation Committee Subjective Knee Form (IKDC2000) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) are knee-specific measures. However, their association with a return to sports after anterior cruciate ligament reconstruction (ACLR) is unknown. This study aimed to investigate the association between the IKDC2000 and the KOOS subscales and the return to the same pre-injury level of sport two years after ACLR. Forty athletes that were two years post-ACLR participated in this study. Athletes provided demographic information, filled out the IKDC2000 and KOOS subscales, and indicated whether they returned to any sport and whether they returned to the same pre-injury level (same duration, intensity, and frequency). In this study, 29 (72.5%) athletes returned to play any sport and eight (20%) returned to the same pre-injury level. The IKDC2000 (r: 0.306, p = 0.041) and KOOS quality of life (KOOS-QOL) (r: 0.294, p = 0.046) significantly correlated with the return to any sport, but it was age (r: −0.364, p = 0.021), BMI (r: −0.342, p = 0.031), IKDC2000 (r: 0.447, p = 0.002), KOOS-pain (r: 0.317, p = 0.046), KOOS sport and recreation function (KOOS-sport/rec)(r: 0.371, p = 0.018), and KOOS QOL (r: 0.580, p > 0.001) that significantly correlated with a return to the same pre-injury level. High KOOS-QOL and IKDC2000 scores were associated with returning to any sport, and high KOOS-pain, KOOS-sport/rec, KOOS-QOL, and IKDC2000 scores were all associated with returning to the same pre-injury level of sport.