This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the studies to assess eligibility, with a third author resolving any discrepancies. Data were extracted and summarized in a narrative format by three independent raters. Clinical trials were evaluated using the PEDro scale to assess the effectiveness of virtual-reality-based exercise therapy in chronic musculoskeletal pain patients. A total of 162 articles were identified from the databases. After applying the inclusion criteria, nine articles were considered suitable for analysis, including six randomized clinical trials. The selected articles were categorized based on study characteristics, virtual-reality-based exercise therapy interventions (including technologies and equipment used), exercise interventions, outcome measures, and effectiveness. The findings indicate that virtual-reality-based exercise therapy shows promising results in reducing pain, improving disability, enhancing range of motion, and increasing treatment satisfaction in patients with chronic musculoskeletal pain. However, it is not possible to conclude that virtual-reality-based exercise therapy is superior to other treatments due to the limited number of available studies, heterogeneity in application protocols, and varying methodological quality. Further research is needed to draw more definitive conclusions.

Background/Objectives: The International Association for the Study of Pain (IASP) recently introduced clinical criteria and a grading system to identify nociplastic pain, marking a pivotal step toward improving diagnostic accuracy. This study aimed to evaluate the reliability and validity of the IASP criteria using clinical vignettes, assessing their effectiveness in identifying nociplastic pain in clinical settings. Methods: A reliability and diagnostic accuracy study was conducted using 32 clinical vignettes based on the literature and pre-existing clinical data. The vignettes represented patients with and without the characteristics of nociplastic pain and were reviewed independently by two expert physiotherapists. Inter-rater and intra-rater reliability were evaluated with a 1-month interval between assessments. Criterion validity was analyzed by comparing the IASP criteria against the standardized vignettes as the reference standard. Sensitivity, specificity, and predictive values were calculated to assess diagnostic accuracy. Results: The IASP criteria demonstrated moderate-to-perfect intra-rater agreement (κ = 0.71–1.00, p < 0.05) and weak-to-perfect inter-rater agreement (κ = 0.52–1.00, p < 0.05). Criterion validity was moderate (κ = 0.68), with strong specificity (89.0%) and moderate sensitivity (69.0%). Positive and negative predictive values were high at 81.8% and 81.0%, respectively, supporting the criteria’s accuracy in identifying and excluding nociplastic pain. Conclusions: The IASP criteria for nociplastic pain exhibited satisfactory reliability and criterion validity in this preliminary study, particularly after initial rater familiarization. Future research should evaluate their application in real-world clinical settings, explore concurrent and prognostic validity, and involve a broader range of raters to enhance generalizability.

Background: Pole dancing is a physically demanding sport that combines dance and acrobatic movements on a vertical pole. Despite its highly growing popularity, there is currently limited research in the field. The aim of this study was to create and evaluate a strength assessment protocol for athletes in pole dancing, with a specific focus on functional positions on the pole. Methods: Thirty-two female pole dancing athletes participated in this study. Maximal voluntary isometric contractions (MVIC) were measured at three different sport-specific positions on the pole (shoulder abduction and adduction, and hip adduction), on two separate days (test and re-test) with a five to seven day interval between them. A hand-held dynamometer (Activ5- Activbody) stabilized on the pole was used for this study. Results: The intra-session reliability was good to excellent for all sports-specific positions and for both sides of the body, across all different movements (ICC = 0.837–0.960, SEM = 5.02 Kg–2.24 Kg, and SDD = 27.46%–14.92%). Slightly better results were found regarding inter-session reliability (ICC = 0.927–0.970, SEM = 3.72 Kg–1.97 Kg, and SDD = 22.86%–15.19%). There was not a statistically significant difference between the MVICs between the left and right or dominant and non-dominant side in shoulder abduction (p = 0.105) and hip adduction (p = 0.282), in contrast to shoulder adduction (p = 0.00). Conclusion: The strength assessment protocol developed in the current study has proven to be a reliable and functional tool, with the potential for utilization in clinical practice as part of objective strength testing. Further studies are needed in order to expand the protocol to other muscle groups and positions and to generalize the results in all pole dancing populations such as male athletes.

Background/Objectives: The Athletic Shoulder Test (ASH) has been described as one of the most promising upper-extremity tests to assess performance in overhead athletes. Its high reliability rates, short testing period, and applicability in any environment with portable and cheap equipment have been highlighted as some of the advantages of the test. However, it has yet to be evaluated in a non-adult athletic population. Therefore, the aim of this study was to investigate the ASH test’s psychometric properties in a sample of young tennis players. Methods: A total of 33 adolescent tennis players were evaluated among two sessions with a week interval. Intra-rater, inter-rater, and test-retest reliability were investigated. Additionally, possible correlations with measures of rotational shoulder strength and upper-extremity performance were examined. Two novice physiotherapists performed all the measurements following appropriate training. Results: The relative reliability scores, as calculated by intraclass correlation coefficient (ICC) indices, were found to be excellent (ICC = 0.924–0.988). Standard error of measurement and minimal detectable change scores have been estimated per position (SEM = 2.74–7.06 N, MDC = 7.55–19.42N). Test-retest reliability provided slightly higher SEM and MDC scores on average (SEM = 3.33–6.47, MDC = 9.32–18.04) than intra-rater and inter-rater reliability. Associations between ASH and the two tests were found to be moderate to strong (r = 0.584–0.856), with the dominant arm providing higher correlation scores (r = 0.605–0.856) than the non-dominant one (r = 0.584–0.823). Absolute values were collected and are provided for all three upper-limb tests; normalized values were calculated for ASH and rotational strength and peak torque only for the ASH measurements. Conclusions: The excellent reliability rates establish the ASH test as a highly recommended testing protocol for adolescent tennis players.

Not-yet-known not-yet-known not-yet-known unknown Background: Chronic musculoskeletal pain has been associated with changes at various levels regarding pain processing. One of the fields that has highlighted such differences between healthy individuals and people suffering from chronic musculoskeletal pain is neuroimaging of the brain. The mixed results arising from the different pathologies in addition to the use of different brain imaging modalities do not offer a conclusive overview, implicating the interpretation of the findings and their relevance as a causal or a consequent factor to chronification of pain. The aim of this systematic review is to provide a comprehensive summary of the available evidence assessing chronic painful conditions against healthy populations per functional neuroimaging modality. Methods: The protocol for this systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews. The databases that will be searched from inception to 8 January 2024 include PubMed, EMBASE (Ovid Interface), Scopus, Cochrane Library and Web of Science (Clarivate Analytics). Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Discussion: The results of this review will provide an up-to-date report on what the main findings of brain neuroimaging per pathological population and imaging modality are, assessing at the same time the quality of the evidence and indicating future directions in the field of neuroimaging assessment of the musculoskeletal patient.

We thank the authors for their constructive comments on our work