Objective: Kinesiophobia has been proposed to influence recovery in individuals with Achilles tendinopathy. However, whether there are differences in outcomes in individuals with different levels of kinesiophobia is unknown. The purpose of this study was to compare the characteristics of patients at baseline and recovery over time in individuals with Achilles tendinopathy and various levels of kinesiophobia.Methods: This study was a secondary analysis of a prospective observational cohort study of 59 individuals with Achilles tendinopathy. The participants were divided into 3 groups on the basis of scores on the Tampa Scale for Kinesiophobia (TSK) (those with low TSK scores [≤33; low TSK group], those with medium TSK scores [34–41; medium TSK group], and those with high TSK scores [≥42; high TSK group]). All participants were evaluated with self-reported outcomes, clinical evaluation, tendon morphology, viscoelastic property measurements, and a calf muscle endurance test at baseline, 6 months, and 12 months. No treatment was provided throughout the study period.Results: There were 16 participants (8 women) in the low TSK group (age = 51.9 [SD = 15.3] years, body mass index [BMI] = 24.3 [22.3–25.4]), 28 participants (13 women) in the medium TSK group (age = 52.7 [SD = 15.2] years, BMI = 26.4 [22.5–30.8]), and 15 participants (8 women) in the high TSK group (age = 61.1 [SD = 11.1] years, BMI = 28.1 [25.2–33.6]). Among the groups at baseline, the high TSK group had significantly greater BMI and symptom severity and lower quality of life. All groups showed significant improvement over time for all outcomes except tendon viscoelastic properties and tendon thickening when there was an adjustment for baseline BMI. The high and medium TSK groups saw decreases in kinesiophobia at 6 months, but there was no change for the low TSK group.Conclusion: Despite the high TSK group having the highest BMI and the worse symptom severity and quality of life at baseline, members of this group showed improvements in all of the outcome domains similar to those of the other groups over 12 months.Impact: Evaluating the degree of kinesiophobia in individuals with Achilles tendinopathy might be of benefit for understanding how they are affected by the injury. However, the degree of kinesiophobia at baseline does not seem to affect recovery; this finding could be due to the patients receiving education about the injury and expectations of recovery.

Impaired proprioception is a recognized complication in individuals with type 2 diabetes mellitus (T2DM), contributing to balance deficits and increased risk of falls. However, limited research has focused on lumbar proprioception in this population. This study aimed to investigate lumbar proprioception in individuals with T2DM, as well as healthy individuals. Additionally, this study aimed to examine the correlation between lumbar proprioception and glycated hemoglobin (HbA1c) levels, which is a marker of long-term glycemic control in T2DM. A cross-sectional study was conducted, comparing lumbar joint reposition errors (JRE) between a T2DM group (n = 85) and a healthy group (n = 85). Lumbar JRE was assessed in flexion, extension, lateral bending left, and lateral bending right using a dual inclinometer device. HbA1c levels were measured as an indicator of glycemic control. Significant differences in lumbar JRE were found between the T2DM and healthy groups, with individuals with T2DM exhibiting larger JRE values, indicating impaired lumbar proprioception (p < 0.001). The correlation analysis revealed significant positive associations between HbA1c levels and lumbar JRE. Higher HbA1c levels were correlated with greater joint JRE in flexion (r = 0.49, p < 0.001), extension (r = 0.51, p < 0.001), left lateral bending (r = 0.45, p < 0.001), and right lateral bending (r = 0.48, p < 0.001) in the T2DM group. This study provides evidence of impaired lumbar proprioception in individuals with T2DM, as evidenced by larger lumbar JRE compared to the healthy group.

Rehabilitative ultrasonography (RUS) has significantly enhanced musculoskeletal care by providing real-time, detailed visualizations of muscle, tendon, and soft tissue structures. This symposium explores the diverse applications of RUS, highlighting its advantages over traditional imaging methods. In muscle rehabilitation, RUS is pivotal for assessing muscle morphology, activation patterns, and providing biofeedback, thereby optimizing personalized rehabilitation programs. For tendon injuries, RUS facilitates precise evaluation of tendon integrity, enabling accurate diagnosis, monitoring, and guiding therapeutic interventions. Beyond muscles and tendons, RUS is invaluable in diagnosing and managing soft tissue pathologies, such as ligament and fascia injuries, allowing for targeted treatment strategies. By offering superior precision, safety, and cost-effectiveness, RUS sets a new benchmark in rehabilitation practices, leading to improved patient outcomes and a deeper understanding of musculoskeletal conditions. The integration of RUS into rehabilitation medicine represents a transformative advancement in patient care and treatment efficacy.

Background: Achilles tendinopathy is a prevalent musculoskeletal condition that limits activity and performance. The Victorian Institute of Sport Assessment–Achilles (VISA-A) questionnaire is the gold-standard patient-reported outcome measure for symptom severity, but no comprehensive Arabic validation has been available. Purpose: To translate, culturally adapt, and validate the VISA-A into Arabic (VISA-A–Arabic) and to examine its psychometric properties in a broad population. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The VISA-A was translated and culturally adapted following international guidelines. A total of 139 participants were recruited: 60 healthy participants, 47 healthy at-risk participants, and 32 patients with Achilles tendinopathy. All participants completed the VISA-A–Arabic and the 36-item Short Form Health Survey (SF-36) at baseline; the VISA-A–Arabic was re-administered after 1 to 3 days. Internal consistency, test-retest reliability, construct validity, measurement error, and known-group validity were evaluated. Results: The VISA-A–Arabic demonstrated acceptable internal consistency (Cronbach α = 0.73 [95% CI, 0.65-0.80]) at baseline and good test-retest reliability (intraclass correlation coefficient = 0.76 [95% CI, 0.68-0.83]). Construct validity was confirmed by a strong correlation with the SF-36 Physical Component Summary ( r = 0.63; P < .001) and a weak correlation with the SF-36 Mental Component Summary ( r = 0.33; P = .02). Known-group validity showed significantly lower VISA-A–Arabic scores at baseline in patients with Achilles tendinopathy (54.8 ± 20.9) compared with healthy (85.9 ± 10.6) and healthy at-risk (92.7 ± 8.0) participants ( F (2,136) = 87.6; P < .001; η ² = 0.56). The standard error of measurement was 10.3, and the smallest detectable change at the individual level was 28.4. No floor effects were observed, and ceiling effects were minimal in the Achilles tendinopathy group. Conclusion: Our study showed that the VISA-A–Arabic is a reliable and valid instrument for assessing Achilles tendon–related symptoms and function. Unlike earlier Arabic validation efforts limited to patients, this study included a larger and more diverse cohort and incorporated additional psychometric analyses (standard error of measurement, smallest detectable change, Bland-Altman plot). These findings provide stronger evidence for the clinical and research application of the VISA-A–Arabic across Arabic-speaking populations.

Background/Objectives: Disability in chronic low back pain (CLBP) is multifactorial, yet the independent associations of pain, fear-avoidance beliefs, and comorbidity burden with self-reported disability and performance-based walking capacity remain unclear, particularly in Saudi Arabia. This study examined factors independently associated with functional disability and walking capacity in adults with CLBP and explored whether disability was independently associated with walking capacity after accounting for demographic and clinical factors. Methods: This cross-sectional study included 339 adults with CLBP. Functional disability was assessed using the Oswestry Disability Index (ODI), walking capacity using the 6-Minute Walk Test (6MWT), and fear-avoidance beliefs using the physical activity (FABQ-PA) and work (FABQ-Work) subscales of the Fear-Avoidance Beliefs Questionnaire. Comorbidity burden was quantified as an unweighted count of previously diagnosed chronic conditions reported by participants and BMI-defined obesity. Multiple linear regression was used to examine factors independently associated with disability and walking capacity. The disability model included age, sex, pain intensity, FABQ-PA, FABQ-Work, and comorbidity burden. Walking capacity was examined using two models: the first included the same factors, whereas the second exploratory model additionally included ODI to examine whether disability was independently associated with 6MWT distance. Results: Bivariate analyses showed that pain intensity was positively correlated with FABQ-PA and FABQ-Work (r = 0.303–0.355), while ODI was positively correlated with comorbidity burden (r = 0.170). The 6MWT was negatively correlated with pain intensity, FABQ-PA, and FABQ-Work (r = −0.162 to −0.170) and more strongly with ODI (r = −0.550). In the adjusted disability model, comorbidity burden was the only factor independently associated with ODI score, with each additional comorbid condition associated with a 2.30-point higher ODI score (B = 2.296, 95% CI 0.834 to 3.759, p = 0.002). In the first adjusted walking-capacity model, higher pain intensity was independently associated with shorter 6MWT distance (B = −5.108, 95% CI −10.05 to −0.17, p = 0.044), while the other factors were not significantly associated with walking capacity. In the second adjusted walking-capacity model, greater disability was independently associated with shorter 6MWT distance (B = −3.996, 95% CI −4.655 to −3.337, p < 0.001). None of the other factors remained significantly associated with walking capacity in this model. Conclusions: Greater comorbidity burden was independently associated with greater disability in adults with CLBP, while greater disability was strongly associated with poorer walking capacity, highlighting the relevance of comorbidity burden and disability to functional limitations in CLBP.