Background: The coronavirus disease (COVID-19) pandemic has led to a global health crisis with significant long-term consequences, including musculoskeletal symptoms such as fatigue, myalgia, and chronic pain. These issues, often linked to altered nociceptive processing, impair quality of life and are exacerbated in severe cases by intensive care unit-acquired weakness from immobilization and mechanical ventilation. Early rehabilitation, particularly pulmonary rehabilitation (PR), is crucial for mitigating these effects. Telerehabilitation, leveraging telemedicine, offers an innovative, accessible alternative, providing personalized programs that improve adherence and recovery. Recent studies highlight telerehabilitation’s benefits alongside traditional methods, underscoring its potential for managing post-COVID-19 musculoskeletal sequelae. This study aimed to evaluate the effects of PR and an eHealth education tool (ET) on pain, functionality, quality of life, and psychological factors in post-COVID-19 patients with musculoskeletal symptoms and to compare telerehabilitation versus face-to-face approaches regarding treatment adherence. Methods: This pilot randomized controlled trial included 12 patients with musculoskeletal symptoms of COVID-19. The participants were randomly assigned to a PR program with or without an evidence-based eHealth ET. Primary outcomes included pain reduction and improvements in functional capacity, quality of life, and psychological factors measured over a 45-week period. The secondary outcome was adherence to rehabilitation. Results: A significant reduction in kinesiophobia was found in the eHealth ET group (P = .048), although no significant differences were observed in pain, Barthel index, or 6-minute walk test results between the groups. Clinically relevant improvements were observed in the telemedicine group. Conclusions: An evidence-based eHealth ET was effective in reducing kinesiophobia, highlighting its potential to address psychological aspects of post-COVID-19 recovery. However, further studies are needed to assess its long-term effects on physical recovery.

Background: Associated lesions in the diagnostic MRI may be related to worse long-term subjective outcomes. There is a lack of conclusive information about the long-term outcomes of associated injuries in anterior cruciate ligament (ACL) tears. The purpose of this study is to assess the long-term effects of associated injuries in ACL tears measured by means of a quality of life (QOL) assessment. Methods: A retrospective cohort study of 225 consecutive patients admitted for physical therapy with ACL injury (42 ± 12 years, 28.2% female) were conducted. All demographic and clinical variables were used to measure a QOL. Univariate and multivariable analyses were completed. Results: The mean follow-up period was 8.4 ± 2.6 years. In univariate analysis, male gender, and sports as the cause of the ACL lesion were factors significantly associated with improved International Knee Documentation Committee (IKDC) scores at the end of follow-up (all p < 0.002). In multivariable analysis, the occurrence of bone contusion was positively associated with injury (OR = 2.12) and negatively associated with sports injury (OR = 0.44) and medial collateral ligament (MCL) injury (OR = 0.48). Conclusions: After ACL injury, male gender and sports injury were associated with better clinical outcomes.

Introduction: Spinal cord injury is defined as the pathological process produced by any etiology affecting the spinal cord, which may alter motor, sensory, and/or autonomic function below the level of the lesion. The complexity of the neurological deficit and, therefore, the resulting clinical picture depends on the level of the lesion, the extent, and the affectation of the white or gray substance. This injury can totally or partially affect the ability to walk, and its highest priority with respect to mobility is to restore the ability to walk. All of which make the improvement of the methods used in their rehabilitation a top priority for health systems. Objective: The main objective of this study was to evaluate the effect of a gait training program for patients with spinal cord injuries. Material and Methods: A single-group, prospective cohort study was developed following the Strengthening the Reporting of Observational Studies in Epidemiology Guidelines (STROBE) at the International Center for Neurological Restoration of Siboney Playa (Havana, Cuba) from May 2020 to July 2021 with a sample of 30 patients by accidental or deliberate non-probabilistic sampling that met the expected inclusion criteria, who underwent a physical rehabilitation program for 8 weeks of work. Results: Statistically significant changes were observed in the overall course, by sex, by topographic level of lesion, and by functional class. Conclusions: The gait training program used produced significant changes in thoracic spinal cord injured patients regardless of the level of injury, sex, or functional class of the patient.

Objective: This study aimed to assess differences in pain neurophysiology knowledge between individuals with chronic musculoskeletal pain (CMP) and those without CMP, and to explore associations between pain knowledge, pain intensity, and demographic and lifestyle factors. Methods: A cross-sectional study was conducted with 171 participants, including 120 with CMP and 51 without CMP. Sociodemographic, pain-related, and lifestyle data were collected. Pain knowledge was assessed using the Revised Neurophysiology of Pain Questionnaire (R-NPQ). Statistical analyses included t-tests, chi-squared tests, Pearson’s correlation, and stepwise regression models to identify predictors of pain intensity and CMP presence. Results: Significant differences were found between participants with and without CMP in BMI (p< 0.001), physical activity (p=0.023), education level (p=0.002), and alcohol consumption (p=0.017). Participants with CMP scored lower on the R-NPQ (mean 4.40 ± 2.1) than those without CMP (mean 6.31 ± 2.03; p< 0.001). Pain intensity was negatively associated with R-NPQ scores (r=− 0.315; p< 0.001), physical activity (r=− 0.199; p=0.030), and education level (rho=0.236; p=0.010). Stepwise regression analysis revealed that R-NPQ scores (20.7%), BMI (6.7%), education level (3.9%), and physical activity (2.6%) collectively explained 33.9% of the variance in pain intensity (adjusted R²=0.339). Binary logistic regression identified BMI, R-NPQ scores, and education level as significant predictors of CMP presence, with higher BMI and lower R-NPQ scores increasing the odds of CMP, while higher education levels and physical activity were predictive factors. Conclusion: Individuals with CMP exhibited lower knowledge of pain neurophysiology, higher BMI, reduced physical activity levels, and lower educational attainment, all of which were associated with increased pain intensity and a greater likelihood of CMP presence.

Background and Clinical Significance: Altered pain perception is a diagnostic challenge for patients with a history of trauma and substance use. Familial dysautonomia (Riley-Day syndrome) may further complicate the sensory profiles. Case Presentation: We describe a male in his late twenties, originally from Central America, with a history of severe childhood trauma and chronic cannabis use, who reported diminished pain perception despite multiple injuries. Despite the absence of nociceptive pain (nociceptive hypoesthesia), abnormal sensations, such as tingling and itching (paresthesia), and occasionally unpleasant burning sensations (dysesthesia) were common symptoms in this case. Diagnosis: Clinical suspicion of familial dysautonomia was raised based on altered pain perception and minor autonomic signs. However, no genetic testing or neurological evaluation was performed. Psychological assessment revealed high levels of neuroticism, depression, and maladaptive coping. The Central Sensitization Inventory (CSI) and the Symptom Severity Scale (SS) further supported the presence of psychological symptoms suggestive of possible central sensitization. Outcome: Functional improvement was observed after a reduction in substance use and implementation of self-directed physical and cognitive rehabilitation. No standardized follow-up or formal interventions were recorded. Conclusions: This case illustrates the complexity of pain modulation in trauma-affected individuals and emphasizes the need for an integrative, interdisciplinary evaluation of atypical pain presentations.