Chronic pain is prevalent among adolescents and is associated with significant impairments in physical, emotional, social, and academic functioning. Despite advances in pediatric pain research, includ...

Low back pain is the leading cause of disability globally. Most prevalence data for low back pain come from high-income countries. Data from low-and middle-income countries such as Nepal are currently...

Although the Numerical Rating Scale (NRS) is commonly recommended for use in research and clinical practice internationally, recent research in non-western countries questions its utility in some coun...

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Low back pain is the leading cause of disability globally. Most prevalence data for low back pain come from high-income countries. Data from low-and middle-income countries such as Nepal are currently...

Introduction/Objective The STarT Back Screening Tool (SBST) stratifies low back pain (LBP) patients based on their risk of chronicity to guide treatment accordingly. The absence of its validated Nep.....

OBJECTIVES: To explore the extent of functional improvement following primary total knee arthroplasty for knee osteoarthritis and compare trajectories of self-reported and performance-based measures of physical function. METHODS: We searched three electronic databases from January 2005 to February 2023 for longitudinal cohort studies involving adults with knee osteoarthritis undergoing primary total knee arthroplasty. Estimates of self-reported and performance-based physical function were extracted pre-surgery and up to five-years post-surgery. Risk of bias was assessed using a six-item checklist. Self-reported function scores were converted to a 0-100 scale (higher scores indicate worse function). Mixed models provided pooled estimates after excluding low-quality studies. RESULTS: Out of 230 relevant studies, 72 (n=19,063) of not low-quality were included in meta-analyses. Self-reported function significantly improved from pre-surgery (55.6/100, 95% CI 53.1 to 58.1) to 3-6 months post-surgery 21.1 (95% CI 17.9 to 24.3) (p < 0.001). A small decline in self-reported function occurred at 6-12 months (31.0, 95% CI 25.8 to 36.2) (p < 0.001), with no further change at 12-24 months (30.9, 95% CI 23.2 to 38.6) (p = 0.919). Performance-based measures exhibited variable trajectories, with most estimates indicating no clinically meaningful improvement following total knee arthroplasty. CONCLUSION: Total knee arthroplasty resulted in clinically meaningful improvements in self-reported function at 3-6 months post-operatively. There was some deterioration in function after 6 months, and at no other timepoint did the estimate reach a clinically important change. There was limited evidence of clinically meaningful improvements in performance-based measures of physical function at any time point.

To explore how process evaluation of complex interventions alongside randomised clinical trials (RCTs) in musculoskeletal conditions are conducted.