Tag: nevin manimala

Int J Soc Determinants Health Health Serv. 2025 Oct 28:27551938251385864. doi: 10.1177/27551938251385864. Online ahead of print.

ABSTRACT

The U.N. Sustainable Development Goals highlighted the importance of good health and healthy well-being (SDG 3). Child health is very important for achieving SDG 3; maintaining proper child health is essential for a developing country like India. Against this backdrop, assessing child health across various states is crucial. Thus, the study developed the composite child health index (CHI) using a novel technique for order preference by similarity to ideal solution (TOPSIS)-based, factor analytic multi-criteria decision-making (MCDM) approach. The index was developed using secondary data compiled from the National Family Health Survey from 2015 to 2020 using 35 child health indicators. Hierarchical and K-means were applied to categorize the various states and union territories based on their CHI values. This analysis reveals significant differences in child health outcomes across Indian states, with two states achieving higher levels and 25 states facing lower levels of child health. Among the states, Nagaland tops the list (CHI = 0.57441), indicating better child health conditions, followed by Odisha (CHI = 0.54384). The states with the lowest scores, Andhra Pradesh (CHI = 0.08406) and Manipur (CHI = 0.1065), have more significant challenges in child health. Thus, there is a need for targeted interventions in the most affected areas.

PMID:41148205 | DOI:10.1177/27551938251385864

Age Ageing. 2025 Aug 29;54(10):afaf316. doi: 10.1093/ageing/afaf316.

ABSTRACT

BACKGROUND: Among various tools developed for mild cognitive impairment (MCI) detection, analysing speech features is a non-invasive and cost-effective approach that shows promise for early detection. This review aimed to systematically synthesise and analyse current evidence on the diagnostic utility of speech-based biomarkers for identifying MCI.

METHODS: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Ovid Medline and PsycINFO databases were searched up to April 2025 without restrictions on language, article status or year.

RESULTS: Of 4432 identified records, 54 peer-reviewed articles met the inclusion criteria. Fixed-effects meta-analyses showed pooled estimates of 80.0% ‘accuracy’ [95% confidence intervals (CI): 70.0%-89.0%, P < .001, n = 21], 78.0% ‘area under the curve’ (95% CI: 70.0%-86.0%, P < .001, n = 21), 80.0% ‘sensitivity’ (95% CI: 71.0%-90.0%, P < .001, n = 22), and 77.0% ‘specificity’ (95% CI: 65.0%-89.0%, P < .001, n = 15) in differentiating MCI from cognitively unimpaired (CU) individuals. Egger’s regression tests indicated no publication bias (P ≥ .299), and the I2 statistic revealed no heterogeneity across studies (I2 = 0.00%, P = 1.00). Four studies also included a subjective cognitive decline group, reporting significant differences in certain speech features compared to CU.

CONCLUSIONS: Speech analysis demonstrates moderate classification performance, with balanced sensitivity and specificity, in distinguishing MCI from CU, suggesting its potential as an accurate and cost-effective diagnostic tool for MCI detection. Further research is needed to address variations in study methodologies, refine speech analysis protocols and validate findings in diverse populations to enhance generalisability.

PMID:41148189 | DOI:10.1093/ageing/afaf316

JAMA Netw Open. 2025 Oct 1;8(10):e2539767. doi: 10.1001/jamanetworkopen.2025.39767.

ABSTRACT

IMPORTANCE: Perioperative cardiac arrest and cardiopulmonary resuscitation (CPR) are associated with significant morbidity and mortality. Despite a growing focus on goal-concordant surgical care and longstanding emphasis on preoperative code status discussions, clinicians lack tools to individualize risk estimates and inform shared decision-making (SDM) regarding perioperative CPR.

OBJECTIVE: To generate and internally validate predictive models for 30-day mortality and nonhome discharge using routinely available preoperative data.

DESIGN, SETTING, AND PARTICIPANTS: A prospective, multicenter, prognostic study of patients within the American College of Surgeons (ACS)-National Surgical Quality Improvement Program (NSQIP), including nearly 700 participating hospitals in the US, from January 1, 2012, through December 31, 2023. Follow-up duration was 30 days. Seven machine learning models were developed using 10-fold cross validation. Participants were patients aged 18 years or older undergoing noncardiac surgery who underwent CPR on the day of surgery.

EXPOSURES: Thirty-three preoperative sociodemographic, clinical, laboratory, and procedural variables were evaluated for their association with 30-day mortality and nonhome discharge.

MAIN OUTCOMES AND MEASURES: The primary outcome was 30-day mortality following CPR. The secondary outcome was nonhome discharge among survivors admitted from home. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and calibration (Brier score and calibration curves). Clinical utility was evaluated using Shapley additive values (SHAP) decision curve analysis (DCA).

RESULTS: Among 6405 patients (median [IQR] age 69 [60-78], 3572 [55.8%] men, 860 [13.4%] Black, 4343 [67.8%] White, and 261 [4.1%] another racial category, including American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander), 3710 (57.9%) died within 30 days. The extreme gradient boosting model (CPR Outcome Prediction for Arrest in Surgical Settings [COMPASS]) achieved the best performance (AUROC for mortality = 0.80; 95 % CI, 0.78-0.82; accuracy = 0.73; 95% CI, 0.71-0.75; sensitivity = 0.77; 95% CI, 0.74-0.79; specificity = 0.68; 95% CI, 0.65-0.71; Brier score = 0.18). Among 2478 survivors admitted from home, 822 (33.2%) were discharged to a facility. For nonhome discharge, extreme gradient boosting demonstrated an AUROC of 0.78 (95 % CI, 0.74-0.82), accuracy of 0.76; and Brier score of 0.17. SHAP analysis identified American Society of Anesthesiologists status, case urgency, and frailty as key predictors. DCA indicated greater net benefit of extreme gradient boosting over default strategies (ie, treat all or treat none) across wide threshold ranges.

CONCLUSIONS AND RELEVANCE: In this prospective prognostic study of outcomes following perioperative CPR, extreme gradient boosting generated individualized predictions of outcomes following perioperative CPR that may inform prevention strategies and goal-concordant surgical care.

PMID:41148140 | DOI:10.1001/jamanetworkopen.2025.39767

JAMA Netw Open. 2025 Oct 1;8(10):e2539778. doi: 10.1001/jamanetworkopen.2025.39778.

ABSTRACT

IMPORTANCE: A paradigm shift is currently under way for the treatment of head and neck squamous cell carcinoma (HNSCC). Recent trials have demonstrated potential effectiveness of neoadjuvant systemic therapy (NST), including chemotherapy and immunotherapy; however, data on application of this approach are limited.

OBJECTIVE: To evaluate trends in the use of NST in patients with HNSCC from 2004 to 2022 and factors associated with treatment.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, retrospective cohort study used the National Cancer Database to identify 312 748 patients diagnosed with HNSCC from January 1, 2004, to December 31, 2022, who received definitive surgery. NST was defined as therapy administered at least 8 weeks before definitive surgery.

EXPOSURES: Sociodemographic factors and clinical characteristics.

MAIN OUTCOMES AND MEASURES: Adjusted risk of receiving neoadjuvant immunotherapy and chemotherapy across the analyzed years.

RESULTS: Among 312 748 patients (mean [SD] age, 63.3 [12.2] years; 218 218 [69.8%] male) who underwent surgery between 2004 and 2022, 1989 (0.6%) received NST, and among these, 1372 (69.0%) received neoadjuvant chemotherapy, 726 (36.5%) received neoadjuvant immunotherapy, and 109 (5.5%) received both. The first year of recorded neoadjuvant immunotherapy was 2007, with a use rate of 0.02%. Use began to increase in 2013 with a rate of 0.14%, peaking at 0.73% in 2019 but decreasing to 0.27% in 2022. From 2007 to 2022, the adjusted risk of receiving neoadjuvant immunotherapy increased by 22.5% per year (risk ratio [RR], 1.22; 95% CI, 1.19-1.26), whereas the adjusted risk of receiving chemotherapy decreased by -2.5% per year (RR, 0.97; 95% CI, 0.96-0.99). Sites with the largest increases in neoadjuvant immunotherapy use since 2013 were the hypopharynx (from 0.25% to 1.30%), gums and other oral cavity (from 0.19% to 0.58%), and tongue (from 0.18% to 0.27%). Patients who received neoadjuvant immunotherapy were more likely to have private insurance (342 [47.1%] vs 125 542 [40.2%]; P < .001), more likely to have stage IV disease (394 [54.3%] vs 100 565 [32.2%]; P < .001), and less likely to identify as Black (33 [4.5%] vs 21 384 [6.9%]; P = .01).

CONCLUSIONS AND RELEVANCE: In this retrospective cohort study of HNSCC, rates of neoadjuvant immunotherapy nearly doubled between 2013 and 2022, whereas neoadjuvant chemotherapy use significantly decreased from 2007 to 2022. These trends highlight the evolving therapeutic landscape for HNSCC and provide context for emerging data on neoadjuvant therapy.

PMID:41148139 | DOI:10.1001/jamanetworkopen.2025.39778

JAMA Netw Open. 2025 Oct 1;8(10):e2539862. doi: 10.1001/jamanetworkopen.2025.39862.

ABSTRACT

IMPORTANCE: There is limited direct evidence of the effects of policies regarding ambient particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5) on the risk of hospitalization for cardiovascular diseases (CVD). This evidence is essential for estimating the benefits of meeting specific PM2.5 standards in the regulatory impact analysis.

OBJECTIVE: To estimate the association of strengthening ambient PM2.5 standards with the risk of hospitalization for major CVD outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This population-based study used data from the UK Biobank cohort and followed up the participants from January 1, 2015, to December 31, 2019. All participants were 60 years or older and had no history of hospitalization with a primary diagnosis of a specific CVD at baseline. Data were analyzed from August 1, 2022, to August 25, 2025.

EXPOSURES: Annual mean PM2.5 exposure was assigned based on a 1 × 1-km2 resolution PM2.5 model linked to participants’ residential locations.

MAIN OUTCOMES AND MEASURES: The main outcomes were the first hospitalization with a primary diagnosis of stroke, myocardial infarction, heart failure, or arrhythmia. Longitudinal targeted maximum likelihood estimation was used to estimate 5-year hospitalization risks under hypothetical PM2.5 interventions.

RESULTS: Among the 502 133 UK Biobank participants recruited from 2006 to 2010 (273 158 [54.4%] female), 307 202 participants met the eligibility criteria for stroke, 304 212 for myocardial infarction, 310 100 for heart failure, and 302 255 for arrhythmia. The median age was 68.0 (IQR, 64.6-71.5) years for stroke, myocardial infarction, and arrhythmia, 68.0 (IQR, 64.7-71.5) years for heart failure, with female participants ranging from 54.4% to 55.0% across cohorts. Compared with no intervention on PM2.5, implementing a stricter ambient PM2.5 standard would reduce the absolute risk of hospitalization for major CVD. It was estimated that for the hypothetical PM2.5 intervention of reducing PM2.5 exposure by 5% if it is above the threshold of 9 µg/m3, the estimated 5-year risk difference of hospitalization for stroke was -2.26 per mille (95% CI, -8.97 to -20.64 per mille); for myocardial infarction, -8.64 per mille (95% CI, -9.16 to -6.38 per mille); for heart failure, -3.20 per mille (95% CI, -4.16 to -1.25 per mille); and for arrythmia, -4.16 per mille (95% CI, -12.70 to 12.93 per mille). For the hypothetical PM2.5 intervention of reducing PM2.5 exposure by 5% if it is above the threshold of 12 µg/m3, the estimated 5-year risk difference of hospitalization for stroke was -1.54 per mille (95% CI, -2.21 to 0.73 per mille). However, the reduction in risk for arrhythmia was not statistically significant (-2.06 per mille [95% CI, -4.79 to 3.12 per mille]).

CONCLUSIONS AND RELEVANCE: In this cohort study using data from the UK Biobank, the absolute risk reduction of hospitalization for stroke, myocardial infarction, heart failure, and arrhythmia due to hypothetical ambient PM2.5 interventions was quantified. The findings suggest the beneficial cardiovascular health impacts of further strengthening the current PM2.5 regulations in the United Kingdom.

PMID:41148138 | DOI:10.1001/jamanetworkopen.2025.39862

JAMA Netw Open. 2025 Oct 1;8(10):e2539870. doi: 10.1001/jamanetworkopen.2025.39870.

ABSTRACT

IMPORTANCE: Incomplete electronic health record (EHR) documentation may limit the effectiveness of clinical decision support (CDS) algorithms designed to identify patients eligible for hereditary cancer genetic evaluation.

OBJECTIVES: To determine whether a CDS algorithm can identify patients who meet criteria for hereditary cancer genetic evaluation when family history data are incompletely documented in the EHR, and to examine whether data missingness is associated with identification patterns across patient subgroups.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed EHR data extracted in December 2020 from 2 large US health care systems: University of Utah Health (UHealth) and NYU Langone Health (NYULH). Eligible patients were adults aged 25 to 60 years who visited a primary care clinic within the previous 3 years and had some EHR documentation of cancer family history. Data analysis was conducted in August 2024.

EXPOSURES: Patient demographic factors (age, sex, race and ethnicity, and language preference) and cancer family history characteristics (number of cancer history records, number of affected first- and second-degree relatives, relatives with rising mortality cancers, presence of hereditary cancer-related terms in comments, and completeness of documentation).

MAIN OUTCOMES AND MEASURES: The primary outcome was meeting at least 1 CDS algorithm criterion for genetic evaluation of hereditary cancer risk based on National Comprehensive Cancer Network guidelines. Missing data patterns were assessed using the Little missing completely at random test, with analyses conducted using complete case analysis and multiple imputation.

RESULTS: This study included 157 207 patients: 55 918 from UHealth and 101 289 from NYULH. Their mean (SD) age was 43.5 (9.8) years, and most (65.7%) were female. A total of 5607 UHealth patients (10.0%) and 10 375 NYULH patients (10.2%) met CDS criteria for genetic evaluation. At UHealth, data appeared to be missing completely at random (χ239 = 39.09; P = .47), and complete case compared with multiple imputation analyses yielded similar results. At NYULH, data were not missing completely at random (χ255 = 914.89; P < .001). Compared with multiple imputation, complete case analysis produced different association magnitudes for older age and having relatives with rising mortality cancers, suggesting bias when excluding incomplete records.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, the magnitude of the association between incomplete family history documentation and identification of patients eligible for hereditary cancer genetic evaluation depended on whether data were missing randomly or systematically. These findings suggest that health care organizations implementing CDS algorithms should assess their specific missing data patterns and consider tailored approaches to handling incomplete family history information to ensure equitable identification of all patients who could benefit from genetic evaluation services.

PMID:41148137 | DOI:10.1001/jamanetworkopen.2025.39870

JAMA Netw Open. 2025 Oct 1;8(10):e2539971. doi: 10.1001/jamanetworkopen.2025.39971.

ABSTRACT

IMPORTANCE: Total hip arthroplasty (THA) delays can be deleterious. Robust evaluation of time to THA enables data-driven improvement efforts across the US Military Health System.

OBJECTIVE: To evaluate time to THA after hip osteoarthritis diagnosis by patient-, care-, and structural-level factors.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study evaluated medical records from US military and civilian health care facilities from March 1, 2015, to June 21, 2024. Participants were adult TRICARE enrollees diagnosed with hip osteoarthritis between March 1, 2018, and March 30, 2023, without diagnosis in the past 3 years, who received at least 1 additional visit 1 week to 3 years after the index date. Data were analyzed from July 2024 to August 2025.

MAIN OUTCOMES AND MEASURES: Time to THA within 3 years of index diagnosis.

RESULTS: Of 37 239 patients diagnosed with hip osteoarthritis (median [IQR] age, 59 [50-64] years; 21 553 [58%] male; 320 American Indian and Alaska Native [1%]; 1603 Asian and Pacific Islander [4%]; 8123 Black [22%]; 2041 Hispanic [5%]; 23 327 White [63%]; 1825 another race and ethnicity [5%]), 10 502 (28%) received a THA within 3 years. A piecewise exponential additive model indicated incidence rate ratios (IRRs) for time to THA were lower for Asian and Pacific Islander (IRR, 0.76; 95% CI, 0.66-0.88), Black (IRR, 0.79; 95% CI, 0.74-0.85), and Hispanic (IRR, 0.84, 0.73-0.96) patients compared with White patients; patients with psychiatric (IRR, 0.79; 95% CI, 0.76-0.83), pain-related (IRR, 0.69; 95% CI, 0.66-0.72), or obesity (IRR, 0.92; 95% CI, 0.88-0.96) diagnoses before the index diagnosis; patients with elevated comorbidity index scores (IRR, 0.85; 95% CI, 0.74-0.97); those diagnosed in the purchased care system (IRR, 0.38; 95% CI, 0.36-0.40) and in later years (IRR, 0.97; 95% CI, 0.95-0.99); and patients with 1 (IRR, 0.83; 95% CI, 0.77-0.90) or more (IRR, 0.75; 95% CI, 0.70-0.81) injections or 2 or more imaging visit days (IRR, 0.77; 95% CI, 0.69-0.86) before the index diagnosis. Retired service members (IRR, 1.39; 95% CI, 1.24-1.56) and family members (IRR, 1.48; 95% CI, 1.30-1.69) had higher incidence of THA compared with active-duty service members. Male patients had higher incidence compared with female patients (IRR, 1.20; 95% CI, 1.11-1.31). Patients with increasing orthopedic surgeon visit days (IRR, 1.67; 95% CI, 1.64-1.69), opioid prescriptions (IRR, 1.02; 95% CI, 1.01-1.03), and imaging visit days (IRR, 1.26; 95% CI, 1.24-1.28) after the index diagnosis were also more likely to undergo THA. Variation across geographic areas was mixed.

CONCLUSIONS AND RELEVANCE: In this cohort study of TRICARE enrollees, variation in THA receipt was identified across multilevel factors. These finding suggest that policy and programming decisions could benefit from including TRICARE-participating orthopedic surgeon locations, structural factors, and reimbursement models to optimize THA access.

PMID:41148135 | DOI:10.1001/jamanetworkopen.2025.39971

JAMA Netw Open. 2025 Oct 1;8(10):e2539977. doi: 10.1001/jamanetworkopen.2025.39977.

ABSTRACT

IMPORTANCE: Adolescent cannabis use is a substantial public health concern given its associations with adverse mental and physical health outcomes. Understanding how distinct use patterns are associated with medical care utilization in young adulthood is critical for prevention.

OBJECTIVE: To examine the association between patterns of adolescent cannabis use and medical care utilization for mental and physical health conditions in young adulthood.

DESIGN, SETTING, AND PARTICIPANTS: This population-based birth cohort study linked to population-wide administrative medical care databases was conducted in the Province of Québec, Canada. Participants included individuals recruited for the Québec Longitudinal Study of Child Development, followed up from birth (1997-1998) to 23 years of age (2021). Data were analyzed November 2023 to February 2025.

EXPOSURE: Self-reported past 12-month cannabis use at ages 12, 13, 15, and 17 years.

MAIN OUTCOMES AND MEASURES: Medical care utilization for any mental disorder (including common mental disorders and substance-related disorders), suicide-related behaviors, and any physical health condition (including respiratory diseases, injuries and poisoning, and other physical diseases) between ages 18 and 23 years. Analyses were adjusted for 32 individual, family, and community-level confounders measured from birth to younger than 12 years of age using overlap weights.

RESULTS: Data for 1591 individuals (818 female [51.4%]; mean [SD] age at first exposure assessment, 12.1 [0.3] years) were analyzed. Three distinct adolescent cannabis use patterns were identified via group-based trajectory modeling: nonuse (948 [59.6%]), late-onset use (318 [20.0%], initiating after age 15 years), and early-onset and frequent use (325 [20.4%], initiating before age 15 years). In fully adjusted analyses, individuals with early-onset and frequent use had significantly higher odds of medical care utilization for any mental disorder (odds ratio [OR], 1.51 [95% CI, 1.10-2.08]), common mental disorders (OR, 1.57 [95% CI, 1.12-2.21]), any physical health condition (OR, 1.86 [95% CI, 1.30-2.67]), injuries and poisoning (OR, 1.41 [1.05-1.89]), and other physical diseases (OR, 1.47 [95% CI, 1.08-1.98]), compared with individuals with no use. Individuals with late-onset use did not differ significantly from those with nonuse for mental health outcomes (OR, 1.13 [95% CI, 0.80-1.58]) but had higher odds of medical care utilization for any physical health condition (OR, 1.63 [95% CI, 1.16-2.28]).

CONCLUSIONS AND RELEVANCE: Findings of this birth cohort study indicated that early-onset and frequent cannabis use was associated with greater medical care utilization for both mental and physical health conditions in young adulthood. These findings support the relevance of delaying initiation and reducing intensity of cannabis use during adolescence.

PMID:41148134 | DOI:10.1001/jamanetworkopen.2025.39977

J Antimicrob Chemother. 2025 Oct 28:dkaf398. doi: 10.1093/jac/dkaf398. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated CYP3A4-mediated pharmacokinetic interactions between ruxolitinib (JAK1/2 inhibitor for steroid-refractory acute and chronic graft-versus-host disease) and posaconazole (antifungal prophylaxis in haematological malignancies) to inform clinical dosing strategies.

METHODS: In this open-label, fixed-sequence trial, eight Chinese patients with haematological malignancies received ruxolitinib 5 mg once daily (Day 1: monotherapy) followed by ruxolitinib 5 mg plus posaconazole 200 mg three times daily (Days 2-6: combination). Plasma concentrations of ruxolitinib and posaconazole were analysed using validated LC-MS/MS. Geometric mean ratios (GMRs) with 90% CIs for PK parameters were calculated to assess PK interactions.

RESULTS: All patients completed the study. Co-administration with posaconazole increased ruxolitinib AUC0-24h by 58% (GMR: 1.58; 90% CI: 1.32-1.88). Geometric mean AUC0-24h values were 179.80 μg·h/L [monotherapy, coefficient of variation (CV) 39.26%] versus 283.60 μg·h/L (combination, CV 41.42%). No significant change in Cmax was observed (GMR: 1.10; 90% CI: 0.90-1.36). Geometric mean of the maximum plasma concentration at steady state (Cmax,ss) and AUC0-24h of posaconazole were 1543.52 μg/L (CV 41.81%) and 31 404.37 μg·h/L (CV 32.14%). There was no significant correlation between the systemic exposure of posaconazole (AUC or Cmax,ss) and the ratio of ruxolitinib AUC0-24h when co-administered versus administered alone.

CONCLUSIONS: Although co-administration of posaconazole with ruxolitinib resulted in a statistically significant increase in ruxolitinib systemic exposure, the magnitude of this interaction was clinically moderate. Although ruxolitinib dose adjustment may not be routinely required when used concomitantly with posaconazole, close monitoring for ruxolitinib-related adverse effects is recommended under this combination therapy setting.

PMID:41148123 | DOI:10.1093/jac/dkaf398

J Back Musculoskelet Rehabil. 2025 Oct 28:10538127251391101. doi: 10.1177/10538127251391101. Online ahead of print.

ABSTRACT

BackgroundNon-specific low back pain (NSLBP) has been associated with proprioceptive deficits that may also affect the knee joint.ObjectiveThis study aimed to examine knee proprioception in young adults with NSLBP and to assess dynamic postural stability using the Biodex Balance System (BBS). It further explored whether gender influences these outcomes.MethodsEighty-eight participants, aged 18 to 26 years with a body mass index under 30 kg/m² and diagnosed with NSLBP, were recruited. They were assigned to male (n = 44) and female (n = 44) groups. Assessments included the Oswestry Disability Index (ODI), knee joint repositioning error (JPE) measured with a digital inclinometer, and dynamic balance evaluated with the BBS. The BBS provided overall stability index (OSI), anterior-posterior index (API), and medial-lateral index (MLI) scores. Statistical analyses were performed using SPSS with significance set at p < 0.05.ResultsThere were no significant gender differences in JPE (males: 30.97 ± 3.62; females: 30.28 ± 5.42, p > 0.05) or ODI. BBS outcomes, however, showed elevated OSI (4.2 ± 1.1 compared with 2.5 ± 0.5 in healthy controls, p < 0.01), API (3.8 ± 0.9 compared with 2.0 ± 0.4, p < 0.01), and MLI (3.5 ± 0.8 compared with 1.8 ± 0.3, p < 0.01), indicating impaired dynamic balance. No significant gender differences were observed in BBS indices.ConclusionNSLBP significantly impairs dynamic knee proprioception, as demonstrated by BBS findings. Gender did not influence proprioceptive performance in this cohort.

PMID:41148105 | DOI:10.1177/10538127251391101