Chronic bone and joint pain is highly prevalent, and rehabilitation is a core component of care. This critical narrative review uses a transparent, structured evidence-mapping approach to examine rehabilitation studies published from January 2021 to April 2026, integrate findings across intervention classes, and identify evidence gaps. Across the included evidence base, exercise therapy supports pain and functional outcomes in selected musculoskeletal conditions, although optimal dose and phenotype-specific matching remain uncertain. Manual therapy and physical modalities may provide short-term adjunctive symptom relief, but their effects are conditional on technique, context, and protocol. Digital rehabilitation and virtual-reality-based approaches can improve access and engagement, but functional and long-term benefits are heterogeneous. Low-load blood-flow-restriction training is promising where high external loads are not tolerated; safety, dose, and longer-term effectiveness require further study. Rather than implying a universal precision-rehabilitation model, we present phenotype-informed treatment matching as a research agenda. Key limitations include heterogeneity of populations, interventions, outcome measures, and follow-up, the selective nature of narrative synthesis, publication bias, and the absence of pooled quantitative estimates. Exercise remains a foundation of care, with adjuncts selected according to presentation, patient priorities, feasibility, and response to reassessment.
Jie Zhuang, Jin-Yan Wang, Yin-Hu Hu et al.· Frontiers in Pain Research· 0 citations
Bis(2-ethylhexyl)-2,3,4,5-tetrabromophthalate (TBPH) is used as a nonreactive brominated flame retardant used in industrial products, particularly in flexible polyvinyl chloride and rigid and flexible polyurethane foams. Although TBPH exposure poses potential health risks, its association with atherosclerosis remains poorly understood.
This study integrated network toxicology, machine learning, molecular docking, and molecular dynamics (MD) simulations to elucidate the influence of TBPH on high-fat diet–induced atherosclerosis.
TBPH exhibited significant predicted toxicity across multiple organs. In total, 167 potential TBPH targets and 690 atherosclerosis-associated targets were identified, with 108 overlapping targets obtained through intersectional analysis. A PPI network was constructed based on these 108 overlapping genes, and the top 20 hub genes were identified. In a parallel independent analysis using a public transcriptomic dataset, 111 differentially expressed genes (DEGs) were identified by comparing atherosclerotic and normal tissues. Subsequent intersection analysis of the 108 overlapping targets and 111 DEGs identified candidate genes that were both TBPH-related and differentially expressed in atherosclerosis. Public transcriptomic data showed higher matrix metalloproteinase 9 (MMP9) level in atherosclerotic tissues. The corresponding receiver operating characteristic (ROC) curve yielded an AUC of 0.806 (95% confidence interval [CI]: 0.698–0.914). Molecular docking and MD simulations indicated favorable predicted binding modes and computational stability between TBPH and MMP9. In vivo experiments further demonstrated an association between TBPH exposure, increased MMP9 expression, and high–fat diet–induced atherosclerotic lesions.
These findings suggest that TBPH may be associated with high-fat diet–induced atherosclerosis progression through the dysregulation of key mediators, providing insight into environmental pollutant–driven disease development.
Huichao Pan, Dong Wang, Sheng-Guang Chen et al.· Frontiers in Pharmacology· 0 citations
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