Fisioterapia

URI permanente para esta comunidadhttps://hdl.handle.net/11441/11039

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A 14-day therapeutic exercise telerehabilitation protocol of physiotherapy is effective in non-hospitalized post-COVID-19 conditions: a randomized controlled trial
(MDPI, 2023-01-18) Rodríguez Blanco, Cleofás; Bernal Utrera, Carlos; Anarte-Lazo, Ernesto; González-Gerez, Juan José; Saavedra-Hernández, Manuel; Universidad de Sevilla. Departamento de Fisioterapia
The emergence of COVID-19 has led to serious public health problems. Now that the acute phase of the pandemic has passed, new challenges have arisen in relation to this disease. The post-COVID-19 conditions are a priority for intervention, as months after the onset of the disease, they continue to present symptoms, especially physical and respiratory symptoms. Our aim is to test the efficacy of a fourteen-day telerehabilitation program of respiratory and strength exercises in people with post-COVID-19 conditions. For this purpose, a randomized controlled trial was generated in which data from 48 patients were analyzed using the BS, 30STSTST, MD12, VAFS, and 6MWT tests. The obtained results showed the benefit of the intervention in generating great results with respect to the control group.
A Comparison of Fourth-Year Health Sciences Students’ Knowledge of Gross Lower and Upper Limb Anatomy: A Cross-Sectional Study
(Elsevier, 2016-08) Díaz Mancha, Juan Antonio; Castillo López, José Manuel; Munuera Martínez, Pedro Vicente; Fernández Seguín, Lourdes María; Polo Padillo, Juan; Heredia Rizo, Alberto Marcos; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS-1043: Salud, Fisioterapia y Actividad Física; Universidad de Sevilla. CTS-601: Hermes; Universidad de Sevilla. CTS-1110: Understanding Movement and Self in health from Science; Universidad de Sevilla. CTS-312: Análisis de la Demanda Sanitaria
Objective: The aim of the study was to assess and compare the knowledge of fourth-year medicine, physiotherapy (PT), nursing, and podiatry students in carpal and tarsal bone anatomy. Methods: A cross-sectional study was carried out. Based on a nonprobability convenience sampling, 177 fourth-year students (117 women and 60 men, mean age of 23.16 ± 3.82 years) from the podiatry (n = 39), nursing (n = 26), PT (n = 73), and medicine (n = 39) schools at a large Spanish university were included. Measurements were taken of their gross anatomy knowledge by means of the carpal and the tarsal bone tests. Students were asked to identify all carpal and tarsal bones in an illustration of the bony skeleton of both regions and were given a maximum of 5 minutes per test. Results: Of a total of 15 bones to be labeled, the PT (11.07 ± 3.30) and podiatry (9.36 ± 2.93) students had the highest rate of correct answers compared with the medicine (6.13 ± 3.27) and nursing (4.04 ± 3.72) undergraduates. When assessing academic degrees and test scores, significant differences were observed between PT and podiatry participants vs those from the medicine and nursing schools (P < .001). Conclusion: Fourth-year students from the PT and podiatry programs correctly identified a higher number of carpal and tarsal bones than students from the nursing and medicine schools.
A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods
(Hindawi, 2015) Luque Moreno, Carlos; Ferragut Garcías, Alejandro; Rodríguez Blanco, Cleofás; Heredia Rizo, Alberto Marcos; Oliva Pascual-Vaca, Jesús; Kiper, Pawel; Oliva Pascual-Vaca, Ángel; Universidad de Sevilla. Departamento de Fisioterapia
Objective. To develop a systematic review of the literature, to describe the different virtual reality (VR) interventions and interactive videogames applied to the lower extremity (LE) of stroke patients, and to analyse the results according to the most frequently used outcome measures. Material and Methods. An electronic search of randomized trials between January 2004 and January 2014 in different databases (Medline, Cinahl, Web of Science, PEDro, and Cochrane) was carried out. Several terms (virtual reality, feedback, stroke, hemiplegia, brain injury, cerebrovascular accident, lower limb, leg, and gait) were combined, and finally 11 articles were included according to the established inclusion and exclusion criteria. Results. The reviewed trials showed a high heterogeneity in terms of study design and assessment tools, which makes it difficult to compare and analyze the different types of interventions. However, most of them found a significant improvement on gait speed, balance and motor function, due to VR intervention. Conclusions. Although evidence is limited, it suggests that VR intervention (more than 10 sessions) in stroke patients may have a positive impact on balance, and gait recovery. Better results were obtained when a multimodal approach, combining VR and conventional physiotherapy, was used. Flexible software seems to adapt better to patients’ requirements, allowing more specific and individual treatments.
A pilot randomised controlled trial on the effectiveness of infant massage on the acceptance, commitment and awareness of influence in parents of babies with Down syndrome
(2023-01) Piñero Pinto, Elena; Romero‐Galisteo, R. P.; Jiménez Rejano, José Jesús; Escobio Prieto, Isabel; Peña Salinas, Marta; Luque Moreno, Carlos; Palomo‐Carrión, R.; Universidad de Sevilla. Departamento de Fisioterapia
Background The emotional state of parents of babies with Down syndrome affects their babies’ development and their parent–child bonding. The aim for this study was to conduct a pilot randomised controlled evaluation of the effect of infant massage on parents of babies with Down syndrome. Methods This pilot study compared two groups (intervention and control), each with 16 parents of babies with Down syndrome. Indices of acceptance, engagement and awareness of influence were measured at two different time points (pre-test and after 5 weeks) using the ‘This Is My Baby’ Interview. The allocation of families to each group was randomised. The experimental group performed infant massage, applied by the parents, for 5 weeks, every day for at least 10 min. The massage protocol was based on the methodology created by Vimala McClure. Parents in the control group received the intervention after completion of the study. Results The indices of acceptance, commitment and awareness of influence improved in the experimental group and in the control group. The 2 × 2 mixed-model analysis of variance indicates a statistically significant group-by-time interaction for all indices (P < 0.001), which was significantly higher in the experimental group than in the control group. Conclusions The application of infant massage, by parents to their babies, improves the rates of acceptance, commitment and awareness of influence of parents of babies with Down syndrome in the short term.
A Short-Term Resistance Training Circuit Improved Antioxidants in Sedentary Adults with Down Syndrome
(HINDAWI LTD, 2021) Rosety-Rodriguez, M.; Bernardi, M.; Elosegui, S.; Rosety, I.; Diaz, A. J.; Rosety, M. A.; Oliva Pascual-Vaca, Ángel; Ordonez, F. J.; Universidad de Sevilla. Departamento de Fisioterapia
Previous studies have found aerobic training improved oxidative damage in people with Down syndrome (DS). However, there is a lack of information regarding the influence of resistance training on redox imbalance in this population. Accordingly, this study was conducted to determine the effect of resistance training (RT) on antioxidant defence system in sedentary adults with DS. Thirty-six male adults with DS were recruited through different community support groups. Eighteen were randomly assigned to perform a circuit RT program with 6 stations, 3 days/week for 12 weeks. Plasma total antioxidant status (TAS), reduced glutathione (GHS), ascorbate, serum α-tocopherol, and erythrocyte glutathione reductase activity were assessed. Plasma malondialdehyde (MDA) and carbonyl groups (CG) were assessed as markers of oxidative damage. Muscle strength was also measured. Dynamic torque of knee extensors and flexors as well as maximal handgrip strength was significantly improved after the completion of the training program. Plasma levels of TAS and erythrocyte glutathione reductase (GR) activity were significantly increased. Conversely, MDA and CG levels were significantly reduced. It was concluded RT improved antioxidant defence system and reduced oxidative damage in adults with DS. Further, long-term studies are required to determine whether the increased antioxidant system may improve clinical outcomes of adults with DS.
A Systematic Review of the Effectiveness of Dry Needling in Subacromial Syndrome
(MDPI, 2022-02-04) Blanco-Diaz, María; Ruiz-Redondo, Rubén; Escobio Prieto, Isabel; Fuente Costa, Marta de la; Albornoz Cabello, Manuel; Casaña, José; Universidad de Sevilla. Departamento de Fisioterapia
Our aim was to evaluate the effectiveness of dry needling (DN) combined with conventional physiotherapy in the recovery of patients with subacromial syndrome (SAS). A search was made of the main open access health science databases. The publication date was not limited for systematic reviews but was for randomized clinical trials (RCTs), which were limited to the last five years (from 2016) in English or in Spanish. Ninety-four studies were selected. In order to assess the quality of the studies, the JADAD scale or Oxford quality scoring system was used. A total of 402 patients were analyzed in all the studies in which the application of conventional physiotherapy was compared to the DN, either in a combination or in isolation. Improvements were obtained in pain intensity (Visual Analogic Scale—VAS), Range of Movement (ROM), Pressure Pain Threshold (PPT), functionality with Disabilities of the Arm, Shoulder and Hand (DASH) and the Shoulder Pain and Disability Index (SPADI), and in the cost–benefit ratio. DN is effective and safe in reducing the pain and disability produced by SAS, with the best combination of treatment turning out to be conventional physiotherapy together with DN, obtaining more stable and longer-lasting benefits than merely applying the techniques in isolation.
A systematic review on spinal asymmetries in case studies of unilateral nephroptosis from a viscerosomatic point of view
(MDPI, 2022-11-30) Oliva Pascual-Vaca, Ángel; Castillo-Cañuelo, María José; Oliva Pascual-Vaca, Jesús; Pérez-Montalbán, María; Ordóñez, Francisco Javier; Martínez Fernández, José Antonio; Universidad de Sevilla. Departamento de Fisioterapia
The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them.
A Systematic Review on the Application of Virtual Reality for Muscular Dystrophy Rehabilitation: Motor Learning Benefits
(MDPI, 2024-06-22) Kiper, Pawel; Federico, Sara; Szczepańska-Gieracha, Joanna; Szary, Patryk; Wrzeciono, Adam; Mazurek, Justyna; Luque Moreno, Carlos; Kiper, Aleksandra; Spagna, Mattia; Barresi, Rita; Cieślik, Błażej; Universidad de Sevilla. Departamento de Fisioterapia
Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the application of VR in supporting MD rehabilitation. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Web of Science to identify relevant articles. The inclusion criteria encompassed studies involving individuals diagnosed with MD who underwent VR interventions, with a primary focus on assessing functional improvement. Methodological quality of the studies was assessed by using the Physiotherapy Evidence Database (PEDro) scale. Seven studies, involving 440 individuals with Duchenne Muscular Dystrophy (DMD), were included in the review. Among these studies, six primarily explored the motor learning potential of VR, while one study investigated the impact of VR training on functional abilities. In conclusion, the qualitative synthesis supports VR-based interventions’ potential positive effects on motor learning, performance improvement, and functional outcomes in individuals with DMD. However, current usage mainly focuses on assessing the potential mechanisms’ benefits, suggesting the importance of expanding clinical adoption to harness their therapeutic potential for MD patients.
Abordaje fisioterápico del dolor cervical relacionado con el vuelo en pilotos de caza del ejército del aire y del espacio español: evaluación, intervención y respuestas psicofisiológicas
(2024-09-20) Fernández-Morales, Carlos; Espejo Antúnez, Luis; Albornoz Cabello, Manuel; Universidad de Sevilla. Departamento de Fisioterapia
Las exigencias físicas y cognitivas del vuelo de combate pueden influir en el desarrollo y la persistencia del dolor cervical relacionado con el vuelo (DCRV). Esta afección constituye una entidad clínica relacionada con el rendimiento, la salud laboral y la seguridad de vuelo en pilotos de caza. El objetivo principal de este estudio es analizar el efecto de un programa de fisioterapia multimodal que combina ejercicio supervisado con retroalimentación guiada por láser y terapia de corriente interferencial en pilotos de caza con DCRV. Para ello, el objetivo inicial será caracterizar a los pilotos de caza en relación a su estado cervical y conocer su nivel de estrés ocupacional para personalizar la intervención. Se planteó un estudio piloto en el que se asignó aleatoriamente a 31 pilotos en dos grupos: un grupo de intervención y un grupo de control. Todos los pilotos fueron instructores o alumnos adscritos al Ala 23 de la Base Aérea de Talavera, Ejército del Aire, Badajoz. El programa de intervención constó de 8 sesiones supervisadas de ejercicio con retroalimentación láser y electro-masaje de corriente interferencial durante 4 semanas, con una frecuencia de 2 sesiones semanales en días alternos. La muestra fue valorada antes y después de la intervención mediante un registro protocolizado y organizado, diseñado en la primera fase del estudio, para a posteriori sistematizar y analizar el conjunto de datos. Se estableció un periodo de seguimiento de 4 semanas para el grupo intervención. Las variables analizadas fueron la intensidad del dolor percibido (Numeric Pain Rating Scale), el error de reposicionamiento cervical activo (JPSE), la discapacidad cervical (Neck Disability Index), el rango de movimiento cervical activo (CRoM), el umbral de dolor a la presión (PPT), actividad mioeléctrica del trapecio superior y el esternocleidomastoideo, catastrofismo del dolor (Escala de Catastrofismo del Dolor - PCS), kinesiofobia (TSK-11) y la Variabilidad de la Frecuencia Cardíaca (VFC; variables de dominio en el tiempo, de dominio en la frecuencia y no lineales). Los datos se analizaron con el programa estadístico SPSS versión 26.0 (SPSS Inc., Chicago, IL, EE.UU.). El nivel de significación se estableció en p<0.05. Se observaron diferencias estadísticamente significativas tanto intra como intergrupos en favor del grupo de intervención para todas las variables clinimétricas analizadas. A nivel de VFC, encontró un aumento significativo de las variables relacionadas con los índices de activación parasimpática, en favor del grupo intervención. Se observaron tamaños de efecto moderados a grandes. En el análisis del beneficio del tratamiento, el número necesario a tratar fue de 2 (IC 95%: 2 a 3, p<0.001) para el dolor cervical y la agudeza propioceptiva. El programa de fisioterapia multimodal basado en ejercicio supervisado con retroalimentación por láser y electro-masaje de corriente interferencial mejora los síntomas y la función cervical en pilotos de caza con DCRV, respaldando su uso como una estrategia eficaz.
Acciones innovadoras y Reflexión docente en la Asignatura "Fisioterapia en Atención Temprana" del Grado en Fisioterapia
(Universidad de Sevilla, 2018) Benítez Lugo, María Luisa; Universidad de Sevilla. Departamento de Fisioterapia
Se realizó un ciclo de mejora en la asignatura optativa: Fisioterapia en Atención Temprana del Grado en Fisioterapia, llevando a cabo sesiones en la docencia teórica, mediante la metodología investigativa para crear emoción, curiosidad y atención en los estudiantes, para conseguir un aprendizaje duradero. Se obtuvieron resultados altos, por ejemplo, en la presentación de la materia utilizando la Técnica de la Flor, el 70% estuvo de acuerdo en que ayudó a contactar y a crear ambiente de clase; la actividad de Exposición de videos de casos fue valorada con un 4,9 (sobre 5); y en las prácticas del centro infantil El Nido de los Perdigones se obtuvo la máxima puntuación (5).
Acercamiento a la disfunción sexual femenina desde la fisioterapia : una cuestión de género y salud
(Unidad para la Igualdad, Universidad de Sevilla, 2010) Suárez Serrano, Carmen; Chillón Martínez, Raquel; Benítez Lugo, María Luisa; Medrano Sánchez, Esther Mª; Rebollo Roldán, Jesús; Universidad de Sevilla. Departamento de Fisioterapia
Existe un déficit de estudios que analicen la integración de la Fisioterapia en la disfunción sexual femenina en los ámbitos del género y la salud, siendo nuestros objetivos en este trabajo determinar la frecuencia de existencia de disfunción sexual y la frecuencia en la que las mujeres experimentan dolor en las relaciones sexuales, los niveles de satisfacción y la posible relación entre ambas dimensiones. El diseño es de corte cuantitativo, descriptivo, observacional y transversal con una muestra de 20 mujeres. Se implementa el Cuestionario sobre la Función Sexual Femenina (FSFI) conformado por 19 ítems categorizados en 5 variables de las que destacamos dos: el “dolor” y la “satisfacción”. En cuanto a resultados, presentan disfunción sexual un 75% de la muestra con valores similares y más bajos que los obtenidos por Rosen y cols. Un 67,7% de las mujeres del estudio consideran el dolor sufrido durante o después de la penetración vaginal como muy alto o alto. El 52,3 % de las mujeres del estudio se muestran satisfechas con su relación sexual en pareja y un 47,6% con su vida sexual en general. Finalmente, existe una elevada correlación entre el dominio dolor y el dominio satisfacción entre las participantes de esta investigación.
Acute Effects of a Single Football Training or Match on Passive Hip Rotation Range of Motion in Semi-Professional Football Players: A Pilot Study
(2020-05-10) Cruz Torres, Blanca de la; Abuín Porras, Vanesa; Blanco Morales, María; Cueva Reguera, Mónica de la; Calvo Lobo, César; López López, Daniel; Romero Morales, Carlos; Universidad de Sevilla. Departamento de Fisioterapia.
Background and Objectives: The repetitive loading forces generated during football activities may induce alterations in the hip rotation range of motion (ROM) in players. The objective of this study was to evaluate the acute effects of a training and a match obilateral passive hip rotation ROM in both lower limbs in soccer. Material and Methods: Twenty-eight male players were divided into two groups: 14 players (28 limbs) with normal bilateral hip rotation ROM (NH group) and 14 players (28 limbs) with restricted bilateral hip ROM (RH group). Passive bilateral hip rotation ROM was measured, by goniometer, before and after training or a match. Internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), total ROM (ROMTOT) and relative internal rotation (ROMREL) were calculated. Results: The NH group did not show substantial changes in hip ROM after a training nor a match. After a training session, only the RH group exhibited a substantial increase in ROMIR, ROMER and ROMTOT. After a match, only the RH group exhibited a substantial increase in ROMER and ROMTOT and exhibited a substantial decrease in ROMREL. Comparing both groups, there were significant differences within ROM changes for ROMER and ROMTOT after training and for ROMER and ROMREL after a match. Conclusions: Despite the small sample size of the present study, the findings indicate that a single football activity leads to significant changes in hip rotation ROM in players with restricted bilateral hip external-rotation ROM. However, these changes did not reach reference cut-off scores.
Acute hamstring injury prevention programs in eleven-a-side football players based on physical exercises: systematic review
(MDPI, 2021-05-09) Rosado-Portillo, Adolfo; Chamorro Moriana, Gema; Gonzalez-Medina, Gloria; Pérez Cabezas, Verónica; Universidad de Sevilla. Departamento de Fisioterapia
Objective: To analyze the exercise programs used to prevent of acute hamstring injuries in eleven-a-side football players, and their effectiveness. (2) Methods: A systematic review (PRISMA) was conducted (2008–2020), including RCTs, that exclusively used physical exercises as a prevention method. (3) Results: Ten studies were selected considering 14 interventions, including nine different programs: FIFA11+ (11+), Harmoknee, eccentric Nordic Hamstring Exercise (NHE) exclusively, with eccentric exercises, with stretching or with proprioceptive, New Warm-up Program (NWP), Bounding Exercise Program (BEP), the only one with no positive results, and proprioceptive exercises. Incidence of injuries and strength were the most considered variables, both with favorable evidences. Programs including NHE, which assessed injury incidence, were always effective. The 11+ program was effective in injury incidence and strength; NWP was effective in balance, stability, and strength. (4) Conclusions: The exercise programs discussed were effective to prevent acute hamstring injuries in football players except BEP and partially Harmoknee. Exercises mostly used to reduce the risk of hamstring injuries are those of eccentric force due to its functionality, especially NHE. Only concentric contractions and isometric contractions obtained significant favorable results. The most complete and promising programs were 11+ (in injury incidence and strength) and NWP (strength, balance, and stability). NWP was the best in strength.
Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
(MDPI, 2020) Hidalgo Agudo, Rubén D.; Lucena Antón, David; Luque Moreno, Carlos; Heredia Rizo, Alberto Marcos; Moral Muñoz, Jose A.; Universidad de Sevilla. Departamento de Fisioterapia
Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson’s disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson’s disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject
Age related changes in the Q angle of non-professional football players
(ELSEVIER SCI LTD, 2023-06) Escamilla Martínez, Elena; Sánchez Martín, Fátima; Ramos Ortega, Javier; González García, Paula; Cortés Vega, María Dolores; Fernández Seguín, Lourdes María; ; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. CTS-1110: Uncertainty, Mindfulness, Self, and Spirituality
Background Football practice involves a great muscular demand, leading to the development of the lower limbs that, on occasions, can cause deviations from the normal anthropometric values. The quadriceps angle (Q angle) is a value often taken as a reference for the alignment of the lower limbs. Objective To observe the changes of the Q angle in young football players, because of muscular effort, analyzing the differences between four groups of different ages and to determine whether the playing position might influence these variations. Methods A cross sectional study was carried out with 104 male subjects divided into four groups according to age: under 8 years-old, 8-17 years-old, 17-21 years-old and over 21 years-old. A photograph was taken in standing position and the Q angle was plotted with KINOVEA® software. As for the reliability of the measurements, intraclass intra and interobserver coefficient were 0.958 and 0.860 respectively. The study was conducted in mid-season. Results Q angle value is greater in those under 8 years of age and decreases gradually and significantly (p < 0.005) until 17–21 years of age, where it stabilizes at values of 5.73° ± 2.78 for right Q angle and 5.88° ± 2.55 for left Q angle. Two way ANOVA demonstrated a significant group*position interaction for goalkeepers with a medium effect size in both angles (p < 0.001) with a medium effect (η2 Right Q angle = 0.31; η2 Left Q angle = 0.37). The values remain unchanged in subjects over 21 years of age (p > 0.005), except for goalkeepers, who suffered a difference in the evolution of the angle within their age category (p < 0.005) and with a high effect size with the other positions (value > 0.8) except forward (value < 0.5). Conclusion This study determines that the Q angle in football players decreases with growth, reaching values below 15° at the end of development. Playing positions only influence players over the age of 21, and the Q-angle of goalkeepers is greater than that of other players.
Altered individual behavioral and EEG parameters are related to the EDSS score in relapsing-remitting multiple sclerosis patients
(PUBLIC LIBRARY SCIENCE, 2019-07-15) Vázquez Marrufo, Manuel; Galvao Carmona, Alejandro; Caballero Díaz, Rocío; Borges, Mónica; Páramo Camino, María Dolores; Benítez Lugo, María Luisa; Ruiz Peña, Juan L.; Izquierdo, Guillermo; Universidad de Sevilla. Departamento de Fisioterapia; Plan Nacional de Excelencia (Ministerio de Economía y Competitividad, Government of Spain, PSI2016-78133-P).
Functional neuroanatomy of cognitive impairment in multiple sclerosis is currently still a challenge. During the progression of the disease, several cognitive mechanisms deteriorate thus diminishing the patient's quality of life. A primary objective in the cognitive assessment of multiple sclerosis (MS) patients is to find reliable measures utilizing diverse neuroimaging techniques. Moreover, especially relevant in the clinical environment is finding technical approaches that could be applied to individual participants and not only for group analysis. A 64-channel electroencephalographic recording (EEG) was made with thirty participants divided into three groups of equivalent size (N = 10) (healthy control, low-EDSS (1-2.5) and moderate-EDSS (4-6)). Correlation analysis was applied to multiple measures: behavior, neuropsychological tests (Paced Auditory Serial Addition Test, 3 seconds (PASAT-3s) and the Symbol Digit Modality Test (SDMT)), Expanded Disability Status Scale (EDSS), even-related potential (P3) and event-related desynchronization (ERD) parameters and the correlation scores between individual participant's P3/ERD maps and the healthy grand average P3/ERDmaps. Statistical analysis showed that diverse parameters exhibited significant correlations. A remarkable correlation was the moderate score found between SDMT and EDSS (r = -0.679, p = 0.0009). However, the strongest correlation was between the value of integrated measures (reaction time, P3 and ERD latency) and EDSS (r = 0.699, p = 0.0006). In regard to correlations for grand average maps between groups, the P3 component exhibited a lower score according to a more deteriorated condition (higher EDSS). In contrast, ERD maps remained stable with an increase of EDSS. Lastly, a Z-transformation of individual values of all variables included in the study exhibited heterogeneity in cognitive alterations in the multiple sclerosis participants.
An Assessment of Balance through Posturography in Healthy about Women: An Observational Study
(MDPI, 2021-11-19) Escamilla-Martínez, Elena; Gómez Maldonado, Ana; Gómez-Martín, Beatriz; Castro Méndez, Aurora; Díaz Mancha, Juan Antonio; Fernández Seguín, Lourdes María; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. Departamento de Fisioterapia
The incidence of falls in adults constitutes a public health problem, and the alteration in balance is the most important factor. It is necessary to evaluate this through objective tools in order to quantify alterations and prevent falls. This study aims to determine the existence of alteration of balance and the influence of age in a population of healthy women. Static posturography was performed on 49 healthy adult women with no history of falls in four different situations using the Romberg test with the NedSVE/IBV® platform. The variables studied were the body sway area and the anteroposterior and mediolateral displacements. The situation of maximum instability occurred in RGC (p = 0.001), with a significant increase in anteroposterior oscillations regarding the ML (p < 0.001), with no correlation to age. Age alone does not influence the balance in the sample studied, other factors must come together to alter it. The joint cancellation of visual and somatosensory afferents could facilitate the appearance of falls, given that it is a situation of maximum instability. Proprioceptive training is interesting as a preventive strategy for falls.
An Exercise and Educational and Self-management Program Delivered With a Smartphone App (CareHand) in Adults With Rheumatoid Arthritis of the Hands: Randomized Controlled Trial
(JMIR PUBLICATIONS, INC, 2022) Rodríguez Sánchez Laulhé, P.; Luque Romero, Luis Gabriel; Barrero García, Francisco José; Biscarri Carbonero, Angela; Blanquero, Jesús; Suero Pineda, Alejandro; Heredia Rizo, Alberto Marcos; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública
Background: Rheumatoid arthritis (RA) is a prevalent autoimmune disease that usually involves problems of the hand or wrist. Current evidence recommends a multimodal therapy including exercise, self-management, and educational strategies. To date, the efficacy of this approach, as delivered using a smartphone app, has been scarcely investigated. Objective: This study aims to assess the short- and medium-term efficacy of a digital app (CareHand) that includes a tailored home exercise program, together with educational and self-management recommendations, compared with usual care, for people with RA of the hands. Methods: A single-blinded randomized controlled trial was conducted between March 2020 and February 2021, including 36 participants with RA of the hands (women: 22/36, 61%) from 2 community health care centers. Participants were allocated to use the CareHand app, consisting of tailored exercise programs, and self-management and monitoring tools or to a control group that received a written home exercise routine and recommendations, as per the usual protocol provided at primary care settings. Both interventions lasted for 3 months (4 times a week). The primary outcome was hand function, assessed using the Michigan Hand Outcome Questionnaire (MHQ). Secondary measures included pain and stiffness intensity (visual analog scale), grip strength (dynamometer), pinch strength (pinch gauge), and upper limb function (shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire). All measures were collected at baseline and at a 3-month follow-up. Furthermore, the MHQ and self-reported stiffness were assessed 6 months after baseline, whereas pain intensity and scores on the shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire were collected at the 1-, 3-, and 6-month follow-ups. Results: In total, 30 individuals, corresponding to 58 hands (CareHand group: 26/58, 45%; control group: 32/58, 55%), were included in the analysis; 53% (19/36) of the participants received disease-modifying antirheumatic drug treatment. The ANOVA demonstrated a significant time×group effect for the total score of the MHQ (F1.62,85.67=9.163; P<.001; η 2 =0.15) and for several of its subscales: overall hand function, work performance, pain, and satisfaction (all P<.05), with mean differences between groups for the total score of 16.86 points (95% CI 8.70-25.03) at 3 months and 17.21 points (95% CI 4.78-29.63) at 6 months. No time×group interaction was observed for the secondary measures (all P>.05). Conclusions: Adults with RA of the hands who used the CareHand app reported better results in the short and medium term for overall hand function, work performance, pain, and satisfaction, compared with usual care. The findings of this study suggest that the CareHand app is a promising tool for delivering exercise therapy and self-management recommendations to this population. Results must be interpreted with caution because of the lack of efficacy of the secondary outcomes.
Análisis clínico, ético y jurídico del delito de intrusismo en odontología
(2017-06-02) Rodríguez Menacho, Diego; Castaño Seiquer, Antonio Luis; Meléndez Sánchez, Felipe Luis; Garrido Peña, Francisco; Universidad de Sevilla. Departamento de Fisioterapia
La repercusión, tanto social como sanitaria, que comprende el delito de intrusismo en la Odontología es la principal justificación de la elaboración de esta empresa. Es de destacar que el delito de intrusismo no sólo debe analizarse e investigarse desde la óptica legal, estrictamente de doctrina jurídica, sino que también tiene una amplia relevancia en los planos social, clínico y ético. Aún siendo un delito de mera actividad, en la que no se requiere resultado para su comisión, es descrito como una infracción penal de peligro abstracto, el cual puede dar lugar a diferentes lesiones, e incluso hasta la muerte, además de un posible detrimento patrimonial y emocional del paciente que lo sufre. El objetivo del presente trabajo de investigación consiste en analizar la legislación, la doctrina, y la jurisprudencia del periodo comprendido en las tres últimas décadas, en los aspectos clínico, ético y jurídico del delito de intrusismo en la Odontología en España. Por ello, se ha trabajado desde la interdisciplinariedad entre las tres ciencias que se encuentran enlazadas: -la jurídica, emanada de las normas y de las resoluciones judiciales y del análisis de los elementos del delito; - la ética, procedente de los principios de la bioética médica; - y de la clínica, origen de la comisión del delito por personas que no están habilitadas para ello y de gran importancia para establecer qué se debe entender por el término de “acto propio”, requisito del tipo del delito. La presente obra se realiza con la intención de conocer mejor en qué consiste el delito de intrusismo, quién lo realiza, para ver su esfera social, y cómo afecta a diferentes aspectos de lo estrictamente jurídico. Además, nace con la finalidad de ser una herramienta para cualquier persona que deseé conocer de primera mano cómo se ha tratado tal delito desde hace siglos y, de una manera mucho más profunda, a lo largo de los últimos treinta y cinco años, con dos Códigos Penales vigentes, de los cuales, el que se encuentra en vigor, ha sido modificado por el poder legislativo en treinta veces, unas de manera más liviana, y otras con reformas muchas más profundas. Y de todas ellas, el delito de intrusismo sólo y únicamente ha sido levemente modificado en dicho texto legal en la última “macrorreforma” operada en el año 2015, por lo cual no podrá ser objeto de su estudio debido a que no ha sido posible su aplicación práctica y que será aplicada sólo en aquellos casos en los cuales los delitos se hayan cometido con posterioridad a la entrada en vigor de la última reforma, ya que si ha sido cometida con anterioridad, el reo puede (y debe para sus mejores pretensiones) elegir la norma penal más favorable, que sería la anterior a la reforma, ya que sus penas son más leves. Se pueden establecer como conclusiones del estudio: 1. El delito de intrusismo en la Odontología ha estado presente a lo largo de la Historia, el cual se ha intentado reprimir mediante normas administrativas y/openales. De lege lata, no se ha obtenido, ni siquiera en la actualidad, el éxito que se debería haber esperado. 2. Tal infracción penal tiene repercusiones tanto clínicas como éticas, ya que aún siendo un delito de mera actividad y de peligro abstracto, afecta a la integridad física, psíquica y moral del paciente. El conocimiento y el consentimiento del paciente de que está bajo la actuación de alguien no adecuado para ello no eximen de responsabilidad penal y ética al intruso. 3. El dato de que la gran mayoría de las resoluciones judiciales hayan sido condenatorias, incluso tras los pertinentes recursos, hace confirmar que el sistema judicial penal funciona cuando se le presentan supuestos, aunque no llegan a sus manos los numerosos casos que existen en la realidad. 4. La actividad de los Colegios Oficiales de Dentistas, en su actividad cotidiana, y en la judicial, en caso de que tengan conocimiento, es clave para la represión de los intrusos, en todo el territorio español, pero sobre todo, destacan estadísticamente en determinados territorios como Andalucía, Valladolid, Las Palmas de Gran Canaria, Barcelona y Madrid. 5. Por lo tanto, de legeferenda, el presente autor estima que la clave futura para la eliminación del delito de intrusismo se basa en tres premisas que deben ser puestas en marcha por parte de los poderes públicos: - en primer lugar, en la educación y concienciación de la población de los efectos de su comisión que debe ser llevada a cabo a través del sistema educativo, social y, como principal emisor de la información, los Colegios Profesionales de Dentistas, como desarrollo de las funciones delegadas normativamente en ellos; - en segundo lugar, la publicidad activa de la descripción de los actos propios de cada uno de los profesionales de la salud dental en las querellas, por medio de los protocolos odontológicos establecidos y del Nomenclator, por ejemplo, mediante lanorma UNE 179004/2009, sobre los Actos Odontológicos, de diciembre de 2009; - y en tercer lugar, en una modificación legislativa que lleve a cabo el considerable aumento cualitativo (penas de prisión en el tipo básico y de multa en el agravado) y cuantitativo (una horquilla mucho mayor de las penas aplicables en la actualidad) atendiendo al principio de proporcionalidad de las penas y de su efecto disuasorio, dejando total y absolutamente descartada la despenalización propuesta por determinados autores.
Análisis de la aplicación de vibración de cuerpo completo en el dolor femoropatelar
(2021-07-08) Yáñez Álvarez, Ángel Rufino; Albornoz Cabello, Manuel; Bermúdez Pulgarín, Beatriz; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Biología Celular
Introducción y Objetivos: El dolor femoropatelar es una afección común de la rodilla caracterizada por dolor en la región anterior durante actividades de carga en ella. Suele provocar una disminución en la actividad diaria y/o participación deportiva, impactando en la calidad de vida e incluso la invalidez. Tiene una prevalencia del 23%-29%, y una cronicidad entorno al 40% de los casos. El ejercicio físico es la parte esencial del tratamiento conservador. El uso de vibración de cuerpo completo puede ayudar a mejorar la fuerza y la función y reducir el dolor en pacientes con trastornos de la rodilla. El objetivo de esta investigación fue analizar la influencia de un procedimiento fisioterápico de aplicación de la vibración de cuerpo completo (vertical, frecuencia de vibración de 40 Hz, con una amplitud de 2 a 4 mm) para el dolor y la discapacidad en adultos con dolor femororrotuliano. Metodología: Es un ensayo clínico aleatorizado, en el que 50 sujetos se distribuyeron aleatoriamente en un grupo de ejercicio más vibración de cuerpo completo o un grupo de control. El dolor, la función de la rodilla, el rango de movimiento y la funcionalidad de las extremidades inferiores se evaluaron al inicio del estudio y a las 4 semanas. El grupo experimental realizó 12 sesiones supervisadas de ejercicios focalizados en cadera, rodilla y tronco sobre una plataforma vibratoria 3 veces por semana durante 4 semanas. El grupo de control siguió el mismo protocolo pero sin estímulos de vibración. Las diferencias en las medidas de resultado se exploraron mediante un análisis de la varianza de 2 medidas repetidas. Los tamaños del efecto se estimaron utilizando Square Eta (η2). El nivel significativo se fijó en P <0,05. Resultados: Se encontraron diferencias estadísticamente significativas después de la intervención a favor del grupo experimental en la comparación entre grupos y en la interacción del grupo experimental antes y después del tratamiento en términos de percepción del dolor (P = 0,000; η2 = 0,63) y de la función (P = 0,000; η2 0,39 y 0,51 para la escala funcional de la extremidad inferior y la puntuación de Kujala, respectivamente). Conclusión: Un programa de ejercicios de vibración de cuerpo entero de 4 semanas reduce la intensidad del nivel del dolor, mejora la funcionalidad de las extremidades inferiores en pacientes con dolor femororrotuliano y es más eficaz que el ejercicio solo para mejorar el dolor y la función a corto plazo.

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