Artículos (Fisioterapia)

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Evaluation of the Wisconsin Gait Scale in Patients with Multiple Sclerosis and Spastic Hemiplegia
(International Scientific Information, Inc., 2025) Guzik, Agnieszka; Wolan-Nieroda, Andżelina; Kiper, Pawel; Cieślik, Błażej; Federico, Sara; Luque Moreno, Carlos; Drużbicki, Mariusz; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
BACKGROUND: Existing clinical tools do not comprehensively assess gait patterns in patients with multiple sclerosis (MS) across all planes or account for spatiotemporal and kinematic parameters. This study investigated the feasibility of the Wisconsin Gait Scale (WGS), originally designed to evaluate hemiparetic gait after stroke, in individuals with the spastic hemiplegic subtype of MS. MATERIAL AND METHODS: The study included 30 patients with the spastic hemiplegic subtype of MS. The WGS-based assessment of participants’ gait was performed twice, by 3 independent raters. The results of the 2 measurements reported by the 3 raters were compared to determine intra-rater and inter-rater reliability. The WGS scores were also compared with results of clinical tools: the 10-Meter Walk Test, the 2-Minute Walk Test, and the Timed Up and Go Test, to determine the concurrent criterion validity of the WGS. RESULTS: A comparison of the scores assigned by the same rater during measurement 1 and measurement 2 showed excellent agreement in each case, with intraclass correlation coefficients (ICCs) equal to or higher than 0.991. Likewise, there was excellent agreement between the scores awarded by the 3 raters, both in measurement 1 and measurement 2, with ICCs of 0.988 and 0.978, respectively. The analyses showed very strong and significant correlations (P<0.001) between the mean scores in the WGS and all the clinical tests applied in this study to assess gait. CONCLUSIONS: The findings show excellent intra-rater and inter-rater reliability and confirm the concurrent criterion validity of the WGS in patients with hemiplegic MS.
Multi-Session whole body vibration program on parkinson’s disease symptoms: systematic review and meta-analysis
(Elsevier, 2025-10-17) González García, Paula; Heredia Rizo, Alberto Marcos; Garrido-Bueno, Alfonso; Casuso-Holgado, María Jesús; García-Bernal, María-Isabel; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1043: Salud, Fisioterapia y Actividad Física; CTS1110: Understanding Movement & Self in Health from Science
Background: Parkinson’s disease is a disorder with a growing prevalence that significantly reduces the quality of life of those affected. Purpose: This review aims to analyze the effects of whole-body vibration on Parkinson’s disease symptoms. Methods: A systematic search was carried out in PubMed, CINHAL, EMBASE, and the Cochrane Library for randomized clinical trials studying the use of whole-body vibration interventions involving more than one session on Parkinson’s Disease related symptoms. The Cochrane Risk of Bias Assessment Tool-2 was used to assess the methodological quality and the GRADE and TIDierR evaluated the certainty of the evidence and replicability of studies. Extracted data was pooled in meta-analysis. Results: Six studies met the selection criteria. The TIDieR scores indicated high replicability. Whole-body vibration interventions improved static balance compared to active controls. No differences were found for gait speed, functional mobility, or motor symptoms. There were high concerns about the risk of bias and the certainty of the evidence. Conclusions: Whole-body vibration showed no better effect than controls to improve Parkinson’s disease symptoms, except for static balance. No clinical recommendations can be made due to the low number of studies and serious methodological issues.
Intra- and inter-rater reliability of anterior and posterior drawer tests for the assessment of people with shoulder instability
(Sage publications LTD, 2025-05-08) Aldon-Villegas, Rocio; Chamorro Moriana, Gema; Lopez-Tarrida, P; Benítez Lugo, María Luisa; Fisioterapia; Grupo de Investigación Área de Fisioterapia; CTS305: Área de Fisioterapia
BackgroundThe well-known drawer tests to assess glenohumeral laxity and instability have shown appropriate reliability, although analysed mainly in healthy subjects.ObjectiveTo evaluate the intra- and inter-rater reliability of anterior and posterior drawer tests in subjects with symptoms of shoulder instability.DesignClinometric study of intra- and inter-rater reliability of drawer tests was carried out following COSMIN recommendations and GRRAS checklist.SettingCentres with equipped facilities for assessments.ParticipantsThere were 105 participants (69 male/36 female) aged 18 to 60 years with instability symptoms in at least one shoulder. Each participant underwent bilateral assessments. The sample consists of 210 shoulders, unstable and healthy.InterventionAnterior and posterior drawer tests.Main measuresHumeral translations were assessed using drawer tests and graded with Hawkins scale, modified Hawkins and dichotomising (positive/negative). Two sessions were performed (seven to fourteen-day washout period): Each patient was evaluated by two examiners in the first session and by one of them in the second. Weighted Kappa analysed the reliability.ResultsThe intra-rater reliability of the anterior and posterior drawer tests was excellent (weighted Kappa = 1) with the Hawkins scale. Inter-rater reliability was good for the anterior drawer: weighted Kappa = 0.76 (95%confidence interval: 0.67-0.85) with the Hawkins scale, weighted Kappa = 0.78 (95%confidence interval: 0.69-0.87) with modified Hawkins, and weighted Kappa = 0.80 (95%confidence interval: 0.71-0.89) dichotomising; and for the posterior drawer: weighted Kappa = 0.62 (95%confidence interval: 0.52-0.72), weighted Kappa = 0.67 (95%confidence interval: 0.57-0.78), and weighted Kappa = 0.70 (95%confidence interval: 0.59-0.80), respectively.ConclusionDrawer tests demonstrated excellent intra-rater and good inter-rater reliability in subjects with symptoms of shoulder instability.
Analysis of Shots Trajectory and Effectiveness in Women’s and Men’s Football European Championship Matches
(MDPI, 2025-06-12) Cruz Torres, Blanca de la; Navarro Castro, Miguel; Ruiz-de-Alarcón-Quintero, Anselmo; Matemática Aplicada I; Fisioterapia
Shots on target are a crucial factor in football performance, yet the impact of categorizing shots as low or ground-level and high or parabolic has not been fully explored. The objective of this study was to analyze whether there are differences in the frequency and effectiveness (as measured by xGOT) between parabolic and low shots on target in international men’s and women’s football competitions. The results revealed that the most common shot type was the parabolic shot, occurring in 59.86% of shots on goal in the men’s competition (270 shots) and 67.12% in the women’s competition (196 shots). In the overall set of shots, 62.77% were parabolic (466 shots). No significant differences were observed between the competitions (p > 0.05). Regarding the xGOT values, no significant differences were observed for any of the interaction effects analyzed (gender, shot type and shot outcome). The conclusion was that the parabolic shot was the most frequent type of shot on target in both men’s and women’s football.
Implant prosthetic rehabilitation in a mandible osteosarcoma patient: a clinical report
(Mdpi, 2025-02-19) Arbelaez-Bonozo, L.; Luis-Sanchez, Laura; Oliva-Ferrusola, Elena; Fernández-Morales, Carlos; Albornoz Cabello, Manuel; Gutiérrez Pérez, José Luis; Torres-Lagares, Daniel; Fisioterapia; Estomatología; CTS947: Salud y Actividad Física para Calidad de Vida; CTS523: Innovación y Desarrollo en Técnicas y Fundamentos de Cirugía Bucal y Craneofacial
Introduction: Generally, after an oral oncological therapeutic process in which, unfortunately, surgery plays a fundamental role, a reconstructive and rehabilitative procedure should be initiated, seeking as far as possible to recover the patient’s vital functions (mastication, aesthetics, and phonetics). Case report: We present the case of a patient who successfully underwent treatment for mandibular sarcoma. After a disease-free period of one year, following oncological treatment, an intervention was performed for the insertion of dental implants into the fibula to subsequently rehabilitate the patient prosthetically. There were several challenges, including free-end edentulous space in the lower jaw with a depth of 18 mm on peri-implant tissues consisting of osteoseptocutaneous skin graft, hypotonic perioral musculature, and high aesthetic expectations of the patient. An overdenture with a titanium milled bar substructure with retentive prosthetic components was chosen for treatment. This implant-supported removable prosthesis was selected to facilitate cleaning, since the patient did not maintain oral hygiene habits. The patient was educated on using and handling the prosthesis, and the treatment objectives were achieved (to restore aesthetics and masticatory function). Conclusions: Removable prostheses are a valid alternative for oncologic patients and patients with unfavorable conditions for more complex implant-supported rehabilitation.
Biomechanical and clinical differences in muscle tone, stiffness, range of motion, and pain perception in children with cerebral palsy: a cross-sectional study
(Frontiers Media SA, 2025-04-15) González-Matilla, Ramón; Abuín-Porras, Vanesa; Mínguez-Esteban, Isabel; Heredia Rizo, Alberto Marcos; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Introduction: Spasticity and altered muscle tone are key features in children withneurodevelopmentaldisorders,particularlycerebralpalsy(CP).Theyimpact movement, range of motion (ROM), and pain perception, influencing functional abilities and quality of life. Understanding the intrinsic muscle differences in children with CP can help improve clinical assessment and therapeutic interventions. This study aims to evaluate differences in muscle tone, stiffness, ROM, and pain perception between children with CP and typically developing peers using objective biomechanical measures. Methods: An observational, cross-sectional study was conducted with 40 participants of both sexes (20 children with CP, 20 typically developing peers). Muscle tone and stiffness of the lower limb muscles were measured using the Myoton PRO device. ROM was assessed by goniometry, and pain perception was evaluated using the Visual Analog Scale during a Straight Leg Raise (SLR) test. A generalized linear mixed model was used to detect differences in myotonometry, ROM, and pain perception measurements. In participants with CP, the Pearson product-moment correlation coefficient analysis was used to explore possible associations between clinical features and muscle tone and stiffness. Results: Children with CP exhibited reduced ROM, with a significant group effect for hip flexion (P < 0.001; η2 = 0.843), knee extension (P < 0.001; η2 = 0.355), and ankle flexion (P < 0.001; η2 = 0.959) and higher pain perception during the SLR test (P < 0.001; η2 = 0.831), compared to controls. Myotonometry revealed significantly increased muscle stiffness of the rectus femoris (P = 0.004; η2 = 0.112) and adductor muscles (P = 0.019; η2 = 0.074) in the CP group, with no differences in muscle tone between the groups. Sex-related differences were found for muscle tone and stiffness, with males showing higher values. Correlation analyses indicated that adductor muscles stiffness was associated with CP severity. Conclusion: Children with CP demonstrate significant changes in ROM, pain perception, and muscle stiffness, emphasizing the need for targeted therapeutic interventions. These findings support the use of objective biomechanical tools for assessing muscle properties in clinical settings, contributing to better management strategies for spasticity-related impairments.
Short-term effects of visceral manual therapy on autonomic nervous system modulation in individuals with clinically based bruxism: a randomized controlled trial
(Mdpi, 2025-07-16) Navarro-rico, Cayetano; Fricke Comellas, Hermann Wolfgang; Heredia Rizo, Alberto Marcos; Díaz Mancha, Juan Antonio; Rosado-Portillo, Adolfo; Fernández Seguín, Lourdes María; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science; CTS1043: Salud, Fisioterapia y Actividad Física
Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT in individuals with clinically based bruxism. Methods: A single-blind randomized controlled trial was conducted including 24 individuals with clinically based bruxism. Participants received two sessions of either VMT or a sham placebo technique. Outcome measures included heart rate variability (HRV), both normal-to-normal intervals (HRV-SDNN), and the root mean square of successive normal-to-normal intervals (HRV-RMSSD), as well as muscle tone and stiffness and pressure pain thresholds (PPTs). Measurements were made at T1 (baseline), T2 (post-first intervention), T3 (pre-second intervention), T4 (post-second intervention), and T5 (4-week follow-up). Results: A significant time*group interaction was observed for HRV-SDNN (p = 0.04, η2 = 0.12). No significant changes were found for muscle tone or stiffness. PPTs significantly increased at C4 after the second session (p = 0.049, η2 = 0.16) and at the left temporalis muscle after the first session (p = 0.01, η2 = 0.07). Conclusions: The findings suggest that two sessions of VMT may lead to significant improvements in HRV-SDNN compared to the placebo, suggesting a modulatory effect on autonomic function. No consistent changes were observed for the viscoelastic properties of the masticatory muscles. Isolated improvements in pressure pain sensitivity were found at C4 and the left temporalis muscle. Further research with larger sample sizes and long-term follow-up is needed to determine the clinical relevance of VMT in the management of signs and symptoms in individuals with bruxism.
Patterns of pain perception in individuals with anxiety or depressive disorders: a systematic review and meta-analysis of experimental pain research
(Elsevier Bv, 2025-08-13) Salas-González, Jesús; Heredia Rizo, Alberto Marcos; Fricke Comellas, Hermann Wolfgang; Chimenti, Ruth L.; Casuso-Holgado, María Jesús; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Differences in pain responses between adults with or without psychiatric conditions are documented, yet the certainty of evidence on the topic has not been assessed. We examined pain responses to experimentally induced pain in individuals diagnosed with anxiety or depressive disorders compared to controls without mental health conditions. We also explored the influence of pain modality and associations between pain perception and symptoms severity. PubMed, CINAHL, PsycINFO, Cochrane, and Embase were searched from inception to March 2025. Included studies reported pain measures (pain threshold, intensity, tolerance, unpleasantness) in adults with anxiety or depression, without co-occurring chronic pain, and healthy controls. The JBI Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies assessed risk of bias. Certainty of evidence was judged by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Twenty-eight studies (1460 participants, 935 females) were included, most presenting moderate to high risk of bias. Compared to controls, individuals with depression exhibit higher pain thresholds [SMD = .30 (95% CI .60, .01)] and pain intensity [SMD = .47 (95% CI .08, .86)], while those with anxiety exhibit lower pain thresholds [SMD = .39 (95% CI .61, .17)] (GRADE: very low for all outcomes). Results differed depending on pain modality. Pain threshold was moderately correlated with depression severity: r = .437 (95% CI .208, .621). The data suggest distinct altered pain perception patterns, characterized by higher pain thresholds in depression and lower pain thresholds in anxiety. Adults with depression may be particularly sensitive, but not restricted to, ischemic stimuli. Registration: OSF (doi:10.17605/OSF.IO/U453J). Perspective: This systematic review assessed how pain perception patterns may differ in individuals with anxiety or depression. Few studies included participants with anxiety, controlled for comorbidities, or were recently conducted, thus caution is needed before interpreting our findings. This underscores the need for updated and methodologically robust research on this field.
Dropout Rate of Participants with Cancer in Randomized Clinical Trials That Use Virtual Reality to Manage Pain—A Systematic Review with Meta-Analysis and Meta-Regression
(MDPI, 2025-07-16) Garcia Muñoz, Cristina; Cortés Vega, María Dolores; Martinez Miranda, Patricia; Fisioterapia; CTS954: Innovaciones en Salud y Calidad de Vida
Background/Objectives: Virtual reality has emerged as a promising intervention for pain management in individuals with cancer. Although its clinical effects have been explored, little is known about participant adherence and dropout behavior. This systematic review and meta-analysis aimed to estimate the pooled dropout rate in randomized controlled trials using virtual reality to treat cancer pain; assess whether dropout differs between groups; and explore potential predictors of attrition. Methods: We conducted a systematic search of PubMed, Web of Science, Scopus, and CINAHL up to April 2025. Eligible studies were randomized trials involving cancer patients or survivors that compared VR interventions for pain management with any non-VR control. Proportion meta-analyses and odds ratio meta-analyses were performed. Heterogeneity was assessed using the I2 statistic, and meta-regression was conducted to explore potential predictors of dropout. The JBI appraisal tool was used to assess the methodological quality and GRADE system to determine the certainty of evidence. Results: Six randomized controlled trials were included (n = 569). The pooled dropout rate was 16% (95% CI: 8.2–28.7%). Dropout was slightly lower in VR groups (12.7%) than in controls (21.4%), but the difference was not statistically significant (OR = 0.94; 95% CI: 0.51–1.72; I2 = 9%; GRADE: very low). No significant predictors of dropout were identified. Conclusions: VR interventions appear to have acceptable retention rates in oncology settings. The pooled dropout estimate may serve as a reference for sample size calculations. Future trials should improve reporting practices and investigate how VR modality and patient characteristics influence adherence.
Diaphragmatic breathing for referred pain after total laparoscopic hysterectomy: a randomized clinical trial
(Springer, 2025-08-18) Partida Márquez Antonio Luis; Fernández Domínguez, Juan Carlos; Martínez Fernández, José Antonio; Pabón Carrasco, Manuel; Melero Cortes Lidia; Oliva Pascual-Vaca, Ángel; Fisioterapia; Enfermería; Universidad de Sevilla; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud; CTS1043: Salud, Fisioterapia y Actividad Física
Background: Referred cervicoscapular pain is common after laparoscopic surgery. This pain has different characteristics from incisional pain and requires a different approach. Method: A blinded, randomized, controlled trial was conducted. Women reporting referred pain with an intensity of 7 points or higher on the visual analogue scale after total laparoscopic hysterectomy (TLH) were randomly assigned to a diaphragmatic breathing group (DBG) or a neck exercise group (NEG). Both groups performed the exercises three times daily, and the usual medical care was maintained. Pain intensity and location were assessed using the McGill questionnaire. Specific self-reported questionnaires were used to assess the evolution of functional disability in the head (HIT-6), shoulder and neck (NDI), or upper limbs (QuickDASH). Follow-up was conducted weekly for 4 weeks after surgery. Results: Seventy-four women (43.7 ± 9,5 years; 26.6 ± 4.9 body mass index) were recruited. The most common area of referred pain was the shoulder and neck (n = 55), followed by the head (n = 48) and upper limbs (n = 14), with four women showing pain in all three areas and thirty-five in two areas. Both groups showed improvement over time in pain intensity and functional disability in all the locations (p < 0,001). However, DBG demonstrated a faster recovery for pain intensity, NDI, and HIT-6 (p < 0,001), while no between-group difference was found for QuickDASH (p > 0,05). No adverse effects were reported for any of the tested interventions. Conclusions: Referred pain in TLH tends to become self-limiting over time, but diaphragmatic breathing exercises resulted in a faster reduction in pain intensity and craniocervical disability when compared with gentle cervical stretching exercises. Thus, abdominodiaphragmatic breathing might be a simple and safe complementary intervention to be taught to patients suffering from referred pain after TLH.
Using a Smartphone Application to Strengthen Pelvic Floor and Manage Symptomatology of Female Track and Field Athletes: A Randomized Controlled Study
(MDPI, 2024-12) Romero Franco, Natalia; Bosch-Donate, Elisa; Vico-Moreno, Elena; Oliva Pascual-Vaca, Ángel; Martínez-Bueso, Pau; Molina-Mula, Jesús; Fernández Domínguez, Juan Carlos; Fisioterapia; Consejo Superior de Deportes (CSD); European Union NextGenerationEU/PRTR; CTS1043: Salud, Fisioterapia y Actividad Física
Despite the high prevalence of pelvic floor (PF) dysfunctions in female athletes, help-seeking is low due to embarrassment and disinformation. This study evaluated the effects of a 6-week exercise program guided by a specific app, with and without intravaginal biofeedback on the PF symptoms, strength, and sonographic measures of female athletes. Compliance with the program was evaluated. Thirty-nine athletes with PF symptoms used the app with different functionalities: experimental group 1 (n = 13) (EG1: exercises, PF information, and physiotherapists contact); experimental group 2 (n = 14) (EG2: exercises with biofeedback, PF information, and physiotherapists contact); and the control group (n = 12) (CG: PF information, and physiotherapists contact). Before and after the 6 weeks, PF symptoms, strength with the Oxford scale, and sonographic measures were evaluated. EG1 and EG2 improved strength (p = 0.028 and p = 0.001, respectively) and incontinence urinary symptoms (p = 0.041 and p = 0.002, respectively) over the baseline, without between-group differences (p > 0.05). No significant differences were observed in sonography (p > 0.05). Regarding compliance, 84.6 and 71.4% of athletes from EG1 and EG2 completed the program twice per week or more. A 6-week PF exercise program guided by the app improved PF symptoms and strength of female athletes and ensured high compliance with the program but was insufficient to improve sonography.
Effectiveness of the scapula mobilization technique on the neural mechanosensitivity of the upper limb neural test 1 in individuals with mechanical cervicalgia. A randomized controlled trial
(Elsevier Science Bv; Elsevier, 2024-10) Heredia Macías, Carlos; Ramos Ortega, Javier; Serrano Sánchez, Francisco Javier; Díaz Mancha, Juan Antonio; Fernández Seguín, Lourdes María; Cabañes-García, Jaime; Podología; Fisioterapia; CTS1136: Patología y Función del Pie; CTS1043: Salud, Fisioterapia y Actividad Física; CTS1110: Understanding Movement & Self in Health from Science
Objective: to observe whether the mobilization of the scapula improves the mechanosensitivity of the median nerve in patients with cervicalgia. Localized cervical pain caused by compression of a nerve root without pre- senting irradiated features along the nerve path is diagnosed as cervicalgia. Muscles around the scapula can be directly responsible of this compression. Methods: 60 adults diagnosed with cervicalgia and with a positive upper limb neural test 1(ULNT1) were recruited. Participants in the experimental group received a scapula mobilization technique. Participants in the control group, with electrodes on both sides of the neck and connected to turned off analgesic current device, received an abduction adduction mobilization of the calcaneus in the lower limb contralateral to the painful area. The variables measured were pain, goniometry of elbow extension in movement for the median neuro- dynamic test (ULNT1) and hand grip strength. Results: Results showed that the increase in strength (p = 0.01) and elbow extension movement (p = 0.01) and the decrease in pain (p < 0.01) from the intervention group showed significant changes compared to the changes from control group. Conclusion: Scapula mobilization technique in subjects presenting with cervicalgia and a positive ULNT1 significantly appears to help improve the neural mechanosensitivity of the median nerve and pain.
Idiopathic Neck Pain or Neck Pain of Gastric Origin? A Systematic Review of Rat Experimental Studies on Gastric Harm Pathophysiology and Therapy
(Wiley, 2025-05-22) Oliva Pascual-Vaca, Ángel; Navarro-Carmona, Ignacio; Oliva Pascual-Vaca, Jesús; Riquelme, Inmaculada; Luque Romero, Luis Gabriel; López Millán, José Manuel; Fisioterapia; Medicina Preventiva y Salud Pública; Cirugía; Instituto de Biomedicina de Sevilla (IBIS); CTS1043: Salud, Fisioterapia y Actividad Física; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: Most cases of neck pain are classified as nonspecific or idiopathic pain and show characteristics such as sensitization, hyperalgesia, limited range of motion, and muscle spasm. Visceral disorders can trigger all those features, and gastric disorders are related to neck pain. Furthermore, stress and anxiety are frequently somaticized as neck pain. However, its pathophysiological link has never been determined. Objectives: To identify the electromyographic and postural response to experimental gastric insult in rats. Methods: A systematic review was undertaken. Searches were conducted in the PubMed and Web of Science databases. The date of publication was not limited. References from included articles were assessed. The sample, experimental intervention, and the results were retrieved from each study. Results: Sixteen studies were included. Acromiotrapezius muscle showed the highest activity to gastric damage, being up to 8–10 times higher than abdominal muscles contraction. Also, a postural response compatible with neck muscles spasm was observed. The threshold for reaching cervical spasm was lowered by the addition of stress, gastritis, dyspepsia, ulcers, diabetes, or inflammation of the colon. Increased visceromotor response persisted even more than 60 days after gastric insult, despite no obvious injury was already visible in the stomach. Furthermore, prenatal or neonatal gastric injury also produced gastric hypersensitivity and increased trapezius spasm in adult rats. On the contrary, neck spasm was reduced by reversing diabetes or blocking the gastric receptors and its afferent pathways. Conclusions: Gastric harm triggers neck muscles spasm. Since many gastric conditions and hypersensitivity are common and tend to be chronic, this may contribute to explain the persistence of neck pain and sensitization in many patients. Prenatal and neonatal gastrointestinal suffering increases trapezius visceromotor response in adults. Furthermore, our findings might contribute to explain why stress is frequently somaticized as neck pain.
An expected goals on target (xGOT) model: accounting for goalkeeper performance in football
(MDPI, 2025-03-10) Cruz Torres, Blanca de la; Navarro Castro, Miguel; Ruiz de Alarcón Quintero, Anselmo; Fisioterapia; Matemática Aplicada I
A key challenge in utilizing the expected goals on target (xGOT) metric is the limited public access to detailed football event and positional data, alongside other advanced metrics. This study aims to develop an xGOT model to evaluate goalkeeper (GK) performance based on the probability of successful actions, considering not only the outcomes (saves or goals conceded) but also the difficulty of each shot faced. Formal definitions were established for the following: (i) the initial distance between the ball and the GK at the moment of the shot, (ii) the distance between the ball and the GK over time post-shot, and (iii) the distance between the GK’s initial position and the goal, with respect to the y-coordinate. An xGOT model incorporating geometric parameters was designed to optimize performance based on the ball position, trajectory, and GK positioning. The model was tested using shots on target from the 2022 FIFA World Cup. Statistical evaluation using k-fold cross-validation yielded an AUC-ROC score of 0.67 and an 85% accuracy, confirming the model’s ability to differentiate successful GK performances. This approach enables a more precise evaluation of GK decision-making by analyzing a representative dataset of shots to estimate the probability of success.
Dropout rate of participants in randomized controlled trials using different exercise-based interventions in patients with migraine. A systematic review with meta-analysis
(MDPI, 2025-05-05) Taghipourazam, Sahar; Cortés Vega, María Dolores; Garcia Muñoz, Cristina; Fisioterapia; CTS954: Innovaciones en Salud y Calidad de Vida
Background/Objectives: Exercise has gained attention as a potentially beneficial non-pharmacological intervention, but whether this type of intervention presents a higher dropout rate compared to other interventions is still unknown. This systematic review, with a meta-analysis of randomized controlled trials, aims to determine whether exercise or comparators present lower or higher attrition in patients with migraine. Methods: A search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library until March 2025. The methodological quality was evaluated using the JBI scale for randomized trials. Proportion meta-analysis calculated the dropout rate. Results: Odds ratio meta-analysis under 1 indicated lower attrition in experimental participants. Subgroup meta-analyses sorted by type of exercise, control, and migraine were conducted to explore variability in results based on the mentioned moderators. The overall pooled dropout rate was 6.7%, 11.6% for the exercise groups, and 10.1% for the comparators. No statistical difference was found between groups of studies, type of migraine, type of exercise, and type of comparator (p ≥ 0.05). Only the odds ratio results for migraine with auras showed a lower pooled dropout rate in favor of control participants, OR = 1.18. Conclusions: Although there is no statistically significant difference, the meta-analysis of proportions shows a higher loss rate in exercise-based interventions. However, the high heterogeneity found in the included studies prevents us from drawing firm conclusions. Furthermore, adequate adherence to the CONSORT guidelines in reporting losses and their reasons could help design appropriate retention strategies for studies and interventions based on exercise in patients with migraines.
The most effective therapeutic exercises for pain intensity in women with fibromyalgia: a systematic review and network meta-analysis
(Associacao brasileira pesquisa pos-graduacao fisioterapia-ABRAPG-FT, 2025) Rodríguez-Domínguez, Álvaro José; Rebollo Salas, Manuel; Chillón-Martínez, Raquel; Rosales Tristancho, Abel; Villa-del-Pino, Inmaculada; Jiménez Rejano, José Jesús; Fisioterapia; Estadística e Investigación Operativa; CTS305: Área de Fisioterapia
Background Therapeutic exercise (TE) is the only intervention with strong recommendation for fibromyalgia. However, there is controversy as to which type of exercise is the most beneficial. Objective To determine which TE approach is the most effective in reducing pain intensity in women with fibromyalgia. Methods A systematic review was performed with a network meta-analysis (NMA). Six databases were searched from inception until January 2024. Randomized controlled trials (RCTs) evaluating the effects of TE on pain intensity were included in women with fibromyalgia. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The size of the effect and the clinically important difference were determined in the short-term (≤3 months) and long-term (>3 months). Results Sixty-one studies were identified, of which 51 were included in the quantitative synthesis (n = 2873). Fifteen TE interventions and eight comparison interventions (comparators) were identified. Aquatic exercise (p-score: 0.8713) was found to provide best benefits in the short-term and resistance training in the long-term (p-score: 0.9749). Statistically significant differences were found in favor of aquatic exercise, Pilates, qigong, resistance training, virtual reality, mixed exercise, and aerobic exercise (in the short-term) and in favor of resistance training, dance, functional training, aquatic exercise, virtual reality, and aerobic exercise (in the long-term) compared to usual care. Conclusion With a moderate level of evidence, our NMA shows that, in the short-term, aquatic exercise is the most effective TE intervention to reduce pain intensity in women with fibromyalgia, while resistance training is the most effective in the long-term. More RCTs are needed to strengthen these findings.
Compliance and adherence to pelvic floor exercise therapy in people with pelvic floor disorders: a systematic review and meta-analysis
(MDPI, 2025-04-06) Inmaculada Villa-Del-Pino; Jiménez Rejano, José Jesús; Rebollo Salas, Manuel; Álvaro‐José Rodríguez‐Domínguez; Suárez Serrano, Carmen; Fisioterapia; CTS305: Área de fisioterapia
Background: The impact of muscle-training treatment on quality of life and functional outcomes in people with pelvic floor dysfunction may be related to adherence rates. Methods: Nine electronic databases were searched for studies published up to 15 October 2024. A qualitative synthesis was used to describe the relationship between adherence or compliance with treatment, quality of life, and symptomatic severity. A meta-analysis of data from selected studies was performed that assessed quality of life and symptomatic severity in the short term. Results: Seven studies with 2190 participants were included. Of these studies, 42% showed rates greater than 80% in terms of adherence. A beneficial effect was found in terms of urinary incontinence severity without statistical differences between the groups (p = 0.813), while quality of life showed statistically significant improvements favoring the experimental group (p = 0.036). The quality of the evidence was collected or measured from low to high. Conclusions: People with pelvic floor disorders show high rates of adherence to pelvic floor muscle exercise and experience an improved quality of life in the short term, but more research is needed on the design of homogeneous systems to measure compliance and adherence to exercise-based treatments.
Eficacia de la marcha en cinta rodante sobre el desarrollo motor de niños con parálisis cerebral y síndrome de Down
(Fundación Revista Medicina, 2021) García-del Pino-Ramos, Silvia; Romero-Galisteo, Rita P.; Piñero Pinto, Elena; Lirio-Romero, Cristina; Palomo-Carrión, Rocío; Fisioterapia; CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
La parálisis cerebral y el síndrome de Down son dos afecciones que cursan con déficit del desarrollo motor. Este retraso mejora con el uso de cinta rodante. Se realizó una revisión sistemática en dife rentes bases de datos con el propósito de analizar estudios y su calidad metodológica en relación a la aplicación del uso exclusivo de cinta rodante y su combinación con otras terapias para fomentar la marcha y equilibrio en niños menores de 12 años con parálisis cerebral y síndrome de Down. Se seleccionaron únicamente ensayos clínicos aleatorizados publicados hasta la fecha en PubMed, PEDro, Cochrane y Science Direct. La calidad me todológica de los estudios identificados se evaluó a través de la escala PEDro. De los 324 artículos inicialmente encontrados, se seleccionaron los 10 que cumplieron con los criterios de inclusión establecidos para su análisis cualitativo. Las variables analizadas fueron la marcha y el equilibrio en ambas poblaciones tras la intervención con cinta rodante, con y sin suspensión del peso corporal. Concluimos que la aplicación de cinta rodante como única herramienta terapéutica resulta una intervención eficaz para favorecer el desarrollo de la marcha y el equilibrio en niños de 0 a12 años con parálisis cerebral y síndrome de Down.
El masaje infantil como herramienta de intervención en el desarrollo de bebés con síndrome de Down. Estudio piloto
(Sociedad andaluza de fisioterapia, 2020-04-30) Piñero Pinto, Elena; Jiménez Rejano, José Jesús; Rebollo Roldán, Jesús; Fisioterapia; CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders; CTS305: Área de Fisioterapia
Objetivo: conocer los efectos del masaje infantil sobre el desarrollo madurativo del bebé con síndrome de Down a corto plazo, atendiendo a todas las áreas del desarrollo. Material y método: se comparan dos grupos de 11 bebés, experimental, que recibe masaje infantil, y control, que no recibe tratamiento. Se miden las variables de desarrollo (cociente de desarrollo, edades parciales y globales de desarrollo) en dos ocasiones, con 5 sema nas de diferencia con la Escala de Desarrollo Psicomotor de la Primera Infancia Brunet–Lézine–Revisada. Re sultados: ambos grupos mejoran con el tiempo, pero el experimental lo hace en todas las variables, tanto en las relativas a la edad de desarrollo como en los cocientes de desarrollo, aspecto este último que no se observa en el grupo control. En las variables relativas a la edad madurativa se produjeron diferencias significativas entre los grupos, siendo en todos los casos mejores los resultados en el grupo experimental. En la edad de desarrollo glo bal la media de las diferencias pretratamiento-postratamiento fue significativamente mayor en el grupo experi mental [47,45 (DT = 12,36)] frente al control [26,64 (DT = 16,35)]. En el cociente de desarrollo global la media de las diferencias del cambio entre las puntuaciones pre-postratamiento entre los grupos fue de 10,21 puntos [IC 3,41 ; 17,02]. El modelo mixto 2x2 de análisis de la varianza indicó una interacción estadísticamente significativa grupo-por tiempo para todos los cocientes de desarrollo, siendo mejores los del grupo experimental. Conclusión: el masaje infantil es un procedimiento que parece mejorar el desarrollo madurativo de los bebés con síndrome de Down a corto plazo de la muestra aplicada.
Fisioterapia y realidad virtual para mejorar el equilibrio en niños/as con síndrome de Down: revisión sistemática
(Sociedad andaluza de fisioterapia, 2020-02-29) Ruvira Quintana, Laura; Piñero Pinto, Elena; Fisioterapia; CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
Introducción: el síndrome de Down se caracteriza, entre otras cosas, por presentar problemas de control del equi-librio. Existen variedad de tratamientos para trabajar el equilibrio desde la Fisioterapia. La realidad virtual se confi-gura como una nueva herramienta desde la fisioterapia pediátrica. Objetivo: verificar en la literatura la eficacia de un tratamiento de fisioterapia combinado con la realidad virtual en el aumento de la mejora del equilibrio en niños/as con síndrome de Down. Material y método: se realizó una revisión sistemática, buscando artículos de interés en las bases de datos Medline, Cochrane y PEDro. Los estudios debían de incluir un tratamiento para el equilibrio en personas con síndrome de Down. Resultados: al realizar la búsqueda se seleccionaron 5 artículos. Se encontraron diferencias significativas en la comparación de las valoraciones pre y post-intervención para aspectos como el control postural o la agilidad, lo que parece indicar una mejora también en el equilibrio. Conclusiones: partiendo de la evidencia cien-tífica sobre el uso de realidad virtual para mejorar el equilibrio en niños/as con síndrome de Down, la herramienta más utilizada es la Nintendo Wii©. De igual forma, se aprecia una mejora en el equilibrio.

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