Artículos (Fisioterapia)

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Design and validation of an immersive virtual rehabilitation system for individuals with vestibular disorders: A feasibility study
(Public Library of Science, 2026-07-30) Ibrahem Altwijri, Abdulaziz; Albiol Pérez, Sergio; Cortés Vega, María Dolores; García-Muñoz, Cristina; Sasián Ramírez de Arellano, Rocio; Gil Gómez, José Antonio; Lozano Quilis, José Antonio; Casuso-Holgado, María Jesús; Fisioterapia; Gobierno de Aragón; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); CTS954: Innovaciones en Salud y Calidad de Vida; CTS1110: Understanding Movement & Self in Health from Science
Background: Vestibular rehabilitation is an essential part of managing balance disorders, but traditional exercises can often be repetitive and demotivating for patients. This can reduce adherence and limit treatment outcomes. Objective: This study aimed to assess the feasibility, usability, patient satisfaction, and safety of DizzyVR, an immersive virtual reality system designed to support vestibular rehabilitation. Preliminary data on its potential effects on clinical outcomes were also collected. Methods: A prospective, single-arm feasibility study was conducted with ten participants diagnosed with various vestibular disorders. Each participant completed eight weekly sessions using DizzyVR. Feasibility was assessed through session attendance and completion rates. Usability, satisfaction, and safety were measured using the System Usability Scale, the User Satisfaction Evaluation Questionnaire, and the Simulator Sickness Questionnaire. Clinical measures included the Dizziness Handicap Inventory (DHI), Timed Up and Go (TUG) test, Activities-specific Balance Confidence (ABC) scale, and Functional Gait Assessment (FGA). Results: Ten participants completed the training, with a high adherence rate (91.25%). Usability scores indicated good ease of use, and satisfaction scores were high. Mild adverse events such as nausea or disorientation were reported by three participants, but improved over time. Exploratory pre–post changes were observed in gait speed (TUG: p = 0.002), balance confidence (ABC: p = 0.007), and gait stability (FGA: p = 0.012). While DHI scores demonstrated a trend toward improvement, the change did not reach statistical significance (p = 0.081). Overall, participants reported feeling safe and expressed willingness to recommend and reuse the system. Conclusions: The findings suggest that DizzyVR is a feasible, usable, and well-accepted tool that may complement conventional vestibular rehabilitation. The system appears to support patient motivation and safe participation while showing promising exploratory changes in balance and gait. Further studies with larger samples, control groups, and longer follow-up are recommended to confirm and expand on these promising preliminary results.
The Efficacy of Exercise Therapy for Non-specific Chronic Low Back Pain According to the FITT Principle: A Systematic Review with Meta-analyses
(JOSPT, Inc., 2026-07-14) Blanco Heras, Laura; Rebollo Salas, Manuel; Cardellat González, Melania; Cuevas Moreno, Alejandro; Jiménez Rejano, José Jesús; Rodríguez-Domínguez, Álvaro José; Fisioterapia; CTS305: Área de Fisioterapia
OBJECTIVE: To evaluate the efficacy of exercise therapy interventions differing in frequency, intensity, type, and time (FITT) on disability in individuals with non-specific chronic low back pain (LBP). DESIGN: Intervention systematic review with meta-analyses. LITERATURE SEARCH: Electronic databases were searched from inception to March 2026. STUDY SELECTION CRITERIA: We included randomized controlled trials (RCTs) that enrolled adults with non-specific chronic LBP (>3 months), and compared exercise interventions differing in at least one FITT component, and reported disability outcomes. DATA SYNTHESIS: Random-effects meta-analyses were conducted for each FITT component. Certainty of evidence was assessed using the GRADE framework, and prediction intervals were calculated. A complementary analysis used a 0–100 disability scale with a 15-point improvement prespecified as the minimal clinically important difference. RESULTS: Seventy RCTs (n = 3,991) were included. High-frequency programs (≥3 sessions/week) showed statistically significant improvements in long-term disability compared with low-frequency programs (SMD = 0.29; 95% CI 0.09, 0.49; moderate-certainty). Sensorimotor short-term (SMD = −0.49; 95% CI −0.78, −0.21; very low-certainty) and long-term (SMD = −0.76; 95% CI −1.48, −0.03; very low-certainty), yoga short-term (SMD = −0.39; 95% CI −0.68, −0.10; moderate-certainty), and assisted exercise long-term (MD = −3.96; 95% CI −5.47, −2.45; moderate-certainty) demonstrated statistically significant reductions in disability compared with other modalities. CONCLUSION: In adults with non-specific chronic LBP, higher-frequency exercise programs were associated with improvements in disability. Sensorimotor, yoga, and assisted exercise may offer modest additional benefits. Given the low-certainty and lack of clinically meaningful effects, exercise prescriptions should prioritize patient preferences, feasibility, and long-term adherence rather than a single FITT component.
Natural Agents for Preventing Skin Damage Induced by Visible Light: A Systematic Review of Preclinical and Clinical Evidence
(Wiley, 2026-08-06) Rodríguez Luna, Azahara María; Zamarrón, Alicia; García-Muñoz, Cristina; Hernández Rodríguez, Juan Carlos; Lim, Henry W.; González, Salvador; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Background/Purpose: Visible light (VL), and particularly high-energy visible light (HEVL), reaching Earth's surface has emerged as a relevant contributor to skin damage. VL has been implicated in oxidative stress, inflammation, pigmentation disorders, and photoaging, especially in individuals with darker skin phototypes. As conventional sunscreens offer limited protection in the visible spectrum, increasing attention has been directed toward complementary photoprotective strategies, including the use of natural compounds with antioxidant and anti-inflammatory properties. This systematic review aims to evaluate and synthesize the available preclinical and clinical evidence on the photoprotective effects of natural compounds against VL-induced skin damage, emphasizing their mechanisms of action, efficacy, and safety. Methods A comprehensive literature search was performed to identify studies reporting validated objective outcomes, including colorimetric parameters, diffuse reflectance spectroscopy, or clinical grading scales. Eligible studies were included, qualitatively synthesized, and risk of bias was evaluated. Results Preclinical studies demonstrated that natural compounds mitigated VL-induced oxidative stress, inflammation, and pigmentation-related pathways. Clinical studies showed that formulations containing natural compounds improved VL-induced erythema and pigmentation outcomes. However, considerable heterogeneity was observed in irradiation protocols, outcome measures, and study designs, precluding quantitative meta-analysis. Conclusion: Overall, available evidence supports a protective role for selected natural compounds against VL-induced skin damage, particularly through antioxidant and anti-inflammatory mechanisms, with the strongest clinical evidence focusing on natural sources of polyphenols. Nevertheless, this review highlights the need for standardized phototesting protocols and well-designed clinical trials. Future research should focus on comparative efficacy, long-term safety, and integration of natural compounds into combined photoprotection strategies tailored to different skin phototypes.
The Comparative Effectiveness of Education Modalities on Patient Adherence in Breast Cancer Survivors: A Systematic Review and Network Meta-Analysis
(MDPI, 2026-04-28) Martinez Miranda, Patricia; Muñoz Fernández, María Jesús; Rosales Tristancho, Abel; García-Muñoz, Cristina; Fisioterapia; Economía Aplicada I; CTS1110: Understanding Movement & Self in Health from Science
Background: Educational interventions are central to breast cancer survivorship care, yet adherence may vary depending on delivery modality. Objective: To compare the effectiveness of face-to-face, online, telephonic, and mixed educational modalities on patient adherence among breast cancer survivors. Methods: A systematic review of randomized controlled trials and Bayesian network meta-analysis were conducted following PRISMA 2020 guidelines. Randomized controlled trials evaluating educational interventions in breast cancer survivors were included. Methodology quality of included studies was assessed using the RoB-2 tool. Pairwise meta-analyses using random-effects models estimated Odds Ratios (ORs) for adherence. A Bayesian network meta-analysis synthesized direct and indirect evidence, and treatment rankings were calculated using SUCRA values. Results: Eleven trials comprising 963 participants were included. In pairwise meta-analysis, no modality demonstrated statistically significant superiority over usual care: face-to-face (OR 0.79; 95% CI 0.44–1.41), mixed (OR 0.42; 95% CI 0.07–2.37), online (OR 0.90; 95% CI 0.49–1.68), and telephonic (OR 0.57; 95% CI 0.18–1.78). The network meta-analysis confirmed the absence of statistically significant differences across modalities. SUCRA rankings suggested that usual care (76.7%) and online modalities (73.1%) had the highest probability of being among the best-performing strategies, followed by face-to-face (51.9%), telephonic (25.4%), and mixed (23.0%). Conclusions: No educational modality demonstrated superior adherence compared to usual care. Delivery format alone may not determine engagement in breast cancer survivorship programs. Decisions should prioritize feasibility and patient preference.
Virtual reality based-rehabilitation for chronic neck pain: an overview of systematic reviews with meta-analysis of randomized clinical trials
(Springer, 2026-05-01) Martínez Calderón, Javier; García-Muñoz, Cristina; Villar Alises, Olga; Heredia Rizo, Alberto Marcos; Matias Soto, Javier; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Purpose: This overview of systematic reviews with meta-analysis aimed to synthesize the quality of the evidence of the short-, and intermediate-effects of virtual reality (VR), alone or combined with other interventions, in individuals with chronic neck pain (NP). Methods: CINAHL, Embase, Epistemonikos, PubMed, Scopus, SPORTDiscus, and the Cochrane Library were searched from inception until April 2025. The methodological quality of systematic reviews was assessed using the AMSTAR 2 checklist. The degree of overlap between reviews was calculated. Results: Nine systematic reviews, with over 2,000 participants, were included. The degree of overlap was very high for all outcomes (40%-100%). The findings of the included systematic reviews were inconsistent about the possible impact of VR on pain intensity, disability, and global perceived effect in the short- and intermediate- terms. Overall, the results show that VR-based rehabilitation was no better than control interventions to manage kinesiophobia, health-related quality of life, and cervical kinematics. Positive effects in favor of VR were only found in the short term for patient satisfaction and cervical range of motion. Conclusion: No consistent findings were found in favor of VR-based rehabilitation to manage chronic pain related symptoms in the short- and intermediate- terms. The clinical applicability of these findings is limited by the heterogeneity between reviews in the delivery mode of VR and control interventions, the poor quality of information provided on how VR was delivered, a very high overlap among meta-analyses, and the low/very low certainty of evidence in most meta-analyses when GRADE system was applied.
Efectividad de la Wii Fit Balance frente a otras intervenciones para la recuperación del equilibrio en pacientes postictus. Revisión sistemática y metaanálisis
(Sociedad Española de Neurología, 2019) García-Muñoz, Cristina; Casuso-Holgado, María Jesús; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Introducción: La realidad virtual es una herramienta terapéutica en auge dentro del campo de la neurorrehabilitación. Entre los sistemas de realidad virtual no inmersiva más empleados destaca la videoconsola Wii Fit Balance. Objetivo: Revisar la literatura científica publicada en los últimos años acerca de la efectividad de la herramienta Wii Fit Balance para el entrenamiento del equilibrio en pacientes que han sufrido un ictus en comparación con las terapias convencionales y analizar dicha información desde un punto de vista cuantitativo y cualitativo. Sujetos y métodos: Se ha llevado a cabo una búsqueda en las bases de datos PubMed, Lilacs, PEDro, Scopus, Web of Science y Cochrane Library. Los descriptores de búsqueda utilizados fueron «Wii Fit Balance», «Wii», «stroke», «ictus» y «balance». Se analiza la calidad metodológica de los estudios incluidos a través de la escala PEDro. Para las variables que fue posible, se llevó a cabo un metaanálisis. Resultados: Se seleccionaron 16 ensayos clínicos aleatorizados para la revisión sistemática, y seis de ellos se incluyeron en el metaanálisis. Dentro del análisis descriptivo se observó heterogeneidad de resultados. Esta misma situación se confirmó a través de los resultados del metaanálisis, ya que tanto para las variables de equilibrio estático como dinámico analizadas se observaron mejoras intragrupo, pero sin que existieran diferencias significativas entre grupos postintervención. Conclusiones: La plataforma de realidad virtual Wii Fit Balance es una herramienta terapéutica válida que ha demostrado ser al menos igual de efectiva que el entrenamiento convencional del equilibrio en pacientes postictus.
Hidden Coherence Bursts and Time-Tagged Holevo Fragment Information Under Finite-Resolution Observation in a Central-Spin Environment
(MDPI, 2026-07-29) Rebollo Martínez, David; Rebollo Salas, Manuel; Fisioterapia
We study a structured QND central-spin testbed under a hybrid finite-resolution protocol. The central-spin state is temporally integrated without retaining the internal readout-time label, whereas environmental fragment information is quantified by a time-tagged scalar-averaged Holevo benchmark. On a converged numerical grid, we identify finite time regions in which the integrated central-spin state has low off-pointer visibility while model-resolved late-time coherence bursts remain present and the typical-fragment Holevo benchmark exceeds a prescribed threshold. A detector-window variance decomposition supplies a model-assisted diagnostic; it requires a fine-grained trajectory or a microscopic model. The Holevo quantity is an upper bound on accessible classical information, and no fragment measurement attaining it is constructed. Grid refinement, an independent trapezoidal quadrature, and a half-cell grid shift preserve the qualitative four-region baseline structure. A sampled-subset calculation benchmarks the typical-fragment classification, but we do not establish constructively disjoint or state-integrated fragment redundancy. A single-realization detector-width/disorder map and a 100-realization ensemble delimit the structured mesoscopic scope. The dimensional conversion is an NV-like scale estimate for an engineered quasi-homogeneous testbed and not an experimental protocol for an arbitrary natural bath.
Effects of transcutaneous vagus nerve stimulation on gastrointestinal symptoms and cardiovascular autonomic outcomes: a systematic review and meta-analysis
(MDPI, 2026-07-03) María Pérez-Montalbán; Encarna García-Domínguez; Pabón Carrasco, Manuel; Oliva Pascual-Vaca, Ángel; Enfermería; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud; CTS1043: Salud, Fisioterapia y Actividad Física
Background: Autonomic dysfunction is increasingly recognized as a key mechanism in disorders involving the brain–gut axis and gastrointestinal symptom generation. Transcutaneous vagus nerve stimulation (tVNS) is a noninvasive neuromodulatory technique investigated for its potential effects on autonomic regulation. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines, with protocol registration in PROSPERO. Randomized controlled trials (RCTs) investigating auricular or cervical tVNS in patients with visceral disorders were included. Continuous outcomes were pooled using mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). When multiple publications originated from the same trial population, only independent datasets were considered for quantitative synthesis to avoid double-counting participants. Risk of bias was assessed using the PEDro scale and certainty of evidence with the GRADE approach. Results: Seven RCTs met the inclusion criteria. tVNS demonstrated a small but statistically significant improvement in gastrointestinal symptoms based on change-from-baseline GSRS scores (MD −0.19; 95% CI −0.29 to −0.09; p < 0.001; I2 = 0%). Although statistically significant, the magnitude of this effect was modest, and its clinical relevance remains uncertain. No significant effects were observed on cardiac vagal tone (SMD 0.19; 95% CI −0.53 to 0.90; p = 0.61; I2 = 73%) or systolic blood pressure (MD −1.24 mmHg; 95% CI −6.69 to 4.21; p = 0.66; I2 = 0%). Evidence regarding cardiac autonomic neuropathy (CAN) was limited to a single independent randomized controlled trial, which found no significant differences between tVNS and sham stimulation. Conclusions: tVNS provides modest statistically significant improvements in gastrointestinal symptoms, supporting its role as a symptomatic neuromodulatory intervention. However, the available evidence for this outcome was based on only two studies, and the clinical relevance of the observed effect remains uncertain. No statistically significant pooled effects were observed for the cardiovascular autonomic markers assessed in this review. Evidence regarding CAN was limited to a single independent study. Therefore, the available evidence remains limited and heterogeneous, and further high-quality randomized controlled trials are warranted.
Cross-cultural adaptation and validation of knee quality of life 26-item questionnaire into spanish in patellofemoral pain
(MDPI, 2026-06-30) Espuny-Ruiz, Fernando; Ridao Fernandez, María Del Carmen; Aldon-Villegas, Rocío; Benítez Lugo, María Luisa; Chamorro Moriana, Gema; Fisioterapia; CTS305: Área de Fisioterapia
Background/Objectives: Patellofemoral pain (PFP) is a persistent knee disorder that impacts quality of life (QoL). Although holistic assessments are needed, no specific tools exist regarding QoL in PFP. The Knee Quality of Life 26-item questionnaire (KQoL-26), covering physical and psychosocial dimensions, could be useful but has not been adapted for Spanish speakers. This study aimed to cross-culturally adapt KQoL-26 into Spanish and assess its psychometric properties regarding PFP, including validity and reliability. Methods: This cross-cultural adaptation followed COSMIN recommendations. The cultural and linguistic adaptation of KQoL-26 included 104 subjects with PFP, involving 145 affected knees. Inclusion criteria: symptomatic PFP, aged between 16 and 55, and being native Spanish speakers. Validity (structural, construct, and external), reliability (internal consistency, test–retest, and agreement), discriminant ability, and feasibility were assessed. Results: Factor Analysis identified five dimensions. Convergent validity demonstrated a strong correlation between KQoL-26 and Knee Injury and Osteoarthritis Outcome Score for Patellofemoral pain and osteoarthritis, Kujala Score, Fulkerson Scale, and the Physical Component Summary of 12-item Short Form, while weak correlations with descriptive data supported discriminant validity. The questionnaire demonstrated high internal consistency (Cronbach’s α = 0.949) and test–retest reliability (ICC = 0.949), with adequate agreement parameters. No floor or ceiling effects were observed. Regarding feasibility, KQoL-26 was understandable and completed by all participants. Conclusions: The Spanish KQoL-26 is a valid, reliable, and feasible QoL assessment tool for Spanish speakers with PFP. Its use may support both clinical decision-making and research in this population group by providing a comprehensive assessment of patient-reported outcomes.
Integrating music listening into exercise for female breast cancer survivors: protocol for a randomized controlled clinical trial
(MDPI, 2026-06-16) Trigueros Murillo, Ana; Heredia Rizo, Alberto Marcos; Muñoz-Fernández, María Jesús; Casuso-Holgado, María Jesús; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1110: Understanding Movement & Self in Health from Science
Breast cancer is the most prevalent malignancy among women. The disease and its treatments often lead to physical and psychosocial impairments, compromising quality of life. While exercise and music-based interventions have individually demonstrated benefits on these symptoms, the advantages of their combination remain unexplored. This study evaluates whether a concurrent exercise program, including aerobic and strength training performed while listening to music based on individual preferences, is more effective than the same exercise program without music in improving self-esteem, body image, cancer-related fatigue, physical function (upper and lower limb strength and cardiorespiratory endurance), quality of life, sleep quality, and intolerance of uncertainty in female breast cancer survivors. A single-blind, two-arm, parallel-group, randomized controlled trial will be conducted including 42 women who completed primary treatment for stage 0–III breast cancer at least six months before enrollment. Participants will be randomly assigned to a music-listening concurrent exercise training group (MLTG), or a no music exercise training group (NMLTG), both performing the same 8-week exercise program. The primary outcome will be self-esteem (Rosenberg Self-Esteem Scale). Secondary outcomes include body image, fatigue, upper and lower limb strength, cardiovascular endurance, quality of life, sleep quality, and intolerance of uncertainty. Measurements will be collected using validated and reliable questionnaires and standardized functional tests at baseline, post-intervention, and at 6 months. Data will be analyzed under the intention-to-treat principle. Music listening, particularly when based on individual preferences and synchronized with movement, may enhance mood and exercise performance while modulating reward-related neural pathways. This trial will provide new evidence on a feasible and low-cost strategy to enhance supportive care and physical and psychosocial outcomes in breast cancer survivors. ClinicalTrials.gov (NCT07045961). Ethics Committee code: 2025-0855.
Assessment of home exercise adherence in patients with non-surgical post-traumatic neck pain: a study protocol using the exercise adherence rating scale
(MDPI, 2026-06-16) Martínez Fernández, José Antonio; Socarrás-Alonso, Luis; Pabón-Carrasco, Daniel; Fisioterapia; Anatomía y Embriología Humana
Background/Objectives: Whiplash-associated disorders (WADs) and non-surgical post-traumatic neck pain often require active rehabilitation, including prescribed home exercise, where poor adherence can limit treatment effectiveness. This protocol describes a standardised observational method to assess home exercise adherence using the Exercise Adherence Rating Scale (EARS). Methods: This prospective protocol outlines eligibility criteria, recruitment settings, core variables, and a structured EARS administration procedure four weeks post-prescription. The primary outcome is the six-item EARS adherence section score. A target sample of approximately 75 participants will be recruited to ensure at least 62 analyzable participants. Outputs: The protocol will generate descriptive data on adherence levels, questionnaire completion rates, and missing data to evaluate implementation feasibility. Planned analyses testing potential associations between adherence and clinical variables will be strictly exploratory and hypothesis-generating. Conclusions: This study operationalizes a standardised method for tracking self-reported adherence in cervical trauma rehabilitation, enhancing methodological transparency and reproducibility.
Technological Innovations to Support Family Caregivers: A Scoping Review
(MDPI, 2024-11-25) Fernández-Bueno, Laura; Torres Enamorado, Dolores; Bravo Vázquez, Ana; Rodríguez Blanco, Cleofás; Bernal Utrera, Carlos; Fisioterapia; CTS954: Innovaciones en Salud y Calidad de Vida
Introduction: Population aging increases the risk of dependency among older adults, which in turn necessitates care, primarily provided by family caregivers. This situation leads to physical and emotional strain on these caregivers. New technologies, such as tele-education, digital platforms, or mobile applications, can offer an accessible and equitable alternative for caregiver training and self-care support. Objective: The objective of this review is to analyze interventions targeted at family caregivers, both for their own self-care and for the care of dependent individuals, using new technologies. Design: A scoping review was conducted, including a total of thirty-two articles extracted from three databases: CINAHL, Scopus, and PubMed. Articles in any language were included, with no fixed time limit, while articles with samples that included family caregivers of oncology patients were excluded. Results: Most of the interventions were conducted via videoconference, showing outcomes that indicated a reduction in depressive symptoms among family caregivers. Conclusions: The implementation of new technologies for the development of interventions presents a viable alternative to in-person sessions. These technologies have shown positive results, while also helping to overcome time and geographical barriers imposed by caregiving responsibilities.
Intervenciones de Fisioterapia en el abordaje de la dispareunia femenina: Impacto en el dolor, función sexual y calidad de vida. Revisión bibliográfica
(Sociedad Andaluza de Fisioterapia, 2024) Espina García, R.; Escobio Prieto, Isabel; Espina Boixo, Miguel Ángel; Fisioterapia
Introducción: la dispareunia es el dolor a nivel del periné durante las relaciones sexuales. Es un problema se xual frecuente, con alta prevalencia y gran impacto en la vida de las mujeres. Existen múltiples intervenciones dis ponibles para su tratamiento, siendo cada vez más los estudios que se centran en el papel de la Fisioterapia en su abordaje. Objetivo: revisar la literatura científica existente sobre la efectividad de las intervenciones fisiotera péuticas en el abordaje de la dispareunia en mujeres, valorando el dolor, la función sexual y la calidad de vida, comparando estas intervenciones con otros tratamientos. Material y método: se llevó a cabo una revisión de la li teratura, los meses de marzo a mayo 2024, de acuerdo con las recomendaciones PRISMA, en las bases de datos Pubmed, PEDro, Cinahl, Scopus, Web of Science, Lilacs y Scielo, limitándose a ensayos clínicos aleatorizados, en inglés, español o francés. Para evaluar la calidad y riesgo de sesgo de los estudios se utilizó la escala PEDro. Resultados: la investigación identificó un total de 79 estudios, de los que se analizaron 6 ensayos clínicos, que engloban 292 pacientes. Las intervenciones fisioterapéuticas aplicadas fueron la terapia manual, ejercicios de fortalecimiento del suelo pélvico, electroterapia, biofeedback, termoterapia y ondas de choque. Conclusión: los datos recogidos evidencian que las intervenciones fisioterapéuticas mejoran el dolor y la función sexual en muje res con dispareunia, influyen positivamente en la calidad de vida y son compatibles y adyuvantes a tratamientos médico-quirúrgicos. Las intervenciones fisioterapéuticas han demostrado ser efectivas para el abordaje de la dis pareunia en mujeres.
Is EMDR effective for improving post-traumatic stress symptoms in people with post-traumatic stress disorders? An overview of systematic reviews with meta-analysis
(Elsevier, 2026) Arriazu Domínguez, Miguel; Martínez Calderón, Javier; Matías Soto, Javier; Cano García, Francisco Javier; Fisioterapia; Personalidad, Evaluación y Tratamiento Psicológicos
Background: Eye movement desensitization and reprocessing (EMDR) is widely recommended as a first-line trauma-focused therapy in post-traumatic stress disorder (PTSD). This overview of systematic reviews with meta-analysis aimed to evaluate the pooled effects of EMDR on PTSD symptoms in people with PTSD; analyse the methodological quality of included reviews; and quantify the degree of overlap between reviews. Method: This overview followed the Preferred Reporting Items for Overviews of Reviews statement. Multiple databases were searched up to September 2025. The methodological quality of reviews was assessed using AMSTAR 2 and the degree of overlap between reviews was quantified using the corrected covered area (CCA). Results: Twenty-two systematic reviews were evaluated, of which only 11 reported the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Included meta-analyses suggests that EMDR may reduce PTSD symptoms compared with inactive controls (e.g., waitlist or usual care). On the other hand, EMDR showed comparable effectiveness with active controls, especially with psychological interventions such as trauma-focused cognitive behavioural therapy, cognitive behavioural therapy, or relaxation therapy. However, the certainty of evidence across meta-analyses was variable, primarily ranging from low to very low. Furthermore, other methodological limitations were identified, including issues related to search strategies and reporting transparency. Finally, overlap between reviews was slight (CCA = 2.5%), although incomplete reporting limited this analysis. Conclusions: EMDR may reduce PTSD symptoms, especially compared with inactive controls, and shows similar effectiveness to other psychological therapies. However, the results should be interpreted with caution due to the low and very low certainty of evidence of most of meta-analyses along with other methodological issues highlighted above.
What Interventions Focused on Physical Activity Could Improve Postpartum Depression Symptoms? An Overview of Systematic Reviews with Meta-Analysis
(MDPI, 2025-06-13) Campos-Marín, Álvaro; García-Muñoz, Cristina; Matías-Soto, Javier; Martínez Calderón, Javier; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Objectives: The objective of this overview of systematic reviews with meta-analysis was to summarize the evidence on the possible effectiveness of interventions focused on physical activity in improving and preventing postpartum depression symptoms. Methods: CINAHL (via EBSCOhost), Embase, Epistemonikos, PsycINFO, PubMed, Scopus, SPORTDiscus (via EBSCOhost), and the Cochrane library were searched from inception to 19 February 2025. The methodological quality of the included reviews was assessed with AMSTAR 2. The degree of overlap between meta-analyses was calculated. Results: A total of eight systematic reviews were included. Overall, the included meta-analyses showed favorable results regarding the effects of physical activity on postpartum depression symptoms. Considering specific physical activity modalities, the largest number of meta-analyses focused on aerobic exercise, yoga, or multimodal exercise. In all three cases, most meta-analyses found that aerobic exercise, yoga, and multimodal exercise could be beneficial in reducing postpartum depression symptoms. Furthermore, several meta-analyses explored the effectiveness of walking, finding positive results in favor of this intervention in reducing postpartum depression symptoms. Finally, movement in water was only explored in one meta-analysis, and no differences were found between these interventions and control groups. Conclusions: Aerobic exercise, walking, yoga, and multimodal exercise programs may improve postpartum depression symptoms. Movement in water was not more effective than control groups for reducing this outcome. However, the results of our overview should be considered with caution, since important methodological and clinical implications have been discussed (e.g., lack of subgroups by prevention and treatment) and should guide the development of future systematic reviews on this topic.
The Incidence of Sport-Related Anterior Cruciate Ligament Injuries: An Overview of Systematic Reviews Including 51 Meta-Analyses
(MDPI, 2025-05-14) Martínez Calderón, Javier; Infante Cano, Marta; Matías-Soto, Javier; Pérez-Cabezas, Verónica; Galan-Mercant, Alejandro; García-Muñoz, Cristina; Fisioterapia; Erasmus + Strategic Partnership for Higher Education Program; CTS1110: Understanding Movement & Self in Health from Science
Background/Objectives: The number of systematic reviews evaluating the incidence of anterior cruciate ligament (ACL) injuries in sports is increasing. To synthesize pooled incidence and prevalence rates of sport-related ACL injuries based on published systematic reviews with meta-analyses. Methods: An overview of systematic reviews with meta-analysis was conducted. The CINAHL, Embase, PubMed, and SPORTDiscus databases were searched from inception to 17 October 2023. AMSTAR 2 was used to assess the methodological quality of reviews. The degree of overlap between reviews was calculated when possible. Results: Seven systematic reviews including 51 meta-analyses of interest were included. The prevalence of ACL injuries was not meta-analyzed. Meta-analyses mainly showed that ACL injuries may have a high incidence in American football, basketball, European football/soccer, and volleyball, among other sports. In addition, ACL injuries may have a higher incidence in females than males in some sports. For example, the pooled incidence rates of ACL injuries in basketball ranged from 0.091 (95%CI, 0.074–0.111) to 0.110 (95%CI, 0.094–0.128) among female athletes, whereas this incidence ranged from 0.024 (95%CI, 0.016–0.034) to 0.027 (95%CI, 0.019–0.035) among male athletes. Conclusions: Sport-related ACL injuries may have a high incidence in sports such as American football, basketball, European football/soccer, or volleyball and show differences between sexes. Therefore, a sex-specific prevention of these injuries may be needed.
Suicidal Ideation, Suicide Attempts, and Suicide Mortality in Cancer: An Overview of Systematic Reviews with Meta-Analysis
(MDPI, 2025-05-27) Martínez Calderón, Javier; Infante Cano, Marta; Matías-Soto, Javier; Galan-Mercant, Alejandro; Pineda-Escobar, Saúl; Villar-Alises, Olga; Pérez-Cabezas, Verónica; García-Muñoz, Cristina; Hernández-Rodríguez, Juan Carlos; Fisioterapia; Erasmus + Strategic Partnership for Higher Education Program; CTS1110: Understanding Movement & Self in Health from Science
Background: this overview of systematic reviews with meta-analysis summarized the epidemiology of suicide in cancer, mainly focused on prevalence, incidence, and risk. Methods: the CINAHL (via EBSCOhost), Embase, PsycINFO (via ProQuest), and PubMed databases were searched from inception to February 2024. AMSTAR 2 evaluated the methodological quality of reviews. The degree of overlap between reviews was calculated. Results: Twelve systematic reviews with meta-analysis were included. The prevalence of suicidal ideation in prostate cancer was 9.85% (95%CI 7.31–12.70%). The relative risk of suicidal ideation in prostate cancer was 2.01 (95%CI: 1.52–2.64) in comparison to controls without this type of cancer during the first 12 months after diagnosis. Furthermore, the risk of suicidal ideation was higher among individuals with bladder cancer in comparison to people without this clinical condition (HR 1.90, 95%CI 1.29−2.81). The crude suicide mortality rate per 100,000 person-years in prostate cancer was 47.1 per 100,000 person-years (95%CI 39.85–54.96). Incidence suicide death per 100,000 person-years was higher in sarcoma (60.99 per 100,000 person-years, 95%CI 17.37–214.19), esophagus (87.71 per 100,000 person-years, 95%CI 27.42–280.54), and pancreas (75.39 per 100,000 person-years, 95%CI 41.80–135.97). Finally, the standardized mortality ratio by suicide was higher in the pancreas (SMR 6.42, 95%CI 1.60–25.76), bone and cartilage (SMR 9.59, 95%CI 1.54–59.77), and mesothelioma (SMR 13.07, 95%CI 1.61–105.80). Conclusions: overall, meta-analyses underlined the relevance of suicide mortality in different cancer sites and geographical regions. Some meta-analyses also found suicidal ideation may be important in prostate or bladder cancer.
Protecting Athletes: The Clinical Relevance of Meta-Analyses on Injury Prevention Programs for Sports and Musculoskeletal Body Regions: An Overview of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials
(PDMI, 2025-06-27) Pineda-Escobar, Saúl; Matías-Soto, Javier; García-Muñoz, Cristina; Martínez Calderón, Javier; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Background: Musculoskeletal injuries have a substantial impact on athletes, affecting sports performance and increasing the risk of future musculoskeletal disorders (e.g., osteoarthritis). Injury prevention programs are essential to reduce the risk of sport-related injuries and meta-analyses can provide a large amount of information in a single article. Objective: To summarize the pooled effects of injury prevention programs focused on any form of physical exercise in the incidence and risk of musculoskeletal injuries and reinjuries by sports and musculoskeletal body regions. Methods: The CINAHL (via EBSCOhost), Embase (via Elsevier), Epistemonikos, PubMed, Scopus, SPORTDiscus (via EBSCOhost), and the Cochrane Library e-databases were searched from inception to 7 October 2024. Systematic reviews with meta-analyses of randomized clinical trials were considered. The methodological quality of systematic reviews was assessed with AMSTAR 2. The degree of overlap between meta-analyses of interest was calculated. Results: Fourteen systematic reviews were included. Thirteen of these reviews were focused on soccer. Overall, meta-analyses including a specific injury prevention program (FIFA 11+ and FIFA 11+ kids) found that these programs may reduce the risk of musculoskeletal injuries among soccer players. Concretely, FIFA 11+ may reduce the risk of ankle, knee, hip/groin, and hamstring injuries, whereas FIFA 11+ kids may decrease the risk of ankle and knee injuries. Conclusions: FIFA 11+ and FIFA 11+ kids may reduce the risk of sports musculoskeletal injuries, mainly in the lower limbs. However, many clinical and methodological issues (e.g., the lack of meta-analyses in many types of sports) were discussed and highlighted the difficulty of making robust clinical recommendations with the current data.
Motor Development Scales Validated in Spanish Populations of Children Aged 0–18 Months: Systematic Review
(PDMI, 2026-08-22) Cala de la Torre, Elena; Piñero Pinto, Elena; Fisioterapia
Background/Objectives: The assessment of motor development in early ages is considered fundamental for the early identification of alarm signs that indicate the possibility of a child suffering from a developmental disorder. To this end, it is necessary to use reliable evaluation tools that have been specifically validated in the target population. The main aim of the current review was to examine the existing motor development assessment tools validated in Spanish populations of children aged 0–18 months. Methods: A systematic review was carried out following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) declaration criteria, and it was registered in PROSPERO. A bibliographic search was conducted in the PubMed, Scopus, Web of Science, and Cochrane databases, using terms related to motor development, assessment tools, and validation. The COSMIN verification list was employed to evaluate the quality of the included scales, and the QUADAS-2 instrument was used to analyse the quality of the included studies. Results: A total of 7 studies were included in the review, all of which were validation studies of motor development assessment tools in Spanish populations of children aged 0–18 months. Moreover, they all show heterogeneity with respect to their characteristics, such as target population, sample size, and metric properties. Conclusions: The present systematic review provides relevant information about the characteristics and methodological quality of motor development assessment tools validated in Spanish populations. There are currently very few of these evaluation tools, as well as limitations in regard to theories that support them, their metric properties, and the methodological quality of their validation studies. Therefore, we confirm the need for validating updated motor development tools to improve the detection, prognosis, and evaluation of children with developmental disorders or at risk of suffering from them.
Improving Methodological Quality in Meta-Analyses of Athlete Pain Interventions: An Overview of Systematic Reviews
(PDMI, 2025-10-02) Pineda-Escobar, Saúl; García-Muñoz, Cristina; Villar Alises, Olga; Martínez Calderón, Javier; Fisioterapia; CTS1110: Understanding Movement & Self in Health from Science
Background: Pain is a disabling issue in athletes, with significant impact on performance and career longevity. Many randomized clinical trials (RCTs) have explored interventions to reduce pain, leading to multiple systematic reviews with meta-analysis, but their methodological rigor and clinical applicability remain unclear. Objective: To provide an overview of systematic reviews with meta-analysis on interventions aimed at alleviating pain intensity in athletes, identifying knowledge gaps and appraising methodological quality. Methods: CINAHL, Embase, Epistemonikos, PubMed, Scopus, SPORTDiscus, and Cochrane Library were searched from inception to February 2025. Systematic reviews with meta-analysis of RCTs evaluating interventions to manage pain in athletes were considered. Athletes without restrictions in terms of sports, clinical, and sociodemographic characteristics were included. Overlap between reviews was calculated using the corrected covered area. Results: Twelve systematic reviews met inclusion criteria. Physical exercise modalities (e.g., gait retraining, hip strengthening), acupuncture, photo biomodulation, and topical medication showed potential benefits in reducing pain intensity. Other interventions, such as certain manual therapy techniques, platelet-rich plasma, or motor imagery, did not show consistent effects. All reviews focused solely on pain intensity, with minimal stratification by sport or clinical condition which may affect the extrapolation of meta-analyzed findings to the clinical practice. Methodological quality was often low, with flaws in reporting funding sources, lists of excluded studies, and certainty of evidence (was mostly rated as low/very low). Overlap was variable across the interventions. Conclusions: Given low/sparse certainty and minimal sport-specific analyses, no strong clinical recommendations can be made; preliminary signals favor proximal hip strengthening, gait retraining, photo biomodulation (acute soreness), and topical NSAIDs pending higher-quality syntheses. Future reviews should consider mandatory GRADE; pre-registered protocols; sport- and condition-specific analyses; and core outcome sets including multi-dimensional pain.

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