Artículos (Fisioterapia)

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Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial
(Taylor & Francis, 2022-08) Bellido Fernández, Lorena María; Jiménez Rejano, José Jesús; Chillón Martínez, Raquel; Lorenzo Muñoz, Almudena; Piñero Pinto, Elena; Rebollo Salas, Manuel; Fisioterapia; ; CTS305: Área de Fisioterapia; CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
Purpose: To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). Methods: A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. Results: The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. Conclusions: Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant.
Pain neuroscience education and resistance training in women with fibromyalgia: a randomized control pilot study
(Hindawi ltd; Wiley, 2026-07-18) Rodríguez-Domínguez, Álvaro José; Rebollo Salas, Manuel; Chillón Martínez, Raquel; Cardellat-González, Melania; Blanco-Heras, Laura; Jiménez Rejano, José Jesús; Fisioterapia; CTS305: Área de Fisioterapia
Objective: The objective was to compare the effectiveness of a combined pain neuroscience education and resistance training program (PNE + RT) with that of a combined aerobic and flexibility exercise program (AE + FE). Design: A randomized pilot study was conducted in women with fibromyalgia. Methods: Thirty-one women with fibromyalgia were randomized into the experimental group (PNE + RT, n = 15) and the usual care group (AE + FE, n = 16). Both groups carried out the intervention 3 days a week for 12 weeks. Primary outcomes were pain intensity, disability, and symptoms related to central sensitization (CS). Among them, pain intensity was considered the main primary endpoint for statistical analysis and interpretation. Secondary outcomes were pressure pain threshold (PPT), maximum handgrip strength (MHS), and stiffness. Results: Statistically significant between-group differences were found in favor of PNE + RT group for short-term pain intensity (p < 0.05) and PPT trapezius (p < 0.05). PNE + RT also showed statistically significant within-group improvements in pain intensity (p < 0.01), CS-related symptoms (p < 0.01), PPT quadriceps (p < 0.01), and MHS of the left hand (p < 0.01). Disability improved significantly in both groups (p < 0.01). There were no significant changes in stiffness. Conclusion: The PNE + RT program is more effective than the AE + FE program in improving pain intensity in the short term and PPT in the trapezius muscle in the long term. PNE + RT is also effective in improving disability, pain intensity, CS-related symptoms (short and long term), and left MHS and PPT in the quadriceps muscle (long term), although it is not more effective than AE + FE. The AE + FE program is only effective in improving disability. These findings are preliminary, and larger studies are needed to confirm the results. Trial Registration: ClinicalTrials.gov identifier: NCT04855851.
Exoskeleton-assisted gait: exploring new rehabilitation perspectives in degenerative spinal cord injury
(MDPI, 2025-12-25) Regazzetti, Martina; Zitti, Mirko; Lazzaro, Giovanni; Vianello, Samuel; Federico, Sara; Cieślik, Błażej; Luque Moreno, Carlos; Kiper, Pawel; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
Background: Recovery following incomplete spinal cord injury (iSCI) remains challenging, with conventional rehabilitation often emphasizing compensation over functional restoration. As most new spinal cord injury cases preserve some motor or sensory pathways, there is increasing interest in therapies that harness neuroplasticity. Robotic exoskeletons provide a promising means to deliver task-specific, repetitive gait training that may promote adaptive neural reorganization. This feasibility study investigates the feasibility, safety, and short-term effects of exoskeleton-assisted walking in individuals with degenerative iSCI. Methods: Two cooperative male patients (patients A and B) with degenerative iSCI (AIS C, neurological level L1) participated in a four-week intervention consisting of one hour of neuromotor physiotherapy followed by one hour of exoskeleton-assisted gait training, three times per week. Functional performance was assessed using the 10-Meter Walk Test, while gait quality was examined through spatiotemporal gait analysis. Vendor-generated surface electromyography (sEMG) plots were available only for qualitative description. Results: Patient A demonstrated a clinically meaningful increase in walking speed (+0.15 m/s). Spatiotemporal parameters showed mixed and non-uniform changes, including longer cycle, stance, and swing times, which reflect a slower stepping pattern rather than improved efficiency or coordination. Patient B showed a stable walking speed (+0.03 m/s) and persistent gait asymmetries. Qualitative sEMG plots are presented descriptively but cannot support interpretations of muscle recruitment patterns or neuromuscular changes. Conclusions: In this exploratory study, exoskeleton-assisted gait training was feasible and well tolerated when combined with conventional physiotherapy. However, observed changes were heterogeneous and do not allow causal or mechanistic interpretation related to neuromuscular control, muscle recruitment, or device-specific effects. These findings highlight substantial inter-individual variability and underscore the need for larger controlled studies to identify predictors of response and optimize rehabilitation protocols.
Acceptance and commitment therapy for chronic pain: an overview of systematic reviews with meta-analysis of randomized clinical trials
(Churchill Livingstone, 2024) Martínez Calderón, Javier; García Muñoz, Cristina; Rufo Barbero, Carmen; Matías Soto, Javier; Cano García, Francisco Javier; Fisioterapia; Personalidad, Evaluación y Tratamiento Psicológicos
This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analysis of randomised clinical trials of the efficacy of Acceptance and Commitment Therapy (ACT) for adults with chronic pain in relation to pain intensity, pain-related functioning, quality of life, and psychological factors. The CINAHL, Embase, PsycINFO, PubMed, and the Cochrane Library databases were searched from inception to July 2, 2023. AMSTAR 2 was used to assess the methodological quality of systematic reviews. The overlap among reviews was calculated. Nine reviews comprising eighty-four meta-analyses of interest were included. At posttreatment, some meta-analyses mainly showed that ACT can reduce depression symptoms, anxiety symptoms, psychological inflexibility, and pain catastrophizing; and can improve mindfulness, pain acceptance, and psychological flexibility. At three-month follow-up, ACT can reduce depression symptoms and psychological inflexibility, as well as improve pain-related functioning and psychological flexibility. At six-month follow-up, ACT can improve mindfulness, pain-related functioning, pain acceptance, psychological flexibility, and quality of life. At six-twelve-month follow-up, ACT can reduce pain catastrophizing and can improve pain-related functioning. Some methodological and clinical issues are identified in the reviews, such as a high overlap between systematic reviews, the fact that the certainty of the evidence is often not rated and specific details needed to replicate the interventions reviewed are often not reported. Overall, however, randomized clinical trials and systematic reviews show that ACT can improve outcomes related to chronic pain (e.g. pain-related functioning). Future systematic reviews should address the methodological and clinical concerns identified here to produce higher quality findings. Perspective: Despite certain methodological and clinical issues, randomized clinical trials and systematic reviews of ACT appear to show that it can improve outcomes related to chronic pain (e.g. psychological factors).
How can clinicians enhance self-efficacy beliefs in osteoarthritis? An overview of systematic reviews with meta-analysis
(Springer, 2024) Martínez Calderón, Javier; Cano García, Francisco Javier; García-Muñoz, Cristina; Rufo Barbero, Carmen; Matías Soto, Javier; Infante Cano, Marta; Fisioterapia; Personalidad, Evaluación y Tratamiento Psicológicos
Objective: This overview of reviews aimed to synthesize the effectiveness of non-pharmacological approaches to enhance self-efficacy in people with osteoarthritis. Data Sources: The CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library databases were searched from inception to December 2023. Review methods: We considered systematic reviews with meta-analysis of randomized clinical trials evaluating any non-pharmacological intervention. We used AMSTAR 2 to assess the methodological quality of reviews. The overlap between reviews was calculated. Results: We included eight systematic reviews with meta-analysis evaluating 30 different clinical trials. Overall, mind-body exercises, psychological interventions, and self-management strategies may improve arthritis self-efficacy. Specifically, the meta-analyses showed tai chi exercises, coping skills training, and the arthritis self-management program are more effective than controls to enhance arthritis self-efficacy in people with hip and/or knee osteoarthritis. In addition, inconsistent results were detected across meta-analyses regarding the effectiveness of multidisciplinary interventions. Finally, the degree of overlap between all reviews was moderate (CCA=6%) and many included reviews reported most of the items of AMSTAR 2. Conclusion: Tai chi exercises, coping skills training, and the arthritis self-management program may be beneficial for enhancing arthritis self-efficacy.
Expected Shot impact Timing (xSIT) and other advanced metrics as indicators of performance in English men’s and women’s professional football
(MDPI, 2025-10-02) Cruz Torres, Blanca de la; Navarro Castro, Miguel; Ruiz de Alarcón Quintero, Anselmo; Fisioterapia; Matemática Aplicada I
Blackground: Football performance analysis has grown rapidly in recent years, with increasing interest in advanced metrics to more accurately evaluate both individual and team performance. The aim of this study was to examine the utility of the Expected Shots Impact Timing (xSIT) metric as an indicator of shooting performance in English professional football, specifically in the men’s Premier League (PL) and the Women’s Super League (WSL). Methods: A total of 9831 shots from the PL (2015/16 season) and 3219 shots from the WSL (2020/21 season) were analyzed. Data were obtained from publicly accessible football databases. The variables examined included goals, Possession Value (PV), Expected Goals (xG), Expected Goals on Target (xGOT), and xSIT. All variables were normalized per match (90 min). Descriptive statistics, correlational analyses, and comparative analyses between leagues. Results: The WSL exhibited a significantly higher PV than the PL (p < 0.001), whereas the remaining metrics showed no significant differences between leagues (p > 0.05). Moreover, in the WSL, all performance indicators displayed very strong correlations with goals, while in the PL, similarly strong associations were observed, except for PV, which showed only a weak relationship. Conclusions: the xSIT metric, as an indicator of shooting performance, may be regarded as an influential factor in determining match outcomes across both leagues.
Workplace-based physiotherapy of elderly-care workers with non-specific chronic neck pain: a randomized controlled trial
(American college of occupational and environmental medicine., 2025-10-03) Cardero-Durán, María de los Ángeles; Espejo-Antúnez, Luis; Fernández-Morales, Carlos; Albornoz Cabello, Manuel; Rodríguez-Mansilla, Juan; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Objective: To analyze the clinical efficacy of a multimodal physical therapy program combined with pain neuroscience education (PNE) in elderly care workers with non-specific chronic neck pain (NSCNP). Methods: A sample of 50 elderly care workers was randomly assigned to an Intervention Group (IG; n = 25), which received a multimodal physiotherapy program combined with PNE, and a Control Group (IG; n = 25). Self-reported pain intensity (VAS), pressure pain threshold (PPT), cervical disability (CDU), active cervical range of motion (CRoM), and health-related quality of life (HRQL), were analyzed. Results: Significant results were observed for IG in the variables analyzed p < 0.001. Improvements were maintained with large effect sizes (d ≥ 0.9) after a 4-week follow up. Conclusion: Five weeks of workplace-based physiotherapy combined with PNE reduced self-reported pain intensity and increase PPT and CRoM in caregivers with NSCNP.
Does pain location influence heart rate variability? A comparative analysis of patients with neck or low back pain, and healthy controls
(Elsevier Science Bv; Elsevier, 2025-09-09) Espejo-Antúnez, Luis; Fernández-Morales, Carlos; Albornoz Cabello, Manuel; Cardero-Durán, María de los Ángeles; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Background/Objectives: Chronic neck pain (CNP) and chronic low back pain (CLBP) are prevalent musculoskeletal disorders linked to autonomic nervous system dysfunction, assessed through heart rate variability (HRV). This study aimed to compare HRV indices among subjects with CNP, CLBP, and healthy controls, examining whether pain location influences autonomic modulation. Methods: An observational study was conducted involving 93 adults (31 per group: CNP, CLBP, and controls). HRV was measured using a Firstbeat Bodyguard® device, analyzing parameters including mean HR, minimum and maximum HR, rMSSD, SD1, SD2, stress score (SS), and sympathetic/parasympathetic ratio (S:PS). HRV data were analyzed following standard guidelines. Additional analyses included multinomial logistic regression and ROC curves to explore the predictive value of rMSSD. Results: Both pain groups showed significantly higher sympathetic dominance (higher SS and S:PS ratio) compared to controls (p < 0.001, d = 1.0–1.3). Subjects with CNP exhibited significantly lower parasympathetic indices (rMSSD and SD1) compared to the CLBP group (both p < 0.01, d = 0.8) and healthy controls (p < 0.001, d = 2.2 and d = 2.3). No differences were observed in sympathetic dominance between CNP and CLBP groups. Logistic regression confirmed the predictive value of rMSSD for group classification, and ROC analyses showed high discriminatory capacity, particularly between CNP and healthy subjects (AUC = 0.932). Conclusions: Significant differences in autonomic modulation were observed between patients with CNP, CLBP, and healthy subjects. CNP was associated with a greater reduction in parasympathetic activity, possibly due to mechanisms related to the anatomical proximity of the vagus nerve to the cervical region.
Effect of home exercise programs in patients with non-tears rotator cuff-related shoulder pain: a systematic review and meta-analysis
(Edizioni Minerva Medica, 2025-08) Hernández-Sánchez, Sergio; Segura-Heras, José V.; Albornoz Cabello, Manuel; Espejo-Antúnez, Luis; Toledo-Marhuenda, José V.; Fisioterapia; Generalitat Valenciana; CTS947: Salud y Actividad Física para Calidad de Vida
Although several studies demonstrate the positive effect of therapeutic exercise, aspects such as the influence of supervised exercises versus home-self training or the level of adherence are still unclear. the objective is to study the effect of home exercise programs compared to super vised exercise, either alone or combined with standard physiotherapy treatment. EVidENcE acQuisitioN: Web of science, pubMed, scopus, EMbasE, trials registries and reference lists with relevant articles were searched up to March 2025. only randomized controlled trials were included that aimed to compare the effect of a home exercise program in patients versus supervised exercise, either in isolation or with usual physiotherapy. the pEdro scale and the cochrane collaboration tool were used to evaluate the quality of the studies and the risk of bias, respectively. Exercise interventions content assessment, using the proforma provided in the cErt, and adherence were extracted from the included manuscripts. data were extracted by two independent assessors using a standardized form. Meta-analyses were conducted with the R statistical program using fixed or random effects models according to the hetero geneity assessed with i2 coefficient. EVIDENCE SYNTHESIS: Twelve RCTs (N.=475) were included. Home self-training was similar and no differences were found at 12 weeks from supervised exercise program, either alone or combined with standard physiotherapy treatment on Visual Analogic Scale (VAS) (SMD, 0.92; 95% CI, 0.58 to 1.26, P=0.66); Constant-Murley Score (CS) (SMD, -0.82; 95% CI, -1.05 to -0-60, P=0.64); and Shoulder Pain and Disability Index (SPADI) (SMD, 1; 95% CI, 0.74 to 1.26, P=0.93). It was impossible to include adherence in the meta-analysis due to the small number of studies reporting this data and the heterogeneity of the criteria for accepting adequate adherence to the prescribed exercise program. coNclusioNs: home self-training might be equally effective as outpatient and supervised exercise, isolated or combined with the usual phys iotherapy, in terms of primary outcomes. however, the lack of information on adherence rates, the content of the exercise or how it is performed is worrying. furthermore, the heterogeneity of the criteria related to treatment adherence and compliance indicates that more literature is needed to relate the effect produced with the type of exercise and therapeutic adherence.
Effectiveness of a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A randomized controlled trial
(Elsevier Science Inc, 2025-05-23) Fernández Morales, Carlos; Albornoz Cabello, Manuel; Cardero-Durán, María de los Ángeles; Moreno-Vázquez, Juan Manuel; Espejo-Antúnez, Luis; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Background Flight-related neck pain constitutes a clinical entity related to the performance, occupational health, and flight safety of fighter pilots. Objective To investigate whether a multimodal physiotherapy program combining supervised motor control exercises with laser-guided feedback and interferential current therapy with electromassage improves cervical pain and function outcomes in fighter pilots with flight-related neck pain compared to their usual operational routines. Design Thirty-one pilots participated in the study, divided into two groups: intervention group (n = 14), who received eight sessions of a multimodal physiotherapy program (twice a week for 4 weeks), and a control group (n = 17), who did not receive any intervention and maintained their usual operational routines. Primary outcome measures were perceived pain intensity (Numeric Pain Rating Scale) and Joint Position Sense Error. The secondary outcome measures were neck disability (Neck Disability Index), cervical range of motion, and pressure pain threshold. Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat were calculated. Results Statistically significant changes were observed between groups in favor of the intervention group in both primary outcomes measures: Numeric Pain Rating Scale (mean difference: 2.5 [1.5–3.5]; p < .001; d = 0.7); Joint Position Sense Error (mean difference: 2 [1.5–2.5]; p < .001; d = 0.8), and secondary outcomes measures (p < .05), with large effect sizes (d ≥ 0.8) in cervical range of motion and pressure pain threshold and moderate (d ≥ 0.6) in Neck Disability Index. In the analysis for treatment benefit, the number needed to treat was 2 (95% confidence interval, 2–3, p < .001) for neck pain and proprioceptive acuity. Conclusions A multimodal physiotherapy program based on supervised exercises with laser-guided feedback and interferential current therapy improves the symptoms and cervical function of fighter pilots with flight-related neck pain.
Adherence to compression garments in lymphedema patients: across-sectional study
(Mdpi, 2025-04-08) Medina Rodríguez, María Elena; Socorro Suárez, Raúl; Albornoz Cabello, Manuel; Aranda Rodríguez, Carolina; Domínguez Trujillo, Pino Delia; Peña Curbelo, Victoria; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Background/Objectives: This study evaluated adherence to compression garments, their role in edema stabilization, and factors influencing patient compliance. Materials and Methods: This observational, descriptive, cross-sectional study evaluated adherence to compression garments in 92 patients with lymphedema treated at the University Hospital of Gran Canaria Dr. Negrín. In addition, sociodemographic, clinical, and design-related factors influencing adherence were analyzed. The evaluation was conducted via telephone questionnaires and a review of medical records. Results: The study revealed low adherence to compression garments in patients with lymphedema. Adherence was related to the garments’ etiology, severity, and perceived comfort. Conclusions: The findings highlight the need to improve education strategies and personalize treatment recommendations to enhance adherence.
Effects of Nmes-guided scapular retraction exercise program in amateur female handball players with scapular dyskinesis without shoulder pain: a randomized controlled clinical trial
(Mdpi, 2025-08-07) Espejo-Antúnez, Luis; Gutiérrez-Coronado, Javier; Fernández-Morales, Carlos; Albornoz Cabello, Manuel; Prato, Luis Fernando; Cardero-Durán, María de los Ángeles; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Objective: This study aimed to evaluate the effect of simultaneously combining therapeutic scapular retraction exercise with and without Neuromuscular Electrical Stimulation (NMES) in amateur female handball players with scapular dyskinesis. Methods: In a randomized, single-blind, controlled trial, the sample (n = 34) was randomized into two groups (Group 1 (n = 17) and Group 2 (n = 17)). The intervention consisted of applying a supervised scapular retraction exercise (SRE) program alone or combined with NMES for 4 weeks (2 ss/week). Scapular Static Positioning Assessment parameters (upper and lower horizontal distance of the scapula from the spine (mm)), internal rotation range of motion (degrees), and external rotation strength (newtons and BW%) were measured. Results: A significant interaction was found to favor the group that received the supervised SRE program + NMES (Group 1) in upper horizontal distance (F1,30 = 30.93 [p < 0.000]; d = 0.65); lower horizontal distance (F1,30 = 12.79 [p = 0.001]; d = 0.72); ER Strength (N) (F1,30 = 19.58 [p < 0.000] d = 0.71); and ER Strength (BW%) (F1,30 = 16.84 [p < 0.000]) d = 0.69), which was statistically significant (p ≤ 0.001 for p < 0.05). In the analysis for treatment benefit, the number needed to treat (NNT) was 2 for upper scapular positioning and 4 for external rotation strength. Conclusions: NMES improves the Scapular Static Positioning and ER Strength when combined with an SRE program in amateur female handball players diagnosed with scapular dyskinesis, with clinically relevant effects. These findings, while promising, are based on a small sample and should be confirmed in larger studies.
How do fear-avoidance and catastrophizing pain beliefs affect functional status and disease activity in axial spondyloarthritis?
(Mdpi, 2025-06-05) Fernández-Morales, Carlos; Cardero-Durán, María de los Ángeles; Albornoz Cabello, Manuel; Espejo-Antúnez, Luis; Fisioterapia; CTS947: Salud y Actividad Física para Calidad de Vida
Background and Objectives: The objective of our study was to describe the biopsychosocial profile of individuals diagnosed with axial spondyloarthritis (AxSpA) and to analyze how their clinical characteristics interact with disease activity. Materials and Methods: An observational study was conducted, involving 28 participants diagnosed with AxSpA. We evaluated clinical outcomes (perceived pain, range of motion [RoM], pressure pain threshold [PPT], and proprioceptive acuity), psychosocial outcomes (the Pain Catastrophizing Scale [PCS], Tampa Scale of Kinesiophobia [TSK-11], and the Fear-Avoidance Beliefs Questionnaire [FABQ]), and AxSpA-specific indices (the Bath Ankylosing Spondylitis Metrology Index [BASMI], Bath Ankylosing Spondylitis Functional Index [BASFI], and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]). Data were analyzed using Spearman's correlation coefficients and simple and multiple linear regression models. Results: Cervical and lumbar RoM values were reduced compared to established normative values for the general population. Significant associations were found between perceived pain, pain catastrophizing, and FABQ scores with both BASDAI and BASFI (p < 0.05). The interaction between perceived pain and pain catastrophizing (p < 0.001) accounted for 45.7% of the variance in BASDAI, while the interaction between perceived pain and FABQ (p < 0.001) explained 52.1% of the variance in BASDAI. Conclusions: The biopsychosocial profile of patients with AxSpA is characterized by moderate-intensity perceived pain and reduced cervical and lumbar mobility. The observed associations between BASDAI, pain catastrophizing, and fear-avoidance beliefs underscore the influence of psychosocial factors on disease progression.
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.

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