Artículos (Fisioterapia)

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Limitación del movimiento de flexión dorsal del tobillo en sujetos pronadores con dolor lumbar crónico
(Elsevier Doyma, 2019) Pabón Carrasco, Manuel; Gago Reyes, Fernando; Fernández Seguín, Lourdes María; Munuera Martínez, Pedro Vicente; Palomo Toucedo, Inmaculada Concepción; Castro Méndez, Aurora; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. Departamento de Fisioterapia
Antecedentes: Estudios han relacionado la posible influencia entre los desequilibrios de la bio mecánica del pie y el dolor lumbar crónico (CLBP). Según indican algunos autores la limitación del movimiento de la flexión dorsal (FD) de la articulación tibioperonea-astragalina del pie (TPA) puede presentarse como un factor de riesgo en el dolor lumbar crónico. Objetivo: Evaluar el dolor lumbar crónico en sujetos con pies pronadores con limitación de la flexión dorsal del tobillo en al menos un pie, frente a sujetos pronadores con movilidad normal del tobillo. Material y método: estudio descriptivo transversal con muestreo por conveniencia realizado en una muestra compuesta por 126 sujetos con dolor lumbar crónico y pies pronados. Se comparó un grupo de sujetos con CLBP que presentaron limitación de la flexión dorsal de al menos un tobillo, frente a otro grupo de pronadores con CLBP y rango de movimiento normal de tobillo. Como herramientas de valoración de la variable dependiente se utilizó la escala visual analógica (EVA) y el Índice de discapacidad por dolor lumbar de Oswestry (ODI). Resultados: Se encontró correlación positiva entre la limitación de FD de la TPA en sujetos pronadores con CLBP frente al grupo de pronadores con CLBP y FD normal (EVA 4 ± 0,22; ODI: 11,85% ± 1,21). La limitación del movimiento de FD de TPA parece mostrarse como un factor de riesgo en el CLBP (EVA 5,3 ± 0,22; ODI: 17,90% ± 1,42; valor de p ODI = 0,004; EVA 0,009). Conclusiones: Se evidencia un mayor CLBP en el grupo de pronadores con limitación de FD de al menos una TPA frente al grupo de sujetos pronadores con rango normal de movimiento.
Dolor lumbar crónico y pronación unilateral o bilateral del pie
(Elsevier Doyma, 2019) Pabón Carrasco, Manuel; Palomo Toucedo, Inmaculada Concepción; Munuera Martínez, Pedro Vicente; Fernández Seguín, Lourdes María; Castro Méndez, Aurora; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. Departamento de Fisioterapia
Antecedentes y objetivo: Diferentes estudios han defendido la relación entre la pronación del pie y el dolor lumbar crónico (DLC). Sin embargo, no se hallan artículos que analicen la reper cusión que puede existir entre la postura en pronación de un solo pie y su influencia en el DLC frente a la pronación en ambos pies. Por ello, se ha planteado evaluar la intensidad del dolor lumbar en sujetos pronadores con un índice de postura del pie (IPP) superior a +6 en un pie comparado con sujetos con pronación superior a +6 en ambos pies. Material y método: Estudio observacional transversal con muestreo por conveniencia en una muestra total de 116 sujetos. Se comparó el DLC en un grupo con dolor lumbar crónico y posición pronada de un pie (IPP, superior a +6), frente a un grupo de sujetos con DLC e IPP superior a +6 en ambos. Como herramientas de valoración de la variable dependiente se utilizó la escala visual analógica (EVA) y el Índice de discapacidad de Oswestry (IDO) para dolor lumbar. Resultados: No se encontró correlación entre la posición unilateral o bilateral en pronación y la intensidad del DLC. La pronación de un solo pie no pareció mostrarse como mayor factor de riesgo en el DLC que la bilateral (IDO p = 0,700; EVA p = 0,235). Conclusiones: No se encuentran diferencias estadísticas en el DLC en el grupo de pacientes con un IPP del pie en pronación frente a los sujetos con posición en pronación bilateral. Futuros estudios son necesarios.
Exercise and mind-body exercise for feeding and eating disorders: a systematic review with meta-analysis and meta-regressions
(Taylor & Francis LTD, 2024) Martínez Calderón, Javier; Casuso-Holgado, María Jesús; Matías-Soto, Javier; Pineda-Escobar, Saúl; Villar-Alises, Olga; Garcia Muñoz, Cristina; Universidad de Sevilla. Departamento de Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS-1110: Understanding Movement & Self in health from Science
Purpose: To develop a systematic review with meta-analysis to summarize the effectiveness of exercise, regular physical activity, and mind-body exercise on harmful exercise habits, psychological factors, and quality of life in people clinically diagnosed with feeding and eating disorders. Material and methods: Randomized clinical trials and pilot randomized clinical trials were considered. Results: Twelve studies were included. No studies evaluated athletes. No studies examined regular physical activity as the targeted intervention. Quality of life could not be meta-analyzed. Overall, meta-analyses showed that exercise or mind-body exercise was not more effective than controls in reducing depression symptoms, harmful exercise habits, eating behaviors, or emotional regulation skills. However, important methodological and clinical issues were detected in the included studies. This affected the certainty of evidence of the meta-analyzed outcomes which ranged from low to very low. No studies reported in sufficient detail their interventions to be replicated. Conclusions: Overall, exercise and mind-body exercise may be ineffective in improving meta-analyzed outcomes. However, the certainty of evidence ranged from low to very low and the body of knowledge in this field needs to be increased to reach robust conclusions.
Digital pain extent is associated with pain intensity but not with pain-related cognitions and disability in people with chronic musculoskeletal pain: a cross-sectional study
(BMC (BioMed Central), 2022-07-30) Luque-Suárez, Alejandro; Falla, Deborah; Barbero, Marco; Pineda-Galán, Consolación; Marco, Derboni; Giuffrida, Vincenzo; Martínez Calderón, Javier; Universidad de Sevilla. Departamento de Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); University of Malaga; Universidad de Sevilla. CTS-1110: Understanding Movement & Self in health from Science
Background: To evaluate whether digital pain extent is associated with an array of psychological factors such as optimism, pessimism, expectations of recovery, pain acceptance, and pain self-efficacy beliefs as well as to analyse the association between digital pain extent and pain intensity and pain-related disability in people with chronic musculoskeletal pain. Methods: A descriptive cross-sectional study conducted in a primary health care setting was carried out including 186 individuals with chronic musculoskeletal pain. Patient-reported outcomes were used to assess psychological factors, pain intensity, and pain-related disability. Digital pain extent was obtained from pain drawings shaded using a tablet and analysed using novel customized software. Multiple linear regression models were conducted to evaluate the association between digital pain extent and the aforementioned variables. Results: Digital pain extent was statistically significantly associated with pain intensity. However, digital pain extent was not associated with any psychological measure nor with pain-related disability. Discussion: The results did not support an association between digital pain extent and psychological measures.
Analysis of dry needling combined with an exercise program in the treatment of knee osteoarthritis: A randomized clinical trial
(MDPI, 2024-11-26) Agost-González, Aida; Escobio Prieto, Isabel; Barrios-Quinta, Cristo Jesús; Cardero-Durán, María de los Ángeles; Espejo-Antúnez, Luis; Albornoz Cabello, Manuel; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. CTS-1137: NEUROPhysiUS - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders; Universidad de Sevilla. CTS-947: Salud y actividad física para calidad de vida
Background: Therapeutic exercise is recommended for people with knee osteoarthritis (OA), although it could be complemented with other treatments such as dry needling (DN). The purpose of this study was to evaluate and compare the resulting data on pain, functionality, strength and range of motion in subjects with knee osteoarthritis after being treated with a specific therapeutic physical exercise program alone or in combination with the DN technique in the popliteus muscle. Methods: A total of 33 participants were randomly assigned to two groups: the dry needling plus therapeutic physical exercise group (n = 15) and the therapeutic physical exercise alone group (n = 18). Both groups received the same exercise protocol, and the dry-needling group conducted three sessions of this technique over 3 weeks. Results: Variables such as pain, functionality, neuropathic pain, stiffness, strength, range of motion, pain catastrophizing and kinesiophobia were evaluated before and after the intervention, as well as at a follow-up 3 months after the intervention. Significant differences were observed between the two groups in pain intensity, stiffness, functionality, pain catastrophizing and kinesiophobia (p < 0.001). Conclusions: The combination of dry needling targeting the popliteus muscle and therapeutic physical exercise showed better results in terms of pain, functionality and strength compared to therapeutic physical exercise alone, especially after the intervention.
Oxford shoulder instability score: cross-cultural adaptation into Spanish and analysis of its methodological quality
(Biomed central LTD, 2024-11-23) Aldon-Villegas, Rocio; Chamorro Moriana, Gema; Espuny Ruiz, Fernando; Benítez Lugo, María Luisa; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. CTS-305: Área de Fisioterapia
Background Oxford Shoulder Instability Score (OSIS) is a patient reported outcome measure designed specifically to assess functional difficulties resulting from shoulder instability. The main aim of this study was to cross-culturally adapt the OSIS to Spanish. Secondary, it aimed to analyse its methodological quality. Methods A cross-cultural adaptation to Spanish has been carried out following the recommendations of COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) with a sample of 167 cases of shoulder instability. Inclusion criteria were: subjects with instability symptoms in at least one shoulder with or without clinical diagnosis; aged between 18 and 60. The following psychometric properties were evaluated: validity (construct, internal and external), reliability (internal consistency, test-retest and measurement error), discriminant ability and feasibility. The methodological quality was addressed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and COSMIN Risk of Bias checklist (COSMIN RoB). Results The construct validity obtained an OSIS correlation with the Simple Shoulder Test of r = 0.636 and with the Western Ontario Shoulder Instability of r = 0.80. The unidimensionality of the OSIS was confirmed through second-order factor analysis. Cronbach’s alpha and intraclass correlation coefficient were both 0.93 (IC95%: 0.91–0.94). Standard error of measurement was 0.70, and the percentage of error and smallest detectable change were 1.46% and 1.94, respectively. No floor or ceiling effects were found. Assessing feasibility of OSIS, the participants answered all questions, had no questions and completion time was: mean 2 min 30 s; SD ± 1 min. Regarding methodological quality, the study showed low risk of bias in the areas of patient selection, index test, reference standard and flow and timing, as well as low concern regarding applicability in the domains of patient selection, index test and reference standard according to QUADAS-2. In relation to COSMIN RoB, all psychometric properties, except for content validity, obtained very good results. Conclusions The Spanish version of OSIS offers valid, reliable and feasible functional outcome measures for Spanish-speaking subjects with shoulder instability, based on its psychometric properties and its methodological quality.
European* clinical practice recommendations on opioids for chronic noncancer pain – Part 1: Role of opioids in the management of chronic noncancer pain
(Wiley, 2021-03-02) Häuser, Winfried; Morlion, Bart; Vowles, Kevin E; Bannister, Kirsty; Buchser, Eric; Casale, Roberto; Suárez Serrano, Carmen; Krčevski Škvarč, Nevenka; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. CTS305: Área de fisioterapia.
Background: Opioid use for chronic non- cancer pain (CNCP) is complex. In the absence of pan- European guidance on this issue, a position paper was commissioned by the European Pain Federation (EFIC). Methods: The clinical practice recommendations were developed by eight scientific societies and one patient self- help organization under the coordination of EFIC. A systematic literature search in MEDLINE (up until January 2020) was performed. Two categories of guidance are given: Evidence- based recommendations (supported by evidence from systematic reviews of randomized controlled trials or of obser vational studies) and Good Clinical Practice (GCP) statements (supported either by indirect evidence or by case- series, case- control studies and clinical experience). The GRADE system was applied to move from evidence to recommendations. The rec ommendations and GCP statements were developed by a multiprofessional task force (including nursing, service users, physicians, physiotherapy and psychology) and formal multistep procedures to reach a set of consensus recommendations. The clini cal practice recommendations were reviewed by five external reviewers from North America and Europe and were also posted for public comment. Results: The key clinical practice recommendations suggest: (a) first optimizing estab lished non- pharmacological treatments and non- opioid analgesics and (b) considering opioid treatment if established non- pharmacological treatments or non- opioid analge sics are not effective and/or not tolerated and/or contraindicated. Evidence- and clini cal consensus- based potential indications and contraindications for opioid treatment are presented. Eighteen GCP recommendations give guidance regarding clinical evaluation, as well as opioid treatment assessment, monitoring, continuation and discontinuation. Conclusions: Opioids remain a treatment option for some selected patients with CNCP under careful surveillance. Significance: In chronic pain, opioids are neither a universal cure nor a universally dangerous weapon. They should only be used for some selected chronic noncancer pain syndromes if established non- pharmacological and pharmacological treatment options have failed in supervised pain patients as part of a comprehensive, multi- modal, multi- disciplinary approach to treatment. In this context alone, opioid therapy can be a useful tool in achieving and maintaining an optimal level of pain control in some patients
Effectiveness of resistance exercise for depression, fatigue, and sleep quality in women with fibromialgia: a systematic review and meta‐analysis
(Wiley, 2024) Rodríguez-Domínguez, Álvaro-José; Rebollo Salas, Manuel; Chillón Martínez, Raquel; Rosales Tristancho, Abel; Arana-Rodríguez, Andrés; Jiménez Rejano, José Jesús; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Economía Aplicada I; Universidad de Sevilla. CTS-305: Área de fisioterapia
Purpose: Fibromyalgia is a chronic disease that mainly affects women, deteriorating the quality of life of these patients. Resistance exercise (RE) has been shown to be beneficial in this disease. The objective of this study is to evaluate the effectiveness of RE for depression, fatigue, and sleep quality in women with fibromyalgia. Design and Methods: A systematic review with meta-analysis was conducted until September 1, 2024. Seven databases were searched as follows: PubMed, Cochrane Library, Web of Science, Scopus, Physiotherapy Evidence Database, Dialnet, and Cumulative Index to Nursing and Allied Health Literature. Randomized clinical trials were conducted in women with a diagnosis of fibromyalgia, including RE as the only intervention in any of the groups and to assess depression, fatigue, and sleep quality. For meta-analyses, we calculated the standardized difference of means and its standard error. A random-effects model was used. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). PROSPERO Registration: CRD42021256162. Findings: Eleven trials were included in the systematic review and eight in the meta-analysis (n = 664). RE showed statistically significant improvements in depression (SMD = −0.54; 95% CI [−0.92, −0.16], p = 0.005) and fatigue (SMD = −0.83; 95% CI [−1.41–0.25], p = 0.005). No significant differences were found in sleep quality (SMD = −0.99; 95% CI [−2.40, 0.43], p = 0.17). In general, the methodological quality of the included trials was good. Practice Implication: RE is an effective tool to improve depression and fatigue in women with fibromyalgia, achieving clinically relevant improvements of more than 50% in symptoms related to depression. RE did not show benefits for sleep quality, although this finding may be due to a lack of studies. More studies are needed to determine the effectiveness of RE on sleep quality.
Descripción de la práctica profesional de la Fisioterapia en España en función de criterios generacionales
(Sociedad Andaluza de Fisioterapia, 2013) Chillón Martínez, Raquel; Rebollo Roldán, Jesús; Suárez Serrano, Carmen; Jiménez Rejano, José Jesús; Gallego-Izquierdo, Tomás; Chamorro Moriana, Gema; Universidad de Sevilla. Departamento de Fisioterapia; Rebollo Roldán, Jesús; Universidad de Sevilla. CTS-305: Área de fisioterapia
Introducción: los estudios sobre la caracterización de la práctica profesional de la Fisioterapia en España son escasos, y los que hay se caracterizan por la confusión en la definición de las dimensiones que la componen y dispersión en los datos. Objetivos: identificar las dimensiones con las que puede estandarizarse el análisis de la práctica profesional en Fisioterapia y categorizar estas dimensiones en función de la relevancia otorgada por los fisioterapeutas. Material y método: diseño cualitativo histórico, implementándose una entrevista semiestructurada de 5 ítems a 45 fisioterapeutas tras un muestreo teórico y en «bola de nieve», realizando una categorización por edad (21-40 años, 41-55, >55), sexo y perfil profesional. La codificación se realiza aplicando la Grounded Theory con el Atlas ti 5.0, el descriptivo se lleva a cabo con el SPSS 17 y el análisis de correspondencias múltiples con el SPAD N. Resultados: las dimensiones con las que se puede estandarizar el análisis de la práctica profesional en Fisioterapia suman un total de 44, entre funciones, concepciones, procedimientos, campos disciplinares y tecnologías aplicadas. Las dimensiones más relevantes según estas categorías son: la función asistencial (84,4 %), la cualificación profesional (46,7 %), la terapia manual (83,5 %) y la electroterapia (75,6 %). Se identifican dos factores que permiten visualizar las correspondencias múltiples entre variables y que explican un 71,6 % de la relación entre ellas, destacando la vinculación existente entre fisioterapeutas de 21-40 años con la cualificación profesional, los de 41-55 con la importancia del método en Fisioterapia y los mayores de 55 con la identidad y estatus profesional. Conclusiones: la caracterización de la práctica profesional de la Fisioterapia en España en la 2ª mitad del siglo XX se describe desde tres grupos generacionales, explicando la tendencia de relación interdimensiones con dos factores, destacando la función asistencial, la cualificación profesional y la terapia manual como elementos clave.
Analysis of spatial and temporal step parameters during crutch-assisted gait as a dual-task: a pilot study
(ASME, 2018) Ridao Fernández, María Del Carmen; Ojeda Granja, Joaquín; Chamorro Moriana, Gema; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Ingeniería Mecánica y de Fabricación; Spanish Ministry of Economics and Competitiveness; Telefonica Chair "Intelligence in Networks" of the University of Seville, Spain; Universidad de Sevilla. TEP-111: Ingeniería mecánica; Universidad de Sevilla. CTS-305: Área de fisioterapia
The main objective was to analyze the changes in the spatial and temporal step parameters during a dual-task: walking with a forearm crutch to partially unload the body weight of the subject. The secondary objective was to determine the influence of the use of the crutch with the dominant or nondominant hand in the essential gait parameters. Seven healthy subjects performed gait without crutches (GWC) and unilateral assisted gait (UAG) with the crutch carried out by dominant hand (dominant crutch (DC)) and nondominant hand (nondominant crutch (NDC)). Gait was recorded using a Vicon System; the GCH System 2.0 and the GCH Control Software 1.0 controlled the loads. The variables were step length, step period, velocity, step width, and step angle. The Wilcoxon signed-rank test compared GWC and UAG while also analyzing the parameters measured for both legs with DC and NDC in general and in each subject. Wilcoxon test only found significant differences in 1 of the 15 general comparisons between both legs. In the analysis by subject, step length, step period, and velocity showed significant differences between GWC and UAG. These parameters obtained less differences in DC. The effect of a forearm crutch on UAG caused a reduction in step length and velocity, and an increase in step period. However, it did not entail changes in step angle and step width. UAG was more effective when the DC carried the crutch. The unloading of 10% body weight produced an assisted gait which closely matched GWC.
Efecto del kinesiotape en la inestabilidad crónica de tobillo. Revisión bibliográfica
(Sociedad Andaluza de Fisioterapia, 2018) Navarro-rico, Cayetano; Herrera-monge, Patricia; Zurita-castañeda, Celia; Chamorro Moriana, Gema; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. CTS-305: Area de fisioterapia
Introducción: el esguince del ligamento lateral externo del tobillo es una de las patologías más frecuentes en las actividades básicas de la vida diaria y en el deporte. Un alto porcentaje desarrollan finalmente dolor e inestabilidad, además de esguinces de repetición, es decir, inestabilidad crónica de tobillo. Actualmente, los vendajes con kinesiotape son empleados con asiduidad para su tratamiento. Objetivo: el objetivo de esta revisión bibliográfica fue compilar y analizar el efecto del kinesiotape, ya sea neuromuscular o biomecánico, en la funcionalidad de tobillos con inestabilidad crónica. Material y método: se realizó una búsqueda de la literatura en Pubmed, CINAHL, Scopus y ScienceDirect, más un estudio que se añadió por su relevancia. Criterios de inclusión: sujetos con inestabilidad crónica de tobillo, kinesiotape como única forma de tratamiento y valoración del efecto del vendaje en la funcionalidad. Se excluyeron aquellos que usaran muestra de pacientes neurológicos y sujetos sanos que no sean referencia de normalidad. Resultados: fueron seleccionados y analizados 6 artículos. Mostraron características muy heterogéneas en diseño, técnicas de vendaje, y métodos de evaluación, entre otros. Se encontraron resultados significativos y eficaces en 4 estudios en relación a la propiocepción y el equilibrio; mientras que en 3 artículos no hubo resultados significativos para el equilibrio, la propiocepción y la activación muscular. Conclusión: no existe evidencia científica sólida en base a esta revisión hasta el momento del efecto del kinesiotape sobre la funcionalidad en la inestabilidad crónica de tobillo con respecto a la propiocepción, el equilibrio y la activación muscular.
Evaluación de la organización y la planificación de un programa de estancias clínicas de Fisioterapia
(Sociedad Andaluza de Fisioterapia, 2013) Tomás Gallego Izquierdo; Daniel Pecos Martín; Chamorro Moriana, Gema; Rebollo Salas, Manuel; M. I. Fernández Tejeda; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. CTS-305: Area de fisioterapia
Introducción: los programas de Estancias Clínicas de Fisioterapia son considerados programas educativos ordinarios y complejos. Un elemento clave es la organización y planificación. Objetivo: valorar mediante un cuestionario de encuesta la organización y planificación de un programa de Estancias Clínicas. Participantes y método: estudio descriptivo observacional, en el que participan 117 estudiantes de Fisioterapia que completaron el programa de Estancias Clínicas. El Cuestionario para la Valoración de la Organización de las Estancias Clínicas (CVOEC) consta de 17 ítems con una escala de 1 a 4. Los cálculos sobre los ítems del cuestionario CVOEC se han concretado en las medianas y las desviaciones con respecto a la mediana. El análisis se realizó estudiando el grado de acuerdo de los aspectos valorados en el cuestionario, agrupando los valores de dos en dos reduciendo la información a una forma dicotómica: medianas con valores 1 y 2 valoración mala, medianas con valores 3 y 4 valoración buena. Se busca la existencia de diferencias por razón de sexo, edad, nota y forma de acceso. Resultados: el cuestionario muestra una aceptable fiabilidad (? de Cronbach = 0,817); en el análisis factorial por componentes principales se retienen 5 factores que explican el 60,863 % de la varianza. Se analizaron las 17 frases del cuestionario mediante el Índice Flesch-Szigriszt obteniéndose un valor de 46,71. El ítem O10 es el mejor valorado (Mediana 4); le siguen los ítems: O.1, O.3, O.4, O.5, O.6a, O.6c, O.8, O.9, O.11, O.12, O.13 y O.15 (Mediana 3); los ítems peor valorados: O.6b, O.14 y O.15 (Mediana 2). Se encontraron diferencias por razón de sexo, edad y nota. Conclusiones: doce de los 17 ítems han obtenido una Mediana de 3, uno una Mediana de 4 y tres una Mediana de 2. A mayor edad y más nota, se encuentra menos acuerdo en los ítems con diferencias significativas.
Estudio de la calidad de la medida de cargas ejercidas sobre bastones canadienses instrumentados
(Sociedad Andaluza de Fisioterapia, 2011) Chamorro Moriana, Gema; Rebollo Roldán, Jesús; Jiménez Rejano, José Jesús; García Valenzuela, Aurelio; Chillón Martínez, Raquel; García Delgado, Antonio; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Tecnología Electrónica; Universidad de Sevilla. CTS-305: Area de fisioterapia
Introducción: en la actualidad no hemos encontrado ningún sistema de medición de cargas adaptado a bastones canadienses, que sea factible en la práctica clínica diaria para conocer y corregir la fuerza aplicada por los pacientes sobre los mismos durante la marcha asistida. Objetivo: conocer la calidad de la medida de las cargas ejercidas sobre bastones canadienses que hemos instrumentado, como primer paso en la validación de un sistema, que hemos ideado, para la medición y el registro informatizado de tales cargas, cuando son ejercidas por los pacientes durante la marcha asistida. Material y método. Diseño: estudio experimental de la medida, y de concordancia. Variables: masa aplicada, mediciones efectuadas por los bastones, y errores en las mediciones. Muestra: nueve pesas calibradas de 5 a 45 kg. Intervalo de confianza 95 %. Resultados: el análisis de la fiabilidad mediante el coeficiente de correlación intraclase y el alfa de Cronbach, así como la correlación entre las variables medida verdadera y observada, aplicando el coeficiente Rho de Spearman y el de Pearson fueron de 1 (p < 0,001). El análisis de la varianza mostró un nivel de significación p > 0,05. El error promedio en las mediciones fue de 0,1097, ajustándose la variable error a la distribución normal (p > 0,05 en la prueba de Shapiro-Wilk). Discusión: el error, considerado azaroso, se tradujo en 110 gr, indicando unos niveles muy bajos del mismo, que oscilaban entre 62 y 167 gr. Por tanto, aceptamos que no hay diferencia entre la medida verdadera, las medidas observadas con el bastón derecho y con el bastón izquierdo. Conclusiones: los bastones canadienses que hemos instrumentado constituyen una herramienta fiable y válida para medir las cargas aplicadas por pesas calibradas. Es indiferente el empleo de uno u otro bastón, dado que no existen diferencias significativas entre sus mediciones.
Effects of respiratory training on pulmonary function, cough, and functional independence in patients with amyotrophic lateral sclerosis
(Mdpi Ag, 2024-11-01) Magni, Eleonora; Hochsprung, Anja; Cáceres Matos, Rocío; Pabón Carrasco, Manuel; Heredia-Camacho, Beatriz; Solís-Marcos, Ignacio; Luque Moreno, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Fisioterapia
Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspi ratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function
Do manual therapy techniques have a positive effect on quality of life in people with tension-type headache? A randomized controlled trial
(Edizioni Minerva Medica, 2016) Espí-López, G.V.; Rodríguez Blanco, Cleofás; Oliva Pascual-Vaca, Ángel; Molina-Martinez, F; Falla, Deborah; Universidad de Sevilla. Departamento de Fisioterapia
Background: Controversy exists regarding the effectiveness of manual therapy for the relief of tension-type headache (TTH). However most studies have addressed the impact of therapy on the frequency and intensity of pain. No studies have evaluated the potentially significant effect on the patient's quality of life. Aim: To assess the quality of life of patients suffering from TTH treated for 4 weeks with different manual therapy techniques. Design: Factorial, randomized, single-blinded, controlled clinical trial. Setting: Specialized center for the treatment of headache. Population: Seventy-six (62 women) patients aged between 18 and 65 years (age: 39.9±10.9) with either episodic or chronic TTH. Methods: Patients were divided into four groups: suboccipital inhibitory pressure; suboccipital spinal manipulation; a combination of the two treatments; control. Quality of life was assessed using the SF-12 questionnaire (considering both the overall score and the different dimensions) at the beginning and end of treatment, and after a one month follow-up. Results: Compared to baseline, the suboccipital inhibition treatment group showed a significant improvement in their overall quality of life at the one month follow-up and also showed specific improvement in the dimensions related to moderate physical activities, and in their emotional role. All the treatment groups, but not the control group, showed improvements in their physical role, bodily pain, and social functioning at the one month follow-up. Post treatment and at the one month follow-up, the combined treatment group showed improved vitality and the two treatment groups that involved manipulation showed improved mental health. Conclusions: All three treatments were effective at changing different dimensions of quality of life, but the combined treatment showed the most change. The results support the effectiveness of treatments applied to the suboccipital region for patients with TTH. Clinical rehabilitation impact: Manual therapy techniques applied to the suboccipital region, for as little as four weeks, offered a positive improvement in some aspects of quality of life of patient's suffering with TTH.
EFisiotrack system for monitoring therapeutic exercises in patients with shoulder orthopedic injuries in a hospital Setting: a pilot feasibility study
(MDPI, 2024-07-24) Hernandez-Sanchez, Sergio; Roses-Conde, Jorge; Martinez-Llorens, Neus; Ruiz, Daniel; Espejo-Antúnez, Luis; Tomás-Rodríguez, Isabel; Toledo-Marhuenda, Jose Vicente; Albornoz Cabello, Manuel; Universidad de Sevilla. Departamento de Fisioterapia
To assess the effects of the eFisioTrack monitoring system on clinical variables in patients with prescribed physiotherapy for shoulder injuries, twenty-four adult patients with shoulder orthopaedic injuries who underwent physical therapy treatment in a hospital setting participated in the study (twelve in the experimental group and twelve as controls). Clinical outcome measures were shoulder function and pain (Constant–Murley Score and Disabilities of the Arm, Shoulder, and Hand or DASH score). Each variable was measured by a blinded physiotherapist at baseline and at one month follow-up. Patients performed the prescribed exercises either supervised by the physiotherapist (control group) or in a separate room without therapist supervision (experimental group). There were no statistically significant differences between groups before treatment or at follow-up for any outcomes (p ≥ 0.05). There was a statistically significant decrease (p ≤ 0.05) of at least 10 points in both groups for the DASH score at follow-up. Differences in the total score and subjective components of the Constant–Murley were also evidenced within groups. The use of the eFisioTrack system showed similar results in clinical measures compared to those performed under the direct supervision of the physiotherapist. This approach might be suitable for providing an effective shoulder exercise program at home.
Effects of adding electro-massage to manual therapy for the treatment of individuals with myofascial temporomandibular pain: a randomized controlled trial
(Universidade de São Paulo, 2024-09-16) Espejo-Antúnez, Luis; Cardero-Durán, María de Los Ángeles; Heredia Rizo, Alberto Marcos; Casuso-Holgado, María Jesús; Albornoz Cabello, Manuel; Universidad de Sevilla. Departamento de Fisioterapia
Objective: To evaluate the effect of the addition of dynamic cervical electrical stimulation (electro-massage, ES) to manual therapy (MT), compared to MT by itself, in individuals with myofascial temporomandibular pain. Methodology: A total of 46 participants with bilateral myofascial temporomandibular pain for at least three months were distributed into two groups. Group 1 (n=21) received local MT consisting of soft tissue mobilization and release techniques over the neck and temporomandibular regions. Group 2 (n=25) received an ES procedure in the cervical region combined with the same intervention as group 1. All participants underwent a 2-week protocol. The primary outcomes were pain intensity (Visual Analogue Scale), pressure pain threshold (PPT) at the masseter and upper trapezius muscles (algometer), and pain-free vertical mouth opening (manual gauge). The secondary outcome was active cervical range-of-movement. Measurements were taken at baseline, immediately after intervention, and at a 4-week follow-up. Results: The ANOVA revealed significant changes over group*time, with better results for group 2 (large effect sizes) regarding pain intensity (p< 0.001; η2>0.14), pressure pain sensitivity and mouth opening (p<0.001; η2>0.14). Similar findings were observed for active cervical range-of-movement in all directions (p<0.001; η2>0.14), except rotation (p≥0.05). Conclusion: Electrical stimulation therapy over the cervical region combined with a MT protocol over the neck and temporomandibular joint shows better clinical benefits than MT by itself in subjects with myofascial temporomandibular pain. Registration code: NCT04098952.
Effectiveness of a treatment involving soft tissue techniques and/or neural mobilization techniques in the management of tension-type headache. A randomized controlled trial
(W B Saunders Co-Elsevier Inc, 2017-02) Ferragut-Garcías, Alejandro; Plaza Manzano, Gustavo; Rodríguez Blanco, Cleofás; Velasco-Roldán, Olga; Pecos Martín, Daniel; Oliva Pascual-Vaca, Jesús; Llabrés-Bennasar, Bartomeu; Oliva Pascual-Vaca, Ángel; Universidad de Sevilla. Departamento de Fisioterapia
Objective To evaluate the effects of a protocol involving soft tissue techniques and/or neural mobilization techniques in the management of patients with frequent episodic tension-type headache (FETTH) and those with chronic tension-type headache (CTTH). Design Randomized, double-blind, placebo-controlled before and after trial. Setting Rehabilitation area of the local hospital and a private physiotherapy center. Participants Patients (N=97; 78 women, 19 men) diagnosed with FETTH or CTTH were randomly assigned to groups A, B, C, or D. Interventions (A) Placebo superficial massage; (B) soft tissue techniques; (C) neural mobilization techniques; (D) a combination of soft tissue and neural mobilization techniques. Main Outcomes Measures The pressure pain threshold (PPT) in the temporal muscles (points 1 and 2) and supraorbital region (point 3), the frequency and maximal intensity of pain crisis, and the score in the Headache Impact Test-6 (HIT-6) were evaluated. All variables were assessed before the intervention, at the end of the intervention, and 15 and 30 days after the intervention. Results Groups B, C, and D had an increase in PPT and a reduction in frequency, maximal intensity, and HIT-6 values in all time points after the intervention as compared with baseline and group A (P<.001 for all cases). Group D had the highest PPT values and the lowest frequency and HIT-6 values after the intervention. Conclusions The application of soft tissue and neural mobilization techniques to patients with FETTH or CTTH induces significant changes in PPT, the characteristics of pain crisis, and its effect on activities of daily living as compared with the application of these techniques as isolated interventions.
Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: a randomised controlled trial
(Elsevier Science Ltd, 2014-09) Antolinos-Campillo, P. J.; Oliva Pascual-Vaca, Ángel; Rodríguez Blanco, Cleofás; Heredia Rizo, Alberto Marcos; Espí-López, G.V.; Ricard, François; Universidad de Sevilla. Departamento de Fisioterapia
Abstract Objectives To assess the immediate effect of a suboccipital muscle inhibition (SMI) technique on: (a) neck pain, (b) elbow extension range of motion during the upper limb neurodynamic test of the median nerve (ULNT-1), and (c) grip strength in subjects with cervical whiplash; and determine the relationships between key variables. Design Randomised, single-blind, controlled clinical trial. Setting Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Spain. Participants Forty subjects {mean age 34 years [standard deviation (SD) 3.6]} with Grade I or II cervical whiplash and a positive response to the ULNT-1 were recruited and distributed into two study groups: intervention group (IG) (n=20) and control group (CG) (n=20). Interventions The IG underwent the SMI technique for 4minutes and the CG received a sham (placebo) intervention. Measures were collected immediately after the intervention. Main outcome measures The primary outcome was elbow range of motion during the ULNT-1, measured with a goniometer. The secondary outcomes were self-perceived neck pain (visual analogue scale) and free-pain grip strength, measured with a digital dynamometer. Results The mean baseline elbow range of motion was 116.0° (SD 10.2) for the CG and 130.1° (SD 7.8) for the IG. The within-group comparison found a significant difference in elbow range of motion for the IG [mean difference −15.4°, 95% confidence interval (CI) −20.1 to −10.6; P=0.01], but not for the CG (mean difference −4.9°, 95% CI −11.8 to 2.0; P=0.15). In the between-group comparison, the difference in elbow range of motion was significant (mean difference −10.5°, 95% CI −18.6 to −2.3; P=0.013), but the differences in grip strength (P=0.06) and neck pain (P=0.38) were not significant. Conclusion The SMI technique has an immediate positive effect on elbow extension in the ULNT-1. No immediate effects on self-perceived cervical pain or grip strength were observed.
Effect of cervical vs. thoracic spinal manipulation on peripheral neural features and grip strength in subjects with chronic mechanical neck pain: a randomized controlled trial
(Edizioni Minerva Medica, 2017) Bautista-Aguirre, Francisco; Oliva Pascual-Vaca, Ángel; Heredia Rizo, Alberto Marcos; Boscá-Gandía, Juan J.; Ricard, François; Rodríguez Blanco, Cleofás; Universidad de Sevilla. Departamento de Fisioterapia
BACKGROUND: Cervical and thoracic spinal manipulative therapy has shown positive impact for relief of pain and improve function in non specific mechanical neck pain. Several attempts have been made to compare their effectiveness although previous studies lacked a control group, assessed acute neck pain or combined thrust and non-thrust techniques. AIM: To compare the immediate effects of cervical and thoracic spinal thrust manipulations on mechanosensitivity of upper limb nerve trunks and grip strength in patients with chronic non-specific mechanical neck pain. DESIGN: Randomized, single-blinded, controlled clinical trial. SETTING: Private physiotherapy clinical consultancy. POPULATION: Eighty-eight subjects (32.09±6.05 years; 72.7% females) suffering neck pain (grades I or II) of at least 12 weeks of duration. METHODS: Participants were distributed into three groups: 1) cervical group (N.=28); 2) thoracic group (N.=30); and 3) control group (N.=30). One treatment session consisting of applying a high-velocity low-amplitude spinal thrust technique over the lower cervical spine (C7) or the upper thoracic spine (T3) was performed, while the control group received a sham-manual contact. Measurements were taken at baseline and after intervention of the pressure pain threshold over the median, ulnar and radial nerves. Secondary measures included assessing free-pain grip strength with a hydraulic dynamometer. RESULTS: No statistically significant differences were observed when comparing between-groups in any of the outcome measures (P>0.05). Those who received thrust techniques, regardless of the manipulated area, reported an immediate increase in mechanosensitivity over the radial (both sides) and left ulnar nerve trunks (P<0.05), and grip strength (P<0.001). For those in the control group, right hand grip strength and pain perception over the radial nerve also improved (P≤0.025). CONCLUSIONS: Low-cervical and upper-thoracic thrust manipulation is no more effective than placebo to induce immediate changes on mech anosensitivity of upper limb nerve trunks and grip strength in patients with chronic non-specific mechanical neck pain. CLINICAL REHABILITATIO N IMPACT : A single treatment session using cervical or thoracic thrust techniques is not enough to achieve clini cally relevant changes on neural mechanosensitivity and grip strength in chronic non-specific mechanical neck.

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