A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome.

BACKGROUND: There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE: To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN: Randomized clinical trial. METHODS: Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS: At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION: MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS: MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.

Effect of narrative photography to improve physical therapy students' learning outcomes when studying heart transplantation: A randomized controlled trial.

Physical therapy students must learn about heart transplantation. They need to know how to care for these patients' emotions and needs. The study aimed to compare the effectiveness of a narrative photography (NP) program and a traditional learning (TL) program in physical therapy students' knowledge, satisfaction, empathy, and moral sensitivity. A two-armed assessor-blinded randomized controlled trial was carried out. One hundred and seventeen physical therapy students participated in the study. They were divided into two groups: (i) NP group (n = 56) and (ii) TL group (n = 61). At the end of the program, NP group's knowledge increased when compared with the TL group (p = 0.02). 90.57% of the sample was very satisfied/satisfied with the NP method, and 88.68% felt that NP helped them to understand the importance of considering subjective realities. In conclusion, NP improved knowledge and satisfaction compared with the TL group. These results suggest that NP may be a useful method to improve the academic outcomes of physical therapy students in the heart transplantation field; thus, NP may be considered a teaching-learning methodology of choice in physical therapy students.

Effects of mirror neuron activation therapies on functionality in older adults: Systematic review and meta-analysis.

PURPOSE: To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls. METHODS: A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases. RESULTS: Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes. CONCLUSIONS: Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial.

Effects of an Oral Stimulation Program on Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-Analysis.

AIMS: To review the literature on the effects of unimodal sensorimotor stimulation protocols on feeding outcomes in very preterm and moderate to late preterm infants (PIs). METHODS: Five databases were searched up to April 2022. Studies comparing unimodal sensorimotor stimulation protocols based on the combination of manual oral stimulation with NNS against usual care in PIs, on-time transition to full oral feeding (FOF), feeding efficacy, length of hospital stay, and/or body weight gain. RESULTS: Eleven studies were included. Compared to usual care, unimodal sensorimotor stimulation protocols based on manual oral stimulation combined with NNS demonstrated to be more effective in decreasing time transition to FOF (standardized mean difference [95%CI] - 1.08 [-1.74, -0.41]), improving feeding efficacy (2.15 [1.18, 3.13]) and shortening length of hospital stay (-0.35 [-0.68, -0.03]). However, the proposed intervention was not effective in improving weight gain (0.27 [-0.40, 0.95]). There were no significant differences according to gestational age (p > .05). CONCLUSIONS: Based on fair-to-high quality evidence, unimodal sensorimotor stimulation protocols combined with NNS reduce time transition to FOF, improve feeding efficacy, and shorten the length of hospital stay; yet the proposed intervention yielded no significant effects on body weight gain when compared to usual care in PIs.

Fibromyalgia syndrome is associated with sexual dysfunction regardless of physical activity status: a cross-sectional study.

BACKGROUND: Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. AIM: The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. METHODS: The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. OUTCOMES: The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. RESULTS: There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). CLINICAL IMPLICATIONS: Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. STRENGTHS AND LIMITATIONS: The main limitation is that the outcome measures were self-reported. CONCLUSION: We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.

Effects of therapeutic exercise in primary dysmenorrhea: an umbrella and mapping review.

PURPOSE: Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE) on PD. METHODS: A systematic search was carried out in PubMed, Embase, SPORTDiscus, CINAHL, and PEDro (December 10, 2022). The outcome measures assessed were menstrual pain intensity, menstrual pain duration, and quality of life. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the advisory committee grading criteria guidelines. RESULTS: Nine systematic reviews were included. The results showed that TE, regardless of the exercise model and intensity, has a clinical effect in improving menstrual pain intensity in women with PD with moderate quality of evidence. In addition, the results showed that TE has a clinical effect in improving the duration of menstrual pain in women with PD with a limited quality of evidence. However, the results are controversial on the improvement of quality of life in women with PD with a limited quality of evidence. CONCLUSIONS: TE seems an effective option to implement in women with PD to improve the intensity and duration of menstrual pain. We cannot draw robust results for quality of life due to the low number of primary studies. More research in this field can help us establish more robust conclusions, as well as to assess whether there is one exercise model or intensity of training that is more effective than others.PROSPERO number: This review was previously registered in PROSPERO (CRD42022371428).

Effect of virtual running with exercise on functionality in pre-frail and frail elderly people: randomized clinical trial.

BACKGROUND: Virtual mirror therapies could increase the results of exercise, since the mirror neuron system produces an activation of motor execution cortical areas by observing actions performed by others. In this way, pre-frail and frail people could use this system to reach an exercise capacity threshold and obtain health benefits. AIM: The aim of this study is to evaluate the effects of a virtual running (VR) treatment combined with specific physical gait exercise (PE) compared to placebo VR treatment combined with PE on functionality, pain, and muscular tone in pre-frail and frail older persons. METHODS: A single blinded, two-arm, randomised controlled trial design was employed. Thirty-eight participants were divided into two intervention arms: Experimental Intervention (EI) group, in which VR and gait-specific physical exercises were administered and Control Intervention (CI) group, in which a placebo virtual gait and the same exercise programme was administered. Functionality, pain, and tone were assessed. RESULTS: EI group improved in aerobic capacity, functional lower-limb strength, reaction time, and pain, while CI group remained the same. Regarding static balance and muscle tone, no differences were found for either group. Further analysis is needed to asses VR effectiveness for improving gait, stand-up and sit-down performance and velocity. CONCLUSIONS: Virtual running therapy appears to enhance capacities related with voluntary movements (i.e., aerobic capacity, functional lower-limb strength, and reaction time) and reduce pain.

Technology Usage, Physical Activity, and Motivation in Patients With Heart Failure and Heart Transplantation.

The cross-sectional study enrolled 231 patients with heart failure (n = 115; 60.87% were men; mean age, 74.34 ± 12.70 years) and heart transplantation (n = 116; 72.41% were men; mean age, 56.85 ± 11.87 years) who self-reported their technology usage, physical activity, and source of motivation for exercise. Patients with heart failure were significantly older ( P = .0001) than patients with heart transplantation. Physical activity levels in patients with heart failure decreased as the New York Heart Association classification increased. Patients with heart failure reported significantly lower physical activity than patients with heart transplantation ( P = .0008). Smartphones were the most widely used electronic device to access the Internet in both groups. Patients with heart transplantation seemed to use more than one device to access the Internet. In both groups, patients reporting more technology usage also reported higher levels of physical activity. Patients who accessed the Internet daily reported lower levels of physical activity. Whereas patients with heart failure identified encouragement by family members as a source of motivation for exercise, patients with heart transplantation reported that they were likely to exercise if motivated by their healthcare provider. Patients with heart failure and heart transplantation have unique technological and motivational needs that need consideration for mobile health-driven interventions.

Short-Term Effects of Manual Therapy on Balance: A Multicenter, Randomized, Double-Blind Controlled Trial.

OBJECTIVE: The purpose of this study was to analyze short-term changes in dynamic and static balance after a manual therapy protocol in healthy participants and analyze any repercussions on mood and perception of change after applying articulatory techniques. METHODS: A single-blind, randomized, multicenter clinical trial was conducted. Participants were allocated to either a manual therapy group (MTG) (n = 101) or a control group (CG) without intervention (n = 99), and measures were taken before treatment, after the intervention, and 1 week after treatment. Assessments included the Star Excursion Balance Test, Unipedal Stance Test (UPST), Profile of Mood States (POMS), and Patient Global Impression of Change (PGIC) scale. RESULTS: Two hundred healthy participants completed the study (mean age, 22 [SD = 2.67]). There was a statistically significant interaction between groups and time measurements in the right leg for anterior (P = .003), posteromedial (P < .001), and posterolateral (P = .001) directions in favor of the MTG, as well as in the left leg for anterior (P < .001), posteromedial (P < .001), and posterolateral (P = .012) directions. The analysis failed to show statistically significant interactions between any of the factors for the UPST and POMS (P > .05). The MTG showed a significant improvement compared to the CG after treatment (P = .003) and at 1-week follow-up (P < .001) on the PGIC scale. CONCLUSION: The results suggest the MT intervention was effective on dynamic balance in post-intervention in healthy participants, and some of the directions maintained the results at 1-week follow-up. Perception of change in post-treatment and 1-week follow-up also significantly improved. The protocol did not seem to produce changes in static balance and mood states. Positive changes after manual therapy were maintained in the short term.

Impact of physical activity levels on the ability to maintain static trunk posture in older adults.

PROPOSE: to assess the impact of physical activity (PA) levels on sitting posture in the older adults. METHODS: One hundred and twenty individuals were divided into three groups according their PA levels: vigorous group (VG); moderate group (MG); low group (LG). The ability to maintain static trunk posture in sitting position as assessed based on the cervical angle (CA) and thoracic angle (TA) was measured. RESULTS: There were no significant differences between measurements in CA for the VG. However, LG and MG participants exhibited a significant decrease in CA from minute 1 to 10 and from minute 2 to 10, respectively. In the thoracic region, only the MG exhibited significant differences in TA from minute 2 to 10 compared to minute 1 (p < 0.05). No significant differences were found in TA between measurements for either VG or LG. CONCLUSIONS: PA has a high impact on the ability to maintain static trunk posture in the older adults.

Systematic review of aquatic therapeutic exercise efficacy in breast cancer survivors.

PURPOSE: The aim of this review is to establish the efficacy of aquatic therapeutic exercise in female breast cancer survivors for improving fatigue, pain, lymphedema, and quality of life. METHODS: A systematic literature review was conducted in PubMed, Web of Science, and Cochrane Library databases for articles published in the last 10 years. The review focuses on aquatic exercise-based rehabilitation in female breast cancer survivors, according to the PRISMA statement and using the PEDRO and Jadad scales. RESULTS: Ten randomized controlled trials with 606 participants were included. Two studies showed aquatic therapeutic exercise to be effective in reducing fatigue, three in reducing pain, and four in improving quality of life after intervention. Three of five studies obtained significant immediate changes in lymphedema volume, although this improvement was only maintained at 3 months in a single study. The methodological quality of all the studies was ≥ 7 on the PEDro scale and ≥ 3 on the Jadad scale. CONCLUSION: Aquatic therapeutic exercise is an effective strategy for improving fatigue, pain, and quality of life in breast cancer survivors, although the effects on lymphedema remain uncertain. Participants showed high adherence to treatment and no adverse effects after intervention were reported.

Physical activity enjoyment, exercise motivation, and physical activity in patients with heart failure: A mediation analysis.

OBJECTIVE: To determine whether physical activity enjoyment mediated the association between motivation and physical activity in patients with heart failure. DESIGN AND SETTING: A cross-sectional study at the cardiology clinic in the university hospital in Valencia, Spain. SUBJECTS: A total of 134 patients with heart failure. MAIN MEASUREMENTS: Physical activity was assessed with the International Physical Activity Questionnaire, motivation was assessed with the Exercise Motivation Index and Physical Activity Enjoyment was assessed with the Physical Activity Enjoyment Scale. ANALYSIS: Mediation analysis using Hayes' PROCESS macro (Model 4) for SPSS. RESULTS: The mean age of the sample was 70 ± 14 years, 47 patients were female (35%), and 87 patients were in New York Heart Association I/II (67%). A positive relationship was found between exercise motivation and physical activity (t = 4.57, p < .01) and physical activity enjoyment (t = 11.52, p < .01). Physical activity enjoyment was found to positively affect physical activity (t = 3.50, p < .01). After controlling for physical activity enjoyment, the effect of exercise motivation on physical activity changed from a significant to non-significant (t = 1.33, p = .89), indicating that enjoyment completely mediated the relationship between motivation and physical activity. Overall, 25% of the variation in physical activity was explained by the mediation model. CONCLUSIONS: Physical activity enjoyment mediates the relationship between exercise motivation and physical activity in patients with heart failure. This means that even highly motivated heart failure patients may not be physically active if they do not enjoy the physical activity.

Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study.

STUDY DESIGN: A feasibility pilot study. OBJECTIVE: To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI). SETTING: A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM). METHODS: Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention. RESULTS: 20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective. CONCLUSION: A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.

Relationship between ankle dorsiflexion range of motion and sprinting and jumping ability in young athletes.

OBJECTIVES: To investigate the relationship between predicted risk of injury based on the dichotomous classification of the weight-bearing lunge (WBL) test scores and variables related to jumping and sprinting ability in young athletes. Furthermore, to compare the impact of the classical dichotomous classification versus a more specific quartile subdivision of the WBL test scores on the explored variables. DESIGN: Cross-sectional study. PARTICIPANTS: 125 healthy athletes (mean age 10.38 (SD = 2.28) years) were recruited. MAIN OUTCOME MEASURES: Ankle dorsiflexion was evaluated with the WBL test, jumping distance with the standing long jump (SLJ) test, and maximal running speed with the 14-m and 28-m sprint test. RESULTS: Athletes with WBL test scores lower than 10 cm exhibited significantly poorer results for the SLJ test as well as lower 14-m and 28-m sprint times than those with WBL test scores higher than 10 cm (p < 0.05). Likewise, when WBL test scores were subdivided by quartiles, a positive trend between range of motion and improved performance was shown. CONCLUSIONS: Reduced ankle dorsiflexion mobility may affect sprinting and jumping ability in young athletes. In addition, a more detailed classification of ankle restriction by quartiles is proposed in this study in order to prevent injury and enhance athletic performance.

Effects of a low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia: A randomized clinical trial.

BACKGROUND AND OBJECTIVES: Self-reported psychological variables related to pain have been posited as the major contributors to the quality of life of fibromyalgia (FM) women and should be considered when implementing therapeutic strategies among this population. The aim of this study was to explore the effect of low-pressure hyperbaric oxygen therapy (HBOT) on psychological constructs related to pain (i.e., pain catastrophism, pain acceptance, pain inflexibility, mental defeat) and quality of life in women with FM. METHODS: This was a randomized controlled trial. Thirty-three women with FM were randomly allocated to a low-pressure hyperbaric oxygen therapy group (HBOTG) (n=17), who received an 8-week intervention (5 sessions per week), and a control group (CG) (n=16). All women were assessed at baseline (T0) and upon completion of the study (T1) for self-perceived pain intensity, pain catastrophism, pain acceptance, pain inflexibility, mental defeat and quality of life. RESULTS: At T1, the HBOTG improved across all variables related to pain (i.e. self-perceived pain intensity, pain catastrophism, pain acceptance, pain flexibility, mental defeat) (p<0.05) and quality of life (p<0.05). In contrast, the CG showed no improvements in any variable. Furthermore, significant differences between the groups were found in quality of life (p<0.05) after the intervention. CONCLUSIONS: HBOT is effective at improving the psychological constructs related to pain (i.e. pain catastrophism, pain acceptance, pain flexibility, mental defeat) and quality of life among women with FM. Clinical Trial Link Clinical Trials gov identifier (NCT03801109).

Effects of mirror therapy on pain, sensitivity and functionality in patients with unilateral carpal tunnel syndrome. Randomised control trial.

PURPOSE: To investigate the effects of mirror therapy (MT) and therapeutic exercise (TE) with the unaffected hand, on pain, sensitivity and functionality in individuals with unilateral carpal tunnel syndrome (CTS). MATERIAL AND METHODS: A randomized controlled trial was carried out. Thirty-nine adults with unilateral CTS were included and randomly allocated to a six-week training programme based on MT (n = 20) or TE (n = 19). Visual Analogue Scale, Semmes-Weinstein monofilament test, Two-point discrimination (2PD), Disabilities of the Arm, Shoulder and Hand (DASH) and Boston Carpal Tunnel Questionnaire (BCTQ) were assessed before (T0) and after the intervention (T1), and at one-month follow-up (T2). RESULTS: At T1, MT and TE showed significant improvements in pain (p = 0.001 and p = 0.03, respectively), however, only MT maintained the achieved effects at T2 (p = 0.01). In addition, 2PD significantly improved in MT in the first (p = 0.04) and fourth fingers (p = 0.02) at T1. The DASH score decreased at T1 in MT (p < 0.001) and TE (p = 0.01). Additionally, the BCTQ score improved in MT (p < 0.001), and TE (p < 0.001) at T1. The effects were maintained at T2 for DASH and BCTQ scores. CONCLUSIONS: Training of the unaffected hand resulted in a significant improvement of the affected hand in both groups; nevertheless, MT achieved a longer duration of the effects.

Training of the unaffected hand may improve pain, sensitivity and functionality in people with unilateral tunnel carpal syndrome.Mirror therapy achieved longer duration of the effects on pain and hand functionality.Our research may inform clinical decision-making and guide the development of therapeutic interventions for patients with carpal tunnel syndrome.

Potential Benefits of a Single Session of Remote Ischemic Preconditioning and Walking in Sedentary Older Adults: A Pilot Study.

Ischemic preconditioning (IPC) has shown positive effects in endurance-type sports among healthy young individuals; however, its effects in endurance-type exercises in older adults have not been explored. We aimed to examine the acute effects of a single session of IPC prior to an endurance-type exercise on cardiovascular- and physical-function-related parameters in sedentary older adults. A pilot study with a time-series design was carried out. Nine participants were enrolled consecutively in the following intervention groups: (i) SHAM (sham IPC + walking) and (ii) IPC (IPC + walking) groups. The main outcomes were resting systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), peripheral oxygen saturation (SpO2), maximum isometric voluntary contraction (MIVC), endurance performance, and perceived fatigue. After the intervention, the IPC group showed a significant reduction in SBP, whereas SpO2 decreased in the SHAM group. The IPC group maintained quadriceps MIVC levels, whereas these levels dropped in the SHAM group. No changes in DBP, resting HR, endurance, or fatigue in any group were observed. These findings are of interest for the promotion of cardiovascular and physical health in older people.

Effectiveness of a Manual Therapy Protocol in Women with Pelvic Pain Due to Endometriosis: A Randomized Clinical Trial.

A randomized controlled trial was carried out to assess the effectiveness of a manual therapy protocol in terms of the clinical characteristics, quality of life, and emotional condition of the women with endometriosis-related pelvic pain. Forty-one women (mean age of 36.10 (6.97) years) with pelvic pain due to endometriosis were randomly divided into (i) a manual therapy group (MTG) (n = 21) and (ii) a placebo group (PG) (n = 20). Both groups received an 8-week intervention. Pain, lumbar mobility, endometriosis health profile, quality of life, depression and anxiety levels, and the patient's perception of change were assessed before (T0) and after (T1) the intervention, as well as at a one-month follow-up (T2) and a six-month follow-up (T3). The MTG significantly improved pain intensity, powerlessness, lumbar mobility, and physical quality of life at T1 (p < 0.05). The results were maintained for pain intensity at T2 and T3. In addition, both the MTG and PG improved emotional wellbeing at T1 (p < 0.05). Neither group improved in terms of social support, self-image, and depression and anxiety levels after the intervention (p > 0.05). In conclusion, manual therapy may be an excellent complement to the gynecological treatment of endometriosis-related pelvic pain by alleviating pain and improving women's endometriosis health profile and physical quality of life.

Respiratory Function Analysis in Patients with Chronic Pain: An Umbrella Review and Meta-Analysis of Pooled Findings.

BACKGROUND: The main aim of this umbrella review was to assess the respiratory function in patients with chronic pain (CP), including patients with chronic neck pain (CNP), chronic low back pain (CLBP), and fibromyalgia syndrome (FMS). METHODS: We searched in PubMed, PEDro, EMBASE, CINAHL, and Google Scholar (4 February 2023). The outcome measures were respiratory muscle strength (MIP/MEP) and pulmonary function (VC, MVV, FVC, FEV1, FEV1/FVC ratio, FEV25-75, and PEF). This review was previously registered in the international prospective register of systematic reviews, PROSPERO (CRD42023396722). The methodological quality was analyzed using AMSTAR and ROBIS scales, and the strength of the evidence was established according to the guidelines advisory committee grading criteria. To compare the outcomes reported by the studies, we calculated the standardized mean differences and the corresponding 95% confidence interval for the continuous variables. RESULTS: Four systematic reviews with and without meta-analysis were included, from which a total of 15 primary studies were extracted. Five meta-analyses were carried out, using analyses by subgroup according to the type of CP. The meta-analyzing variables were MIP, MEP, MVV, FEV1, and FVC. CONCLUSIONS: Overall, patients with CP have decreased respiratory muscle strength with a moderate quality of evidence. Regarding the pulmonary function, patients with CNP showed a diminished VC, PEF, MVV, FEV1, and FVC, while FEV25-75 and the FEV1/FVC ratio were conserved with a limited to moderate quality of evidence. Finally, patients with FMS and CLBP only showed a decrease in MVV with a limited quality of evidence.

Effects of mirror therapy on spasticity and sensory impairment after stroke: Systematic review and meta-analysis.

OBJECTIVE: To review and synthesize existing evidence on the effectiveness of mirror therapy (MT) compared to active exercise-based interventions (ie, cross-training and conventional exercise) for reducing spasticity and sensory impairment in stroke survivors. TYPE: Systematic Review and Metanalysis. LITERATURE SURVEY: Pubmed/MEDLINE, Cochrane, Embase, CINAHL, and Physiotherapy Evidence Database (PEDro), were searched. METHODOLOGY: Randomized controlled trials (RCTs) that investigated MT effectiveness in improving spasticity and sensory impairment in stroke survivors compared to a control group. SYNTHESIS: Fifteen RCTs (653 volunteers) were included. Spasticity improvements achieved with MT were similar to those obtained with cross-training (standard mean difference [SMD]: 0.12, 95% confidence interval [CI]: -0.43 to 0.68). In addition, when further combined with conventional exercise, spasticity improved similarly in both groups (SMD: 0.10, 95% CI: -0.16, 0.36). Lastly, when MT plus exercise was compared to exercise alone, spasticity decreased in both groups (SMD: 0.16, 95% CI: -0.16 to 0.48). Nevertheless, none of the Interventions seem effective on sensory impairment (SMD: 0.27, 95% CI: -0.28 to 0.81). CONCLUSIONS: MT is equally effective as other exercise therapies, such as cross-training and conventional exercise, for improving spasticity in stroke survivors, whereas none of the explored interventions yielded beneficial effects on sensory impairment. Further well-designed RCTs are needed to confirm the results.