Effect of Supervised over Self-Performed Eccentric Exercise on Lateral Elbow Tendinopathy: A Pilot Study.

Background: The efficacy of eccentric exercise self-performed by the patient has not been proved in the treatment of lateral elbow tendinopathy (LET). The aim of this study was to compare the effects of a programme of eccentric exercises applied by a physiotherapist to patients with LET through a structured manual programme compared to its self-performance, guided by an illustrated brochure. Method: A single-blind, pilot, randomised, controlled trial was conducted. Twenty patients were randomised. The intervention group carried out eccentric exercises applied directly by a physiotherapist (10 sessions). The control group carried out eccentric exercises that were self-performed by the patient (10 sessions). Both groups received simulated ultrasounds. Pain (visual analogue scale (VAS)), function (DASH questionnaire) and satisfaction (with a Likert scale) were measured at the beginning of the intervention, immediately after the intervention and 3 months after the intervention. Results: The mean age was 53.17 and 54.25 years old. The experimental group presented a greater tendency to improve function (DASH −15.91) and reduce pain (VAS −2.88) compared to the control group, although these differences were not significant (p > 0.05). Conclusion: Eccentric exercise, both performed by the physiotherapist and self-performed by the patient, improved function and pain in the patients with LET.

The Type of Conservative Management Could Be Related to the Strength of the Inspiratory Muscles of Adolescents with Idiopathic Scoliosis-A Case Series.

Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine with a Cobb angle of at least 10° with an unknown etiology. It is recognized that AIS may affect respiratory function. This study aims to describe and compare respiratory function in a case series of patients with scoliosis who underwent different types of therapeutic management: no intervention, orthotic brace, and global postural reeducation (GPR). Fifteen AIS patients were included in this study (seven no intervention, four orthotic brace and four GPR). Lung function and inspiratory muscle strength were measured and analyzed, as well as sociodemographic, clinical, and anthropometric variables. Significant correlations were observed between height (cm) and maximum inspiratory pressure (MIP) reference (cmH2O) and forced vital capacity (FVC) (liters) (r = 0.650 and r = 0.673, respectively; p < 0.01); weight (Kg) and MIP reference (cmH2O) (r = 0.727; p < 0.01); and Main curve degrees (Cobb angle) and FVC% (r = -0.648; p < 0.01). The AIS cases that underwent GPR treatment presented a greater MIP (% predictive) compared to the no intervention and brace cases (201.1% versus 126.1% and 78.4%, respectively; p < 0.05). The results of this case series show a possible relation whereby patients undergoing treatment with the GPR method have greater inspiratory muscle strength compared to the no intervention and brace cases. Studies with larger samples and prospective designs must be performed to corroborate these results.

Validation of the FACT-B+4-UL questionnaire and exploration of its predictive value in women submitted to surgery for breast cancer. / Validación del cuestionario FACT-B+4-MS y exploración de su capacidad predictora en mujeres intervenidas de cáncer de mama.

INTRODUCTION AND OBJETIVE: The early detection of upper limb complications is important in women operated on for breast cancer. The "FACT-B+4-UL" questionnaire, a specific variant of the Functional Assessment of Cancer Therapy-Breast (FACT-B) is available among others to measure the upper limb function. PATIENTS AND METHODS: The Spanish version of the upper limb subscale of the FACT-B+4 was validated in a prospective cohort of 201 women operated on for breast cancer (factor analysis, internal consistency, test-retest reliability, construct validity and sensitivity to change were determined). Its predictive capacity of subsequent lymphoedema and other complications in the upper limb was explored using logistic regression. RESULTS: This subscale is unifactorial and has a great internal consistency (Cronbach's alpha: 0.87), its test-retest reliability and construct validity are strong (intraclass correlation coefficient: 0.986; Pearson's R with "Quick DASH": 0.81) as is its sensitivity to change. It didn't predict the onset of lymphedema. Its predictive capacity for other upper limb complications is low. CONCLUSIONS: FACT-B+4-UL is useful in measuring upper limb disability in women surgically treated for breast cancer; but it does not predict the onset of lymphoedema and its predictive capacity for others complications in the upper limb is low.

Microwave diathermy for treating nonspecific chronic neck pain: a randomized controlled trial.

BACKGROUND CONTEXT: Although the use of deep heat therapy is widespread, there is scant literature available on its effectiveness in treating back or neck pain. PURPOSE: The purpose of this study was to determine the efficacy of microwave diathermy to treat nonspecific chronic neck pain. DESIGN: The study was designed as a double-blind, randomized controlled trial. PATIENT SAMPLE: The patient sample consisted of 149 patients with nonspecific chronic neck pain in a hospital of the Andalusian Public Health Care System, Spain OUTCOME MEASURES: The study outcome measures are as follows: at baseline, pain intensity (using a visual analogue scale), disability (Neck Disability Index), and health-related quality of life (36-item short form health survey [SF-36]); at 3 weeks, baseline measures and patients' perceived overall outcome and satisfaction with the treatment; and at 6 months, 3-week measures, therapeutic co-interventions, and adherence to exercises. METHODS: Patients were allocated randomly to three groups. The first group received continuous microwave diathermy, the second group was administered pulsed microwaves, and the third group (the control group) received unplugged microwaves. All three groups received the same general treatment: range of motion, isometric exercises, and transcutaneous electrical nerve stimulation. RESULTS: The three groups had reduced pain and disability, and improvement was seen in some dimensions of the SF-36. However, there were no differences found in any of the parameters measured among the three therapeutic groups. CONCLUSIONS: Microwave diathermy does not provide additional benefit to a treatment regimen of chronic neck pain that already involves other treatment approaches.

Validation of the Spanish version of the Neck Disability Index.

STUDY DESIGN: Observational prospective study. OBJECTIVE: Validate the Spanish version of the Neck Disability Index (NDI). SUMMARY OF BACKGROUND DATA: The NDI is the most widely used neck pain scale in the largest number of populations and has been validated most often against multiple measurements of function, pain, and clinical signs and symptoms. METHODS: The Spanish version of the NDI was administered 2 or 3 times to 175 individuals with neck pain (including those requesting or not requesting specific healthcare at a given time and those with acute and subacute/chronic nonspecific or post-traumatic neck pain). After establishing the factorial structure by extracting the main components, the internal consistency was assessed with the Cronbach alpha method, the test-retest reliability was assessed with the Bland-Altman plot and the intraclass correlation coefficient methods, and the validity was established by calculating Pearson correlation coefficient with pain visual analogue scale values and with Northwick Park Neck Pain Questionnaire (Spanish version) values. Sensitivity to change was estimated while comparing the mean difference between the first application of the NDI score and the one after the treatment in the patients who improved, felt the same, or worsened. RESULTS: A single factor explained 51.6% of the variance, the Cronbach alpha score was 0.89, the intraclass correlation coefficient was 0.98, the Pearson correlation coefficient with pain visual analogue scale was r = 0.65 and with Northwick Park Neck Pain Questionnaire was r = 0.89. In the subgroup of 147 subjects in whom the sensitivity to change was studied, those who reported an improvement in neck pain showed a decrease in the NDI score of 8.20, those who felt the same showed a decrease of 0.23, and those who felt worse showed an increase of 5.55. CONCLUSION: This first Spanish version of the Neck Disability Index is reliable, valid, and sensitive to change.

[Validation of a Spanish version of the Neck Disability Index]. / Validación de una versión española del Indice de Discapacidad Cervical.

BACKGROUND AND OBJECTIVE: The Neck Disability Index (NDI) is the most used scale for neck pain and disability. There is no validated Spanish version so far. This prospective study's objective was to evaluate a Spanish version's comprehension and metrics characteristics. MATERIAL AND METHOD: The Spanish version of the NDI was obtained by the "translation-backward translation" method. This version and the pain visual analogue scale were both administered 2 times to 48 patients with nonnespecific or posttraumatic neck pain. RESULTS: 16% had comprehension troubles. The cultural level had no influence on it. Items more commonly called into question were the IX (neck pain and sleeping) and the VII (neck pain and working). The scales were fulfilled in 6 min 08 s (54 s) by those with middle-high cultural level, and in 7 min 59 s (1 min 26 s) by those with low one (p < 0.001). As shown by factor analysis, our NDI version is a one-dimension scale. Internal consistence was very good (Cronbach alpha of 0.937 at the first time and 0.944 at the second one). An optimal test-retest reliability was settled by intraclass correlation coefficient (0.978) and by Bland-Altman plot. For the construct validity, correlation with the pain visual analogue Scale was 0.643 (p < 0.01) at first time, and 0.743 (p < 0.01) at second one. This was the only metric characteristic where the cultural level had any influence. CONCLUSIONS: On reformulation of some items, our NDI Spanish version's feasibility will allow its use for future definitive validation.