Effect of a Virtual Reality Exercise on Patients Undergoing Haemodialysis: A Randomised Controlled Clinical Trial Research Protocol.

High levels of inflammatory markers have been associated with a greater deterioration of renal function and cardiovascular morbidity and mortality. For its part, physical exercise has been shown to be beneficial in improving the functional, psychological, and inflammatory states of patients with chronic kidney failure (CKF) undergoing haemodialysis (HD) treatment, improving their health-related quality of life. In recent years, virtual reality (VR) has been studied and described as an effective and safe tool that improves patients' adherence to exercise programs. For these reasons, we propose to analyse the effect of VR exercise on the functional, psychological, and inflammatory states of patients on HD, as well as their levels of adherence to exercise, and compare them with static pedalling exercises. We will randomise 80 patients with CKF into two blind groups: an experimental group, which will carry out an intradialytic exercise program with non-immersive VR (n = 40), and a control group, which will exercise with a static pedal (n = 40). Functional capacity, inflammatory and phycological status, and exercise adherence will be analysed. Higher levels of adherence to exercise are expected in the VR group, which will have greater effects on the patients' functional capacity and psychological and inflammatory status.

Scanning electron microscopy examination of needle tips after different procedures of deep dry needling in humans.

The aim of this study was to evaluate the tips and the surface conditions of two types of needles with different quality and their possible alterations after performing different needling on human beings. A total of 160 needles from AguPunt brand were examined. Surface conditions (lumps and scratches) and tip of the needles after needling procedures in humans were tested using a JEOL JSM-6360LV microscopy device. Additionally, a group of physiotherapists assessed the use of both types of needles in clinical practice using a self-reported questionnaire. Both types of needles, after performing different needling on human beings, kept the needle tips well preserved although the dry needle (Type B) suffered very little deformation even touching the bone of the scapula 10 times versus acupuncture needle (Type A), which were deformed slightly. The surface conditions revealed irregularities and scratches in both types of needles but the tips of Type A suffered more damage after different procedures (Odds ratio = 0.04,95% CI:0.01-0.13, p < 0.001). The cellular tissue adhered to the surface was similar in both types of needles and the questionnaire about clinical practice of both types of needles showed that Type B seemed easier than Type A when the physical therapist penetrated the skin and when the needle went out the skin.

Changes in Postural Sway After a Single Global Postural Reeducation Session in University Students: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this study was to assess the effectiveness of a single session of global postural reeducation (GPR) in postural sway in young adult university students who use data visualization screens. METHODS: A randomized controlled trial with 2 parallel groups was performed. Sixty-four subjects were randomized in the experimental group (12 men and 20 women) who underwent the GPR session, and a control group (13 men and 19 women) that did not receive any intervention was included. Center of pressure (COP) was assessed using a stabilometric platform, with eyes open and eyes closed before, immediately after, 48 hours after, and 7 days after intervention in both groups. RESULTS: In the interaction of time and gender, statistically significant differences were found for the area covered by COP (P = .020) and for the standard deviation (SD) in the mediolateral axis (P = .035). Considering the complete interaction time, gender, and group, statistically significant differences were found (P = .015) for the anteroposterior rate covered by COP and the SD in the anteroposterior axis (P = .033). In eyes closed condition, the intersubject analysis showed statistically significant differences for the interaction between group and gender for the variable mediolateral SD (P = .043). Considering the interaction of time with group, statistically significant differences were found for full length covered by COP (P = .017). CONCLUSIONS: Changes in postural sway were observed after a single GPR session, mainly at 48 hours, with different behaviors between men and women.

Referred Pain Patterns of the Infraspinatus Muscle Elicited by Deep Dry Needling and Manual Palpation.

OBJECTIVES: To identify the most common referred pain (ReP) pattern of the infraspinatus myofascial trigger point (MTrP) and compare its coincidence with the original ReP pattern, to verify whether there are any significant differences by sex and types of technique and to determine the observed signs and symptoms evoked by deep dry needling (DDN) and manual palpation (MPal). DESIGN: A cohort study of patients randomized to two different examination methods (July and August 2016). SETTINGS: Students and staff recruited from Miguel Hernandez University (Southeast Spain). PATIENTS: One hundred thirty-three participants (70.7% women) with shoulder complaints were randomly assigned to either an MPal (n = 67) or DDN group (n = 66). INTERVENTIONS: The same physiotherapist carried out the techniques on all participants, and the same protocol was followed for both the DDN and MPal groups. The physiotherapist did not ask participants about their pain features or other relevant issues. OUTCOME MEASURES: Local twitch response (LTR) and ReP assessed through a visual analogue scale and features of ReP of the infraspinatus muscle. RESULTS: The areas with the highest percentage of ReP were the front (area 3; 27.1%) and back (area 11; 21.1%) of the arm, anterior (area 4; 36.1%) and posterior (area 12; 42.1%) shoulder, and infraspinatus muscle area. DDN proved to be significantly easier than MPal in evoking an LTR (p ≤ 0.001). There were significant differences between sexes in zone 2 (p = 0.041) and no statistically significant differences were found by technique. CONCLUSIONS: The ReP pattern of the infraspinatus muscle coincides with the original pattern described by Travell and Simons, although the neck area should be questioned. The study found no significant differences in the ReP pattern by sex and when comparing MPal with DDN of MTrP of the infraspinatus muscle. DDN proved to be significantly easier than MPal in evoking an LTR.