Effectiveness of mirror therapy in phantom limb pain: a literature review.

INTRODUCTION: Phantom limb pain (PLP) is a type of neuropathic pain that affects the territory of an amputated limb or other surgically removed body parts. Between 60% and 90% of amputees suffer from PLP during follow-up. There are a range of therapeutic options for PLP, both pharmacological (gabapentin, amitriptyline, tricyclic antidepressants, etc) and non-pharmacological (transcutaneous electrical nerve stimulation, hypnosis, acupuncture, etc). A widely accepted hypothesis considers PLP to be the consequence of postamputation cortical reorganisation. New treatment approaches, such as mirror therapy (MT), have been developed as a result of Ramachandran's groundbreaking research in the 1990s. This review analyses the current evidence on the efficacy of MT for treating PLP. DEVELOPMENT: We performed a literature review of publications registered from 2012 to 2017 on the CINAHL, Cochrane, Scopus, and PubMed (including Medline) databases using the descriptors "phantom limb" and "mirror therapy." We identified 115 publications addressing MT in PLP. Of these, 17 (15%) contributed useful information for pooled analysis. CONCLUSIONS: MT seems to be effective in relieving PLP, reducing the intensity and duration of daily pain episodes. It is a valid, simple, and inexpensive treatment for PLP. The methodological quality of most publications in this field is very limited, highlighting the need for additional, high-quality studies to develop clinical protocols that could maximise the benefits of MT for patients with PLP.

Frailty and cognitive impairment in Parkinson's disease: a systematic review.

BACKGROUND: Frailty can lead to increased vulnerability in older people and patients with Parkinson's disease (pwPD) and worsen their health conditions. These patients can also develop cognitive function impairment. The objective is to analyze whether there is a relationship between frailty and cognitive impairment in pwPD, and to find out which instruments to use for its evaluation. METHODS: Publications were searched in PubMed, Medline, Web of Science, Cinalh, Cochrane Library, Embase, Phycinfo, and Scopus. The results were measured with the instruments that are used to assess frailty and cognitive impairment, and analyze their relationship. RESULTS: Two hundred seventy-one articles were identified, of which 12 met the inclusion criteria. All studies assessed frailty and cognitive function in pwPD. Five studies analyzed the relationship between frailty and cognitive impairment. The most used instruments were the Fried scale followed by the Clinical Frailty Scale (CFS) for frailty. Cognitive impairment was mostly evaluated with the Mini-Mental State Examination and the Montreal Cognitive Assessment. The prevalence data ranged from 20.2 to 51.5% with the Fried scale and from 35.6 to 83.9% with the CFS. Cognitive impairment was present in 15 to 45.2% of the pwPD. CONCLUSION: Analysis of the included studies shows a relationship between frailty and cognitive impairment in pwPD. There was significant variability in the application of the scales used, which influences the prevalence data. More observational and experimental studies are needed to provide more evidence on this association and to determine which is the optimal tool to identify frailty in pwPD using multidimensional scales.

Effectiveness of mirror therapy in phantom limb pain: A literature review. / Efectividad de la terapia de espejo en el dolor del miembro fantasma. Una revisión actual de la literatura.

INTRODUCTION: Phantom limb pain (PLP) is a type of neuropathic pain that affects the territory of an amputated limb or other surgically removed body parts. Between 60% and 90% of amputees suffer from PLP during follow-up. There are a range of therapeutic options for PLP, both pharmacological (gabapentin, amitriptyline, tricyclic antidepressants, etc) and non-pharmacological (transcutaneous electrical nerve stimulation, hypnosis, acupuncture, etc). A widely accepted hypothesis considers PLP to be the consequence of postamputation cortical reorganisation. New treatment approaches, such as mirror therapy (MT), have been developed as a result of Ramachandran's groundbreaking research in the 1990s. This review analyses the current evidence on the efficacy of MT for treating PLP. DEVELOPMENT: We performed a literature review of publications registered from 2012 to 2017 on the CINAHL, Cochrane, Scopus, and PubMed (including Medline) databases Using the descriptors "phantom limb‿ and "mirror therapy.‿ We identified 115 publications addressing MT in PLP. Of these, 17 (15%) contributed useful information for pooled analysis. CONCLUSIONS: MT seems to be effective in relieving PLP, reducing the intensity and duration of daily pain episodes. It is a valid, simple, and inexpensive treatment for PLP. The methodological quality of most publications in this field is very limited, highlighting the need for additional, high-quality studies to develop clinical protocols that could maximise the benefits of MT for patients with PLP.

[Current status of immersive virtual reality as a tool for physical and functional rehabilitation in patients with Parkinson´s disease: systematic review]. / Estado actual de la realidad virtual inmersiva como herramienta de rehabilitación física y funcional en pacientes con enfermedad de Parkinson: revisión sistemática.

INTRODUCTION: Parkinson's disease (PD) is a complex neurodegenerative process that usually appears from the 6th decade of life and is characterized by the appearance of motor and non-motor symptoms that progress, generating functional disability and negatively impacting in quality of life. Recently, Immersive Virtual Reality (IVR) has great positive impact on health domains: as a support in psychotherapy or as a treatment of cognitive-behavioral pathologies in neurological patients. OBJECTIVE: To analyze the current published evidence in the fields of physical and functional PD rehabilitation in fully immersive environments. MATERIALS AND METHODS: A literature review, covering publications registered until December 2020 in Cinahl, Scopus, Web of Science, Sport-Discus, Dialnet and Pubmed (including Medline) was carried out. The descriptors used for the search were the terms: Parkinson disease, Virtual Reality and Exercise therapy. 140 publications were identified that addressed IVR with physical rehabilitation proposes in PD. Of these, 7 contribute useful information for pooled analysis. RESULTS: The results support the application of IVR to improve physical and functional capacities in the population with PD. Its feasibility, usability and safety suggest potential benefits in the treatment of the prevalent symptoms of the parkinsonian patient. CONCLUSIONS: Research of high methodological quality is lacking, reflecting and early stage of preclinical development. Randomized control studies with larger sample size and IVR protocols that confirm the results, while analyzing their impact on the physical and functional variables related to PD are needed.

TITLE: Estado actual de la realidad virtual inmersiva como herramienta de rehabilitación física y funcional en pacientes con enfermedad de Parkinson: revisión sistemática.Introducción. La enfermedad de Parkinson (EP) es un proceso neurodegenerativo que se caracteriza por la aparición de síntomas motores y no motores que progresan, generando discapacidad funcional e impactando negativamente en la calidad de vida del paciente. Recientemente, la realidad virtual inmersiva ha adquirido gran relevancia como apoyo al tratamiento de patologías cognitivo-conductuales del paciente neurológico. Objetivo. Analizar la evidencia actual publicada en el campo de la rehabilitación física y funcional de la EP en entornos completamente inmersivos. Materiales y métodos. Se realizó una revisión bibliográfica de publicaciones registradas en las bases de datos Medline, Cinahl, PubMed, Scopus, Web of Science, Sport-Discus y Dialnet hasta diciembre de 2020. Los descriptores utilizados para la búsqueda fueron: Parkinson disease, Virtual Reality y Exercise therapy. Tras la aplicación de los criterios de selección, del total de 140 artículos identificados, se seleccionaron siete. Resultados. Describen una experiencia segura, positiva y factible, aunque obtenidos, en su mayoría, tras la aplicación de una única sesión. Los resultados hallados en las variables vinculadas a las capacidades funcionales que se deben mejorar en la EP apoyan potenciales beneficios en el tratamiento de la sintomatología prevalente del paciente parkinsoniano. Conclusiones. Los pocos estudios existentes muestran resultados preliminares, por lo que se hacen necesarias más investigaciones de mayor calidad metodológica, mayor tamaño muestral, con un proceso de control aleatorizado y protocolos que confirmen los resultados, al tiempo que analicen su impacto en las variables físicas y funcionales vinculadas a la patología parkinsoniana.

[Relationship between the prone position and achieving head control at 3 months]. / Relación entre la postura en prono y la adquisición del sostén cefálico a los 3 meses.

INTRODUCTION: Owing to the significant increase of mild motor delays and the strong intolerance of infants to be placed on prone position observed in the Physiotherapy Unit of the Maternal and Children's University Hospital of the Canaries (HUMIC), a study was conducted to determine whether positioning infants in the prone position while awake affected the achievement and quality of head control at three months. PATIENTS AND METHODS: A prospective comparative practice-based study of a representative sample of 67 healthy infants born in the HUMIC, and divided into an experimental group (n = 35) and control group (n = 32). The Alberta Infant Motor Scale (AIMS) and a parent questionnaire were used as measurement tools. The intervention consisted of regular home visits to the experimental group (from the first to the third month). The two groups were evaluated in their homes at the end of 3 months. RESULTS: The differences in mean raw score of the AIMS at 3 months were, 16.26 in the experimental group and 10.38 in control group (P<.001). The percentile mean was 94 in the experimental group, and less than 50 (42) in the control group. All of the experimental group babies achieved the head control, with only 8 in the control group (25%). CONCLUSIONS: The significant findings suggest a direct relationship between the time spent in the prone position when the baby is awake and the achievement of head control at three months.

Environmental monitoring using acetylcholinesterase inhibition in vitro. A case study in two Mexican lagoons.

Cholinesterase inhibition is considered a specific biomarker of exposure and effect for organophosphorous pesticides. Its use for monitoring has been hindered, particularly in tropical countries where organophosphates are widely used for malaria and dengue control, because of the frequent lack of suitable controls. An in vitro technique is proposed as a biochemical method for monitoring pollutant mixtures in sediment toxicity tests. Brain homogenate from the fish Oreochromis niloticus is used as the enzyme source. Optimum incubation time, extraction solvent and effect of crude oil on acetylcholinesterase (AChE) are reported. The method described was used in sediments from two Mexican lagoons, located in an oil extraction area where pesticides are used in agriculture and vector control campaigns. AChE inhibitions from 3 to 21% were found in these lagoons, even in the presence of high concentrations of petroleum.