Effect of Mirror Therapy on Post-Needling Pain Following Deep Dry Needling of Myofascial Trigger Point in Lateral Elbow Pain: Prospective Controlled Pilot Trial.

Background: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from post-needling pain diagnosed as Lateral Elbow Pain. Methods: A total of 49 participants (23 female, 26 male) were enrolled and randomly allocated to either the experimental group, which received Deep Dry Needling in the m. Brachioradialis, Ischemic Compression, Cold Spray, Stretching, and Mirror Visual Feedback Therapy (n = 25), or a control group without Mirror Visual Feedback Therapy (n = 24). Pre- and post-treatment evaluations included assessments of post-needling pain intensity, pressure pain threshold, two-point discrimination threshold, and maximum hand grip strength. Results: Intergroup analysis revealed a statistically significant reduction in post-needling pain intensity favoring the experimental group (U = 188.00, p = 0.034). Additionally, intragroup analysis showed significant improvements in post-needling pain intensity (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) and pressure pain threshold (MD = 0.148 Kg/cm2, SEM = 0.038, W = 262.00, p < 0.001) within the experimental group following the intervention. Conclusions: These findings suggest a potential benefit of integrating Mirror Visual Feedback Therapy into treatment protocols for individuals with Lateral Elbow Pain experiencing post-needling discomfort. Further research is necessary to fully elucidate the clinical implications of these findings.

Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review.

Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.

Social support in low-income women with Fibromyalgia Syndrome from a sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain): a mixed method study.

BACKGROUND: Women with Fibromyalgia Syndrome (FMS) can benefit form adequate social support to fight the consequences of their illness, but the extent to which this is available to those with low incomes who live in depressed areas of Tenerife (Canary Islands, Spain) is currently unknown. The purpose of this study was to explore social support in low-incomes women with FMS in sub-urban and peri-urban areas of Tenerife. METHODOLOGY: A sequential exploratory mixed method study was carried out from January 20, 2023, to June 10, 2023, at the Fibromyalgia and Chronic Fatigue Association of Tenerife (AFITEN) using non-probability convenience sampling. Social support was analyzed quantitatively through MOS-SSS survey and Duke-UNC-11 questionnaire, while qualitative data were obtained through semi-structured interviews to identify social support providers and analyze their satisfactions levels. RESULTS: A total of 49 women, with a mean age of 57.80 years-old (SD = 13.25) were finally included in this study. MOSS-SSS and Duke-UNC-11 both indicated lower social support levels at 68.6 (SD =16.3) and 38.0 (SD = 9.74), respectively. The qualitative analysis revealed that partners and friends provided the most significant support with the highest satisfaction scores. CONCLUSIONS: The socioeconomic status of low-income women with FMS living in sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain) influences on their social support, with the affective support and confidentiality being the most affected dimensions.

Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review.

AIM: The aim was to identify, evaluate, and summarize the findings of relevant individual studies on the precision and accuracy of radiological BA assessment procedures among children from different ethnic groups. MATERIALS AND METHODS: A qualitative systematic review was carried out following the MOOSE statement and previously registered in PROSPERO (CRD42023449512). A search was performed in MEDLINE (PubMed) (n = 561), the Cochrane Library (n = 261), CINAHL (n = 103), Web of Science (WOS) (n = 181), and institutional repositories (n = 37) using MeSH and free terms combined with the Booleans "AND" and "OR". NOS and ROBINS-E were used to assess the methodological quality and the risk of bias of the included studies, respectively. RESULTS: A total of 51 articles (n = 20,100) on radiological BA assessment procedures were precise in terms of intra-observer and inter-observer reliability for all ethnic groups. In Caucasian and Hispanic children, the Greulich-Pyle Atlas (GPA) was accurate at all ages, but in youths, Tanner-Whitehouse radius-ulna-short bones 3 (TW3-RUS) could be an alternative. In Asian and Arab subjects, GPA and Tanner-Whitehouse 3 (TW3) overestimated the BA in adolescents near adulthood. In African youths, GPA overestimated the BA while TW3 was more accurate. CONCLUSION: GPA and TW3 radiological BA assessment procedures are both precise but their accuracy in estimating CA among children of different ethnic groups can be altered by racial bias.

Percutaneous Electrical Nerve Stimulation (PENS) for Infrapatellar Saphenous Neuralgia Management in a Patient with Myasthenia gravis (MG).

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness of the cranial and skeletal muscles, however, neuropathies are extremely rare. In this case report we present a case of a 61-year-old man diagnosed Myasthenia gravis who came to our attention due to a 1 week of acute deep pain [NPRS 8/10] in the anterior and medial right knee which occurred during walking [NPRS 8/10] or stair climbing [NPRS 9/10]. A complete medical record and clinical examination based on physical exploration and ultrasound assessment confirmed a infrapatellar saphenous neuralgia. Therapeutic interventions included Percutaneous nerve electrical stimulation combined with pain neuroscience education, neural mobilization of the saphenous nerve and quadriceps resistance exercises. After 4 weeks, pain intensity [NRPS = 1/10], knee functionality [OKS = 41/48] and lower limb functionality [LLFI = 80%] were notably improved, nevertheless, fatigue [RPE = 2/10] was similar than baseline. At 2 months of follow-up, the effect on intensity of pain NRPS [0/10] and functionality OKS [40/48] and LLFI [82%] was maintained, however, no significant clinical changes were detected on perceived fatigue RPE Scale [2/10]. Despite the important methodological limitations of this study, our case report highlights the efficacy of percutaneous electrical nerve stimulation combined with physical agents modalities for pain and functionality of infrapatellar saphenous neuralgia in the context of Myasthenia gravis.

A new ultrasound-guided percutaneous electrolysis and exercise treatment in patellar tendinopathy: three case reports.

Purpose: To present preliminary clinical results of the effects of a new treatment with percutaneous electrolysis directed to peripheral tendon and therapeutic resistance exercise, with or without the presence of degenerative zone. Methods: 3 patients with patellar tendinopathy aged 37-45 years with diagnostic of patellar tendinopathy with pain since 5-8 weeks were treated with a novel, less invasive electrolysis technique. Pain severity was measured by Numerical Pain Rating Scale (NPRS). Lower limb functionality was measured by a Victorian Institute of Sport Assessment questionnaire (VISA-P). A clinical interview and ultrasonography assesment were performed before study protocol were carried out. Each participants received 4 to 7 sessions of percutaneous electrolysis (350 µA, 80 s) leaving at least one week between sessions during a total of 8 weeks. During this time, subjects also were undergone a therapeutic exercise protocol of lower limbs resistance training. Results: Pain severity decreased after 3 weeks treatment (p = 0.01) and was practically abolished after 4-7 sessions at 8 weeks (p = 0.2). The lower limb functionality (VISA-P) increased after 3 weeks treatment and the major difference was found at 8 weeks post-intervention (p = 0.001). Thickness of the patellar tendon decreased after 8 weeks treatment (p = 0.01). Conclusions: The present work provides the first evidence that percutaneous electrolysis with a least invasive physiotherapy treatment targeted to peripheral tendon in combination with therapeutic resistance exercise diminished pain, improved funcitonality and showed a tendency to decreased thickness in subjects with patelallar tendinopathy.

An Up-Date of the Muscle Strengthening Exercise Effectiveness in Postmenopausal Women with Osteoporosis: A Qualitative Systematic Review.

BACKGROUND: Osteoporosis (OP) is a systemic disease that is characterized by decreased bone density and quality. Purpose: The purpose of this systematic review was to determine the effects of muscle strengthening exercise in postmenopausal women with OP. Methods: A literature search was conducted systematically in MEDLINE, CINAHL, EMBASE databases for human studies up to 31 March 2021. Two researchers screened the articles against predefined inclusion criteria; a third resolved discrepancies. Articles were included if they assessed the effects of muscle strengthening exercise in postmenopausal women with OP. The protocol for this systematic review was registered on PROSPERO (CRD42021207917) and a qualitative systematic review was carried out following the PRISMA statement. Methodological quality was evaluated through the scientific validity scales PEDro. Finally, RTCs and NRCTs risk of bias was assessed with the Cochrane risk of bias tool (Risk of Bias-ROB 2.0) and ROBINS-1, respectively. Results: A total of 16 studies (1028 subjects) that met the different eligibility criteria previously established were selected. There is evidence of good methodological quality and a low to moderate risk of bias that supports that muscle strengthening exercise alone or in combination with other therapeutic modalities improves BMD (9, n = 401) in proximal femur and lumbar vertebra body, muscle strength (10, n = 558), balance (4, n = 159), functionality (7, n = 617), and quality of life (5, n = 291). CONCLUSIONS: Exercise programs focused on muscle strengthening have benefits for all variables studied in postmenopausal women with OP.

Relationship between the Gut Microbiome and Osteoarthritis Pain: Review of the Literature.

BACKGROUND: Osteoarthritis (OA) is the most common form of chronic pain in Europe (34%), representing a great economic and social cost to society. There are studies that suggest an intestine-brain-articulation axis and hint at the existence of low-grade intestinal inflammation in OA, which would be related to an alteration of the microbiota and to the impairment of the epithelial barrier, with leakage of the microbial components. PURPOSE: The purpose of this study was to review the association between gut microbiome and pain in the OA population through a review of the literature. METHODS: A literature search was conducted to identify all available studies on the association between the gut microbiome and pain in the OA population, with no publication date limit until September 2020 and no language limit, in the MEDLINE, CINAHL, Web of Science and Cochrane Central Register of Controlled Trials databases. RESULTS: Only three of 2084 studies detected and analyzed by performing the proposed searches in the detailed databases, were finally selected for this review, of which one was with and two were without intervention. These studies only weakly support a relationship between the gut microbiome and OA, specifically a correlation between certain taxa or microbial products and the inflammatory landscape and severity of OA symptoms, including knee pain. Conclusions: Despite encouraging results, this review highlights the paucity of high-quality studies addressing the potential role of the gut microbiome in OA-related pain, along with the disparity of the techniques used so far, making it impossible to draw firm conclusions on the topic.

Lower Limb Tendinopathy Tissue Changes Assessed through Ultrasound: A Narrative Review.

Tendinopathy is a common disease that affects athletes, causing pain and dysfunction to the afflicted tendon. A clinical diagnose is usually combined with imaging and, among all the existing techniques, ultrasound is widely adopted. The aim of this review is to sum up the existing evidence on ultrasound as an imaging tool and guide for treatments in lower limbs tendinopathy. Using three different databases-PubMed, MEDLINE and CENTRAL-a literature search has been performed in May 2020 combining MeSH terms and free terms with Boolean operators. Authors independently selected studies, conducted quality assessment, and extracted results. Ultrasound imaging has a good reliability in the differentiation between healthy and abnormal tendon tissue, while there are difficulties in the identification of tendinopathy stages. The main parameters considered by ultrasound imaging are tendon thickness, hypoechogenicity of tendon structure and neovascularization of the tendon bound tissue. Ultrasound-guide is also used in many tendinopathy treatments and the available studies gave encouraging results, even if further studies are needed in this field.