Efficacy of Kinesiotape to Improve Upper-Extremity Function in Children and Adolescents with Cerebral Palsy: A Systematic Review.

BACKGROUND: Cerebral palsy (CP) is one of the primary causes of physical disabilities in children that affects posture and movement. Upper-extremity (UE) function is frequently impaired, which may result in activity and participation limitations in people with CP. The use of kinesiotape (KT) has increased in the treatment of CP for various purposes. The aim of this systematic review was to assess the efficacy of KT for improving UE function in children and adolescents with CP. METHODS: The literature search was carried out in PubMed, Cochrane, PEDro, Web of Science and SCOPUS databases. The methodological quality was analyzed with the PEDro scale. Review Manager (RevMan 5.4.1) was used for data extraction and risk of bias assessment. RESULTS: A total of five randomized clinical trials were included. The use of KT showed improvement in UE functionality in three studies, with significant outcomes for range of motion (ROM) (three studies), fine motor skills (two studies), grip strength (one study) and manual dexterity (one study). Moreover, it also showed significant improvements in spasticity and gross motor function (one study). Overall, methodological quality was moderate, and the risk of bias was high in the domains related to blinding. CONCLUSION: The use of KT showed improvement in UE function in children and adolescents with CP. However, further research is needed to reinforce the conclusions on the efficacy of KT as a therapeutic tool.

Physical Activity in Cerebral Palsy: A Current State Study.

This document analyzes a survey conducted in three geographical areas in Spain, focusing on centers for individuals with cerebral palsy (CP). The study aims to determine the adherence rate to recommended physical activity guidelines, assess if there is a decline in interest in physical activity over time, identify the stage at which this decline occurs, and explore potential mechanisms, tools, or strategies to sustain long-term engagement in regular physical activity for this population. The 36-item questionnaire comprises multiple-choice, open-ended, and Likert scale-type questions. Data were collected on physical activity frequency and duration, daily living activities, and demographics. Statistical analysis identified patterns and relationships between variables. Findings reveal that only a 17.6% meets the World Health Organization (WHO) recommendations regarding regular physical activity (RPA), decreasing in frequency or number of days a week, (3.7 d/w to 2.9 d/w; p < 0.01) and duration (50.5 min/d to 45.2 min/d; p < 0.001) with age, especially for those with higher Gross Motor Function Classification System (GMFCS) mobility levels. Obesity slightly correlates with session duration (ρ = -0.207; p < 0.05), not mobility limitations. Gender has no significant impact on mobility, communication, or physical activity, while age affects variables such as body mass index (BMI) and engagement (p < 0.01). A substantial proportion follows regular physical activities based on health professionals' advice, with interest decreasing with age. To improve adherence, focusing on sports-oriented goals, group sessions, and games is recommended. These findings emphasize the importance of personalized programs, particularly for older individuals and those with greater mobility limitations.

Effectiveness of a Telecare Physical Therapy Program in Improving Functionality in Children and Adolescents with Cerebral Palsy: A Cases Study.

Cerebral palsy (CP) is the most common physical disability in childhood and results in motor impairment that is often associated with other disorders. The aim of this study was to assess whether a telecare intervention consisting of Action Observation Therapy with a family-center approach produces improvements in functionality in children and adolescents with CP. Seven girls with CP ages between 6 and 17 participated in this case series study that lasted 12 weeks: 6 weeks of telecare program with a total of six sessions; and a follow-up period of 6 weeks. The outcome variables were Gross Motor Function (Spanish version of the Gross Motor Function Measure), balance (Spanish version of the Pediatric Balance Scale), walking endurance (6-min walk test) and walking speed (10-m walk test). The variables were measured before starting the study, after 6 weeks of intervention and after the 6-week follow-up period. Results showed statistically significant improvements in gross motor function (p = 0.02) after the intervention. After the follow-up period, gross motor function remained statistically significant (p = 0.02), as well as balance (p = 0.04) and walking endurance (p = 0.02). These results show that a telecare program has been beneficial in improving functionality with enhancements in gross motor function, balance and endurance in children and adolescents with CP that will facilitate participation.

Evaluation of Physical Therapy Interventions for Improving Musculoskeletal Pain and Quality of Life in Older Adults.

Background: The ageing process may lead to functional limitations, musculoskeletal pain, and worsened quality of life. The aim of this paper is to evaluate two physical therapy interventions for reducing musculoskeletal pain and improving quality of life in older adults. Methods: A cohort study was carried out with older people (60−75 years old). The Geriatric Physical Therapy group (n = 70) received massage therapy, therapeutic exercise, and therapeutic education program for 5 weeks; the Standardized Therapeutic Exercise group (n = 140) received a standardized therapeutic exercise and therapeutic education program for 3 weeks. Health-related quality of life (SF-36v2) and musculoskeletal pain intensity (VAS) were collected at baseline (A0), post-intervention (A1), and 12 weeks after baseline (A2). Results: There was pain intensity reduction in both groups (p < 0.05) and health-related quality of life improvement, except for Emotional Role (p = 0.34); Physical Function (p = 0.07), Bodily Pain (p = 0.02), and General Health (p = 0.09). At A2 there was a difference (p < 0.05) for neck pain in favor of the Geriatric Physical Therapy Group. Conclusions: Within the limitations of the study, it was possible to conclude that both physical therapy interventions showed a positive effect for reducing non-specific neck pain and low back pain in older adults, which may contribute to health-related quality of life improvement.

Responsiveness of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL).

OBJECTIVE: To evaluate the responsiveness of the Spanish version of the Newcastle Stroke-specific Quality of Life measure (NEWSQOL) to assess quality of life in Spanish people after suffering a stroke. DESIGN: A prospective observational study was conducted to assess the responsiveness of the Spanish version of NEWSQOL. The sample contained 128 patients who filled in the questionnaires before and after a physical therapy intervention. The responsiveness was assessed with p-values using the effect size (ES) and the standardized response means (SRMs) of the change. Besides, two other external criteria were used to distinguish patients who improved with the treatment from those who remained stable. This classification was based on one functional independence measure (the Barthel Index) and one disability measure (the modified Rankin Scale). RESULTS: There was a statistically significant correlation (Spearman's coefficient = p < 0.01) between the domains of the Spanish version of NEWSQOL in relation to the Barthel Index and the modified Rankin Scale. All domains showed between marked-to-mild change responsiveness except sleep and relationships; mobility (ES 0.66 and SRM 0.92) and activities of daily living (ES 0.75 and SRM 0.87) were markedly responsive; communication (ES 0.38 and SRM 0.61) was moderately responsive; and pain, vision, cognition, feelings, emotions and fatigue were mildly responsive (ES 0.21-0.41 and SRM 0.23-0.44). CONCLUSION: The Spanish version of NEWSQOL shows between marked and mild responsiveness to measure the perception of QoL in post-stroke patients. Therefore, its use can be suitable for evaluation studies, clinical trials and clinical practice.

A Low-Cost Assistive Robot for Children with Neurodevelopmental Disorders to Aid in Daily Living Activities.

In this paper, we present a new low-cost robotic platform that has been explicitly developed to increase children with neurodevelopmental disorders' involvement in the environment during everyday living activities. In order to support the children and youth with both the sequencing and learning of everyday living tasks, our robotic platform incorporates a sophisticated online action detection module that is capable of monitoring the acts performed by users. We explain all the technical details that allow many applications to be introduced to support individuals with functional diversity. We present this work as a proof of concept, which will enable an assessment of the impact that the developed technology may have on the collective of children and youth with neurodevelopmental disorders in the near future.

Validation of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL).

BACKGROUND: Stroke causes a wide variety of clinical manifestations that may have a negative impact on quality of life. Therefore, it is very important to use specific instruments for measuring quality of life in individuals who suffered a stroke. The aim of this study was to develop a psychometrically validated Spanish version of the Newcastle stroke-specific quality of life measure (NEWSQOL). METHODS: A psychometric validation of the Spanish version of the NEWSQOL questionnaire was carried out in 159 patients. The reliability (intraclass correlation coefficient and Cronbach's alpha coefficient), validity (factorial analysis and Spearman's coefficient), feasibility (response rate), and the ceiling and floor effects were calculated. RESULTS: Internal consistency showed that Cronbach's alpha coefficient was 0.93. The test-retest reliability was high or excellent for all domains (range 0.71-0.97 p < 0.001). The response rate of the questionnaire was 100% and the average administration time was 20.5 (±7.2) min. No ceiling effect was detected and two domains (pain and vision) may have a significant potential for floor effect. Construct validity showed that all the variables are important enough to keep them all in the questionnaire. Concerning convergent construct validity, a high correlation was found with the Nottingham Health Profile, the Barthel Index, and the Modified Rankin Scale. CONCLUSION: The Spanish version of the NEWSQOL questionnaire is reliable, valid, and feasible to evaluate quality of life in the Spanish population.

Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial.

BACKGROUND: Chronic non-specific neck pain is related to limited cervical mobility, impaired function, neck muscles myofascial pain syndrome, and stress at work. The aforementioned factors are strongly related and may lead to a negative impact on health-related quality of life. There are some effective conservative Physical therapy interventions for treating chronic non-specific neck pain. Currently, Deep Dry Needling is emerging as an alternative for improving symptoms and consequently, the quality of life in patients with chronic non-specific neck pain. The purpose of the study was to examine the effectiveness of Deep Dry Needling of myofascial trigger points on health-related quality of life improvement, as a secondary analysis, in people with chronic non-specific neck pain. METHODS: A randomized parallel-group blinded controlled clinical trial was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2011 to September 2014. One hundred thirty subjects with chronic non-specific neck pain and active myofascial trigger points in neck muscles were randomly allocated into two groups. Subjects in the intervention group (n = 65) were treated with Deep Dry Needling in active myofascial trigger points plus stretching in neck muscles; Control group (n = 65) received only stretching. Both interventions lasted 2 weeks, 2 sessions per week. Health-related quality of life was measured with Short Form-36 (SF-36), in 5 assessments: at baseline, after intervention period; and at 1, 3 and 6 months after intervention. RESULTS: For both groups, SF-36 mean values increased in all dimensions in every assessment. Significant differences (p < 0.05) were found in favor of the intervention group for all dimensions at the last assessment. For some dimensions (physical function, physical role, social function and vitality), the evidence was more consistent from the beginning. CONCLUSIONS: Deep Dry Needling plus stretching is more effective than stretching alone for Health-related quality of life improvement, especially for physical function, physical role, social function and vitality dimensions, in people with non-specific neck pain. TRIAL REGISTRATION: Current Controlled Trials ISRCTN22726482 . Registered 9 October 2011.

Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial.

BACKGROUND AND PURPOSE: Shoulder pain is a prevalent condition in older adults. Some authors associate nonspecific shoulder pain with myofascial trigger points (MTrPs) in the infraspinatus muscle. Dry needling is recommended to relieve the MTrP pain of shoulders in the short term (<9 days). Active MTrPs dry needling improves shoulder pain and the irritability of the satellite MTrPs in the referred pain area. Nociceptive activity at a latent MTrP may influence motor activity and the sensitivity of MTrPs in distant muscles at a similar segmental level. Therefore, this study aimed to evaluate dry needling on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle of older adults with nonspecific shoulder pain. METHODS: A single-center, randomized, single-blinded, controlled study (NCT02032602) was carried out. Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder were randomly assigned to (1) of (2) treatment groups. A session of dry needling on the infraspinatus was performed in (1) the most hyperalgesic active and latent MTrP or (2) only the most hyperalgesic active MTrP. The Numeric Rating Scale, the pressure pain threshold (primary outcome) on the anterior deltoid and extensor carpi radialis brevis latent MTrPs, and grip strength were assessed before, after, and 1 week after the intervention. RESULTS: Statistically significant differences in the reduction of pain intensity (P ≤ .001; η = 0.159-0.269; d = 1.017-1.219) and the increase of pressure pain threshold (P < .001; η = 0.206-0.481; d = 0.870-1.924) were found for the (1) treatment group immediately and 1 week postintervention. Nevertheless, no statistical significant differences were found in grip strength (P >. 05; η = 0.006-0.033; d = 0.158-0.368). CONCLUSIONS: One dry needling intervention of the latent MTrP associated with the key active MTrP of the infraspinatus reduces pain intensity and the irritability of the satellite MTrPs located in the referred pain area in the short term in older adults with nonspecific shoulder pain.

Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study.

BACKGROUND: Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. PURPOSE: To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. METHODS: This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. RESULTS: Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). CONCLUSIONS: A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis brevis muscle area immediately following and 1 week after the intervention in older adults with nonspecific shoulder pain.

Spanish cultural adaptation and validation of the shoulder pain and disability index, and the oxford shoulder score after breast cancer surgery.

BACKGROUND: The Oxford Shoulder Score (OSS) and the Shoulder Pain and Disability Index (SPADI) are patient-based outcome scores with valid psychometric properties which are widely used for shoulder interventions. OBJECTIVE: The purpose of the study is to adapt both questionnaires cross-culturally to Spanish, and to test their reliability, validity, responsiveness, and feasibility. DESIGN: Cultural adaptation and psychometric validation study. METHODS: Consecutive patients who had undergone breast cancer surgery referred to an outpatient clinic at the University of Alcalá de Henares, Spain. One hundred and twenty women who had undergone breast cancer surgery, with pain and shoulder dysfunction. Cross-cultural adaptation was performed according to the international guidelines. Reliability was analysed by test-retest reliability and internal consistency. Content and convergent construct validity were measured by the Expert Committee's and Spearman coefficient respectively. Responsiveness, feasibility, floor and ceiling effects were also tested. RESULTS: One hundred and twenty women aged 54.2 (±11) years took part in the study. The reliability was excellent; test-retest reliability was 0.974 (p < 0.001) for OSS, and 0.992 (p < 0.001) for SPADI; and Cronbach's alpha value was 0.947 for OSS, and 0.965 for SPADI. High construct validity was found between the OSS and SPADI questionnaires (r = -0.674). The effect size (ES) and standardized response mean (SRM) was moderate in OSS (ES = 0.50 and SRM = 0.70 (p < 0.001)), and moderate to good in SPADI (ES = 0.59 and SRM = 0.82 (p < 0.001)). LIMITATIONS: This study has some limitations, such as the group of participants is composed only of women following breast cancer treatment; the measurement took place in a single centre; and all the questionnaires administered were always provided to the participants in the same order. CONCLUSIONS: The OSS and SPADI Spanish versions are applicable, reliable, valid, and responsive to assess shoulder symptoms and quality of life in Spanish women with shoulder pain and disability after breast cancer treatment.

Responsiveness of the Spanish Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaires Short Forms (PFDI-20 and PFIQ-7) in women with pelvic floor disorders.

OBJECTIVE: To evaluate the responsiveness of the Spanish versions of Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7), in order to assess symptoms and quality of life in Spanish women with pelvic floor disorders. STUDY DESIGN: Prospective observational study to assess the responsiveness in 85 women with pelvic floor disorders. PFDI-20 and PFIQ-7 were completed before and after Physiotherapy intervention. The responsiveness was assessed with the p values using the Wilcoxon signed-rank test, the standardized response means of the change (SRM) and the effect size (ES). RESULTS: The Spanish PFDI-20 and PFIQ-7 and the subscales demonstrated small to good responsiveness. The responsiveness was higher for PFDI-20 than for PFIQ-7. The statistic for PFDI-20 was moderate to good (ES 0.68 and SRM 0.84; p<0.0001), and small to moderate for PFIQ-7 (ES 0.48 and SRM 0.57; p<0.0001). Regarding the subscales, the responsiveness was better for Pelvic Organ Prolapse Distress Inventory (POPDI) than Pelvic Organ Prolapse Impact Questionnaire (POPIQ) (ES 0.70 and SRM 0.78; ES 0.42 and SRM 0.47 respectively; p<0.0001). Moderate responsiveness was found for Urinary Distress Inventory (UDI) and Urinary Impact Questionnaire (UIQ) (ES 0.54 and SRM 0.67; ES 0.52 and SRM 0.61 respectively; p<0.0001). Colo-Rectal-Anal Distress Inventory (CRADI) and Colo-Rectal-Anal Impact Questionnaire (CRAIQ) showed poor responsiveness, small in both (ES 0.42, SRM 0.50 and p<0.0001; ES 0.34, SRM 0.39 respectively; p<0.001). All responsiveness was significant. CONCLUSIONS: PFDI-20 and PFIQ-7 Spanish versions showed good responsiveness to evaluate the symptoms and the quality of life in Spanish women with PFD undergoing Physiotherapy treatment.

Mobilization With Movement for Shoulder Dysfunction in Older Adults: A Pilot Trial.

OBJECTIVE: The purpose of this study was to evaluate the feasibility of the methods proposed to conduct a full randomized clinical trial to assess the effectiveness of mobilization with movement on shoulder functionality in older adults with shoulder dysfunction. METHODS: A pilot, randomized, single-blinded clinical trial was carried out with 44 older adults (83.9±8.2 years) with shoulder dysfunction in 3 nursing homes in Toledo, Spain. Participants were recruited through information sessions and were randomly allocated into 2 groups. The control group (n = 22) intervention consisted of a physical therapy standard protocol proposed by the Spanish Rheumatology Society. Techniques based on Mulligan's concepts of mobilization with movement were added to the standard protocol for the experimental group (n = 22) intervention. Interventions took place 3 times a week for 2 consecutive weeks and were performed by 2 experienced therapists. Main outcomes were recruitment rates, participation and adherence to interventions, assessment procedures, and the implementation of mobilization with movement. Clinical outcomes were shoulder functionality, active glenohumeral range of motion, and pain intensity. Data were collected at baseline, after each group intervention, and at 1 and 3 months after finishing interventions. RESULTS: All the participants accepted to be randomized. Participation rates were 97.7% for the experimental group and 95.5% for the control group. The analysis of variance did not show any statistically significant difference between treatment groups for any of the variables (all P values for the group effect were greater than .36) or a change of the difference between groups over time (all P values for the time-treatment interactions were greater than .3). CONCLUSION: The research methods tested in this pilot study offer a suitable foundation to conduct a full clinical trial.

Cultural adaptation and validation of the Pelvic Floor Distress Inventory short form (PFDI-20) and Pelvic Floor Impact Questionnaire short form (PFIQ-7) Spanish versions.

OBJECTIVE: To develop a linguistically adapted and psychometrically validated Spanish version of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7) to assess symptoms and quality of life in Spanish women with pelvic floor disorders. STUDY DESIGN: Cross-cultural linguistic adaptation was performed following the translation-backtranslation method in 30 native Spanish-speaking women with pelvic floor disorders to obtain PFDI-20 and PFIQ-7 Spanish versions. The psychometric properties were evaluated in 114 women with pelvic floor disorders. We calculated the reliability with the intraclass correlation coefficient and Cronbach's alpha coefficient, the validity with Spearman coefficient, the feasibility with the response rate and the filling time, and the ceiling and floor effects. RESULTS: Spanish versions of the PFDI-20 and PFIQ-7 achieved good semantic, conceptual, idiomatic and content equivalence. Concerning the psychometric validation, internal consistency was high with Cronbach's alpha coefficient of 0.837 (p<0.001) for PFDI-20 and 0.967 (p<0.001) for PFIQ-7. The test-retest reliability was 0.644 (p<0.001) for the PFDI-20 and 0.786 (p<0.001) for the PFIQ-7. Good construct validity was found with questionnaires: SF-12, EPIQ and ICIQ-SF. The average administration time was 10.1 (5.8)min for the PFDI-20, and 7.5 (4.7)min for the PFIQ-7. A ceiling effect was detected in the PFIQ-7 (25.4%). CONCLUSIONS: The PFDI-20 and PFIQ-7 Spanish versions showed semantic, conceptual, idiomatic and content equivalence with the original versions. Both instruments are reliable, valid and feasible to evaluate symptoms and quality of life in Spanish women with pelvic floor disorders.