Capacitive resistive monopolar radiofrequency at 448 kHz plus exercising versus exercising alone for subacromial pain: A sham-controlled randomized clinical trial.

OBJECTIVE: To investigate the effectiveness of thermal and sub-thermal capacitive-resistive monopolar radiofrequency at 448 kHz plus exercising compared to sham radiofrequency plus exercising on pain, functionality, and quality of life in patients with subacromial pain. DESIGN: Randomized, controlled, parallel, double-blind, three-arm clinical trial. SETTING: Hospital and Primary Care. SUBJECTS: Eighty-one participants with subacromial pain in three intervention groups. INTERVENTIONS: Three interventions with capacitive-resistive radiofrequency (thermal, sub-thermal, and sham) over 9 sessions (3 per week) plus an exercising protocol identical for all groups over 15 sessions (5 per week). OUTCOME MEASURES: Visual analogue scale and pressure pain threshold for pain, Shoulder Pain and Disability Index and Quick-Disabilities of the Arm, Shoulder and Hand for functionality, and quality of life via the European Quality of Life-Five Dimensions were assessed at baseline, immediately posttreatment, and 1 month and 3 months post-intervention. RESULTS: No between-group differences were found in the pain visual analogue scale (F = 1.0; P = 0.37), Shoulder Pain and Disability Index (F = 1.0; P = 0.36), European Quality of Life-Five Dimensions (F = 0.76; P = 0.47), and pressure pain (F = 0.14; P = 0.86) outcomes, with a statistical power < 0.30 for all comparisons. Between-group differences were found in the Quick-Disabilities of the Arm, Shoulder and Hand (F = 3.4; P < 0.038), with an improvement of -14.1 points (confidence interval at 95% (95% CI) -28.1 to -0.1) in the thermal versus the sham group at 1 month follow-up. The mobility dimension of European Quality of Life-Five Dimensions improved in a greater proportion of participants in the thermal group (22.2% thermal, 7.4% sub-thermal, and 0.0% sham; P = 0.02). CONCLUSION: Adding thermal radiofrequency to exercising can further improve slightly functionality and mobility in people with subacromial pain in the short term, but not pain perception. Future studies with larger sample sizes are warranted to increase statistical power.

Correlation between three assessment pain tools in subacromial pain syndrome.

OBJECTIVE: To compare the correlation of Visual Analog Scale with pain subsections of Shoulder Pain and Disability Index and Constant-Murley Score in subacromial pain syndrome patients. DESIGN: Single cross-sectional analysis. SETTING: Hospital Rehabilitation Department. METHODS: The assessment tools were applied at baseline. Correlations between Visual Analog Scale, Shoulder Pain and Disability Index and Constant-Murley Score pain subsections were assessed by Pearson correlation coefficient. Linear regression models were calculated between scales. Statistical significance was set at two-sided p < 0.05. RESULTS: Forty-three patients were included. Pearson's correlation between assessments was for Visual Analog Scale-Shoulder Pain Disability Index-pain (r = 0.61, p < 0.001) and for Visual Analog Scale-Constant Murley Score-pain were (r = -0.74, p < 0.001). Visual Analog Scale-Shoulder Pain and Disability Index-pain determination coefficient was r2 = 0.37 and r2 = 0.54 for Visual Analog Scale-Constant-Murley Score-pain. CONCLUSIONS: Visual Analog Scale showed better correlation with Constant Murley Score-pain than with Shoulder Pain and Disability Index-pain in subacromial pain syndrome patients.

Efficacy of high-intensity laser therapy in subacromial impingement syndrome: a three-month follow-up controlled clinical trial.

OBJECTIVES: To evaluate the effectiveness of high-intensity laser therapy on shoulder pain and function in subacromial impingement syndrome. DESIGN: Clinical controlled trial with alternate allocation. SETTING: Hospital Department of Rehabilitation. SUBJECTS: A total of 46 participants with subacromial impingement syndrome. INTERVENTION: Participants were sequence allocated to an intervention group (high-intensity laser therapy + exercise therapy) and control group (sham-laser + exercise therapy) and received 15 sessions (five days a week during three weeks). MAIN MEASURES: Patiens were evaluated at baseline, after 15 sessions, and at one month and at three months after completing the intervention. The main outcome variables were pain and functionality as measured by visual analogue scale; pressure pain threshold; Shoulder Pain and Disability Index; Constant-Murley Score; and QuickDASH. Secondary outcomes were number of sessions at discharge and drug use. RESULTS: A total of 21 patients in high-intensity laser therapy group (56.7 ± 8.9 years) and 22 patients in sham-laser group (61.3 ± 8.9 years) concluded the study. Visual analogue scale (cm) at baseline, one-month, and three-months were 6.2 ± 0.5, 3 ± 2.6, and 2.6 ± 2.4 for the control group and 5.4 ± 1.5, 3.6 ± 1.3, and 1.8 ± 1.7 for experimental group, respectively. Shoulder Pain and Disability Index (points) at baseline, one-month, and three-monts were 51.8 ± 16.1, 16.3 ± 16.1, and 13.6 ± 17.1 in the control group and 41.8 ± 20.6, 20.5 ± 19.7, 11 ± 14.5 in experimental group, respectively. No differences were found between groups ( P > 0.05). CONCLUSION: The effect of high-intensity laser therapy plus exercise is not higher than exercise alone to reduce pain and improve functionality in patients with subacromial syndrome.

High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = -1.3 cm; confidence interval (CI) 95%: -1.6 to -1.0) and an improvement in functionality (standardized mean difference (SMD) = -1.0; CI95%: -1.4 to -0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias.

Short-term effectiveness of kinesio taping as therapeutic tool in conservative treatment of carpal tunnel syndrome: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Carpal tunnel syndrome is the most common peripheral neuropathy of the upper extremities and kinesio taping is one of the tools used as a complementary tool within the conventional treatment of carpal tunnel syndrome. To investigate the short-term effects of kinesio taping on pain, functionality, strength, and nerve conduction in subjects suffering from carpal tunnel syndrome. METHODS: Systematic review with meta-analysis. Seven electronic databases (MEDLINE-Pubmed, Web of Science, Scopus, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were searched for full-text articles published from inception to March 1st , 2023. Studies had to meet the following inclusion criteria: randomised clinical trials, including patients of legal age with mild, moderate, or severe symptoms of carpal tunnel syndrome without associated pathologies, and treating the studied body area with kinesio taping, whether or not in combination with other therapies. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes. RESULTS: Thirteen studies were included, comprising 665 participants with carpal tunnel syndrome. This meta-analysis revealed a strong effect of kinesio taping on distal sensory latency and a weak effect on functionality and pain, while no significantly superior effects were found on the symptom severity, strength, or neurophysiological outcomes (distal motor latency and sensory conduction velocity) compared to other physical therapy techniques or untreated control group in the short term, with moderate-certainty evidence. DISCUSSION: Kinesio taping is a complementary tool to the conventional treatment of carpal tunnel syndrome that improves functionality, pain, and distal sensory latency in the short term.

Effectiveness of Different Electrical Stimulation Modalities for Pain and Masticatory Function in Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

Temporomandibular disorders comprise a set of conditions that include alterations of the temporomandibular joint and masticatory muscles. Although different modalities of electric currents are widely used for treating temporomandibular disorders, previous reviews have suggested these are ineffective. This systematic review and meta-analysis aimed to determine the effectiveness of different electrical stimulation modalities in patients with temporomandibular disorders for reducing musculoskeletal pain, increasing the range of movement, and improving muscle activity. An electronic search was conducted of randomized controlled trials published until March of 2022 that compared the application of an electrical stimulation therapy versus a sham or control group. The main outcome measure was pain intensity. Seven studies were included in the qualitative analysis and in the quantitative analysis (n = 184 subjects). The overall effect of electrical stimulation on pain reduction was statistically superior to sham/control (MD = -1.12 cm; CI 95%: -1.5 to -0.8), showing moderate heterogeneity of results (I2 = 57%, P = .04). The overall effect on range of movement of the joint (MD = 0.97 mm; CI 95%: -0.3 to 2.2) and muscle activity (SMD = -2.9; CI 95%: -8.1 to 2.3) were not significant. Transcutaneous electrical nerve stimulation (TENS) and high-voltage current stimulation reduces pain intensity clinically in people with temporomandibular disorders with a moderate quality of evidence. On the other hand, there is no evidence of the effect of different electrical stimulation modalities on range of movement and muscle activity in people with temporomandibular disorders with a moderate and low quality of evidence respectively. PERSPECTIVE: TENS and high voltage currents are valid options for the control of pain intensity in patients suffering from temporomandibular disorder. Data suggest clinically relevant changes compared to sham. Healthcare professionals should take this into account as it is inexpensive therapy, has no adverse effects and can be self-administered by patients.

Novel Ultrasound Anatomical Measurement of the Deep Transverse Metatarsal Ligament: An Intra-Rater Reliability and Inter-Rater Concordance Study.

Insufficient space below the Deep Transverse Metatarsal Ligament (DTML) could be an etiological factor for Morton's Neuroma (MN). To date, there is a lack of studies measuring the space below the DTML. For this reason, this study assesses the intra- and inter-rater concordance and reproducibility of measurements of the space below the DTML between the third and the fourth metatarsal heads (M3 and M4) using ultrasound imaging to assess and verify the reliability and reproducibility of measurements of the space under the DTML. Forty feet from twenty patients were examined using ultrasound by three trained evaluators at two different times. The two measurements taken on each foot were: base (b)­distance between M3 and M4, and height (h)­distance between the DTML and the plantar skin surface. This was a quantitative, observational, analytical study. The concordance rate between observers for measurements of height and base were 98.5% and 99.5%, respectively. The mean area obtained of the space was 54.6 mm2 and 57.2 mm2 for both the left and right foot (p > 0.05). Reproducibility over time calculated in pre- and post-measurements showed an intraclass correlation coefficient of 1.00 (95%CI: 0.99−1.00), which leads us to conclude that the measurements are perfectly reproducible. Both measurements (height and base) of the space under the DTML, performed by ultrasound, are reliable and reproducible.

What emotions do physical therapy students feel during their first visit to the dissection room?

Dissections are a fundamental practical methodology for teaching human anatomy. However, this experience can be stressful, generating anxiety situations among students. This study tries to understand the attitudes, reactions, fears and anxiety state among students earning a physiotherapy degree when facing their first prosection. A cross-sectional before-and-after study was carried out with students who were provided with an anonymous "ad hoc" questionnaire and the State-Trait Anxiety Inventory (STAI).The values obtained from the total STAI questionnaire remained stable and unchanged during the prosection (p>0.05). The levels of trait anxiety (TA) and state anxiety (SA) remained stable except in female students, who showed higher TA and SA scores, with a significance of p<0.05 before and after the prosection. Although 100% of the students were satisfied with the dissection practices, the experience can provoke stressful responses and should be addressed using coping mechanisms, especially among female students.

The Importance of Optional Practical Anatomy Courses for Undergraduate Speech Therapy Students.

An in-depth understanding of the anatomy discipline is essential for the work of healthcare professionals. In recent decades, the content and time of teaching anatomy have decreased in all health science degrees. The aim of this study was to look for alternatives for compensating the reduction of the teaching of anatomy by supplementing students with a practical training course and to know evaluations of the course given by students enrolled in the degree in Speech Therapy and its impact on their academic results. All students (100%) positively evaluated having acquired skills and attitudes for their future professional life. The majority of the students (95.8%) believed that their knowledge was acceptable; 97.2% of the students thought they would have the possibility to apply their acquired anatomical knowledge as professionals; 98.5% were satisfied with the voluntary course; and finally, the percentage of students that passed the "Anatomophysiology of language and voice organs" course increased from previous academic years. Optional (theoretical/practical) undergraduate courses can be used in parallel to overcome the devaluation of anatomical studies in new curricula. The optional undergraduate anatomy course in the Speech Therapy program has been positively evaluated because it stimulated students' motivation and appealed to their interest in anatomy. Students considered that these courses would help them in their training and they could put what they had learned into practice in their future professions. However, very little evidence for the impact of optional practical courses exists, yet it could be an efficient method to increase anatomical knowledge.

How Relevant Is the Place Where First-Year College Students Live in Relation to the Increase in Body Mass Index?

(1) Objective: This study analyzes the evolution of the body mass index (BMI) throughout the academic year associated with changes in the lifestyle associated with the place where students live during the course, lifestyle design, and health strategies for the university community. (2) Methods: A total of 93 first-year nursing students participated in this study. Data were collected throughout the course by administering self-reported questionnaires about eating habits and lifestyles, weight, and height to calculate their BMI and place of residence throughout the course. Data were analyzed using statistical analysis (Mann-Whitney, chi-square, Student's t-test, repeated-measures analysis of variance, and least significant difference tests). (3) Results: We found that the mean BMI increases significantly throughout the course among all students regardless of sex, age, eating habits, or where they live during the course. At the beginning of the course, the mean BMI was 22.10 ± 3.64. The mean difference between the beginning of the course and the middle has a value of p-value < 0.015 and between the middle of the course and the end a p-value < 0.009. The group that increased the most is found among students who continue to live in the family nucleus rather than those who live alone or in residence. Students significantly changed their eating and health habits, especially those who live alone or in residence. (4) Conclusions: There is an increase in BMI among students. It is necessary to carry out seminars or talks that can help students understand the importance of good eating practices and healthy habits to maintain their weight and, therefore, their health, in the short, medium, and long term and acquire a good quality of life.

Long-term effect of high-intensity laser therapy for persistent shoulder pain: A case report.

BACKGROUND AND OBJECTIVE: This case report describes the long-term effect of the high-intensity laser therapy (HILT) in a patient with chronic shoulder pain refractory in comparison to other treatments. CASE DESCRIPTION: Ten sessions of HILT were applied in a thirty-one-year-old woman diagnosed with subacromial syndrome. Assessment was carried out through different tests: Shoulder Pain and Disability Index (SPADI), Numeric Pain Rating Scale (NPRS) and pressure pain threshold (PPT). All measurements were taken at four different points: at the end of the 10 sessions, after one month, three months after the intervention and nine months after the initial intervention. RESULTS: There was a clinically significant improvement in NPRS (decrease of 5 points), PPT (increase of 1.5 kg/cm2) and SPADI (decrease of 24 points) one month after the intervention. After three months, the increase of NPRS and SPADI required a 5-session intervention to support the clinical improvement. Six months after these booster sessions an increase in PPT and a decrease in NPRS and SPADI were observed. CONCLUSION: Results indicate the suitability of developing new research lines which will optimize the use of HILT.

[Health-related quality of life in patients diagnosed with subacromial syndrome in the Talavera Integrated Area]. / Calidad de vida relacionada con la salud en los pacientes diagnosticados de síndrome subacromial en el Área Integrada de Talavera.

OBJECTIVE: There is a high prevalence of subacromial syndrome among patients with shoulder pathology, where the pain and tendency to chronification are some of its most important characteristics. This is why it is necessary to objectively interact with the quality of life of the subject. The main goal was to determine if there are differences between subacromial patients and asymptomatic patients regarding quality of life. METHODS: Transversal study carried out in the Talavera Integrated Area during the months of November 2016 to March2017. Participated a total of 92 subjects, 46 were symptomatic mating by age and sex with an asymptomatic sample and without joint pathology of the same size and health area. In both cases, the EQ-5D questionnaire was administered. The prevalence was calculated from the waiting list of traumatology physiotherapy in the year 2015. The SPSS statistical program was used, applying the T-test and the chi-square. RESULTS: The EQ-5D questionnaire obtained a standardized mean of 0.70 in the subacromial syndrome and 0.85 in the asymptomatic population (P=0.0001). The prevalence of impingement subacromial within shoulder pathology was 39.19%. CONCLUSIONS: Subacromial syndrome has a high prevalence within the shoulder pathology in the Rehabilitation Service and significantly interferes in the quality of life related to the health of the subject.

OBJETIVO: Existe una alta prevalencia del síndrome subacromial dentro de los pacientes con patología de hombro, en el cual el dolor y la tendencia a la cronificación son alguna de sus características más importantes. Por ello es necesario objetivar su interacción con la calidad de vida del sujeto. El objetivo principal del estudio fue determinar si existían diferencias en la calidad de vida entre sujetos con síndrome subacromial y asintomáticos. METODOS: Se realizó un estudio transversal en el Área Integrada de Talavera de la Reina (Toledo), durante los meses de noviembre de 2016 a marzo de 2017. Participaron un total de 92 sujetos, de los que 46 eran sintomáticos, apareándose por edad y sexo con una muestra asintomática y sin patología articular del mismo tamaño y área de salud. En ambos casos se les administró el cuestionario EQ-5D. La prevalencia se calculó a partir de la lista de espera de fisioterapia traumatológica del año 2015. Se utilizó el programa estadístico SPSS, empleándose la prueba T y la chi-cuadrado. RESULTADOS: El cuestionario EQ-5D obtuvo una media estandarizada de 0,70 en el síndrome subacromial y de 0,85 en la población asintomática (p=0,0001). La prevalencia del impingement subacromial dentro de la patología de hombro fue del 39,19%. CONCLUSIONES: El síndrome subacromial tiene una alta prevalencia dentro de la patología de hombro en el Servicio de Rehabilitación e interfiere significativamente en la calidad de vida relacionada con la salud del sujeto.