Lifestyle behavior of physiotherapy students from Ecuador upon admission to higher education: a cross-sectional study.

Introduction: Admission to university has been identified as a period involving the adoption of unhealthy lifestyle behaviors. However, few studies have addressed the extent of this experience among Latin American university students. The aim of this study was twofold: first, to describe anthropometric variables, body composition, physical activity, sedentary behavior, sleep duration and quality, diet, and alcohol consumption in first-year students entering physiotherapy school at the Universidad de las Americas in Quito, Ecuador; second, to test differences in these variables between sexes. Methods: A total of 116 students were recruited. Sociodemographic variables, anthropometric indices, body composition, physical activity, sedentary behavior, sleep quality and duration, adherence to 24-hour movement guidelines, physical fitness (i.e., handgrip strength), diet, alcohol consumption, and smoking habits were evaluated. Results: A total of 50 male (43.1%) and 66 female (56.9%) students were assessed. Overall, the adherence to the 24-hour movement guidelines of the students upon admission to university was 8.6%. Conversely, 86 students (74.1%) did not meet any of the recommendations. Upon admission to university, only 8.6% of the students (female 2.6%; male 6%) met the overall 24-hour movement guidelines. Additionally, 82 students (70.7%) needed changes in diet quality, 81 students (69.8%) had significant sleep disturbances, and 22 students (18.9%) had harmful alcohol consumption. A greater proportion of males met all three 24-h movement recommendations (p = 0.025) than females did. In addition, females reported a greater percentage of occasional smokers (p = 0.025) and a greater prevalence of obesity (p < 0.001), a lower level of physical activity (p < 0.001), and a greater percentage of sleep disturbance (p < 0.001). Conversely, males reported greater waist circumference (p = 0.005), weight (p < 0.001), handgrip strength (p < 0.001), and a greater percentage of harmful alcohol consumption (p < 0.001). Discussion: Our study showed that upon admission to university, overall adherence to the 24-hour movement guidelines is low among university students. Additionally, a high percentage of students reported unhealthy lifestyle behaviors, with differences according to sex. Our findings could lead to the use of specific sex-specific strategies for the prevention and promotion of movement and lifestyle behaviors during this critical period.

Intra-articular Pressure in the Distal Radioulnar Joint: A Biomechanical Study.

PURPOSE: The aim of the study was to use cadaveric models to assess the effect of loading the forearm muscles in different forearm rotations, with or without disruption to the stabilizing components, on the intra-articular pressure of the distal radioulnar joint (DRUJ). METHODS: Ten forearms with no severe osteoarthritis or injury to the DRUJ stabilizers were used. They were placed in a vertical support, and pressure sensors measured pressure within the DRUJ in 5 forearm rotations (neutral, pronation, supination, extension, and flexion) under the following 6 conditions: 1) no loading; 2) loading (at 1/5 of the load per cross-sectional area) with no disruption; 3) loading with disruption of the triangular fibrocartilage complex (TFCC); 4) loading with disruption of the TFCC and ulnar ligaments (ULs); 5) loading with disruption of the TFCC, ULs and interosseous membrane (IM); and 6) loading with disruption of the TFCC, ULs, IM, and pronator quadratus (PQ). RESULTS: Under the no disruption-no load, no disruption-loaded, and disrupted TFCC conditions, the highest intra-articular pressures were recorded in supination. Compared with the no-load condition, pressure was greater in the no disruption-loaded condition with a mean difference (MD) of 1.57 kg/cm2 in a neutral position. In flexion, pressure was greater with a disrupted TFCC (MD, 4.3 kg/cm2). In supination, pressure was only greater with a disrupted TFCC (MD, 3.3 kg/cm2), and pressure decreased in the other disruption conditions. The pressures recorded did not differ from the no disruption-no load condition in pronation or extension. CONCLUSIONS: Pressures within the DRUJ changed with forearm rotations. In the no disruption-no load, no disruption-loaded, and disrupted TFCC conditions, intra-articular pressure was highest in supination. In flexion and supination with load and disruption of stabilizers, intra-articular pressure only increased significantly in the disrupted TFCC condition compared with no load. CLINICAL RELEVANCE: Based on our findings, exercises in supination should be avoided during the first phase of rehabilitation of TFCC injuries given the increased pressure on the DRUJ.

A scoping review of tendon transfer surgeries and postsurgical physical therapy interventions in individuals with massive rotator cuff tears.

OBJECTIVE: To identify tendon transfer surgeries and postsurgical physical therapy interventions in people with massive rotator cuff (RC) tears. METHODS: The literature search was conducted in the MEDLINE, Science Direct, Scopus, Web of Science, and PEDro databases from inception to September 2022. Studies with patients diagnosed with massive RC tears undergoing tendon transfers that reported physical therapy interventions after surgery were included. Two reviewers pooled the data into ad hoc summary tables with the following information: authors, year, study characteristics (sample size, tendon transfer surgical used, approach type, preoperative risk, deficit addressed, additional surgical interventions), and physical therapy interventions (early stage, intermediate stage, and advanced stage). RESULTS: Forty-four articles (59.0% case series) were included, with a total sample of 1213 participants. The most frequently used surgery was the isolated tendon transfer of the latissimus dorsi (49.1%). Most of the studies reported three main stages of physical therapy interventions after tendon transfer surgery: early stage (lasting 5-6 weeks), intermediate stage (started at 7-12 weeks), and advanced stage (started at 12 weeks). Physical therapy interventions included passive, active-assisted, resisted therapeutic exercise, and hydrotherapy. CONCLUSIONS: The evidence regarding physical therapy interventions after RC tendon transfer surgery is limited to the number and duration of the stages and general characteristics without specifying the type and dose of the interventions. Future research with high methodological quality should integrate more detailed rehabilitation protocols to better guide therapeutic decisions after RC transfer surgery.

Correlación entre los Estilos de Aprendizaje Según el Modelo de Felder-Silverman y el Rendimiento Académico de la Asignatura de Morfología y Función en Estudiantes Universitarios / Correlation Between Learning Styles According to the Felder-Silverman Model and the Academic Performance of the Morphology and Function Subject in University Students

El objetivo del estudio fue determinar la relación existente entre la tendencia predominante del estilo de aprendizaje, según el modelo de Felder-Silverman, evaluando el rendimiento académico parcial y final de los estudiantes que cursan la asignatura Morfología y Función I. Se realizó un estudio transversal en 231 estudiantes universitarios que ingresaron a las Facultades de Salud y Educación en el primer semestre del año 2019. Para poder evaluar el rendimiento, a los estudiantes se les aplicó el cuestionario de Índice de Estilos de Aprendizaje y se correlacionó con la nota de la prueba teórica 1, la evaluación práctica 1 y el promedio final de la asignatura. Los resultados muestran que el 53,4 % del total de estudiantes evaluados son visuales, para estos estudiantes el coeficiente de correlación de Spearman fue de -0,378 para prueba teórica (p<0,001), -0.467 para evaluación práctica (p<0,001) y -0.500 para el promedio final (p<0,001). Los estudiantes visuales tienen promedio de notas más altos en la prueba teórica y el promedio final comparado con los activos (p<0,05). Se concluyó que la tendencia predominante es el visual, para estos estudiantes existe una correlación inversa y estadísticamente significativa con el rendimiento académico. Además, presentan un promedio de notas significativamente más alto que las otras tendencias.

SUMMARY: The objective if this study was to determine the relation that exists between the predominant tendency of the learning style, according to the Felder-Silverman model, and partial and final academic performance of the students attending the subject Morphology and Function I. A transversal study was carried out among 231 college students who joined the Faculties of Health and Education during the first term of 2019. They received the Index of Learning Styles Questionnaire and it was correlated with the mark of the theoretical test n°1, the practical evaluation n° 1 and the final average of the course. Results showed that 53.4 % of the total numbers of students assessed are visual, for these pupils the Spearman correlation coefficient was -0.378 for the theoretical test (p<0.001),-0.467 for the practical evaluation (p<0.001) and -0.500 for the final average (p<0.001). Visual students have higher average marks in the theoretical test and the final average contrasted with the active ones (p<0.05). We concluded that the predominant tendency is the visual style. For these students there is an inverted and statistically significant correlation with the academic performance. Besides, they show significantly higher average marks than the other tendencies.

Can exercise-based interventions reverse gray and white matter abnormalities in patients with chronic musculoskeletal pain? A systematic review.

BACKGROUND: Recent evidence has suggested that reversal of gray or white matter abnormalities could be a criterion of recovery in patients with chronic pain. OBJECTIVE: To determine the effectiveness of exercise-based interventions in reversing gray and white matter abnormalities in patients with chronic musculoskeletal pain. METHODS: An electronic search was performed in the MEDLINE (Via PubMed), EMBASE, Web of Science, LILACS, SPORTDiscus, CINAHL, PEDro, and CENTRAL databases. Randomized clinical trials (RCTs) including patients with chronic musculoskeletal pain, which assessed the change in gray and white matter abnormalities after exercise-based interventions were selected. The risk of bias was assessed using the Risk of Bias II tool. RESULTS: Four RCTs were included (n= 386). Three studies showed reversal of abnormalities with exercise-based interventions compared to control groups. The reversal was observed in the gray matter volume in the medial orbital prefrontal cortex and in the supplementary motor area of patients with osteoarthritis, in the hippocampus, insula, amygdala and thalamus in fibromyalgia patients. Furthermore, in patients with chronic spinal pain, reversal was observed in the gray matter thickness of the frontal middle caudal cortex and in the caudate, putamen and thalamus gray matter volume. CONCLUSIONS: There is insufficient evidence to determine the effectiveness of exercise-based interventions for reversing gray and white matter abnormalities in patients with chronic pain. Further studies are still needed in this field.

Effectiveness of anthocyanins rich foods on cardiometabolic factors in individuals with metabolic syndrome: a systematic review and meta-analysis.

PURPOSE: The aim of this systematic review with meta-analysis was to determine whether anthocyanin-rich foods are effective to improve cardiometabolic markers in individuals with metabolic syndrome (MetS), compared with placebo or control interventions. METHODS: We searched MEDLINE, CENTRAL, Embase, LILACS, CINAHL, and Web of Science from their inception up to March 2022. We include clinical trials (randomized clinical trials, controlled clinical trials, and cross-over trials) with anthocyanin-rich foods versus placebo or control intervention that assessment cardiometabolic factors. RESULTS: We found 14 clinical trials that met the eligibility criteria, and we included 10 studies for the quantitative synthesis. For anthocyanin-rich foods versus control interventions, the mean difference (MD) for low-density lipoprotein (LDL) was - 7.98 mg/dL (CI = - 15.20 to - 0.77, GRADE: Very low). For homeostatic model assessment for insulin resistance (HOMA-IR), the MD was 0.04 (CI = 0.08 to 0.16, GRADE: Moderate). The MD for interleukin 6 was 0.00 pg/mL (CI = - 0.01 to 0.00, GRADE: Low). For tumor necrosis factor alpha (TNF-α), the standardized mean difference (SMD) was - 0.52 pg/mL (CI = 0.85 to 0.19 GRADE: Very low) when compared with the control interventions. The certainty of the evidence for the other outcomes it is very low. CONCLUSION: Our findings suggest that anthocyanin-rich foods could improve certain cardiometabolic markers (e.g., TC, TG, LDL, and TNF-α) among individuals with MetS (with very low quality evidence according to GRADE), compared with placebo or other control interventions. PROSPERO REGISTRATION NUMBER: CRD42020187287.

Effectiveness of surgical versus conservative treatment of distal radius fractures in elderly patients: A systematic review and meta-analysis.

BACKGROUND: The aim of this study was to determine whether surgical treatment is more effective than conservative treatment in terms of functional outcomes in elderly patients with distal radius fractures (DRFs). METHODS: An electronic search of the Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases was performed, from inception until July 2021. The eligibility criteria for selecting studies were randomized clinical trials that compared surgical versus conservative treatment in subjects older than 60 years with DRFs. Two authors independently performed the search, data extraction, and assessed risk of bias (RoB) using the Cochrane RoB tool. RESULTS: Twelve trials met the eligibility criteria, and nine studies were included in the quantitative synthesis. For volar plate versus cast immobilization at 1-year follow-up, the mean difference (MD) for PRWE was -5.36 points (p=0.02), for DASH was -4.03 points (p=0.02), for grip strength was 8.32% (p=0.0004), for wrist flexion was 4.35 degrees (p=0.10), for wrist extension was -1.52 degrees (p=0.008), for pronation was 2.7 degrees (p=0.009), for supination was 4.88 degrees (p=0.002), and for EQ-VAS was 2.73 points (p=0.0007), with differences in favor of volar plate. For K-wire versus cast immobilization at 12 months, there were no statistically significant differences in wrist range of motion (p>0.05). CONCLUSIONS: There was low to high evidence according to GRADE ratings, with a statistically significant difference in functional outcomes in favor of volar plate versus conservative treatment at 1-year follow-up. However, these differences are not minimally clinically important, suggesting that both types of management are equally effective in patients older than 60 years with DRFs. LEVEL OF EVIDENCE: I; Therapeutic (Systematic review and meta-analysis of randomized clinical trials).

Effectiveness of multicomponent treatment in patients with fibromyalgia: protocol for a systematic review and meta-analysis.

BACKGROUND: The purpose of this protocol is to provide a new systematic review with meta-analysis using the current methodology to compare the effectiveness of multicomponent treatment versus other interventions for patients with fibromyalgia. METHODS: This protocol conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the recommendations of the Cochrane Collaboration Handbook. An electronic search will be conducted in MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, LILACS, CINAHL, and PEDro, from inception until April 2022. There will be no language restrictions. The Cochrane Collaboration tool for assessing the risk of bias (RoB2) will be used. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale will be used to evaluate the strength of the evidence. The Hartung-Knapp-Sidik-Jonkman random effects or Mantel-Haenszel fixed effects methods will be used, depending on the heterogeneity, to compute a pooled estimate of the mean difference (MD) or standardized mean difference (SMD) and respective 95% confidence intervals for clinical outcomes. DISCUSSION: This systematic review will synthesize evidence on the effectiveness of multicomponent treatment in patients with fibromyalgia and could add important evidence in the treatment of FM to improve clinical practice and decision-making/actions in this field. This new systematic review will try to show the effects of multicomponent treatment by type (endurance, resistance, stretching, or mind-body exercises [pilates or taichi]) and intensity (light, moderate, moderate-to-vigorous, vigorous) of exercise in patients with FM. The results will be disseminated by publication in a peer-reviewed journal. Ethics approval will not be needed because the data used for this systematic review will be obtained from individual trials and there will be no concerns about privacy. However, if we identify ethical issues during the development of the systematic review, these findings will be reported in the discussion of the study. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020142082.

Effectiveness of manual therapy in patients with distal radius fracture: a systematic review and meta-analysis.

OBJECTIVE: To determine the effectiveness of manual therapy (MT) for functional outcomes in patients with distal radius fracture (DRF). METHODS: An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included randomized clinical trials that included MT techniques with or without other therapeutic interventions in functional outcomes, such as wrist or upper limb function, pain, grip strength, and wrist range of motion in patients older than 18 years with DRF. RESULTS: Eight clinical trials met the eligibility criteria; for the quantitative synthesis, six studies were included. For supervised physiotherapy plus joint mobilization versus home exercise program at 6 weeks follow-up, the mean difference (MD) for wrist flexion was 7.1 degrees (p = 0.20), and extension was 11.99 degrees (p = 0.16). For exercise program plus mobilization with movement versus exercise program at 12 weeks follow-up, the PRWE was -10.2 points (p = 0.02), the DASH was -9.86 points (p = 0.0001), and grip strength was 3.9 percent (p = 0.25). For conventional treatment plus manual lymph drainage versus conventional treatment, for edema the MD at 3-7 days was -14.58 ml (p = 0.03), at 17-21 days -17.96 ml (p = 0.009), at 33-42 days -15.34 ml (p = 0.003), and at 63-68 days -13.97 ml (p = 0.002). CONCLUSION: There was very low to high evidence according to the GRADE rating. Adding mobilization with movement and manual lymphatic drainage showed statistically significant differences in wrist, upper limb function, and hand edema in patients with DRF.

Comment on Siracusa et al. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int. J. Mol. Sci. 2021, 22, 3891.

We have read the study by Siracusa et al. [...].

Association between type of rotator cuff tear and functional outcomes in patients with massive and irreparable rotator cuff tear: A pre-post intervention study.

BACKGROUND: The aim of this study was to analyze: (1) the differences in the pre-post change in functional outcomes after a physical therapy program by the type of massive and irreparable rotator cuff tear (MIRCT) controlling for potential confounders, and (2) the influence of lifestyle behaviors and demographic and tear tendon characteristics on function in patients over 60 years of age with conservatively treated MIRCT. MATERIALS AND METHODS: In this pre-post intervention study, 92 patients were prospectively recruited at the Clinical Hospital San Borja Arriaran, with atraumatic MIRCT, between 60 and 75 years of age (mean: 67.9 ± 4.5 years), and the mean of length of symptoms was 16.5 months (±5.7 months). Patients received a physical therapy program consisting of manual therapy and a specific exercise program of 2 sessions per week for 12 weeks. The imaging findings were performed by 2 medical radiologists who classified the rotator cuff tear according to the criteria proposed by Collins. Shoulder function, upper limb function, and pain intensity were assessed with the Constant-Murley; Disabilities of the Arm, Shoulder, and Hand; and visual analog scale (VAS), respectively. Analysis of covariance models were estimated to assess differences in MIRCT categories between functional outcomes. Multiple regression model analysis was used for the association between the change in functional outcomes and lifestyle behaviors, and demographic and tear tendon characteristics. RESULTS: The results showed no pre-post change in functional outcomes by type of MIRCT in all models (P > .05). There is an association between length of symptoms (P = .000), and the baseline values of the 3 functional measures (P = .000) are associated with changes in Constant-Murley; Disabilities of the Arm, Shoulder, and Hand; and VAS. In addition, changes in VAS are associated with body mass index (BMI) (P = .000), and changes in Constant-Murley are associated with gender (P = .023), BMI (P = .000), and tobacco consumption (P = .000). CONCLUSION: There is no difference in functional outcomes by type of MIRCT after a physical therapy program controlling for potential confounders. In addition, there is an association of length of symptoms with all functional outcomes, an association of BMI with VAS and Constant-Murley questionnaire, and an association between tobacco consumption and Constant-Murley questionnaire. Our results could influence the orthopedic surgeon's decisions; thus, not predicting the functional outcome through imaging findings could lead clinicians to reconsider the need for surgery in the treatment algorithm in patients over 60 years with MIRCT. In addition, demographic characteristics and lifestyle behaviors might be considered within the patient's evaluation and follow-up to decide on surgical interventions and evaluate the clinical course of the disease. Further studies measuring additional variables and longer follow-up are needed to confirm these results.

Effectiveness of a multicomponent treatment versus conventional treatment in patients with fibromyalgia: Study protocol.

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain and multiple symptoms. It is a common clinical condition whose etiology is unclear. Currently, there is no gold standard treatment for FM. Management of this condition is therefore aimed at reducing symptoms and maintaining the individual's ability to function optimally. Based on the principal symptoms and characteristics of individuals with FM, we hypothesized that the implementation of a multicomponent treatment (with physical exercise, cognitive behavioral therapy adding to a graded motor imagery program, and therapeutic neuroscience education) would be more effective than conventional treatment in women with FM. This paper describes the rationale and methods of study intended to test the effectiveness of multicomponent treatment versus conventional treatment in patients with FM. METHOD/DESIGN: Fifty-six female individuals between 18 and 65 years of age, who were referred to the physical therapy department of the Rehabilitar Center in Chile, will be randomized into two treatment arms. The intervention group will receive a multicomponent treatment program for duration of 12 weeks. The control group will receive a conventional treatment for this condition for 12 weeks. The primary outcome measure will be the pain intensity score, measured by the numeric pain rating scale (NPRS), and the secondary outcomes will be the FM Impact Questionnaire (FIQ), and affective components of pain, such as catastrophizing using the Pain Catastrophizing Scale (PCS), fear of movement using the Tampa Scale Kinesiophobia (TSK), and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). DISCUSSION: This paper reports the design of a randomized clinical trial aimed at assessing the effectiveness of the multicomponent treatment versus conventional treatment in women with FM. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN number U1111-1232-0862. Registered 22 April 2019.

Effectiveness of supervised early exercise program in patients with arthroscopic rotator cuff repair: Study protocol clinical trial.

BACKGROUND: Based on the available evidence, it is difficult to make a clinical decision about the best exercise program and to establish the most favorable time to start postoperative treatment after rotator cuff (RC) repair. The aim of this trial is to evaluate the effects of adding a supervised early exercise program to standard treatment for functional improvement and pain relief compared with standard treatment alone in patients with arthroscopic RC repair. METHOD/DESIGN: A total of 118 patients between the ages of 18 and 50 years with arthroscopic RC repair will be randomized to 2 treatment arms. The control group will receive a standard exercise program based on a consensus statement on shoulder rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The intervention group will receive a supervised early exercise program in combination with standard treatment. This supervised exercise program will be based on electromyographic evidence. Three evaluations will be performed: before surgery, at 6 weeks, and at 12 weeks. The primary outcome measure will be the shoulder function by the Constant-Murley questionnaire, and the secondary outcome measures will be the upper limb function by the disabilities of the arm, shoulder, and hand questionnaire; pain by the visual analog scale; and the shoulder range of motion by a goniometer. DISCUSSION: We hypothesize that patients who receive a supervised early exercise program in combination with standard treatment will benefit more in respect to shoulder function, pain reduction, and range of motion than those who receive a standard exercise program. If this is confirmed, our study can be used clinically to enhance the recovery of patients with arthroscopic RC repair. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN number U1111-1224-4143. Registered December 18, 2018.

Ultrasonido terapéutico para el aumento de la cicatrización en úlceras venosas de extremidad inferior: CAT / Therapeutic ultrasound to promote healing of lower extremity venous ulcers: CAT

Objetivo: comprobar la validez de los resultados y aplicabilidad respecto a la efectividad de la aplicación del ultrasonido terapéutico en el aumento de la cicatrización de úlceras en extremidad inferior y responder a la interrogante: en sujetos que presentan úlceras venosas de extremidad inferior, ¿puede el ultrasonido terapéutico de alta frecuencia mejorar la tasa de cicatrización, comparado con placebo? Método: se realizó un análisis del artículo “Ultrasonido terapéutico para úlceras venosas en extremidad inferior. Revisión sistemática Cochrane” de Cullum, et al. Resultados: la aplicación de ultrasonido terapéutico de alta frecuencia podría aumentar la cicatrización en sujetos con úlceras venosas de extremidad inferior con riesgo relativo de 1,40 (IC 95 por ciento; 1-1,96). Conclusión: no se aprueba ni desaconseja la aplicación de ultrasonido terapéutico orientada al aumento de la cicatrización en úlceras venosas de extremidad inferior.

Purpose. The aim of this CAT (Critically Appraised Topic) was to check the validity of the results and applicability regarding the effectiveness of therapeutic ultrasound in increasing healing of lower extremity ulcers and to answer the question: In subjects that have lower extremity venous ulcers, does high-frequency therapeutic ultrasound improve healing rate compared to placebo? Method. We conducted an analysis of the article "Therapeutic Ultrasound for lower extremity venous ulcers, Cochrane Systematic Review" of Cullum, et al (2010). Results. The application of high-frequency therapeutic ultrasound could increase healing in patients with lower extremity venous ulcers, RR = 1.40 (95 percent CI 1.00 to 1.96). Conclusion. The use of therapeutic ultrasound to promote healing in lower extremity venous ulcers is neither endorsed nor discouraged.