Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.

Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness of some physiotherapy techniques in the treatment of PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were "dysmenorrhea", "physical the-rapy", "physiotherapy", and "manual therapy". The search was performed in five databases: Scopus, PubMed, PEDro, Web of Science, and Medline, in February 2021. The inclusion criteria were randomized controlled trials over the last six years. Articles not related to the treatment of PD or using pharmacology as the main treatment were excluded. Nine articles met the objectives and criteria, with a total of 692 participants. The most used scale to measure pain was the VAS (visual analogue scale). The main techniques were isometric exercises, massage therapy, yoga, electrotherapy, connective tissue manipulation, stretching, kinesio tape, progressive relaxation exercises and aerobic dance. Meta-analysis shows benefits of physiotherapy treatment for pain relief compared with no intervention or placebo (MD: -1.13, 95% CI: -1.61 to -0.64, I2: 88%). The current low-quality evidence suggests that physiotherapy may provide a clinically significant reduction in menstrual pain intensity. Given the overall health benefits of physiotherapy and the low risk of side effects reported, women may consider using it, either alone or in conjunction with other therapeutic modalities.

Effectiveness of Physiotherapy Treatment for Urinary Incontinence in Women: A Systematic Review.

BACKGROUND: Urinary incontinence (UI) may be defined as involuntary urine loss, which can be diagnosed based on patient-reported measures and is a hygiene and social problem in those who have it, affecting their quality of life negatively. OBJECTIVE: The study aimed to determine the effectiveness of distinct physiotherapy techniques used in the treatment of UI in women through a systematic review of the existing literature. The scales and instruments used for the assessment and follow-up of UI were described. METHODS: On searching the PubMed, Dialnet, PEDro, and SciELo databases, 16 articles, with information on 1220 patients that comply with the inclusion criteria and conform to the proposed objectives were obtained, limiting the publication period to 2007-2016. The PRISMA statement was adopted. RESULTS: The "Pad Test" is a commonly used diagnostic test and bladder diaries on paper; the Oxford scale was used in the assessment of pelvic floor muscle strength. Distinct protocols and techniques have been described in the treatment of UI in women, namely, pelvic floor exercises, vaginal cones, biofeedback, and electrostimulation. Upon analysis of the content of the articles, the quality of the included clinical trials was determined using the PEDro scale. CONCLUSIONS: Studies included in this work propose that physiotherapy treatment may improve UI, the patients' quality of life, and social relations in women. It is necessary to establish group treatment protocols for women with UI, supervised by a physiotherapist to reduce the financial burden incurred from this health problem.

Tratamiento y rehabilitación de la disfagia tras enfermedad cerebrovascular / Treatment and rehabilitation of dysphagia following cerebrovascular disease

Introducción. La bronconeumonía es una complicación frecuente en los primeros días después de una enfermedad cerebrovascular y se asocia con una mayor tasa de mortalidad. Se produce en pacientes con el nivel de conciencia o el reflejo tusígeno alterado, y podría prevenirse con un programa temprano de rehabilitación de la disfagia. Objetivo. Revisar la literatura científica en relación con el tratamiento y rehabilitación de pacientes con disfagia tras sufrir un ictus, entre 2002 y 2012. Desarrollo. Las bases de datos PubMed, Cochrane, PEDro, CINAHL y ENFISPO ofrecieron 15 artículos que cumplieron los criterios de inclusión y los objetivos planteados, con información sobre 3.212 pacientes. Se describen distintos protocolos y técnicas para la reeducación de la disfagia, como estrategias compensatorias, terapia de regulación orofacial, musicoterapia, estimulación sensorial, entrenamiento muscular labial, de la lengua, faringe, laringe y aparato respiratorio, maniobra de Mendelsohn, estimulación eléctrica neuromu cular, estimulación magnética transcraneal repetitiva y acupuntura. Conclusiones. Los estudios incluidos en esta investigación afirman que el tratamiento de la disfagia tras ictus puede mejorar la función deglutoria (coordinación, velocidad, volumen), la calidad de vida y las relaciones sociales de las personas. Existe una labor pendiente para establecer o definir qué tipo de terapias, técnicas, ejercicios o maniobras son los más eficaces en la disfagia, y para elaborar protocolos de tratamiento o rehabilitación consensuados dentro de las unidades que abordan integralmente el ictus (AU)

Introduction. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. Aims. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. Development. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetiti transcranial magnetic stimulation and acupuncture. Conclusions. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people’s social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner(AU)

[Home-based rehabilitation in the functional recovery of patients with cerebrovascular disease]. / Rehabilitacion domiciliaria en la recuperacion funcional de los pacientes con enfermedad cerebrovascular.

INTRODUCTION: The study of the effectiveness of rehabilitation treatment applied to patients with sequelae following a cerebrovascular disease (CVD) plays a decisive role nowadays in planning their management in public healthcare and to improve existing guidelines regarding assessment and treatment. AIM: To describe the characteristics presented by patients who have suffered a CVD and were treated in mobile rehabilitation-physiotherapy units (MRPU) and how such treatment affects their functional recovery. PATIENTS AND METHODS: Descriptive, prospective study conducted on 124 patients referred to the MRPUs in the province of Almeria between 2008 and 2011. The variables analysed (both pre- and post-treatment) included personal history and characteristics, Barthel index, Modified Ashworth Spasticity Scale, pain (shoulder) and the Canadian Neurological Scale. RESULTS: The final sample consisted of 106 participants (mean age: 73.72 years). The disabling process was ischaemic in 77.4% and hypertension was the most prevalent risk factor (81%). The mean initial Barthel index was 31.04 and the mean final index was 57.62 (t = -11.75; p < 0.001). The Canadian Neurological Scale showed a favourable progression in the level of consciousness, orientation and language (p < 0.001). Altogether 56.2% of the patients were discharged as a result of the improvement of their condition, and did not require any further outpatient rehabilitation. CONCLUSIONS: The results obtained reflect an important functional improvement in patients treated in the MRPUs. Home-based rehabilitation is considered a necessary tool for persons with greater clinical vulnerability and no access to outpatient care, which provides them with the benefits of effective treatment.

TITLE: Rehabilitacion domiciliaria en la recuperacion funcional de los pacientes con enfermedad cerebrovascular.Introduccion. El estudio de la eficacia en los tratamientos de rehabilitacion aplicados a pacientes con secuelas tras una enfermedad cerebrovascular (ECV) resulta decisivo en la actualidad para planificar su abordaje desde la sanidad publica y mejorar las directrices de evaluacion y tratamiento existentes. Objetivo. Describir las caracteristicas que presentan los pacientes que han sufrido ECV atendidos por las unidades moviles de rehabilitacion-fisioterapia (UMRF) y como influyen estos tratamientos sobre su recuperacion funcional. Pacientes y metodos. Estudio descriptivo prospectivo en 124 pacientes derivados a las UMRF de la provincia de Almeria entre 2008 y 2011. Se analizaron variables (pre y postratamiento) como las caracteristicas y antecedentes personales, indice de Barthel, escala de espasticidad de Ashworth modificada, dolor (hombro) y escala neurologica canadiense. Resultados. La muestra final estuvo compuesta por 106 participantes (edad media: 73,72 años). El proceso discapacitante fue isquemico en un 77,4%, y la hipertension, el factor de riesgo mas prevalente (81%). La media del indice de Barthel inicial fue de 31,04, y la media del indice final, de 57,62 (t = ­11,75; p < 0,001). La escala canadiense mostro una evolucion favorable en el nivel de conciencia, orientacion y lenguaje (p < 0,001). El 56,2% de los pacientes recibio alta por mejoria, sin precisar rehabilitacion ambulatoria adicional. Conclusiones. Los resultados obtenidos reflejan una importante mejora funcional en los pacientes tratados en las UMRF. La rehabilitacion domiciliaria se plantea como una herramienta necesaria para las personas con mayor vulnerabilidad clinica y sin acceso a los cuidados ambulatorios, que logra los beneficios de tratamientos que son efectivos.

Análisis de la actividad en las unidades móviles de rehabilitación-fisioterapia en atención primaria / Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care

ObjetivoDescribir la atención domiciliaria que ofrecen los equipos móviles de rehabilitación-fisioterapia (EMRF) como respuesta a las necesidades de la población dependiente, las características que tiene su aplicación y las consecuencias que produce sobre el paciente y su independencia funcional.DiseñoEstudio descriptivo transversal desde 2004 hasta junio de 2007.EmplazamientoMedio comunitario. Los EMRF de atención primaria en Almería.ParticipantesEn total 1.093 pacientes incluidos en el programa.Mediciones principalesSe recogió sistemáticamente el estado de salud de los pacientes (proceso discapacitante principal, motivos de inclusión en el tratamiento, valoración funcional inicial y final e índice de Barthel), los datos sobre la atención fisioterapéutica y el n.o de sesiones.ResultadosUn 64,2% de la muestra fueron mujeres; la edad media fue de 78 años. El tiempo medio de espera para su valoración fue de 4 días y hubo una gran diversidad de procesos discapacitantes principales que han quedado descritos. Existió un elevado porcentaje de síntomas de grave deterioro motor, dolor y debilidad muscular. El 88,6% de los pacientes realizó tratamiento fisioterapéutico; el 11,1% de los pacientes fisioterapia y tratamiento ocupacional y el 0,3% de los pacientes tratamiento ortésico. El número medio de sesiones fue de 12,85. Se describe la variación en el índice de Barthel final tras la intervención realizada (cinesiterapia [61,9%]; combinada con electroterapia [10,2%]; cinesiterapia y educación al cuidador [14,5%], etc.).ConclusionesSe aporta información valiosa respecto a las características de la población geriátrica y dependiente así como la ayuda fisioterapéutica que viene recibiendo y cómo se lleva a cabo el proceso(AU)

ObjectiveTo describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence.DesignA descriptive, cross-sectional study from 2004 to June 2007.SettingCommunity setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria.ParticipantsA total of 1093 patients were included in the programme.Main measurementsData were collected on, the state of the patients’ health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions.ResultsOf the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education.ConclusionsValuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out(AU)

[Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care]. / Análisis de la actividad en las unidades móviles de rehabilitación-fisioterapia en atención primaria.

OBJECTIVE: To describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence. DESIGN: A descriptive, cross-sectional study from 2004 to June 2007. SETTING: Community setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria. PARTICIPANTS: A total of 1093 patients were included in the programme. MAIN MEASUREMENTS: Data were collected on, the state of the patients' health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions. RESULTS: Of the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education. CONCLUSIONS: Valuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out.