Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study.

BACKGROUND: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. OBJECTIVE: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. METHODS: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. RESULTS: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). CONCLUSIONS: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.

Kinesio Taping vs. Auricular Acupressure for the Personalised Treatment of Primary Dysmenorrhoea: A Pilot Randomized Controlled Trial.

BACKGROUND: Dysmenorrhoea is the medical term for menstrual pain. The World Health Organization estimates that up to 81% of women of childbearing age are affected by this condition, and it is one of the leading causes of absenteeism from work and school among women. Although there are pharmacological treatments available for menstrual-pain relief, they do not respond to all women's needs. Therefore, there is a need to study and develop non-pharmacological alternatives to broaden the individualised treatment options for dysmenorrhea. There are scarce studies published on non-pharmacological treatments, such as kinesio tape and auricular acupressure for the relief of menstrual pain, but the scientific evidence available suggest that these techniques may be beneficial in addressing this problem. The objective of this pilot study was to assess and compare the effectiveness of kinesio tape and auricular acupressure to decrease pain and drug intake in women with primary dysmenorrhoea. METHODS: This was a double-blind randomized clinical controlled trial. The period of study was from September 2017 to August 2018. Women enrolled in the University of Extremadura and who had primary dysmenorrhoea were randomized to five groups: control (n = 23), kinesio tape (n = 23), placebo kinesio tape (n = 23), auricular acupressure (n = 23) and placebo auricular acupressure (n = 22). Measures were taken during the pretreatment phase (at four menstrual cycles), during the post-intervention phase (at four menstrual cycles) and during the follow-up phase (at the first and third menstrual cycles after the treatment was completed). The primary outcome measures were mean pain intensity, maximum pain intensity, number of painful days and dose of drug intake during menstruation, measured with the Visual Analogue Scale. The secondary outcome measures were the length of the cycle, the length of menstruation, the drug intake and the type of drug. RESULTS: In all, 108 participants completed the study. The statistical analysis (MANOVA, ANOVA, t-paired and McNemar tests) showed that kinesio tape and auricular acupressure have a beneficial effect on pain relief (mean pain intensity, p < 0.001; maximum pain intensity, p < 0.001; number of painful days, p = 0.021; dose of drug intake, p < 0.001). In addition, once the treatments were withdrawn, the auricular-acupressure group maintained lower scores during the first follow-up cycle (p < 0.001). CONCLUSIONS: Kinesio tape and auricular acupressure decrease pain and drug intake in women with primary dysmenorrhoea. The changes in the auricular-acupressure group seemed to last longer. The results suggest that these techniques could be used as complementary personalised therapies to the pharmacological treatment and not as a substitution.

The effects of ear acupressure, massage therapy and no therapy on symptoms of dementia: a randomized controlled trial.

OBJECTIVE: To assess the effectiveness of ear acupressure and massage vs. control in the improvement of pain, anxiety and depression in persons diagnosed with dementia. DESIGN: A pilot randomized controlled trial. SETTING: Residential homes in Extremadura (Spain). SUBJECTS: A total of 120 elders with dementia institutionalized in residential homes. INTERVENTION: The participants were randomly allocated, in three groups. Control group - they continued with their routine activities; ear acupressure intervention group - they received ear acupressure treatment (pressure was applied to acupressure points on the ear); and massage therapy intervention group - they received relaxing massage therapy. MAIN MEASURES: The variables pain, anxiety and depression were assessed with the Doloplus2, Cornell and Campbell scales. The study was carried out during five months; three months of experimental treatment and two months with no treatment. The assessments were done at baseline, each month during the treatment and at one and two months of follow-up. In the statistical analysis the three groups were compared with each other. RESULTS: A total of 111 participants completed the study. Their aged ranged from 67 to 91 years old and 86 of them (77.4%) were women. The ear acupressure intervention group showed better improvements than the massage therapy intervention group in relation to pain and depression during the treatment period and at one month of follow-up. The best improvement in pain was achieved in the last (3rd) month of ear acupressure treatment (p < 0.001) being the average improvement 8.55 (4.39) with IC 95% (7.14, 9.95). Regarding anxiety, the best results were also observed in the last month of treatment. The average improvement in anxiety was 9.63 (5.00) with IC 95% (8.02, 11.23) CONCLUSIONS: Ear acupressure and massage therapy showed better results than the control group in relation to pain, anxiety and depression. However, ear acupressure achieved more improvements.

Ear therapy and massage therapy in the elderly with dementia: a pilot study.

OBJECTIVE: To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients. METHODS: We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format questions done by an occupational therapist not involved in the study. RESULTS: There was a statistically significant positive effect of massage and ear acupuncture (P < 0.001) on measured variables in the third month of intervention, which were maintained at two months after completing the treatment (P < 0.021), when compared to the control group. CONCLUSION: Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients.

Qigong improves balance in young women: a pilot study.

BACKGROUND: Balance problems are common in people of all ages and can lead to falls, thus causing fractures with consequent disability. Qigong practice has long been part of daily life in Chinese culture, and has good effects on physical health maintenance. OBJECTIVE: The present work describes the change in balance in young, healthy women after practising Qigong for eight weeks. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: The study took the form of a controlled, randomised longitudinal trial, and involved 30 women aged 18-25 years. The subjects had no prior experience of Qigong or Tai Chi and were unaware of the aims of the study. Subjects were randomly assigned to a Qigong intervention group or a control group. Those in the Qigong intervention group performed "exercises in 20 figures for health and long-life" (Wang Ziping) for 1 h twice per week, for 4 weeks. The control group undertook no exercise at all. MAIN OUTCOME MEASURES: The main outcome measure was the stabilometry values. These were obtained in a unipodal support test, using a plantar pressure platform with optical sensors. RESULTS: The Qigong subjects showed a significant improvement in their stabilometry results (40.1% pre-intervention and 56.4% post-intervention) (P< 0.045), while no improvement was seen in the control group (51.2% pre-intervention and 53.5% post-intervention). At the beginning of the intervention, the stabilometry values recorded for the Qigong intervention group were worse than those recorded for the control group (40.15% and 51.21% respectively; P=0.121). However, a comparison of the post-intervention values between these groups showed that these differences have disappeared (P=0.653). CONCLUSION: Qigong can improve balance in healthy, young women.

Qigong improves balance in young women: a pilot study / 中西医结合学报

Balance problems are common in people of all ages and can lead to falls, thus causing fractures with consequent disability. Qigong practice has long been part of daily life in Chinese culture, and has good effects on physical health maintenance.