Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study.

STUDY DESIGN: A feasibility pilot study. OBJECTIVE: To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI). SETTING: A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM). METHODS: Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention. RESULTS: 20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective. CONCLUSION: A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.

A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome.

BACKGROUND: There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE: To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN: Randomized clinical trial. METHODS: Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS: At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION: MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS: MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.

Effects of a low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia: A randomized clinical trial.

BACKGROUND AND OBJECTIVES: Self-reported psychological variables related to pain have been posited as the major contributors to the quality of life of fibromyalgia (FM) women and should be considered when implementing therapeutic strategies among this population. The aim of this study was to explore the effect of low-pressure hyperbaric oxygen therapy (HBOT) on psychological constructs related to pain (i.e., pain catastrophism, pain acceptance, pain inflexibility, mental defeat) and quality of life in women with FM. METHODS: This was a randomized controlled trial. Thirty-three women with FM were randomly allocated to a low-pressure hyperbaric oxygen therapy group (HBOTG) (n=17), who received an 8-week intervention (5 sessions per week), and a control group (CG) (n=16). All women were assessed at baseline (T0) and upon completion of the study (T1) for self-perceived pain intensity, pain catastrophism, pain acceptance, pain inflexibility, mental defeat and quality of life. RESULTS: At T1, the HBOTG improved across all variables related to pain (i.e. self-perceived pain intensity, pain catastrophism, pain acceptance, pain flexibility, mental defeat) (p<0.05) and quality of life (p<0.05). In contrast, the CG showed no improvements in any variable. Furthermore, significant differences between the groups were found in quality of life (p<0.05) after the intervention. CONCLUSIONS: HBOT is effective at improving the psychological constructs related to pain (i.e. pain catastrophism, pain acceptance, pain flexibility, mental defeat) and quality of life among women with FM. Clinical Trial Link Clinical Trials gov identifier (NCT03801109).

Effects of mirror neuron activation therapies on functionality in older adults: Systematic review and meta-analysis.

PURPOSE: To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls. METHODS: A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases. RESULTS: Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes. CONCLUSIONS: Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial.

Relationship between neck kinematics and neck dissability index. An approach based on functional regression.

Numerous studies use numerical variables of neck movement to predict the level of severity of a pathology. However, the correlation between these numerical variables and disability levels is low, less than 0.4 in the best cases, even less in subjects with nonspecific neck pain. This work aims to use Functional Data Analysis (FDA), in particular scalar-on-function regression, to predict the Neck Disability Index (NDI) of subjects with nonspecific neck pain using the complete movement as predictors. Several functional regression models have been implemented, doubling the multiple correlation coefficient obtained when only scalar predictors are used. The best predictive model considers the angular velocity curves as a predictor, obtaining a multiple correlation coefficient of 0.64. In addition, functional models facilitate the interpretation of the relationship between the kinematic curves and the NDI since they allow identifying which parts of the curves most influence the differences in the predicted variable. In this case, the movement's braking phases contribute to a greater or lesser NDI. So, it is concluded that functional regression models have greater predictive capacity than usual ones by considering practically all the information in the curve while allowing a physical interpretation of the results.

Importancia de la música para y en la formación del fisioterapeuta / Importance of music for and in the training of the physiotherapist / Importância da música para e no treinamento do fisioterapeuta

Resumen Introducción: son muchos los especialistas de Ciencias de la Salud que han demostrado lo interesante y significativo de utilizar la Música en sus tratamientos terapéuticos. No obstante, en España, solo una universidad pública cuenta con formación musical para capacitarlos en su utilización. Objetivo: esta investigación intentó demostrar la necesidad de formación musical desde el Grado de Fisioterapia, a través de propuestas de Movimiento con Música desde la perspectiva dalcroziana. Materiales y métodos: se realizaron una serie de prácticas de concienciación corporal con Música, atendiendo al trabajo de distintos elementos musicales y partiendo de las propuestas de Jaques-Dalcroze; que terminaron concretándose después en role-playing extrapolables a sus sesiones de prácticas fisioterapéuticas. Se distribuyeron a lo largo de cuatro semanas de trabajo, a razón de tres horas semanales de trabajo, que finalizaban con el feedback aportado por las propuestas prácticas adaptadas a sus futuras sesiones de Fisioterapia. Resultados: los datos mostraron la importancia que el fisioterapeuta concede al estímulo auditivo musical como motivador y no solo como relajante. Los resultados centrados en la interiorización-corporización, por parte del fisioterapeuta, fueron significativos porque se produjo un aumento de la concienciación acerca del propio movimiento corporal; hecho que, posibilitó una incorporación de sus propias propuestas durante el período de Prácticum. Conclusiones: Se pudo comprobar cómo la implementación de una materia musical en el Grado de Fisioterapia podrá contribuir al desarrollo de las competencias genéricas, específicas y transversales vinculadas a dicha titulación. La Universidad de Valencia se convirtió, así, en pionera al ofertar Musicoterapia a sus estudiantes.

Abstract Introduction: there are many specialists in Health Sciences who have shown how interesting and meaningful to use music in their therapeutic treatments. However, in Spain, only one public university has musical training to train the in its use. Objective: this research attempted to demonstrate the need for musical training from the Degree of Physiotherapy, through proposals of Movement with Music from the Jaques-Dalcrozian perspective. Materials and methods: a series of body awareness practices with Music was carried out, based on the works of different musical elements and based on Dalcroze's proposals; that ended up being concreted later in role-playing extrapolables to their sessions of physiotherapeutic practices. They were di stributed over four weeks of work, at the rate of three hours per week of work, which ended with the feedback provided by the practical proposals adapted to their future physiotherapy sessions. Results: the data showed the importance that the physiotherapist gives to the musical auditory stimulus as motivator and not only as relaxing. The results focused on the internationalization-embodiment by the physiotherapist, were significant because there was an increase in awareness about one's body movement; fact that, it made possible an incorporation of its own proposals during the Practicum period. Conclusions. It was possible to verify how the implementation of a musical subject in the Degree of Physiotherapy can contribute to the development of the generic, specific and transversal competences linked to said degree. The University of Valencia thus became a pioneer in offering Music Therapy to its students.

Resumo Introdução: muitos especialistas em ciências da saúde mostraram como é interessante e significativo usar a música em seus tratamentos terapêuticos. No entanto, na Espanha, apenas uma universidade pública possui treinamento musical para treiná-las em seu uso. Objetivo: esta pesquisa procurou demonstrar a necessidade de treinamento musical a partir do Grau de Fisioterapia, através de propostas de Movimento com Música na perspectiva dalroziana. Materiais e métodos: realizou-se uma série de práticas de consciência corporal com a música, atendendo ao trabalho de diferentes elementos musicais e com base nas propostas de Jaques-Dalcroze; que acabaram-se concretizando na encenação extrapolada para as sessões de prática fisioterapêutica. Eles foram distribuídos ao longo de quatro semanas de trabalho, na proporção de três horas por semana de trabalho, terminando com o feedback fornecido pelas propostas práticas adaptadas às suas futuras sessões de Fisioterapia. Resultados: os dados mostraram a importância que o fisioterapeuta atribui ao estímulo auditivo musical como motivador e não apenas como relaxante. Os resultados focados na incorporação-incorporação, pelo fisioterapeuta, foram significativos porque houve um aumento na consciência do próprio movimento corporal; fato que possibilitou a incorporação de suas próprias propostas durante o período de estágio. Conclusões: foi possível verificar como a implementação de uma disciplina musical no Grau de Fisioterapia poderia contribuir para o desenvolvimento de competências genéricas, específicas e transversais vinculadas a esse diploma. A Universidade de Valência tornou-se assim pioneira em oferecer Musicoterapia aos seus alunos.