Assisted Robots in Therapies for Children with Autism in Early Childhood.

Children with autism spectrum disorder (ASD) have deficits that affect their social relationships, communication, and flexibility in reasoning. There are different types of treatment (pharmacological, educational, psychological, and rehabilitative). Currently, one way to address this problem is by using robotic systems to address the abilities that are altered in these children. The aim of this review will be to analyse the effectiveness of the incorporation of the different robotic systems currently existing in the treatment of children up to 10 years of age diagnosed with autism. A systematic review has been carried out in the PubMed, Scopus, Web of Science, and Dialnet databases, with the following descriptors: child, autism, and robot. The search yielded 578 papers, and nine were selected after the application of the PRISMA guideline. The quality of the studies was analysed with the PEDRo scale, and only those with a score between four and six were selected. From this study, the conclusion is that the use of robots, in general, improves children's behaviour in the short term, but longer-term experiences are necessary to achieve more conclusive results.

Perceptions of recovery and rehabilitation in people with brain injury in Spain. A qualitative study.

INTRODUCTION: Acquired brain injury (ABI) is a condition that severely impairs the personal, family, social and professional lives of the individuals who experience it. The aim of this study was to gain insight into ABI patients' perceptions of their condition and rehabilitation process so that physiotherapists can approach their treatment in a more comprehensive, satisfactory manner. METHODS: A qualitative study was carried out with individual interviews, and focus group sessions (semi-structured interviews) were held with 33 individuals from various associations. RESULTS: Four themes emerged in this study: physiotherapy treatment, changes in lifestyle, patients' feelings about their condition and aspirations for the future. The participants reported that their condition had led to multiple changes in their personal and family lives that were not always positive. CONCLUSIONS: These findings may be useful for identifying ways to increase acceptance of their condition and design a comprehensive rehabilitation programme for these patients and their families. The psychosocial needs of ABI patients could be optimized by providing good physical care through effective communication within the rehabilitation environment where communication between professionals and patients prevails, to meet their real needs and expectations. PATIENT OR PUBLIC CONTRIBUTION: This study was conducted based on interviews with adult ABI patients regarding their experiences concerning their rehabilitation process and daily life.

Use of Robotic Devices for Gait Training in Patients Diagnosed with Multiple Sclerosis: Current State of the Art.

Multiple sclerosis (MS) is a neurodegenerative disease that produces alterations in balance and gait in most patients. Robot-assisted gait training devices have been proposed as a complementary approach to conventional rehabilitation treatment as a means of improving these alterations. The aim of this study was to investigate the available scientific evidence on the benefits of the use of robotics in the physiotherapy treatment in people with MS. A systematic review of randomized controlled trials was performed. Studies from the last five years on walking in adults with MS were included. The PEDro scale was used to assess the methodological quality of the included studies, and the Jadad scale was used to assess the level of evidence and the degree of recommendation. Seventeen studies met the eligibility criteria. For the improvement of gait speed, robotic devices do not appear to be superior, compared to the rest of the interventions evaluated. The methodological quality of the studies was moderate-low. For this reason, robot-assisted gait training is considered just as effective as conventional rehabilitation training for improving gait in people with MS.

Use of a Portable Inertial Measurement Unit as an Evaluation Method for Supraspinatus Muscle: Proposed Normative Values.

Treatment protocols do not specify an appropriate weight for rehabilitating the shoulder joint. The purpose of this study was to establish normative values for the shoulder abduction range of motion and recommended weights to be used in the rehabilitation process after injury to the supraspinatus muscle. Fifty-eight volunteers were assessed using the DyCare system. A test was conducted by lifting the arm to a 90° angle and having the participants lift different weights. The range of motion was similar for both sexes, suggesting that sex had no influence on this variable. Regarding the use of weights, men did not show as much stability in their movement execution, with a high dispersion seen in values between zero and three kilograms of weight, reaching a maximum weight of six kilograms. However, women showed good joint stability from the beginning of the test, with values that remained constant as weight increased up to a maximum of five kilograms. In conclusion, no major differences were observed in supraspinatus muscle injury recovery according to sex. However, differences were observed in the amount of weight that was necessary and appropriate to allow the participants to recover their muscular strength and avoid relapses.

Exploring the attitudes of health science students in Spain and Bolivia towards death. A cross sectional survey.

BACKGROUND: One of the most difficult and stressful tasks faced by health science students is having to cope with death and dying due to the emotional burden of the same. Furthermore, the moral, ethical and professional values of future health professionals are influenced by the cultures where they live. PURPOSE: This study sought to compare and analyze the perception on end of life among a sample of health science students in Spain and Bolivia. METHODS: A descriptive, cross-sectional and multi-centric study. The total sample (548 students) was comprised of three groups: medical, nursing and physiotherapy students, of whom 245 were from Bolivia, and 303 were Spanish students. The measurement instruments used were the Bugen's Coping with Death Scale and the Death Self-Efficacy Scale by Robbins. RESULTS: No statistically significant differences were observed between Spanish and Bolivian students (t (546) = - 0.248, p = 0.804) using the Bugen scale. This implies that there are no differences between the perception of both groups of students and that both groups use similar strategies to cope with death. Additionally, the beliefs and attitudes of both groups were similar, with Bolivian students presenting a trend towards improved scores. No differences were found between Spain and Bolivia in the results obtained on the Robbins scale, with students from both countries displaying similar skills and capabilities for facing death. CONCLUSIONS: The beliefs on death of health science students from Spain and Bolivia were not affected by the respective cultures, type of degree studied, students' age, or the country of origin, however, we found that students in Bolivia value death as something more natural than their Spanish counterparts. PRACTICE IMPLICATIONS: To appropriately prepare students for this topic, education on coping with death and dying must be included within the university curriculum. TRIAL REGISTRATION: 2016DEC018.

Effect of an Aquatic Balance-Training Program in Patients with Chronic Stroke: A Single-Group Experimental Pilot Study.

Background and Objectives: Stroke survivors face severe problems affecting their mobility, such as balance impairments and an increased risk of falls. The principal aim of this study was to quantify the effects of 12 sessions of Halliwick aquatic therapy for the treatment of balance in patients with chronic stroke. Materials and Methods: Twenty-nine people with stroke participated in this single-group experimental pilot study. Sessions were performed three times a week for a total of 12 sessions. A stabilometric assessment was conducted using a computerized platform. The evaluations were performed at baseline, at four weeks, and one month after completing the aquatic program. Results: The results obtained revealed significant differences for postural stability values (p < 0.001) and single-leg stabilometry. However, in the case of values within the limits of stability, such as forward (F = 0.339, p = 0.676), backward (F = 0.449, p = 0.644), forward right oscillations (F = 1.637, p = 0.21), and the anterior/posterior instability index (F = 0.614, p = 0.55), no significant differences were found. Conclusions: These findings suggest that Halliwick therapy may potentially improve stroke balance impairments. The main limitations of the study were the sample size, the lack of a control group, and the study not being blind.

Comparative study among Spanish students of health sciences degrees: Facing death.

The purpose of this study was to explore the perceptions and attitudes of students of health sciences faculties (medicine, nursing, and physiotherapy) regarding specific issues related to death and end of life in both professional and personal realms. A descriptive, cross-sectional, and multi-center approach was used. The modified Bugen Scale for facing death was used. The study population (411 students) encompassed three distinct groups: students from the degrees of medicine, nursing, and physiotherapy. In total, 12 items showed significant differences between the three groups. The sample presented a moderate level of perceived competency in the ability to face death. We found significant differences in the scores obtained by the three groups regarding their ability to face the death of people who are emotionally close. Furthermore, the sample demonstrated a good level of self-efficacy when facing death, with nursing students displaying the greatest emotional involvement when compared to their colleagues studying medicine and physiotherapy. It is therefore recommended that study curricula of future health professionals contain specific training in end-of-life care.

Spinal cord injury in pediatric age in Spain. Reality of a national reference center.

UNLABELLED: The aim of this study was to analyze the incidence and the main characteristics of ambulant children with spinal cord injury (SCI) treated at the Unit of Biomechanics and Technical Assistance, at the National Spinal Cord Injury Hospital in Toledo, Spain. To date, there are no detailed studies on the effects of this disease in children regarding their walking ability. MATERIAL AND METHODS: A retrospective study was performed including all patients attending the unit between January 2006 and December 2013, who were aged 18 years or younger and who were outpatients able to walk independently for at least 10 m, with or without technical aids. RESULTS: Forty-eight patients were included in this study (25 males and 23 females) aged between 2 and 18 years (mean age, 12 ± 2.31 years). The etiology of SCI ranged between congenital (33.33%), traumatic (29.16%), and neoplastic (8.33%), and the level of injury varied between cervical (31.25%), lumbar (29.16%), a non-spinal origin (20.83%), dorsal (16.66%), and sacral (2.08%). The mean score on the Barthel Index was 82.61, the mean value of the Functional Independence Measure (FIM) locomotion score was 6.4, and 29 patients did not require the use of walking aids (WISCI 20). CONCLUSION: The findings of this study contribute to the knowledge regarding the situation of children with SCI in Spain. The incidence of pediatric SCI is very low; however, the provision of care remains a personal and social challenge.

Influence and Relationship of Pain on Lumbar Biomechanics in a Young Adult Population with Non-Specific Low Back Pain.

The therapeutic actions indicated for low back pain, in addition to physiotherapy, include mobilization of the affected segment, as it is assumed that a loss of mobility may contribute to a patient's pain. The aim of this study was to investigate the influence of back pain on the degrees of spinal mobility in young adults. Eighty-six volunteers participated in the study. Fingertip-to-floor distance, Schöber's test, the fingertip-to-floor lateral flexion test, GHQ-12, the Fear-Avoidance Beliefs Questionnaire and the STarT Back Screening Tool were used. There were statistically significant differences between the two groups (pain and no pain) in degrees of spinal flexion (Schöber's test and side flexion) showing greater mobility in the group with pain. However, the group with low back pain showed less rotational mobility. The presence or absence of back pain had an impact on the individual's sporting practice and perception of pain, and they were able to carry out their sporting activities normally. Young adults with idiopathic low back pain showed some statistically significant differences in relation to the mobility of the spine in the different planes of movement (flexion and side flexion), conditioning their quality of life and sports practice.

Validation and Application of a Spanish Version of the ALR-RSI Scale (Ankle Ligament Reconstruction-Return to Sport after Injury) in an Active Non-Athlete Population.

The most recent scale to quantify psychological readiness before returning to sport is the ALR-RSI (Ankle Ligament Reconstruction-Return to Sport after Injury) scale. The aim of this study was the cross-cultural adaptation to Spanish and application of the ALR-RSI scale in a sample of active people who were not professional athletes, and to carry out an initial psychometric analysis of the functioning of the instrument in this sample. The sample consisted of 257 participants (161 men and 96 women) aged between 18 and 50 years. The adequacy of the model obtained in the exploratory study was confirmed, obtaining a model composed of one factor and 12 indicators in total. The estimated parameters were statistically significant (p < 0.05), and the factor loadings presented values higher than 0.5; thus, all indicators revealed a satisfactory saturation in the latent variable (convergent validity). Regarding internal consistency, the Cronbach's alpha value was 0.886 (excellent internal consistency). This study demonstrated that the ALR-RSI in Spanish is a valid and reproducible scale for evaluating psychological readiness to return to non-professional physical activity after ankle ligament reconstruction in the Spanish population.

Spanish Validation of the PALMS (Physical Activity and Leisure Motivation Scale).

Although there is abundant evidence supporting an active lifestyle, it is necessary to promote the practice of physical activity among the population. To understand this phenomenon, several studies have been conducted to describe the reasons why people participate in sports activities. The PALMS (Physical Activity and Leisure Motivation Scale) was created as a comprehensive tool to measure the reasons for practicing sports. This tool consists of 40 items related to sports and is designed for the young and adult population. Each of the subscales is formed of five items (mastery, enjoyment, psychological condition, physical condition, appearance, the expectations of others, affiliation, competition/ego) that reflect the possible reasons for practicing sports. This study sought to validate the PALMS in the cultural context of Spain, for the type of population for which it is designed. In total, 596 voluntary participants completed the study from Spain, aged 18 to 53, who regularly practice sports. The adequacy of the model obtained in the exploratory study was confirmed, since a model composed of eight factors and 40 indicators in total was obtained. The parameters were statistically significant (p < 0.05) and the factor loadings presented values greater than 0.5. Regarding internal consistency, the values of Cronbach's alpha and those of the composite reliability were above 0.8. In conclusion, the validation of the Spanish PALMS proved to be a valid and reliable measurement instrument for the evaluation of the reasons that lead the population to perform sports physical activity.

Attitudes of health science students towards death in Spain.

BACKGROUND: Health science students in Spain should be trained to manage the process of death and dying. AIM: To compare the perceptions, attitudes and fears of death from a sample of these students. METHODS: This descriptive, cross-sectional and multi-centre study comprised 411 students studying degrees in medicine, nursing and physiotherapy. The variables used were the hospice-related death self-efficacy scale by Robbins and the Collet-Lester fear of death scale. FINDINGS: The total score obtained on the death self-efficacy scale was 74.43/110, which is considered moderate to high self-efficacy for facing death. Facing the death of a friend at a young age obtained the lowest score (3.85±2.809). Regarding the Collet-Lester scale, the lowest score was 'fear of one's own death' (3.58±0.983) with a value of p=0.81. CONCLUSION: The health science students who participated in this study displayed high levels of fear and anxiety towards death.

Comparison between Three Therapeutic Options for the Treatment of Balance and Gait in Stroke: A Randomized Controlled Trial.

Stroke patients are more likely to be at risk of falling, which leads to limitation in their abilities to perform daily living activities and participate in society. The aim was to compare the relative effectiveness of three different treatment groups for improvements in postural control and for improvements in balance. Forty-five participants diagnosed with acquired brain injury, with over one year's evolution, were divided into a dry land therapy group (control group), an experimental group (Ai Chi aquatic therapy), and a combined group (therapy on dry land and aquatic therapy with Ai Chi). The Berg balance scale, tandem stance, the timed up and go test, and the five times sit-to-stand test were used. After twelve weeks of treatment, the results improved significantly for the combined therapy group (p < 0.01), and were significantly higher compared to the dry land therapy group (p < 0.01). In addition, improvements were also found in the aquatic Ai Chi therapy group. In conclusion, aquatic Ai Chi and/or the combination of aquatic therapy with dry land therapy is effective for the improvement of static and dynamic balance and for enhancing functional capacity, therefore, increasing the quality of life of acquired brain injury patients.

Validity and intra-examiner reliability of the Hawk goniometer versus the universal goniometer for the measurement of range of motion of the glenohumeral joint.

AIM: The aim of this study was to establish the validity of an external measurement system (the Hawk goniometer). This is a digital device which measures joint ranges compared to the universal goniometer for the measurement of shoulder range of motion in healthy adults. MATERIAL AND METHODS: a correlational study with 157 healthy volunteers completed six shoulder movements (forward flexion, abduction, extension, adduction and internal and external rotation) with each shoulder. The degree of agreement between each goniometer and Hawk measurement was assessed using Intra-class Correlation Coefficients (ICC) and Bland-Altman 95% limits of agreement (LOA). RESULTS: the tests showed a very strong relationship between the readings of both devices (CI between 0.81 and 0.99) and there were no significant differences between the mean readings of both devices. An intraclass correlation coefficient (ICC) of above 0.9 was obtained, indicating a high intra-evaluator reliability of the Hawk goniometer in repeated measurements of shoulder range of motion. CONCLUSIONS: the Hawk goniometer is a valid and reliable element for the objective measurement of the range of motion at the shoulder joint.

Comparison of Aquatic Therapy vs. Dry Land Therapy to Improve Mobility of Chronic Stroke Patients.

One of the most serious and disabling problems of stroke is pain and a decrease in balance, with the consequent increased risk of falls. The aim of the randomized controlled trial study was to compare the efficacy of three different treatment proposals to improve pain, gait, and balance in chronic stroke patients. Forty patients diagnosed with stroke were divided into three groups: the dry-land therapy group (control group) received sessions that included walking exercises and trunk mobility. The experimental group received Ai Chi aquatic therapy, and the combined group received alternating dry-land therapy sessions and Ai Chi aquatic therapy. The measurement instruments used were: the Tinetti balance and gait scale, the visual analog scale (VAS), 360° turn, single leg stance, and the 30-s stand test (CS-30). After twelve weeks of treatment, the results were significantly better for the combined therapy group and the experimental group compared to the dry-land therapy group (p < 0.01) in the VAS scale, CS-30, and 360° turn, although improvements were also found in the evaluations carried out in the aquatic therapy group. In total, for the Tinetti scale and single-leg stance, the differences between the groups were evident, although not statistically significant (p = 0.001). Aquatic therapy with Ai Chi and the combination of aquatic therapy with dry-land therapy was effective in improving pain, balance, and gait in patients with chronic stroke, thus improving their functional capacity and quality of life.

Influence of an Aquatic Therapy Program on Perceived Pain, Stress, and Quality of Life in Chronic Stroke Patients: A Randomized Trial.

Pain and depressive states may have a negative impact on the quality of life of individuals with stroke. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression, and quality of life in a sample of people with stroke. Forty-five participants received physiotherapy treatment on dry land (control group), an experimental group received aquatic Ai Chi therapy, and a combined therapy group received alternating sessions of physiotherapy on dry land and aquatic Ai Chi therapy. The Visual Analog Scale (VAS) scale for pain, the resilience scale, and the SF-36 quality of life scale were used as outcome measures. Statistically significant differences were found in the experimental group and the combined intervention group for post treatment pain and resilience (p < 0.001). Concerning the SF-36, statistically significant changes (p < 0.01) were found in the experimental group and the combined therapy group for all items except general health, vitality, and social function, where no between group differences were observed (p = 0.001). In conclusion, physical exercise performed in water has positive effects on several factors that contribute towards improving the mood and quality of life of people with acquired brain injury.

Parents' Perceptions Regarding the Implementation of a Physical Therapy Stimulation Program for Children with Disabilities in Bolivia: A Qualitative Study.

The purpose of this study was to explore how parents of children with neuromotor disorders in the department of Chuquisaca (Bolivia) perceive attendance to a physical therapy stimulation program and the expectations they place on the therapy and professional care provided to their children. Semi-structured interviews were conducted with the parents, related to their role in supporting the recommended exercise program for the child, generating topics such as benefits of the therapy for the child, impact on the family, and role of the project in terms of therapy and the physical therapists providing treatment, including both positive and negative aspects of the overall process. This study revealed the importance of understanding the feelings of families receiving intervention under a pioneering program in Bolivia for the detection and treatment of children with neuromotor disorders. Being able to access these types of services provides them with extensive personal, social, and economic support. Knowing their concerns, desires, and demands will allow us to continue to improve and offer the best care for children and families. The professionals involved should also be encouraged to develop effective teaching techniques to promote the inclusion of parents in the stimulation program.

Factors and Beliefs that Condition the Attitude of Health Science Students towards End of Life in Spain and Bolivia: A Multicenter Study.

Health Science students in Spain and Bolivia should be trained in the management of the processes of death and dying of patients. The aim of this study was to examine the degree of training, self-perceived safety and preferences in relation to the care of terminal and non-terminal patients. It was a descriptive, cross-sectional, multicenter study with students of Medicine, Nursing and Physiotherapy in Spain and Bolivia. The following variables were evaluated: care preparation and emotional preparation to caring for terminally ill and non-terminally ill patients, the Death Attitude Profile Revised (PAM-R) and the Bugen Scale for Facing Death. The self-perceived preparation of students for caring for terminally ill patients can be considered "fair" (mean 2.15, SD 0.756), and this was also the case for their perceived emotional preparation (mean 2.19, SD 0.827). In contrast, the score obtained for their preparedness for treating non-terminal patients was higher (mean 2.99 and 3.16, respectively). Working with terminally ill patients, including terminal or geriatric cancer patients, was the least preferred option among future health professionals. The results obtained show a limited preference for end-of-life care and treatment, highlighting a lack of preparation and motivation among health science students in Spain and Bolivia for working with these patients.

Study of Psychomotor Development and Environmental Quality at Shelter Homes for Children Aged 0 to 2 in the Department of Chuquisaca (Bolivia).

Children in situations of destitution who become institutionalized commonly display developmental disorders, including delayed growth. The aim was to evaluate the environmental quality of the casas cuna of the Department of Chuquisaca (Plurinational state of Bolivia) in children aged 0 to 2 years old after receiving an early stimulation program based on psychomotor therapy. Thirty-six children who were institutionalized at shelter homes in the Department of Chuquisaca were selected to receive sessions of psychomotricity over a five-month period. The Infant/Toddler Home Observation for Measurement of the Environment (IT-HOME) scale and the Attachment During Stress Scale (ADS) were used. The adult-child relationship with factors of responsiveness (-0.89; p = 0.037), acceptance (0.57; p = 0.024), organization (-1.03; p < 0.001), learning material (-2.57; p < 0.001) and involvement (-1.92; p < 0.001) scored below expectations, showing that environmental indicators are a poor stimulation for children growing up in shelter homes. Improvements were found in the children's development after receiving this therapy. In conclusion, an early stimulation program based on psychomotor therapy over five months provided favorable results for the acquisition of skills for communication, motor development and social skills, which positively affect the psychomotor development.

Mental health in Parkinson's disease after receiving aquatic therapy: a clinical trial.

Depression is a major determinant of quality of life in individuals with Parkinson's disease. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression and quality of life in people with Parkinson's disease. Participants were randomized to receive dry land physiotherapy treatment (control group) or aquatic Ai Chi sessions in the pool (experimental group). The outcome measures used included the VAS pain scale, the Geriatric Depression Scale and the SF-36 quality of life scale. In the experimental group treated with aquatic therapy, significant differences were found in the pain, depression and quality of life variables post-treatment (p < 0.001). In the control group, improvements were only observed in the VAS pain scale, and these were less significant than the changes found in the experimental group (p = 0.006). The significant changes registered in the experimental group at the post-treatment assessment were maintained 1 month after completing the experimental intervention program. In conclusion, these findings indicate that physical exercise performed in water has positive effects on some of the factors that influence mood and quality of life in people with Parkinson's disease.