Low power laser stimulation of the bone consolidation in tibial fractures of rats: a radiologic and histopathological analysis.

The objective of this study is to analyze the effectiveness of low power laser irradiation in the bone consolidation of tibial fractures in rats. An experimental, comparative, prospective study with control group was designed. Twenty Wistar rats were grouped into control (n = 10) and experimental groups (n = 10). A tibial fracture, with a mechanical drill, was inflicted in all rats. The experimental group received ten days of low power arsenide-gallium laser irradiation of 850 nm (KLD, Sao Paulo, Brasil)-100 mW, 8 J/cm(2), 64 s. Before and after the laser treatment, a radiologic analysis was carried out in both groups, in which the rats were graded from 0 to IV according the Montoya scale of bone consolidation. Also, we histopathologically analyzed the bone to estimate the proliferation of fibroblasts, bone matrix, and angiogénesis with a microscopy, which were graded as I (thin layer of fibroblasts and osteoid matrix), II (thick layer of fibroblasts and osteoid matrix), or III (thick layer of fibroblasts and osteoid matrix and new blood vessels). Radiologic data showed that the experimental group had a higher bone consolidation of Montoya scale after ten days of laser irradiation compared to control group (P < 0.004). Histopathologic data showed more fibroblasts and angiogenesis presence in the group receiving laser irradiation, compared to control group (P < .002). The low power laser radiation therapy may expedite the bone repair after tibial fractures in rats, according to radiologic and histopathologic analysis.

Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review.

[Purpose] The aim of this study was to analyze the effectiveness of conservative treatment of patellofemoral pain syndrome with physical exercise. [Subjects and Methods] A computer-based review conducted of four databases (PubMed, the Cochrane Library, PEDro, and the University Library) was completed based on the inclusion criteria of patellofemoral pain syndrome patients treated with physical exercise methods and examination with self-reported pain and/or functional questionnaires. [Results] The findings of ten clinical trials of moderate to high quality were evaluated to determine the effectiveness of physical exercise as conservative management for patellofemoral pain syndrome. [Conclusion] The intervention programs that were most effective in relieving pain and improving function in patellofemoral pain syndrome included proprioceptive neuromuscular facilitation stretching and strengthening exercises for the hip external rotator and abductor muscles and knee extensor muscles.

Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: A randomized controlled trial.

BACKGROUND: Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations. OBJECTIVES: To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain. DESIGN: Double-blind, controlled, within-subject, repeated-measures design. METHOD: Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention. RESULTS/FINDINGS: No significant differences were found among the treatment conditions in any of the variables investigated. A significantly greater mean decrease in self-reported shoulder pain was observed following treatment condition [0.63 (0.12, 1.14); p = 0.01]. PPT at the affected shoulder increased significantly following both the treatment [0.23 (-0.43, 0.02); p = 0.02] and manual contact [0.28 (-0.51, 0.04); p = 0.01] conditions. Shoulder AP joint mobilization also increased PPT at a distal, non-painful site [0.42 (-0.85, 0.01); p = 0.04]. No changes were observed in shoulder ROM or muscle strength. CONCLUSIONS: This study found no superior effects in various pain or function-related outcome measures of a passive oscillatory anteroposterior mobilization applied to the glenohumeral joint compared to manual contact and no-contact interventions in overhead athletes with chronic shoulder pain. Some ability to modulate shoulder pain and local and widespread pain sensitivity was observed in the short term after the passive oscillatory anteroposterior mobilization.

[Translation into Spanish and a preliminary analysis of the psychometric properties of the Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) questionnaire for rating the quality of life among post-stroke patients]. / Traduccion al castellano y analisis preliminar de las propiedades psicometricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus.

INTRODUCTION: The Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) is one of the few specific questionnaires for evaluating the quality of life among patients who have suffered an ischaemic or haemorrhagic stroke. AIMS: To translate and adapt this questionnaire into Spanish and to evaluate its reliability and acceptability. PATIENTS AND METHODS: The original version of the NEWSQOL questionnaire was translated into Spanish. The translation was agreed upon by a team of experts, and was then back-translated into English and sent to the author, who gave her approval of the rendering. This version was later administered to a group of patients in order to evaluate its reliability, acceptability, floor effect and ceiling effect. RESULTS: The process of linguistic adaptation allowed semantic, conceptual and content equivalence to be achieved in the Spanish version of the NEWSQOL. The results obtained in the preliminary analysis show excellent acceptability, an internal consistency index of 0.9 for the whole questionnaire and a good or excellent test-retest agreement for all the domains. No ceiling effect was detected, but a floor effect was observed in the case of the vision and cognition domains. CONCLUSION: The Spanish version of the NEWSQOL questionnaire is reliable for evaluating the quality of life in post-stroke patients, as well as being well accepted. The questionnaire must be used in more broader samples in order to evaluate its validity and sensitivity.

TITLE: Traduccion al castellano y analisis preliminar de las propiedades psicometricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus.Introduccion. El Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) es uno de los pocos cuestionarios especificos para valorar la calidad de vida en pacientes que han sufrido ictus isquemico u hemorragico. Objetivo. Traducir y adaptar dicho cuestionario al castellano y evaluar su fiabilidad y aceptabilidad. Pacientes y metodos. Se tradujo al castellano la version original del cuestionario NEWSQOL, traduccion que fue consensuada por un equipo de expertos, y a partir de la cual se hizo una retrotraduccion al ingles que se envio a la autora, quien mostro su conformidad. Posteriormente esa version se administro a un grupo de pacientes para valorar su fiabilidad, aceptabilidad, efecto suelo y efecto techo. Resultados. El proceso de adaptacion linguistica permitio obtener la equivalencia semantica, conceptual y de contenido de la version española de NEWSQOL. Los resultados obtenidos en el analisis preliminar reflejan una excelente aceptabilidad, un indice de consistencia interna de 0,9 para la totalidad del cuestionario y una concordancia test-retest buena o excelente para todos los dominios. No se detecto efecto techo, pero si efecto suelo para los dominios de vision y cognicion. Conclusion. La version española del cuestionario NEWSQOL es fiable para valorar la calidad de vida en pacientes postictus, ademas de aceptarse bien. Es necesario utilizar el cuestionario en muestras mas amplias para evaluar su validez y sensibilidad.

Immediate effects of thoracic spinal mobilisation on erector spinae muscle activity and pain in patients with thoracic spine pain: a preliminary randomised controlled trial.

OBJECTIVES: To investigate the activity of the thoracic erector spinae muscles and perceived pain intensity immediately after central postero-anterior (PA) mobilisation of the thoracic spine. DESIGN: Randomised, placebo-controlled, experimental design. PARTICIPANTS AND INTERVENTIONS: Thirty-four participants with non-specific thoracic pain were randomised to the experimental group [grade III central PA mobilisation performed for 3minutes at the level of the seventh thoracic vertebra (T7)] or the placebo group (less than grade I central PA mobilisation performed for 3minutes at T7). MAIN OUTCOME MEASURES: Before and immediately after PA mobilisation, surface electromyography (EMG) was recorded from the thoracic erector spinae muscles as the participants performed 10° spine extension from a prone position for 10seconds. Each participant rated their pain intensity as an investigator performed grade III central PA over the most symptomatic thoracic segment, and the pressure pain threshold (PPT) was evaluated bilaterally over the erector spinae muscles. RESULTS: The EMG amplitude of thoracic erector spinae activity was reduced significantly after the intervention in the experimental group (P<0.05), but not in the placebo group. The difference between the groups was significant {pre-post change: placebo -14 [standard deviation (SD) 50]mV, experimental 28 (SD 48)mV; mean difference -42mV; 95% confidence interval of the difference -76 to 7; P<0.05} albeit small (Grissom=0.44). However, both groups showed a significant reduction in pain immediately after the intervention, and both groups showed a similar pre-post change in PPT. CONCLUSION: These preliminary findings indicate that grade III central mobilisation over the most symptomatic thoracic segment reduces thoracic erector spinae activity during extension of the trunk in people with non-specific thoracic spine pain. CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN47601528.

Las manos del fisioterapeuta como instrumento de conocimiento / Physiotherapist's hands as knowledge instrument

En este artículo se analiza el papel de las manos del fisioterapeuta como instrumento de conocimiento y herramienta de trabajo por excelencia. Se realiza un breve repaso a la importancia que ha tenido la mano como instrumento sanador en diferentes culturas y momentos de la historia, y se argumenta que en la actualidad es precisamente la fisioterapia la disciplina que debe reivindicar por derecho propio el uso científico de la mano como instrumento terapéutico. Posteriormente se analiza el doble papel de la mano en el tratamiento fisioterápico: por un lado, vehículo de obtención de información, imprescindible para realizar un diagnóstico fisioterapéutico acertado, y por otro como vehículo de aplicación de conocimiento a través del tratamiento manual de las dolencias (AU)