Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders.

INTRODUCTION: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. METHODOLOGY: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). RESULTS: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). CONCLUSION: The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.

Breast cancer survivors suffering from lymphedema: What really do affect to corporeality/body image? A qualitative study.

Breast cancer-related lymphedema is currently one of the most serious complications that most affect the quality of life of women undergoing breast cancer. The aim of this study was to explore in-depth the experience of women who suffer from lymphoedema after breast cancer and how does this condition affect corporeality, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, interviewer's field notes and participants' letters were used for data collection. The participants were twenty Spanish women with lymphoedema after overcome a breast cancer in the past. Healthcare specialists with experience in the topic were also included. Results showed 2 main categories: "From cancer to lymphedema, another disease another disease" and "Potential for transition and transformation towards a new way of life". As a conclusion, the difficulty in accessing adequate treatment, the need for greater awareness of lymphedema and the importance of the emotional and psychological dimension of this chronic disease. Highlighting the attitudes that these women develop for self-care and the concept of new corporeality. After breast cancer, women with lymphedema experience a drastic change that affects all areas of their lives. The adaptation process, and the search for resources and aid, play a fundamental role in overcoming this process.

Autonomic stress response of physiotherapy student in the different scenarios of an objective structured clinical examination.

The aim of the present research was to analyse modifications in the autonomic stress response of Physiotherapy students undergoing a 12-scenario Objective Structured Clinical Evaluation (OSCE). A total of 86 last year students of the Physiotherapy bachelor's degree (27.29 years (SD = 6.66); 36 females and 50 males) randomly assigned were monitored during the complete OSCE to measure heart rate variability (HRV) in temporal, frequency, and non-linear domains. The HRV analysed showed a large anticipatory stress response of students maintained during the entire evaluation. The stress response varied regarding OSCE station complexity and demands and the highest sympathetic response was not found in higher emotional scenarios.The autonomic modulation monitoring allows teachers to design OSCE scenarios more adapted to the students, limiting the effect of the stress response to allow a better performance.

The Effect of Studying a Double Degree in the Psychophysiological Stress Response in the Bachelor's Thesis Defense.

The aim of this research was to analyze the effect of studying a single or double degree in the psychophysiological stress response and academic performance of university students in their bachelor's thesis defense. We analyzed the autonomic stress response, cortical arousal, subjective distress perception, and the sense of objective and subjective academic fulfilment of 84 single-degree physiotherapy students and 26 double-degree sport sciences and physiotherapy students during their bachelor's thesis defense. The results showed that the bachelor's thesis defense was a stressful event for double-degree students, showing an activation of the sympathetic nervous system and presenting a higher autonomic habituation response for the double degree students compared to the single degree students. We found higher mean grades during the whole degree and higher grades in the written and oral bachelor's thesis academic achievements for single-degree students compared to double-degree students. No significant differences were found between single-degree and double-degree students in subjective distress perception and cortical arousal. No correlation was found between academic performance variables and subjective distress perception, cortical arousal, and autonomic modulation variables. We conclude that the bachelor's thesis defense produces a large anticipatory anxiety response in single-degree physiotherapy students and in double-degree sport sciences and physiotherapy students. Double-degree students showed higher levels of habituation and adaptability to the stressful event, with a better autonomic response. Academic achievements were significantly higher among single-degree students compared to the double-degree group.

The Impact of Nationality on the Psychophysiological Stress Response and Academic Fulfilment in the Final Degree Dissertation.

The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.

The effect of final dissertation defense language, native vs. non-native, in the psychophysiological stress response of university students.

The objective of this study was to analyze the effect of final dissertation defense language in the autonomic stress response and cortical arousal of Physiotherapy students. We analysed in 110 students divided in 2 groups: native language (83) and non-native language (27), the autonomic stress response in four different moments of the dissertation defense; the cortical arousal and subjective perception of distress before and after the dissertation; and academic performance perception of students and the real performance obtained. Results showed a high sympathetic modulation at the beginning of the evaluation, which was maintained until the end of the evaluation in both groups. In addition, no decrease in cortical activity was found, possibly due to the short time of exposure to the stressful event. The final dissertation defense of Physiotherapy students produces an anticipatory anxiety response and a maintained high sympathetic nervous system activation during the defense, not negatively affecting cortical arousal, regardless of defending in native or non-native language.

Effectiveness of manual lymphatic drainage vs. perineal massage in secundigravida women with gestational oedema: A randomised clinical trial.

Perineal trauma (PT) may be considered as a very common injury during the childbirth. The incidence of PT was estimated in 30% to 85%, with 60% to 70% requiring suture. The present study was a prospective, single-blinded, randomised, clinical trial carried out from January 2015 to January 2016. For this study, 49 secundigravida women diagnosed with gestational oedema were recruited and randomly divided into two groups (A and B). Group A (n = 30) received the conventional treatment plus perineal massage and group B (n = 19) the conventional treatment plus manual lymphatic drainage (MLD). Visual analogue scale (VAS) and King Health's Questionnaire (KHQ) were performed to assess pain intensity and quality of life-related with urinary incontinence (UI). Pain intensity measurements showed statistically significant differences for a decrease after 30-weeks (P = .037), after 36-weeks (P = .000), and at the end of puerperium (P = .014) for MLD with respect to perineal massage group. Moreover, inter-groups repeated measures ANOVA for the values related statistically significant differences to the interaction of each applied treatment (perineal massage and MLD group, separately) over the pain intensity variable. MLD treatment reduced pain intensity with respect to perineal massage in secundigravida women with gestational oedema from 25-weeks of gestation to the end of puerperium.

Psychophysiological stress response of physiotherapy last year students in his final degree dissertation.

Final dissertation is considered one of the most stressful situations in university studies, but the stress response and its incidence in academic achievement is poor knowledge. The aim of the present research was to analyze the effect of the psychophysiological stress response of physiotherapy last year students in his final degree dissertation performance. We analyzed the heart rate variability (HRV) of 110 volunteers during their final degree dissertation to evaluate the autonomic stress response. Results showed a large anticipatory anxiety response of students prior to the final degree dissertation and a no habituation response, since low HRV results were found before and during the final degree dissertation. Only after the dissertation, the HRV increased. No relationship between autonomic modulation and the dissertation academic achievement were found. Final degree dissertation in physiotherapy students, produce a large anticipatory anxiety response. Autonomic modulation parameters do not present relationship with the final degree dissertation performance.

Relationship between attention and balance: a dual-task condition study in children.

This study explored the relationship between motor functions and attention in children aged 4-5 years. A sample of 85 children was collected from a primary school (44 boys and 41 girls). We applied a standardized continuous attention performance test, the Kiddie Continuous Performance Test, under two conditions (sitting and balancing). Data were collected from two standardized balance tests, the Battelle and Pediatric Balance Scale. There was a significant relationship between attention and balance and gender differences that may condition the way to address balance issues in boys and girls. Gender should be considered when addressing balance problems to get efficient interventions. Balance skill may be a contributing factor in attention-deficit/hyperactivity disorder.

Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points: A cross-sectional study.

The myofascial pain syndrome (MPS) is considered the most common musculoskeletal condition. The lumbopelvic pain (LPP) is established as one of the most prevalent musculoskeletal disorders. Nevertheless, previous research has not yet studied the contractibility changes by tensiomyography between myofascial trigger point (MTrP) types and normal tissue. Therefore, the aim of this study was to determine the tensiomyography, sonoelastography, and pressure pain threshold (PPT) differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. A cross-sectional descriptive study was performed. A convenience sample of 60 points (20 active MTrPs, 20 latent MTrPs, and 20 control points) was registered bilaterally in the lumbar erector spinae muscles from subjects with nonspecific LPP. The palpation order of active MTrPs, latent MTrPs, or control points was randomized for each side. The outcome assessors were blinded to the order or point type. The outcome measurements order for each point was sonoelastography manual strain index, tensiomyography, and PPT, separated by 15 minutes. Five contractile objective parameters were: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Tensiomyography parameters did not show any statistically significant difference (P > 0.05) between active MTrPs, latent MTrPs, and control points. Nevertheless, PPT and sonoelastography showed statistically significant differences (P < 0.05) between all point types, except for active and latent MTrPs PPT comparison (P = 0.091). Regarding the active MTrPs, a moderate positive correlation was observed between PPT and Dm (P = 0.047; τB = 0.450). Considering the control points, a moderate positive correlation was shown between sonoelastography and Td (P = 0.044; τB = 0.328). The tensiomyography contractile properties did not seem to show differences, while the sonoelastography and mechanosensitivity presented a higher stiffness and a lower PPT, respectively, between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. Considering the correlations, further research is needed regarding the muscle contractile properties modifications under MPS treatments, especially Dm in active MTrPs and Td in normal sites.

Pregnancy in Spanish elite sportswomen: A qualitative study.

Pregnancy and motherhood have been historically considered as reasons why elite sportswomen may end their sport careers. During pregnancy, the safety of both mother and baby has been identified as a key reason for ceasing sport participation. Recent "official" statistics on how many elite athletes are mothers suggest that pregnancy, motherhood, and sport could be no longer mutually exclusive. The aim of this qualitative phenomenological study was to describe the lived pregnancy of Spanish elite sportswomen. Spanish elite sportswomen (n = 20) aged between 18 and 65 years that had been pregnant during their sporting professional career and after the end of their pregnancy had taken up again their professional sporting career for at least one year were included. Data were collected from May 2010 to April 2012 using in-depth personal interviews, investigator's field notes, and extracts from the participants' personal letters. Identified themes included: (1) choosing the right moment; (2) fears and doubts; and (3) justifying physical exercise. By giving voice to these elite Spanish sportswomen, their pregnancy experiences are made visible, which might help to gain a better understanding into their expectations and develop policies and practices focused on elite sportswomen during and after pregnancy.

Experiencing the body during pregnancy: A qualitative research study among Spanish sportswomen.

The aim of the current qualitative phenomenological study was to describe the body experiences during pregnancy among Spanish elite sportswomen. Twenty Spanish sportswomen with the following criteria were included: (1) aged between 18 and 65 years; (2) had been pregnant during their professional sporting career; and (3) after the end of their pregnancy, had returned to their professional sports career for at least 1 year. A qualitative thematic analysis was conducted. Data were collected from May 2010 to April 2012 using in-depth personal interviews, investigator's field notes, and extracts from the participants' personal letters. Identified themes included: (1) a new body; (2) body control; (3) to feel their bodies and communicate with them; and (4) body's beauty ideal. Understanding the meaning of the body experience for elite Spanish sportswomen might provide us with deeper insight into their expectations and might help in the development of training systems focused on them.

El análisis de datos cualitativos mejora las investigaciones médicas / Qualitative data analysis improves medical research

Los métodos cualitativos pueden ayudar a comprender y mejorar las intervenciones médicas (clínica, educación, investigación y gestión) y las respuestas de los pacientes. Una de las fases clave en la investigación cualitativa es el análisis de los datos cualitativos. El análisis se fundamenta en la identificación de aquellos elementos relevantes de los participantes, sobre la base de su experiencia, situación social, entorno y expectativas. Objetivo: Describir las estrategias de análisis para los datos cualitativos, aplicados en investigación médica. Diseño: Revisión de la bibliografía de referencia sobre metodología cualitativa para el desarrollo de estrategias prácticas de análisis de datos cualitativos. Resultados: Se describen aproximaciones de análisis cualitativo que pueden aplicarse de manera deductiva e inductiva, junto al empleo de la codificación para guiar el análisis y la interpretación. Conclusión: Las investigaciones cualitativas pueden mejorar la descripción de fenómenos complejos en la investigación médica y en la práctica clínica. El análisis de datos cualitativos es un instrumento que ayuda a los médicos en su práctica clínica y en sus investigaciones...

Maternity in Spanish elite sportswomen: a qualitative study.

The aim of this qualitative phenomenological study was to describe the experiences of maternity among Spanish elite sportswomen. Twenty (n = 20) Spanish elite sportswomen with the following criteria were included: (a) aged 18-65 years; (b) had been pregnant during their sporting professional career; and (c) after the end of their pregnancy they had returned to their professional sporting career for at least one year. A qualitative analysis was conducted. Data were collected using in-depth personal interviews, investigator's field notes, and extracts from the participants' personal letters. Identified themes included: (a) a new identity, with two sub-themes ("mother role" and "being visible"); (b) going back to sport, with three subthemes ("guilt appears," "justifying going back to sport," and "rediscovering sport"); and, (c) reaching a goal, with two subthemes ("balancing mother-sportswoman" and "the challenge of maternity"). Understanding the meaning of maternity for elite Spanish sportswomen might help gain deeper insight into their expectations and develop training systems focused on elite sports women after pregnancy.

Evolución del envejecimiento poblacional y respuesta sociosanitaria / No disponible

El progresivo envejecimiento poblacional está determinandoun importante reajuste de las estructuras socialesy sanitarias de los países occidentales. El incremento dela esperanza de vida ocasiona elevadas tasas de dependenciaque, junto al menor soporte de la estructura familiaractual, hace necesaria la articulación de distintasmedidas comunitarias e institucionales, sanitarias y socialesque den respuesta a la creciente demanda asistencial.En el presente trabajo se revisa el marco legislativoactual, así como las distintas propuestas socio-sanitariasde atención a las personas mayores (AU)

The progressive ageing of the population is changing thecomplex infrastructure of the society and sanitary servicesin occidental countries. The presence of more older personsin the world is increasing the dependence levels, for thatreason and because familiy support has decreased, it isnecessary the development of different community,institutional, sanitary and social services in order topromote progress for all ages in all areas. In this study wemake an analysis of the legislative system and the sociosanitaryservices in relationship with the ageing people (AU)