Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial.

BACKGROUND: The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP. METHODS: Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11). RESULTS: Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6). CONCLUSIONS: The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05541848.

Non-Invasive Radiofrequency Diathermy Neuromodulation Added to Supervised Therapeutic Exercise in Patellofemoral Pain Syndrome: A Single Blind Randomized Controlled Trial with Six Months of Follow-Up.

The evidence-based treatment of patellofemoral pain (PFP) suggests that therapeutic exercise (TE) focused on improving muscle strength and motor control be the main conservative treatment. Recent research determined that the success of the TE approach gets improved in the short term by the addition of neuromodulation via radiofrequency diathermy (RFD). As there is no follow up data, the objective of this research is to assess the long-term effects of adding RFD to TE for the pain, function and quality of life of PFP patients. To this aim, a single-blind randomized controlled trial was conducted on 86 participants diagnosed of PFP. Participants who met the selection criteria were randomized and allocated into either a TE group or an RFD + TE group. TE consisted of a 20 min daily supervised exercise protocol for knee and hip muscle strengthening, while RFD consisted of the application of neuromodulation using a radiofrequency on the knee across 10 sessions. Sociodemographic data, knee pain and lower limb function outcomes were collected. The RFD + TE group obtained greater improvements in knee pain (p < 0.001) than the TE group. Knee function showed statistically significant improvements in Kujala (p < 0.05) and LEFS (p < 0.001) in the RFD + TE group in the short and long term. In conclusion, the addition of RFD to TE increases the beneficial effects of TE alone on PFP, effects that remain six months after treatment.

Effects of Radiofrequency Diathermy Plus Therapeutic Exercises on Pain and Functionality of Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial.

Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding radiofrequency diathermy to therapeutic exercises in patients with patellofemoral pain syndrome. Fifty-six participants were randomly assigned either to radiofrequency diathermy plus therapeutic exercises group (n = 29) or therapeutic exercises group (n = 27). Both groups received the same therapeutic exercises, and the diathermy group additionally received monopolar dielectric diathermy for three weeks (5-3-2 weekly sessions). Data related to intensity of pain, probability of neuropathic pain, functionality, and range of movement of the knee were measured at baseline and three weeks after the intervention. Comparing pre-treatment and values obtained at the third week, significant improvements were found in intensity of pain, neuropathic pain, functionality, and range of motion in both groups (p < 0.05). The diathermy plus exercises group had significantly better intensity of pain than the control group at the end of the three weeks (p < 0.01). The addition of diathermy by emission of radiofrequency to the therapeutic knee exercise protocol is more effective than a therapeutic exercise protocol alone in the relief of intensity of pain in patients with patellofemoral pain in the immediate post-treatment follow-up compared with baseline scores.

Supervised exercise therapy versus laser-guided exercise therapy on postural control in subjects with non-specific chronic low back pain: a randomized controlled clinical trial.

BACKGROUND: Among the most effective therapeutic interventions in non-specific chronic low back pain, clinical practice guidelines highlight exercise therapy and patient education. However, the variability in the type of exercise and its dosage means that there is no clear evidence regarding the most optimal form of therapeutic exercise. AIM: The main objective of this study was to ascertain the effects produced by two different exercise interventions (supervised exercise therapy and laser-guided exercise therapy) and pain neuroscience education on postural control measured by the displacement center of pressure (CoP) and energy spectral density (ESD) in subjects with non-specific chronic low back pain. DESIGN: This is a single-blinded randomized clinical comparative controlled trial. SETTING: The study was carried out in different private physiotherapy care centers. POPULATION: We enrolled 60 subjects with non-specific chronic low back pain of at least 3-month duration, aged 18-45 years. METHODS: Both groups performed a total of 16 therapeutic exercise sessions and 8 pain neuroscience education sessions, with the laser-guided exercise therapy group performing laser-guided exercises. The main outcome measures evaluated were ESD and displacement of CoP measured at 3 different times (baseline, post-treatment, and 3 month follow-up). RESULTS: The most important differences for ESD and displacement of CoP variables were obtained for eyes open, unstable surface anteroposterior axis (F(2,92)=7.36, P=0.001, d=0.71) and eyes closed, stable surface mediolateral axis (F(2,92)=3.24, P<0.001, d=0.76). Further, time × group interactions showed significant statistical differences in both cases as well as significant differences between baseline and 3 month's follow-up. CONCLUSIONS: Both exercise modalities (supervised exercise therapy and laser-guided exercise therapy) showed changes in variables related to postural control (displacement of CoP and ESD). However, the laser-guided exercise therapy program showed greater improvements in ESD. CLINICAL REHABILITATION IMPACT: Analysis of a new approach for the quantification of data obtained from postural control assessment relying on widely used devices (accelerometers and pressure platforms).

Does Inspiratory Muscle Training Affect Static Balance in Soccer Players? A Pilot Randomized Controlled Clinical Trial.

Inspiratory muscle training (IMT) is effective in improving postural stability and balance in different clinical populations. However, there is no evidence of these effects in soccer players. A single-blind, two-arm (1:1), randomized, placebo-controlled pilot study on 14 soccer players was performed with the main aim of assessing the effect of IMT on static balance, and secondarily, of examining changes in the respiratory muscle function. The experimental group (EG) received an IMT program with progressive intensity, from 20% to 80%, of the maximal inspiratory pressure (MIP). The sham group (SG) performed the same program with a fixed load of 20% of the MIP. Static balance and respiratory muscle function variables were assessed. A two-factor analysis of variance for repeated measures was used to assess differences after training. Statistical significance was set at p < 0.05. Significant increases were observed in the EG on length of sway under eyes open (from 2904.8 ± 640.0 to 3522.4 ± 509.0 mm, p = 0.012) and eyes closed (from 3166.2 ± 641.3 to 4173.3 ± 390.8 mm, p = 0.004). A significant increase in the maximal voluntary ventilation was observed for both groups (EG p = 0.005; SG p = 0.000). No significant differences existed between the groups. IMT did not improve the static balance in a sample of soccer players. Conducting a high-scale study is feasible and could refine the results and conclusions stemming from the current pilot study.

The Impact on the Stress-Associated Autonomic Response of Physiotherapy Students Receiving Interferential Current in an Electrotherapy Training Session.

Electrical currents are didactic contents widely applied in the training of physiotherapy students, but the treatment is considered a stressful situation for both the patient who receives it and the student who applies it. The aim of this study was to evaluate the stress-associated autonomic response of physiotherapy students receiving interferential current by measuring and analysing heart rate variability. An observational case-control study was conducted. Ninety healthy male volunteers, all physiotherapy degree students, were enrolled while attending laboratory practice during the 2020-2021 academic year. Participants were randomly allocated to a sham electrotherapy group (44 subjects), in which heart rate variability was recorded for 10 min, both at rest and during the application of sham technique on the lower back (10 min), and an electrotherapy group (46 subjects), applying the same procedure with the electrical current flowing. Outcome measures included baseline (seated position) and postintervention (prone position) time domain parameter, diameters of the Poincaré plot 1 and 2, stress score, and sympathetic/parasympathetic ratio. The sham electrotherapy group exhibited significant increases in time domain parameter (p = 0.027) and diameters of the Poincaré plot 1 (p = 0.032), with a small effect size (d ≤ 0.5). The electrotherapy group exhibited significant increases in time domain parameter and diameters of the Poincaré plot 1 and 2 (p < 0.001) and decreases in the stress score and sympathetic/parasympathetic ratio (p < 0.001), with a large effect size (d > 0.8) other than for the time domain parameter (d = 0.42), indicating increased parasympathetic and decreased sympathetic activity. After interventions, there were significant differences between groups in diameters of the Poincaré plot 2 (p < 0.001), stress score (p = 0.01) and sympathetic/parasympathetic ratio (p = 0.003), with moderate effect size (d > 0.5). The application of the interferential current technique produces stress-associated autonomic response characterized by greater parasympathetic activity and decreased sympathetic activity. Further studies are needed to determine possible adverse effects.

Kinesiology tape increases muscle tone, stiffness, and elasticity: Effects of the direction of tape application.

The claim that the effects of kinesiology tape are different depending on the direction of tape application needs to be clearly ascertained. This study aimed to determine the immediate effects of two forearm kinesiology tape applications on muscle tone, stiffness, and elasticity of young individuals. Thirty-nine participants (15 men and 24 women) were randomized (1:1:1) to: the facilitatory group, receiving kinesiology tape applied from origin to insertion; the inhibitory group, receiving kinesiology tape applied from insertion to origin; or, a control group, without any intervention. The mechanical properties - tone, elasticity, and stiffness - of the forearm muscles were measured with a handheld mechanical impulse-based myotonometric device before and 30 min after the kinesiology tape application. Only the application of kinesiology tape from origin to insertion significantly increased muscle tone [16.6 (2.5) to 17.4 (3.5) Hz, p = 0.036], stiffness [318.3 (52) to 355.0 (87) N/m, p = 0.004], and elasticity [0.98 (0.1) to 1.10 (0.1), p = 0.023]. No changes were observed in both inhibitory kinesiology tape and the control group. In conclusion, kinesiology tape application has different effects depending on the direction of the taping application. The facilitatory tapping increased muscle tone, elasticity, and stiffness.

Assessment from a Biopsychosocial Approach of Flight-Related Neck Pain in Fighter Pilots of Spanish Air Force. An Observational Study.

Flying on fighter aircraft is the only human activity that exposes the body to acceleration levels for long periods of time. In this sense, the regular exposure to G forces has been related to a high incidence of flight-related neck pain. The aim is to evaluate flight pilots of the Spanish Air Force (instructors vs. students) diagnosed with flight-related neck pain from a biopsychosocial perspective. Eighteen fighter pilots with flight-related neck pain were divided into two groups: instructor fighter pilots (n = 7) and student fighter pilots (n = 11). The Neck Disability Index (NDI), Cervical Range of Motion (CRoM), Pain Pressure Threshold (PPT), cervical repositioning error, and myoelectric activity were evaluated. Cervical flexion, extension and left and right rotation showed a reduced range of motion in both groups with respect to the normative values of the healthy population. There were no statistically significant differences between the groups (p ≥ 05). The correlational analysis showed a strong association between the NDI and CRoM of the left rotation (ß =-0.880, p = 0.002). The NDI also had a positive association with the pilot's age (ß = 1.353, p < 0.01) and the number of flight hours (ß = 0.805, p = 0.003). In conclusion, the Cervical Range of Motion at the left rotation seems to determine the perceived degree of disability in both the instructors and students. This factor could be influenced by the number of flight hours and accumulated experience as an F-5 fighter pilot.

The Clinical Benefits of a Dynamic vs. Static Component as Part of a Comprehensive Warm-Up for Recreational Sports Players with Clinical Histories of Hamstring Injuries: A Randomized Clinical Trial.

Background: Few previous studies have analyzed the effects of certain specific static and dynamic warm-up components on recreational sports players with a previous hamstring injury. Therefore, the aim of this study was to analyze changes in some modifiable and external risk factors after (immediately and in a follow-up assessment after 10 min) a static or dynamic warm-up program on recreational sports players with a previous hamstring injury. Methods: A total of 62 participants were randomized into 2 groups: static warm-up (SW) (n = 31) or dynamic warm-up (DW) (n = 31). Range of movement (RoM), perceived pain, the pressure−pain threshold, and joint position sense were assessed at baseline, immediately after the intervention and 10 min afterwards. The intervention for the SW (hot pack procedures in both hamstring muscles) lasted 20 min. The DW intervention consisted of a running exercise performed on a treadmill for 10 min. Results: Both groups showed statistically significant changes (p ≤ 0.05) in the primary outcomes (perceived pain and the pressure−pain threshold) at the three measurement times (this was also true for RoM for the SW group, with statistically significant differences only between times from the baseline to the 10-min follow-up; p ≤ 0.05, d = 0.23). The intra-group secondary outcome showed no statistically significant changes (p > 0.05) in both groups (except for the period from the baseline−immediately after in the DW group; p ≤ 0.05, d = 0.53). The comparison between groups showed no statistically significant differences for any of the variables analyzed. (p ≥ 0.05). Conclusion: The present findings suggest that both specific warm-up modalities seem to positively influence perceived pain on stretching and the pressure threshold; however, the significant reduction in the joint repositioning error and the larger effect sizes observed in the DW group suggest that this method has a greater beneficial impact in recreational sports players with clinical histories of hamstring injuries.

Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain.

Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP.

What Are University Professors' Motivations? A Realistic Approach to Self-Perception of a Group of Spanish University Professors Belonging to the G-9 Group of Universities.

Universities face challenges on a number of levels. In this scenario, university professors play an important role as facilitators of knowledge. The main objective of this study was to analyse the motivations that influence the professional performance in a sample of 102 university professors from nine Spanish public universities (Male: 54 (52.9%); Female: 48 (47.1%)). For this purpose, a questionnaire of 22 closed-ended Likert-type questions was designed, in which scores ranged from 0 to 10 (do not agree at all, strongly agree). Following analysis, the final questionnaire was composed of 17 items, and showed good internal consistency (Cronbach's alpha = 0.858). The validity analysis showed a value of 0.822 (>0.5) in the sample adequacy measure of Kaiser-Meyer-Olkin and Bartlett's sphericity test (p < 0.0001). The exploratory factor analysis showed a clustering in four factors (two for intrinsic motivations and two for extrinsic motivations), explaining 64.33% of the total variance. Comparisons between each factor score by gender (male and female) showed statistically significant differences for factor F1 (higher for females) and F2 (higher for males). Finally, Q1 and Q13 showed a statistically significant correlation (p ≤ 0.05) with years of teaching experience. The motivations of Spanish university professors appear to be associated with the age and gender of the teacher.

Test-Retest Reliability of an iPhone® Inclinometer Application to Assess the Lumbar Joint Repositioning Error in Non-Specific Chronic Low Back Pain.

Background: The joint position sense (JPS) has been used as an indirect marker of proprioception in subjects with non-specific chronic low back pain (NSCLBP), showing impairment in previous studies. It seems necessary to devise reliable tests to measure proprioceptive deficits in subjects with NSLBP. The objective of this study was to analyse the test-retest reliability and smallest real difference (SRD) of lumbar proprioception through the JPS indicator in a sample of patients with NSCLBP. Methods: Fifty participants with NSCLBP performed three repetitions of 30° lumbar flexion while standing and sitting using the iPhone® inclinometer application to measure the lumbar joint repositioning error. For the reliability analysis, we performed an intra-session test-retest. Results: The total sample ICC values were excellent for standing (0.96) and sitting (0.93) 30° lumbar flexion. In addition, our results showed that, for the total sample, an SRD < 12% can be considered as a true change in proprioception concerning this procedure. On the other hand, men have better reliability than women in both standing and sitting positions. Additionally, the sitting position has better reliability than the standing position. The standard error of measurement (SEM) percentage was 4.2 for standing and 3.8 for sitting. The SRD percentage was 11.6 for standing and 10.4 for sitting. Conclusions: The iPhone® inclinometer seems reliable for assessing proprioceptive ability through the lumbar joint repositioning error in subjects with NSCLBP in both standing (ICC = 0.96) and sitting (ICC = 0.93) positions. This technological device showed a lower measurement error for sitting position (SRD < 12%).

Energy spectral density as valid parameter to compare postural control between subjects with nonspecific chronic low back pain vs healthy subjects: A case-control study.

BACKGROUND: Nonspecific chronic low back pain (NSCLBP) is one of the most common and frequent health problems. OBJETIVE: to compare postural control (i.e. center of pressure (CoP) displacement and energy spectral density (ESD)) using technological devices (accelerometers and pressure platform) between subjects with NSCLBP and healthy subjects. METHODS: A cross-sectional case-control study was conducted. Observational study (STROBE). The final sample consisted of 60 subjects (30 NSCLBP subjects and 30 healthy subjects). Triaxial accelerometer and pressure platform were used in order to obtain ESD and CoP displacement measurements during four balance tasks (i.e. with and without vision and on stable versus unstable surface). Independent t tests were used to compare participants with NSCLBP and healthy controls in the two clinical measurements (i.e., CoP displacement and ESD) for the four balance tests. A multivariate analysis of variance (MANOVA) together with a Fisher's linear discrimination was applied in order to categorize NSPLBP. RESULTS: Patients with NSCLBP showed greater CoP migration in the positions eyes open, stable surface on the anteroposterior axis (p = 0.012), eyes closed, stable surface on the mediolateral axis (p = 0.025), eyes closed, stable surface on the anteroposterior axis (p = 0.001), eyes open, unstable surface on the anteroposterior axis (p = 0.040), eyes closed, unstable surface on the anteroposterior axis (p = 0.015). Also the ESD was significantly greater for the four situations described (p ≤ 0.01) in subjects with NSCLBP. CONCLUSIONS: Accelerometer appears to be a technological device that could offer a potential benefit within the battery of tests on physical performance among subjects with NSCLBP and healthy subjects.

Treatment of Patellofemoral Pain Syndrome with Dielectric Radiofrequency Diathermy: A Preliminary Single-Group Study with Six-Month Follow-Up.

Background and Objectives: Notwithstanding patellofemoral pain syndrome (PFPS) being one of the most common causes of pain in the front of the knee in outpatients, few studies have shown the effects of radiofrequency on knee pain and function in this population. The aim of the present study was to determine whether outpatients diagnosed with PFPS obtained improvement in pain and function after treatment by dynamic application of monopolar dielectric diathermy by emission of radiofrequency (MDR). Materials and Methods: An experimental study was conducted with 27 subjects with PFPS. Subjects were treated with 10 sessions of MDR in dynamic application. The visual analogue scale (VAS), the Kujala scale, the DN4 questionnaire, the lower extremity function scale (LEFS), the range of movement (ROM) in knee flexion and extension and the daily drug intake were measured pre- and post-intervention and at the time of the follow-up (six months). Results: Statistically significant differences were found in pain perception (VAS: F1,26 = 92.43, p < 0.000, ŋ2 = 0.78 and DN4: F1.26 = 124.15, p < 0.000, ŋ2 = 0.82), as well as improvements in functionality (LEFS: F1.26 = 72.42, p < 0.000, ŋ2 = 0.74 and Kujala: F1.26 = 40.37, p < 0.000, ŋ2 = 0.61]) and in ROM (Flexion: F1.26 = 63.15, p < 0.000, ŋ2 = 0.71). No statistically significant changes in drug intake were found. Conclusions: The present study shows that the dynamic application of MDR seems effective in reducing pain and increasing functionality and knee flexion in patients with PFPS, after a follow-up of six months.

Immediate clinical benefits of combining therapeutic exercise and interferential therapy in adults with chronic neck pain: a randomized controlled trial.

BACKGROUND: Therapeutic exercise (TE) is highly recommended for the management of non-specific neck pain (NSNP) and has shown promising results combined with interferential current therapy. Yet, the clinical relevance of the pooled effect of these approaches remains uncertain. AIM: To investigate the immediate clinical effect size of combining TE and interferential therapy, compared with the isolated use of TE, in adults with chronic NSNP. DESIGN: Randomized, single-blinded, controlled, superiority trial. SETTING: Outpatients, primary care center. POPULATION: Forty-nine adults with chronic NSNP. METHODS: Participants with neck pain (grades I or II) lasting for more than 12 weeks were allocated to a TE plus interferential currents group (N.=25) or to a TE only group (N.=24). All individuals underwent treatment 5 times a week for 2 weeks. The primary outcome was current neck pain intensity (11-point Numeric Pain Rating Scale). Secondary outcomes included neck disability (Neck Disability Index) and active cervical range-of-movement (CROM device). Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat (NNT) were calculated. RESULTS: A significant time*group effect was found for pain intensity, disability, and neck flexion and right rotation (all, P<0.05). In the analysis for treatment benefit, the NNT was 2 (95% CI: 2 to 4, P<0.001) for neck pain and disability, and 3 (95% CI: 2 to 11, P=0.029) for neck flexion. CONCLUSIONS: Adding interferential therapy to TE is clinically more effective than TE alone to immediately improve neck pain and disability, but not active cervical range-of-movement, in adults with persistent neck pain. CLINICAL REHABILITATION IMPACT: Our results suggest that this multimodal intervention can be a useful strategy for rehabilitation of patients with NSNP. This is the first study on this topic reporting findings in terms of clinical relevance, which is key to transfer research evidence into practice.

Effectiveness of Tele-Prescription of Therapeutic Physical Exercise in Patellofemoral Pain Syndrome during the COVID-19 Pandemic.

The health crisis caused by COVID-19 has had a huge impact on the provision of physiotherapists' services during the pandemic. Patellofemoral pain syndrome (PFPS) is a major health problem and one of the most common causes of pain in the front of the knee in outpatients. The objective was to evaluate the effectiveness of a therapeutic physical exercise (TPE) program supervised by a physiotherapist using telematic channels in reducing pain and disability in a sample of 54 patients with PFPS in the Physiotherapy Service of the San José de la Rinconada Health Center (Seville). Subjects were evaluated pre- and post-intervention (4 weeks-12 treatment sessions). An analysis was made of perceived pain-using the visual analog scale (VAS) and the DN4 neuropathic pain questionnaire-and functional balance-through the Kujala Score test and the Lower Extremity Functional Scale. The supervised TPE program in patients with PFPS produced a reduction in pain: VAS F1, 52 = 8.68 (p = 0.005) η2 = 0.14 and DN4: F1, 52 = 69.94 (p = 0.000) η2 = 0.57; and in Lower Extremity Functional Scale (LEFS) disability: F1, 52 = 19.1 (p = 0.000) η2 = 0.27 and KUJALA: F1, 52 = 60.28 (p = 0.000) η2 = 0.54, which was statistically significant (p = 0.000 for p < 0.05). Hence, the TPE program presented was effective in reducing pain and disability in patients with PFPS.

Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS).

Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS) measuring the level of physical therapy patient satisfaction in hospital rehabilitation services. This study has a multicenter cross-sectional survey design. This study used the structural validity and internal consistency domains from COSMIN (consensus-based standards for the selection of health status measurement instruments) guideline. The H-PTPS questionnaire consists of 20 closed questions. A sample of 384 adult patients from physical therapy units from three Spanish public hospitals completed this questionnaire. A factor structure and internal consistency reliability analysis were performed. The factor analysis including the 20 items of the H-PTPS showed an adequacy index of 0.922 according to the Kaiser-Meyer-Olkin measure and the Barlett test allowed us to reject the null hypothesis (p < 0.001). In the rotated component matrix, four specific factors were obtained, explaining 66.75% of the accumulated variance. All factors present satisfactory internal reliability, achieving Cronbach's alpha indices and Omega coefficients higher than 0.74. The H-PTPS questionnaire has shown a four-factor solution with satisfactory reliability evaluating the satisfaction of Spanish patients treated in physical therapy units in the hospital rehabilitation services.

The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial.

OBJECTIVES: To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. DESIGN: Randomized, single-blind, controlled trial. SETTING: A Spanish nursing home in the autonomous community of Extremadura, Spain. PARTICIPANTS: An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. INTERVENTIONS: Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. MAIN OUTCOME MEASURES: Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). RESULTS: Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). CONCLUSIONS: A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.

Effects of Adding Interferential Therapy Electro-Massage to Usual Care after Surgery in Subacromial Pain Syndrome: A Randomized Clinical Trial.

Subacromial pain syndrome (SAPS) is a prevalent condition that results in loss of function. Surgery is indicated when pain and functional limitations persist after conservative measures, with scarce evidence about the most-appropriate post-operative approach. Interferential therapy (IFT), as a supplement to other interventions, has shown to relieve musculoskeletal pain. The study aim was to investigate the effects of adding IFT electro-massage to usual care after surgery in adults with SAPS. A randomized, single-blinded, controlled trial was carried out. Fifty-six adults with SAPS, who underwent acromioplasty in the previous 12 weeks, were equally distributed into an IFT electro-massage group or a control group. All participants underwent a two-week intervention (three times per week). The control group received usual care (thermotherapy, therapeutic exercise, manual therapy, and ultrasound). For participants in the IFT electro-massage group, a 15-min IFT electro-massage was added to usual care in every session. Shoulder pain intensity was assessed with a 100-mm visual analogue scale. Secondary measures included upper limb functionality (Constant-Murley score), and pain-free passive range of movement. A blinded evaluator collected outcomes at baseline and after the last treatment session. The ANOVA revealed a significant group effect, for those who received IFT electro-massage, for improvements in pain intensity, upper limb function, and shoulder flexion, abduction, internal and external rotation (all, p < 0.01). There were no between-group differences for shoulder extension (p = 0.531) and adduction (p = 0.340). Adding IFT electro-massage to usual care, including manual therapy and exercises, revealed greater positive effects on pain, upper limb function, and mobility in adults with SAPS after acromioplasty.