Effects of unstable shoes on trunk muscle activity in patients with chronic low back pain.

INTRODUCTION: Unstable shoes were developed as a walking device to strengthen the lower extremity muscles and reduce joint loading. Many studies have reported increased muscle activity throughout the gait cycle in most of the lower limb muscles in healthy adults using these shoes. However, no previous studies have explored the effects of wearing unstable shoes on trunk muscle activity in patients with chronic low back pain (CLBP). Therefore, the aim of the present study was to compare the activity of selected trunk muscles in patients with CLBP during a gait test while walking wearing unstable shoes or conventional flat shoes (control). METHODS: Thirty-five CLBP patients (51.1 ±â€¯12.4 y; 26 ±â€¯3.8 kg/m2; 9.3 ±â€¯5.2 Roland Morris Disability Questionnaire score) were recruited from the Orthopedic Surgery Service at the Hospital to participate in this cross-sectional study. All the participants underwent gait analysis by simultaneously collecting surface electromyography (EMG) data from erector spinae (ES), rectus abdominis (RA), obliquus internus (OI), and obliquus externus (OE) muscles, while walking on a treadmill with flat control shoes or experimental unstable shoes. RESULTS: The results showed significantly higher %EMG activity in the ES (mean difference: 1.8%; 95% CI: 1.3-2.2), RA (mean difference: 1.5%; 95% CI: 0.3-2.7), and OI (mean difference: 1.5%; 95% CI: 0.2-2.8) in the unstable versus the flat-shoe condition, with a large effect size for the ES (Cohen's d = 1.27). CONCLUSIONS: Based on these findings, the use of unstable shoes may be implicated in promoting spine stability, particularly in improving neuromuscular control of the trunk muscles in CLBP treatment.

Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults: A randomized controlled trial.

OBJECTIVE: To examine the effect of KT on gastrocnemius surface electromyography (SEMG) activity and ankle range of motion during walking in healthy subjects. DESIGN: Randomized controlled trial, with concealed allocation and assessor blinding. SETTING: University Biomechanics Laboratory. PARTICIPANTS: Thirty six healthy physiotherapy students were randomized to KT or control group. OUTCOME MEASURES: At baseline and immediately after 72 h with the tape in situ: amplitude of LG SEMG activity during the stance phase, duration of the LG activity, onset and offset times of LG activity, ankle plantar- and dorsiflexion peaks, and the cadence of gait. RESULTS: ANOVA revealed a significant time × intervention interaction effect across two variables: duration of LG activation, F(1, 33) = 4.71, p = .037, η = .015; and onset F(1, 33) = 7.92, p = .008, η = .037. KT group showed significantly shorter duration of the LG activity as compared with control, and similar results were observed when comparing the onset of LG activation. No statistically significant differences between both groups were noted in the rest of the outcomes. CONCLUSION: KT does significantly shorten the duration of the LG activity during gait when applied 72 h in healthy adults. However, this result was not accompanied by a significant reduction in the amplitude of LG SEMG activity.

Efecto del entrenamiento en cinta rodante sobre la marcha y el riesgo de caída en personas adultas con parálisis cerebral / Effect of training on a treadmill on gait and risk of falls in adult persons with cerebral palsy cerebral

OBJETIVOS: El objetivo de este estudio fue determinar el efecto del entrenamiento en cinta rodante combinado con terapia convencional vs. terapia convencional en personas adultas con parálisis cerebral sobre la marcha, el equilibrio y el riesgo de caída. Material y métodos Estudio longitudinal prospectivo y controlado. Participan 11 personas adultas con parálisis cerebral, nivel Gross Motor Function Classification System i-iii , divididas en 2 grupos (n = 6 intervención y n = 5 control). El grupo intervención realiza entrenamiento en cinta rodante más la terapia convenida. El grupo control solo recibe la terapia convenida. Los efectos de esta intervención se determinaron mediante el Test Up and Go, el promedio de la frecuencia cardíaca, la velocidad de marcha y la distancia recorrida en cada sesión. Resultados Mejora estadísticamente significativa en el Test Up and Go, velocidad de marcha y distancia recorrida dentro del grupo intervención. Conclusiones El entrenamiento en cinta rodante combinado con la terapia convencional puede ser un tipo de intervención terapéutica beneficiosa para la mejora de la marcha y la disminución del riesgo de caída en personas adultas con parálisis cerebral

OBJECTIVE: This study has aimed to determine the effect of training on a treadmill combined with conventional therapy versus conventional therapy in adults with cerebral palsy on gait, balance and fall risk. MATERIAL AND METHODS: A prospective, controlled, longitudinal study that included 11 adults patients with cerebral palsy, gross motor functional classification system level i-iii was performed. They were divided into two groups: intervention group (n = 6) and control group (n = 5).The intervention group received treadmill training combined with agreed therapy while the control group only received agreed therapy. The effects of this treatment were determined by analyzing the results of the Test Up and Go, average heart rate, walking speed and distance covered in each session. RESULTS: The was a statistically significant improvement in the intervention group in the Test Up and Go, walking speed and distance covered. CONCLUSIONS: Treadmill training combined with conventional therapy could be a beneficial therapeutic tool to improve gait, balance and fall risk in adult's people with cerebral palsy

Efectividad del calzado inestable sobre la osteoartritis de cadera y rodilla. Revisión sistemática / Effectiveness of unstable footwear on hip and knee osteoarthritis. a systematic review

Objetivo Determinar si existe suficiente evidencia científica para apoyar o refutar la utilización del calzado inestable en la osteoartritis (OA) de cadera y rodilla. Estrategia de búsqueda Las bases de datos consultadas fueron: Academic Search Complete, Cochrane, TESEO, Biomedical Reference Collection, Fuente Académica Premier, MedicLatina, Medline, CINAHL, Nursing & Allied Health Collection, ISI Web of Knowledge, Embase, Ebsco, Dialnet, Índice Médico Español y SportDiscus, desde la primera fecha disponible hasta el 21 de febrero de 2012.Selección de estudios Fueron seleccionados 9 artículos. La calidad metodológica y la validez de los artículos se valoró de acuerdo a los criterios PeDro. Síntesis de resultados El nivel de evidencia es bajo y con limitaciones metodológicas que restan credibilidad a los resultados obtenidos. Conclusiones No hay resultados clínicos importantes sobre la efectividad del calzado inestable en la OA de cadera y rodilla (AU)

Aim To determine whether there is sufficient scientific evidence to support or refute the use of unstable footwear in hip and knee osteoarthritis (OA).Search strategy Databases searched were: Academic Search Complete, Cochrane, TESEO, Biomedical Reference Collection, Academic Source Premier, MedicLatina, Medline, CINAHL, Nursing & Allied Health Collection, ISI Web of Knowledge, Embase, Ebsco, Dialnet, Índice Médico Español and Sport Discus, from the first available date to February 21, 2012.Study selection Nine articles that met the inclusion criteria were selected. Methodological quality and validity of the articles were evaluated according to criteria PeDro. Summary of results The low level of evidence and methodological limitations undermine the credibility of the results. ConclusionsT here are no clinically important results regarding the effectiveness of the unstable shoe in hip and knee OA (AU)

Exercise intervention in childhood obesity: a randomized controlled trial comparing hospital-versus home-based groups.

OBJECTIVE: The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise-diet program for the treatment of childhood obesity. METHODS: One hundred ten overweight/obese Spanish children and adolescents (6-16 years) in 2 intervention groups (hospital clinic group-based [n = 45] and home-based [n = 41]) and a sex-age-matched control group (n = 24) were randomly assigned to participate in a 6-month combined exercise (aerobic and resistance training) and Mediterranean diet program. Anthropometric values (including body weight, height, body mass index, BMI-Z score, and waist circumference) were measured pre- and postintervention for all the participants. Percentage body fat was also determined with a body fat analyzer (TANITA TBF-410 M). RESULTS: Our study showed a significant reduction in percentage body fat and body mass index Z-score among both intervention-group participants (4%, 0.16, hospital clinic group-based; 4.4%, 0.23, home-based; P < .0001). There was also a significant reduction in waist circumference in the home-based group (4.4 cm; P = .019). Attendance rates at intervention sessions were equivalent for both intervention groups (P = .805). CONCLUSIONS: The study findings indicate that a simple home-based combined exercise and Mediterranean diet program may be effective among overweight and obese children and adolescents, because it improves body composition, is feasible and can be adopted on a large scale without substantial expenses.

Efecto inmediato del kinesio tape sobre la respuesta refleja del vasto interno ante la utilización de dos técnicas diferentes de aplicación: facilitación e inhibición muscular / Immediate effect of kinesio tape on the reflex response of the vastus medialis regarding the use of two different application techniques: facilitation and inhibition of muscle

ObjetivoAnalizar el efecto inmediato del Kinesio Tape (KT) mediante dos técnicas de aplicación (inhibición o facilitación muscular), sobre la respuesta refleja del vasto interno del cuádriceps.Material y métodoEn el estudio participaron voluntariamente 30 sujetos sanos (25,9±6,2 años; 67,1±12,9kg; 171,1±9,5cm). Se utilizó un goniómetro electrónico para determinar el inicio del desequilibrio y electromiografía de superficie para comparar la intensidad y la latencia de la respuesta refleja del vasto interno entre tres condiciones diferentes: sin KT, con KT aplicado de origen a inserción y con KT aplicado de inserción a origen. Con la finalidad de valorar la fiabilidad interobservador, dos investigadores calcularon de forma independiente la intensidad de la respuesta refleja (máximo pico de la electromiografía normalizada) y la latencia de la respuesta refleja (tiempo desde el inicio del desequilibrio hasta la aparición de la respuesta refleja).ResultadosSe obtuvieron correlaciones elevadas entre los grupos para las variables de estudio (0,773≤ICC≤0,883). Con relación al efecto del vendaje, no se encontraron diferencias significativas en las 3 condiciones (sin KT, KT origen-inserción y KT inserción-origen) (p≥0,05).ConclusionesLos resultados obtenidos sugieren que tanto la aplicación de facilitación como la de inhibición no tienen un efecto inmediato sobre la respuesta muscular refleja del músculo analizado (AU)

ObjectiveTo analyze the immediate effect of Kinesio Tape (KT) with two techniques (inhibition and facilitation) on reflex response of vastus medialis.MethodsThirty healthy individuals volunteered to take part in this study (25.9±6.2 years, 67.1±12.9kg; and 171.1±9.5cm). An electrogoniometer was used to determine the onset of the imbalance and superficial electromyography was recorded to compare intensity and latency of the reflex response of the vastus medialis under three different conditions: without KT, with KT origin-insertion and with KT insertion-origin. In order to assess the inter-observer reliability, two groups of researchers independently calculated the response intensity (maximum peak of the normalized electromyography) and latency (the time it takes between the start of the imbalance and the onset of reflex response).ResultsHigh correlations between groups were found for the variables (0.773≤ICC≤0.883). With regards to the effect of the KT, significant differences between the three conditions, without KT, with KT origin-insertion and with KT insertion-origin, were not found (P≥.05).ConclusionsThe results suggest that the application of KT origin-insertion and KT insertion-origin does not have an immediate effect on the reflex response of the analyzed muscle (AU)

Efectos de un programa combinado de ejercicio físico y Halliwick sobre la hipertonía en personas adultas con lesión cerebral. Estudio piloto / Effects of a combined program of physical exercise and Halliwick method on hypertonia in adults with brain injury. A pilot study

ObjetivoDeterminar los efectos de un programa combinado de ejercicio físico y el Método Halliwick sobre la hipertonía del músculo sóleo de personas adultas con lesión cerebral.Material y métodosSe estudiaron 7 sujetos con lesión cerebral. Recibieron un total de 24 sesiones (12 de fisioterapia acuática más 12 de fisioterapia en seco). Es un estudio con un solo grupo, con un diseño pretest y postest. Se valoró la temperatura superficial de la piel, la movilidad articular pasiva máxima, la resistencia al movimiento pasivo del tobillo (Escala Modificada de Ashworth) y el registro electromiográfico durante el estiramiento del músculo sóleo. Para el análisis estadístico se empleó una prueba t para muestras relacionadas.ResultadosIncremento en la movilidad articular pasiva de dorsiflexión del tobillo (p=0,05). Disminución en la temperatura superficial de la piel tras la sesión de hidroterapia (p=0,001). No se hallaron cambios estadísticamente significativos en la Escala Modificada de Ashworth ni en la actividad eléctrica del músculo sóleo al estiramiento (p≥0,05).ConclusiónEl programa combinado de fisioterapia acuática y de fisioterapia en seco en personas adultas con lesión cerebral con una intervención de 3 meses mejora la movilidad articular. Se requieren futuros estudios aleatorios con muestras más amplias para determinar la efectividad clínica de esta terapia(AU)

AimTo determine the effects of a combine program of physical exercise and the Halliwick Method on hypertonia of the soleus muscle in adults with brain injury.Subjects and methodsSeven subjects with brain injury were studied and a total of 24 sessions were applied (12 aquatic physiotherapy and 12 regular physical therapy activity program). The study was performed in a single group, using a pre- and post- test design. Skin surface temperature, maximum passive joint range of movement, resistance to passive movement of the ankle (Modified Ashworth Scale) and electromyographic recording during the stretching of the soleus muscle were evaluated. The statistical analysis used was a T test for related samples.ResultsIncreased passive joint range of movement of ankle dorsiflexion (p=0.05). The skin surface temperature decreased after the hydrotherapy session (p=0.001). No statistically significant changes were found in the Modified Ashworth Scale or the electrical activity of the soleus muscle during the stretching (p ≥0.05).ConclusionThe combined program of aquatic physical therapy and a dry-land physical therapy program in adults with brain injury with a 3-month intervention improves joint range of movement. Future, prospective randomized studies with larger samples are required to determine the clinical effectiveness of this therapy(AU)

Efecto del Kinesio taping sobre la respuesta refleja de los músculos bíceps femoral y gemelo externo / Effect of Kinesio taping on reflex response of biceps femoris and gastrocnemius lateralis

ObjetivoAnalizar el efecto inmediato de la aplicación de Kinesio Tape (KT) sobre la respuesta refleja de los músculos bíceps femoral y gemelo externo ante un desequilibrio rápido e inesperado aplicado sobre la rodilla mediante una técnica conocida como quick release.Material y métodosEn el estudio participaron voluntariamente 11 sujetos sanos (23,6±3,0 años; 171,8±6,8cm y 63,3±9,7kg). Se utilizó un goniómetro electrónico para determinar el inicio del desequilibrio y electromiografía de superficie para comparar la intensidad y la latencia de la respuesta refleja de los músculos referidos entre dos condiciones diferentes: sin vendaje (control) y con vendaje (KT). Con el objeto de valorar la fiabilidad interobservador, dos grupos de investigadores calcularon por separado la intensidad (pico de la electromiografía normalizada) y la latencia de la respuesta (tiempo desde el inicio del desequilibrio hasta el inicio de la activación muscular).ResultadosLos datos obtenidos por ambos grupos fueron similares (t-test: p≥0,204). Asimismo, con la excepción del pico de activación del músculo gemelo externo en la condición KT (coeficiente de correlación intraclase [ICC] = 0,363) se obtuvieron correlaciones elevadas entre los grupos para la mayor parte de las variables (0,741≤ICC≤0,996). En relación con el efecto del vendaje, no se encontraron diferencias significativas entre las condiciones control y KT (t-test: p≥0,123), aunque la tendencia observada fue una respuesta de menor intensidad y mayor latencia cuando se aplicó el KT.ConclusionesNuestros resultados sugieren que la aplicación del KT no tiene un efecto inmediato sobre la respuesta refleja de los músculos analizados(AU)

ObjectiveTo analyze the immediate effect of the application of Kinesio Tape (KT) on reflex response of biceps femoris and gastrocnemius lateralis subject to a sudden and unexpected perturbation applied to the knee by means of a technique known as quick release.MethodsEleven healthy individuals volunteered to take part in this study (23.6±3.0 years; 171.8±6.8cm; and 63.3±9.7kg). An electrogoniometer was used to determine the onset of the perturbation and superficial electromyography was recorded to compare the intensity and the latency of the reflex response of biceps and grastrocnemius under two different conditions: without bandage (control) and with bandage (KT). In order to assess the inter-experimenter reliability, two groups of researchers independently calculated the response intensity (peak of the normalized electromyography) and latency (the time it takes between the start of the perturbation and the onset of muscle activation).ResultsThe data obtained by both groups were similar (t-test: p≥0.04). In addiction, with the exception of the activation peak of grastrocnemius in the KT condition (ICC=0.363), high correlations between groups were found for most of the variables (0.741≤ICC≤0.996). With regard to the effect of the bandage, significant differences between the control and the KT conditions were not found (t-test: p≥0.123). However, the observed trend was a muscular response of lower intensity and larger latency when the KT was used.ConclusionsOur results suggest the application of KT does not have an immediate effect on the reflex response of the analyzed muscles(AU)

Estudio del marco de referencia bioético en estudiantes españoles de Fisioterapia / Study of the bioethics framework of Spanish physiotherapy students

Objetivo: Determinar el marco de referencia antropológico y moral general de los estudiantes de Fisioterapia de una universidad española. De los resultados obtenidos se pretende colegir claves para modificar/potenciar los contenidos docentes que se les impartirán a lo largo de los años de formación.MétodoCon la base de un cuestionario sobre valores y ética, ya validado y estadísticamente significativo, se ha realizado una encuesta a 124 estudiantes españoles de la titulación de Fisioterapia.ResultadosSe realizó la comparación de medias mediante el contraste de hipótesis, utilizando la prueba de la t de Student, tomando como nivel de significatividad el 95% (p<0,05), con el fin de hallar diferencias significativas en las respuestas entre hombres y mujeres. Los estudiantes de Fisioterapia presentan un sistema de valores morales generales centrado en el factor religioso, comparten la idea de que el ser humano posee una dignidad intrínseca y son mayoritariamente creyentes; a su vez, se inclinan por los conceptos de ayuda y bienestar de los pacientes por delante de la autonomía y de la justicia; el 81% de los estudiantes se plantea a menudo cuestiones de tipo existencial.ConclusionesAunque paradójicamente en España toda la educación en el ámbito sanitario ha estado tradicionalmente influida por el marco de referencia biomédico, la visión ética de los estudiantes españoles de Fisioterapia es claramente humanística (AU)

Objective: To determine the general anthropological and moral reference framework of the physiotherapy students of a Spanish university. Based on the results obtained, it is aimed to find the keys to modify/strengthen the teaching content of the student's curricula.MethodUsing a reliable and already validated questionnaire on values and ethics, a survey was made of 124 Spanish physiotherapy students.ResultsMeans comparison were made with the contrast of hypothesis, using the t test with a 95% (p<0.05) reliability in order to find the significant differences between the answers of the men and women. The physiotherapy students have a moral value system focused on the religious factor. They share the idea that the individual has an intrinsic dignity and most of them are believers while they tend to give priority to helping and providing well-being to the patients over their autonomy and equal rights in health care. A total of 81% of the students usually pose existential type questions.ConclusionsAlthough paradoxically in Spain, all the education of the health professional has been traditionally based on the biomedical frame of reference and the Spanish physiotherapy student's ethics view is clearly humanistic (AU)