Electrical dry needling versus a non-invasive multicomponent intervention in the treatment of myofascial trigger points in patients with chronic low back pain: A randomised clinical trial.

OBJECTIVE: To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain. DESIGN: A randomised single-blind clinical trial. SETTING: Outpatient Physiotherapy Clinic; home. PARTICIPANTS: Sixty-four patients with chronic low back pain aged 30-65 years. INTERVENTIONS: Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression). MAIN MEASURES: Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months. RESULTS: ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points (P < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14, P = 0.016; and Oswestry Disability Index: F = 7.36, P = 0.009), for trunk anteflexion (F = 10.03, P = 0.002) and for habitual sleep efficacy (F = 6.65, P = 0.012), use of hypnotics (F = 4.77, P = 0.033) and total score of quality of sleep (F = 8.23, P = 0.006). CONCLUSIONS: In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients' sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months. CLINICAL TRIAL REGISTRATION NUMBER: NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228.

Efficacy of Dual-Task Training in Patients with Parkinson's Disease: A Systematic Review with Meta-Analysis.

Background: Dual-task training (DTT) involves simultaneously motor and cognitive exercises. Objectives: To determine the effectiveness of DTT, in comparison to other interventions [single-task training (STT) and usual care (UC)], on gait and balance parameters, motor impairments, activities of daily living (ADLs) and quality of life (QoL) in patients with Parkinson's disease (PD) immediately post-intervention and at 3, 6, and 12 months after therapy. Methods: A meta-analysis was performed following PRISMA Guidelines through searching in PubMed, SCOPUS, WOS, CINAHL, SciELO and PEDro up to September 2022. We included randomized controlled trials (RCTs) that compare the effect of DTT versus STT and UC on gait (speed, step and stride length, cadence and steps per day), balance (functional and dynamic balance), motor impairments, ADLs and QoL. Methodological quality was assessed using the PEDro scale. The pooled effect was calculated through Cohen's Standardized Mean Difference (SMD) and its 95% confidence interval (95%CI). Results: Seventeen RCTs with 826 participants and a mean PEDro score of 6.59 ± 1 points were included. In comparison to STT and UC, DTT is effective in improving walking speed (SMD 0.42, 95%CI 0.23-0.6), stride length (SMD 0.69, 95%CI 0.23-1.15), cadence (SMD 0.41, 95%CI 0.19-0.63), functional balance (SMD 1.15, 95%CI 0.92-1.4), dynamic balance (SMD -0.5, 95%CI -0.81 to -0.18) and motor impairments (SMD -0.86, 95%CI -1.25 to -0.47). No adverse effects related to DTT were reported. Conclusions: DTT is an effective and safe therapy for improving gait, balance and motor impairments in patients with PD.

The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review.

BACKGROUND: The aim of this systematic review was to determine whether strength exercises improve the symptoms of menopause and to provide an update on the most recent scientific evidence on the type and regimen of exercise that help reduce the symptoms. METHODS: An electronic search of scientific databases was performed from 2015 to 2022. Randomized clinical trials that analyzed the effects of strength exercises versus other types of interventions, considering all the outcome measures of interest, were included in this review. RESULTS: We found 5964 potential articles. After applying the selection criteria, we selected 12 of the articles. The studies compared strength exercises versus other therapies or compared strength exercises versus no intervention in one of the groups. The results showed improvements in the strength of the legs and pelvic floor, physical activity, bone density, metabolic and hormonal changes, heart rate and blood pressure and a change in hot flashes. CONCLUSIONS: There is evidence that strength exercises can be beneficial for improving strength, physical activity, bone density and hormonal and metabolic levels. In terms of the appropriate type of strength training, the evidence is still unclear given that the same benefits are achieved by various types of exercises.

Efficacy of Dry Needling for Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Objective: To evaluate the current evidence of the effectiveness of dry needling in patients with chronic low back pain (LBP). Methods: PubMed, Medline, ScienceDirect, Web of Science, CINAHL and PEDro databases were searched until 2020. Study selection: Randomised controlled trials (RCTs) that used dry needling as the main treatment and which included participants diagnosed with chronic LBP. Data extraction: Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at post-intervention and follow-up. Results: A total of 8 RCTs involving 414 patients were included in the meta-analysis. All trials examined the efficacy of DN in patients with chronic LBP. Results suggested that compared with other treatments, dry needling combined was more effective in alleviating the pain intensity of LBP post-intervention (standardised mean difference [SMD], -0.42; 95% confidence interval [CI], -0.79 to -0.05; P = .03) and at short- term (SMD -0.99, 95% CI -1.61 to -0.37, P = .002). Conclusion: Current evidence showed that dry needling, especially if associated with other therapies, could be recommended to relieve the pain intensity of LBP at post-intervention and at short-term follow up. There is no evidence that dry needling alone or in combination improves disability at post-immediate or at short-term follow up. Registration: This review was registered on PROSPERO (PROSPERO CRD42020215781) and was aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews that evaluate healthcare interventions.

Effects of a supervised exercise program in addition to electrical stimulation or kinesio taping in low back pain: a randomized controlled trial.

Chronic low back pain it is one of the most common health problems worldwide. Usually is accompanied by a complex set of symptoms and generates significant direct and indirect socioeconomic and health costs. From a therapeutic point of view, there are a wide variety of methods to address the treatment of this pathology, however, these therapies have not been shown definitive efficacy. To investigate the effect of a mixed treatment with exercise and electrical stimulation versus exercise and kinesio taping in patients with non-specific chronic low back pain. A total of 58 patients participated in this single-blinded randomised clinical trial. Participants were assigned to the exercises- kinesio taping group, or exercises- analgesic current group, both received 12 treatment sessions. Disability, fear of movement, anxiety, depression, sleeps quality, pain, lower limb mechanosensitivity and pressure-pain thresholds were recorded at baseline and after 4 weeks of treatment. The 2 × 2 mixed analysis of covariance test showed statistically significant differences between groups for pain (P = 0.046). Pair-wise comparisons with baseline demonstrated significant differences for both groups in pain (P ≤ 0.001), disability (P ≤ 0.001), pressure-pain thresholds (P ≤ 0.044), lower limb mechanosensitivity, (P ≤ 0.047), anxiety (P ≤ 0.001), depression (P ≤ 0.001) and sleep quality (P ≤ 0.010). Patients with chronic low back pain who received a combined treatment of exercises and kinesio taping or analgesic current showed an improvement in pain, disability, anxiety, depression and sleep pattern. Moreover, exercises combined with electrotherapy produces greater improvements over these variables.Trial registration: NCT02812459.

Efficacy of e-Health Interventions in Patients with Chronic Low-Back Pain: A Systematic Review with Meta-Analysis.

Introduction: Low-back pain (LBP) is the leading cause of disability worldwide. Around 75-84% of the world's population will experience LBP at some point, establishing it as a major global health problem. e-Health is the remote delivery of therapeutic services, clinical information, and medical care, and may prove a very useful approach to tackle this pathology. Objectives: To evaluate the efficacy of e-health-based interventions in improving the symptoms of chronic LBP. Methods: A systematic review with meta-analysis was performed in PubMed, Web of Science, and PEDro until January 2022 through the assessment of methodological quality of systematic reviews (AMSTAR). Studies were included in which e-health interventions were used as experimental treatment compared to physical therapy to determine changes in back-specific functional status and pain in patients with chronic LBP. Two reviewers examined the sources individually, calculated the risk of bias, and extracted the data (PROSPERO number CRD42022306130). The effect size was calculated using the standardized mean difference (SMD) and its confidence interval (95% CI). Results: A total of 9 randomized controlled trials with 3,180 participants were included. The results of the findings showed an effect of e-health compared to other physical therapy on short-term (SMD = -0.59, 95% CI: -1.77 to 0.59) and intermediate short-term (SMD = -0.40, 95% CI: -0.91 to 0.11) pain intensity and back-specific functional status in the short term (SMD = -0.20, 95% CI: -0.81 to 0.41) and intermediate short term (SMD = -0.30, 95% CI: -0.74 to 0.14). The effect of e-health compared to minimal intervention on short-term intermediate pain intensity (SMD = -0.64, 95% CI: -1.72 to 0.45) and short-term intermediate back-specific functional status (SMD = -0.39, 95% CI: -0.87 to 0.09). Conclusions: e-Health interventions based on self-maintenance and education are as effective on pain and back-specific functional status as other face-to-face or home-based interventions in patients with chronic LBP, with moderate scientific evidence.

Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain.

BACKGROUND: Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. METHODS: This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment. DISCUSSION: We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain. TRIAL REGISTRATION: ClinicalTrials.gov NCT04804228. Registered on 14 January 2021.

Comparison of the effectiveness of an e-health program versus a home rehabilitation program in patients with chronic low back pain: A double blind randomized controlled trial.

OBJETIVE: We conducted a randomized double blind clinical trial, to compare the effectiveness of McKenzie exercises and electroanalgesia via an e-Health program versus a home rehabilitation program on functionality, pain, fear of movement and quality of life in patients with non-specific chronic low back pain. METHODS: Seventy-four participants with non-specific chronic low back pain were randomized to either the e- Health program group (n = 39) or the home rehabilitation program group (n = 35). The interventions consisted of the e-Health program group performing McKenzie exercises and received transcutaneous electrical nerve stimulation, while the home rehabilitation group attended an information session to explain the exercises, which they then performed at home with printed instructions. Both groups performed 3 weekly sessions for 8 weeks. The following were analyzed main measures: pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline and at 2 months. RESULTS: Independent samples Student's t-tests showed that although the patients who followed the e-Health program showed significantly greater improvement than those who followed the home disability rehabilitation program in terms of intensity of pain, lumbar flexion mobility (P < 0.001), and the following dimensions of quality of life (P < 0.005), both groups improved significantly in the immediate post-treatment follow up compared with baseline scores. CONCLUSIONS: Patients with chronic low back pain who followed an unsupervised home intervention supported by an individualized video exercise program showed greater post-treatment improvement than those who followed the same program with printed instructions.

Comparing an e-Health program vs home rehabilitation program in patients with non-specific low back pain: A study protocol randomized feasibility trial.

BACKGROUND: There is little evidence on the reliability of the web application-based rehabilitation systems to treat chronic low back pain (CLBP). METHODS: This protocol describes a double-blind, randomized controlled feasibility trial of an e-Health intervention developed to support the self-management of people with CLBP in primary care physiotherapy. Three Hospitals with primary care for outpatients will be the units of randomisation, in each Hospital the participants will be randomized to one of two groups, a pragmatic control group receiving either the usual home program based on electrostimulation and McKenzie Therapy and e-Health intervention. Patients are followed up at 2 and 6 months. The primary outcomes are (1) acceptability and demand of the intervention by GPs, physiotherapists and patients and (2) feasibility and optimal study design/methods for a definitive trial. Secondary outcomes will include analysis in the clinical outcomes of pain, disability, fear of movement, quality of life, isometric resistance of the trunk flexors, lumbar anteflexion and lumbar segmental range of motion. DISCUSSION: The specific e-Health programs to home could increase adherence to treatment, prevent stages of greater pain and disability, and improve the painful symptomatology. CONCLUSIONS: The e-Health programs could be an effective healthcare tool that can reach a large number of people living in rural or remote areas.

Non-Immersive Virtual Reality to Improve Balance and Reduce Risk of Falls in People Diagnosed with Parkinson's Disease: A Systematic Review.

(1) Objective: To evaluate the effectiveness of non-immersive virtual reality in reducing falls and improving balance in patients diagnosed with Parkinson's disease. (2) Methods: The following databases were searched: PUBMED, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus and MEDLINE. These databases were searched for randomized controlled trials published using relevant keywords in various combinations. The methodological quality of the articles was evaluated using the PEDro scale. (3) Results: A total of 10 studies with a total of 537 subjects, 58.7% of which (n = 315) were men, have been included in the review. The age of the participants in these studies ranged between 55 and 80 years. Each session lasted between 30 and 75 min, and the interventions lasted between 5 and 12 weeks. These studies showed that non-immersive virtual reality is effective in reducing the number of falls and improving both static and dynamic balance in patients diagnosed with Parkinson's disease. Results after non-immersive virtual reality intervention showed an improvement in balance and a decrease in the number and the risk of falls. However, no significant differences were found between the intervention groups and the control groups for all the included studies regarding balance. (4) Conclusions: There is evidence that non-immersive virtual reality can improve balance and reduce the risk and number of falls, being therefore beneficial for people diagnosed with Parkinson's disease.

Manipulative therapy of sacral torsion versus myofascial release in patients clinically diagnosed posterior pelvic pain: a consort compliant randomized controlled trial.

BACKGROUND CONTEXT: Chronic low back pain represents a health care problem with substantial costs. It is generally accepted that approximately 10% to 25% of patients with persistent chronic low back pain may have pain arising from the sacroiliac joints. PURPOSE: This study aimed to analyze the effects of manipulative therapy of sacral torsion versus myofascial release on disability, pain intensity, and mobility in patients with chronic low back pain and sacroiliac joints. STUDY DESIGN/SETTING: A prospective, single-blinded randomized clinical trial. PATIENT SAMPLE: Sixty-four patients (mean±SD age: 51±9; 60% female) with chronic low back pain and sacroiliac joints comprised the patient sample. No participant withdrew because of adverse effects. OUTCOME MEASURES: Self-reported disability (primary), pain intensity, scale of kinesiophobia, quality of life, isometric endurance of trunk flexor muscles, and lumbar mobility in flexion were assessed at baseline, pos-treatment, and one month follow-up. METHODS: Participants were randomly assigned to a sacral torsion manipulation group or myofascial release group, receiving a total of 12 sessions (once weekly). RESULTS: ANCOVA did not showed a statistically significant difference between groups for disability (95% CI -2.40-1.90, p=.177). Effect sizes were large in both groups at both follow-up periods. Similar results were achieved for all secondary outcomes (p˂. 05). The linear model longitudinal analyses showed significant improvements in both groups over time for all outcomes with the exception of fear of movement (manipulative: Minimum within-groups change score 1.91, p˂.001; myofascial: 1.66, p˂.001). CONCLUSION: Manipulative and myofascial release therapy in patients with clinically diagnosed sacroiliac joints syndrome resulted in a similar short-term benefits on patient reported disability. Both groups experienced similar decrease in the intensity of pain over time, although no clinically meaningful effects were demonstrated in either group.

Effect of Myofascial Therapy on Pain and Functionality of the Upper Extremities in Breast Cancer Survivors: A Systematic Review and Meta-Analysis.

(1) Objective: The purpose was to analyze the effectiveness of myofascial therapy on musculoskeletal pain and functionality of the upper extremities in female breast cancer survivors, and to evaluate the changes in range of motion, quality of life, and mood state of these patients. (2) Methods: Systematic searches were performed on the MEDLINE/PubMed, Web of Science, Scopus, and Physiotherapy Evidence Databases for articles published until October 2020, in order to identify randomized controlled trials which analyzed the effectiveness of myofascial therapy as compared to a control group, passive treatment, placebo, or another intervention, and allowed co-interventions on female breast cancer survivors. Two reviewers examined the sources individually, calculated the risk of bias and extracted the data (PROSPERO number CRD42020215823). (3) Results: A total of eight RCTs were included. The results suggested that myofascial therapy does not have a greater statistically significant immediate effect on pain intensity (SMD: -0.15; 95% CI -0.48, 0.19), functionality (SMD: -0.17; 95% CI -0.43, 0.09) and range of motion in flexion (SMD: 0.30; 95% CI -0.13, 0.74) than an inactive, passive treatment or another intervention. However, a statistically significant result was observed for the abduction shoulder in favor of the experimental group (SMD: 0.46; 95% CI 0.05, 0.87; p = 0.03). (4) Conclusion: In general, although we found greater overall effects in support of the intervention with myofascial therapy than other control groups/types of interventions, the subgroup analysis revealed inconsistent results supporting myofascial therapy applied to breast cancer survivors.

Physical Therapists' Opinion of E-Health Treatment of Chronic Low Back Pain.

(1) Background: Using new technologies to manage home exercise programmes is an approach that allows more patients to benefit from therapy. The objective of this study is to explore physical therapists' opinions of the efficacy and disadvantages of implementing a web-based telerehabilitation programme for treating chronic low back pain (CLBP). (2) Methods: Nineteen physical therapists from academic and healthcare fields in both the public and private sector participated in the qualitative study. Texts extracted from a transcript of semi-structured, individual, in-depth interviews with each consenting participant were analysed to obtain the participants' prevailing opinions. The interviews lasted approximately 40 min each. The participants' responses were recorded. (3) Results: The results suggest that telerehabilitation can only be successful if patients become actively involved in their own treatment. However, exercise programmes for LBP are not always adapted to patient preferences. New technologies allow physical therapists to provide their patients with the follow-up and remote contact they demand, but long-term adherence to treatment stems from knowledge of the exercises and the correct techniques employed by the patients themselves. (4) Conclusions: Physical therapists treating patients with chronic non-specific low back pain believe that new technologies can provide highly effective means of reaching a greater number of patients and achieving significant savings in healthcare costs, despite the limitations of a telerehabilitation approach in developing an appropriate and effective patient-based physiotherapy programme.

Comparison of efficacy of a supervised versus non-supervised physical therapy exercise program on the pain, functionality and quality of life of patients with non-specific chronic low-back pain: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of supervised physical therapy program versus non-supervised on pain, functionality, fear of movement and quality of life in patients with non-specific chronic low back pain. DESIGN: A randomized double-blind clinical trial. SETTING: Clinical outpatient unit; home. SUBJECTS: A total of 64 participants with non-specific chronic low back pain were randomized into either supervised exercise group (n = 32) or non-supervised home exercise group (n = 32). INTERVENTIONS: The supervised group was treated with therapy exercises (strengthen lumbopelvic musculature), while the non-supervised received an informative session of the exercises, which were performed un-supervised at home. Both groups received three weekly sessions for eight weeks. MAIN MEASURES: Pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline, two, and six months of follow-up. RESULTS: Although analysis of variance (ANOVA) test showed statistically significant differences between groups for pain (P = 0.028; supervised: 2.5 ± 2.1; non-supervised: 3.5 ± 1.5) and disability for Roland-Morris Disability Questionnaire (P = 0.004; supervised: 3.1 ± 2.2; non-supervised: 5.1 ± 3.0) and for Oswestry Disability Index (P = 0.034; supervised: 14.5 ± 7.1; non-supervised: 19.2 ± 10.0) at 8 weeks immediately posttreatment, there were no differences between the groups in patient-rated pain, functionality, fear of movement and quality of life at six months of follow-up. CONCLUSION: Patients with chronic low back pain who received supervised exercise showed more improvement in both the short and long term in all patient-rated outcomes over the non-supervised group, but the differences were small and not clinically significant.

Benefits of dry needling of myofascial trigger points on autonomic function and photoelectric plethysmography in patients with fibromyalgia syndrome.

BACKGROUND: Fibromyalgia syndrome (FMS) is a condition characterised by the presence of chronic, widespread musculoskeletal pain, low pain threshold and hyperalgesia. Myofascial trigger points (MTrPs) may worsen symptoms in patients with FMS. OBJECTIVE: The purpose of this randomised controlled trial was to compare the effects of dry needling and transcutaneous electrical nerve stimulation (TENS) on pain intensity, heart rate variability, galvanic response and oxygen saturation (SpO2). METHODS: 74 subjects with FMS were recruited and randomly assigned to either the dry needling group or the TENS group. Outcomes measures (pain intensity, heart rate variability, galvanic skin response, SpO2 and photoplethysmography) were evaluated at baseline and after 6 weeks of treatment. 2×2 mixed-model analyses of variance (ANOVAs) were performed. RESULTS: The mixed-model ANOVAs showed significant differences between groups for the sensory dimension of pain, affective dimension of pain, total dimension of pain, visual analogue scale (VAS) and present pain intensity (PPI) (P=0.001). ANOVAs also showed that significant differences between groups were achieved for very low frequency power of heart rate variability (P=0.008) and low frequency power (P=0.033). There were no significant differences in dry needling versus TENS groups on the spectral analysis of the photoplethysmography and SpO2. CONCLUSIONS: This trial showed that application of dry needling therapy and TENS reduced pain attributable to MTrPs in patients with FMS, with greater improvements reported in the dry needling group across all dimensions of pain. Additionally, there were between-intervention differences for several parameters of heart rate variability and galvanic skin responses. TRIAL REGISTRATION NUMBER: NCT02393352.

Effect of adding interferential current stimulation to exercise on outcomes in primary care patients with chronic neck pain: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of adding interferential current stimulation to exercise on pain, disability, psychological status and range of motion in patients with neck pain. DESIGN: A single-blinded randomized controlled trial. SETTING: Primary care physiotherapy units. SUBJECTS: A total of 84 patients diagnosed with non-specific mechanical neck pain. This sample was divided into two groups randomly: experimental (n = 42) versus control group (n = 42). INTERVENTIONS: Patients in both groups had a supervised therapeutic exercise programme, with the experimental group having additional interferential current stimulation treatment. MAIN MEASURES: The main measures used were intensity of neck pain according to the Visual Analogue Scale; the degree of disability according to the Neck Disability Index and the CORE Outcome Measure; anxiety and depression levels according to the Goldberg scale; apprehension as measured by the Personal Psychological Apprehension scale; and the range of motion of the cervical spine. The sample was evaluated at baseline and posttreatment (10 sessions/two weeks). RESULTS: Statistically significant differences between groups at posttreatment were observed for Visual Analogue Scale (2.73 ± 1.24 vs 4.99 ± 1.56), Neck Disability Index scores (10.60 ± 4.77 vs 18.45 ± 9.04), CORE Outcome Measure scores (19.18 ± 9.99 vs 35.12 ± 13.36), Goldberg total score (6.17 ± 4.27 vs 7.90 ± 4.87), Goldberg Anxiety subscale, Personal Psychological Apprehension Scale scores (28.17 ± 9.61 vs 26.29 ± 11.14) and active and passive right rotation. CONCLUSIONS: Adding interferential current stimulation to exercise resulted in better immediate outcome across a range of measures.

The influence of balance, physical disability, strength, mechanosensitivity and spinal mobility on physical activity at home, work and leisure time in women with fibromyalgia.

BACKGROUND: Fibromyalgia syndrome is a chronic disease consisting of widespread pain, fatigue, sleep disturbances, and cognitive impairments, among other symptoms, which affect daily physical activity. However, the influence of functional status on physical activity involved in leisure, household and work activities has not been researched previously. The main objective was to evaluate balance, strength, spinal mobility, mechanosensitivity and function levels as related factors of physical activity in female with fibromyalgia. METHODS: Thirty-four patients with Fibromyalgia and 22 matched controls were included in a cross-sectional study. Dynamic and static balance, general and daily activities disability, lumbosacral mechanosensitivity, spinal range of motion, lower limb strength, physical activity in leisure, household and work activities were registered. We tested for differences between groups by using independent sample t-tests. The influence of demographics, symptoms and physical outcomes on physical activity was statistically analyzed using bivariate and multivariate regression analyses. FINDINGS: There was a significant association between leisure-time physical activity scores and age (r = 0.564), spinal flexion (r = 0.512), spinal extension (r = 0.421) and the total range of spinal inclination (r = 0.533). Fifty-eight percent of the variance of leisure-time physical activity was explained by age and range of spinal flexion-extension. Similarly, functional mobility was associated with physical activity at home and work scores (r = 0.459), explaining 21% of its variance. INTERPRETATION: A higher time spent in leisure, household and work activities was related to higher age, spinal range of motion and lower functional mobility in women with Fibromyalgia. Rehabilitation intervention programs should promote physical activity at home, work and leisure time.

Spanish validation of the Exercise Therapy Burden Questionnaire (ETBQ) for the assessment of barriers associated to doing physical therapy for the treatment of chronic illness / Validación en español del cuestionario «Exercise Therapy Burden Questionnaire» para la evaluación de las barreras asociadas a la práctica de ejercicio físico para el tratamiento de enfermedades crónicas

Background and objetive: To validate the Spanish version of the Exercise Therapy Burden Questionnaire (ETBQ) for the assessment of barriers associated to doing physical therapy for the treatment of chronic ailments. Patientes and methods: A sample of 177 patients, 55.93% men and 44.07% women, with an average age of 51.03±14.91 was recruited. The reliability of the questionnaire was tested with Cronbach's alpha coefficient, and the validity of the instrument was assessed through the divergent validation process and factor analysis. Results: The factor analysis was different to the original questionnaire, composed of a dimension, in this case determined three dimensions: (1) General limitations for doing physical exercise. (2) Physical limitations for doing physical exercise. (3) Limitations caused by the patients’ predisposition to their exercises. The reliability of the test-retest was measured through the intraclass correlation coefficient (ICC) and the Bland-Altman plot. Cronbach's alpha was 0.8715 for the total ETBQ. The ICC of the test-retest was 0.745 and the Bland-Altman plot showed no systematic trend. Conclusion: We have obtained the translated version in Spanish of the ETBQ questionnaire

Antecedentes y objetivo: Validar la versión en español del cuestionario «Exercise Therapy Burden Questionnaire» (ETBQ) para la evaluación de las barreras asociadas a la realización de terapia física para el tratamiento de enfermedades crónicas. Pacientes y métodos: Se reunió una muestra de 177 pacientes, con un 55,93% de varones y un 44,07% de mujeres, y una edad media de 51,03±14,91. Se probó la fiabilidad del cuestionario mediante el coeficiente alfa de Cronbach, y se evaluó la validez del instrumento a través del proceso de validación divergente y el análisis factorial. Resultados: El análisis factorial fue diferente al del cuestionario original, que se componía de una dimensión, y en este caso determinaba 3 dimensiones: 1) Limitaciones generales a la práctica de ejercicio físico; 2) Limitaciones físicas para la realización de ejercicio físico, y 3) Limitaciones causadas por la predisposición de los pacientes a la práctica de ejercicio. La fiabilidad de la prueba-reprueba se midió mediante el coeficiente de correlación intraclase (ICC) y la gráfica de Bland-Altman. El valor alfa de Cronbach fue de 0,8715 para ETBQ total. El ICC para la prueba-reprueba fue de 0,745, y la gráfica de Bland-Altman no reflejó ninguna tendencia sistemática. Conclusión: Hemos obtenido la versión traducida al español del cuestionario ETBQ

Social Support for Female Sexual Dysfunction in Fibromyalgia.

The aim of this study is to describe and understand experiences related to social support for women with fibromyalgia who suffer from sexual dysfunction. An interpretive qualitative research methodology based on Gadamer's philosophical hermeneutics was used. Data collection included a focus group and in-depth interviews with 13 women who averaged 44.8 years of age and 14.3 years since being diagnosed with fibromyalgia. Data were analyzed using Fleming's method and two themes were identified: "searching for understanding in socio-family support" and "lack of formal support regarding fibromyalgia patient's sexuality." The partner constitutes the main support for women with fibromyalgia. Although they can find understanding and social support in patient associations, they lack formal support from health care professionals. Women demand trusted and expert professionals, like sexologists and nurses, to carry out a multidisciplinary approach to tackle sexual dysfunction associated with fibromyalgia.

Spanish validation of the Exercise Therapy Burden Questionnaire (ETBQ) for the assessment of barriers associated to doing physical therapy for the treatment of chronic illness.

BACKGROUND AND OBJETIVE: To validate the Spanish version of the Exercise Therapy Burden Questionnaire (ETBQ) for the assessment of barriers associated to doing physical therapy for the treatment of chronic ailments. PATIENTES AND METHODS: A sample of 177 patients, 55.93% men and 44.07% women, with an average age of 51.03±14.91 was recruited. The reliability of the questionnaire was tested with Cronbach's alpha coefficient, and the validity of the instrument was assessed through the divergent validation process and factor analysis. RESULTS: The factor analysis was different to the original questionnaire, composed of a dimension, in this case determined three dimensions: (1) General limitations for doing physical exercise. (2) Physical limitations for doing physical exercise. (3) Limitations caused by the patients' predisposition to their exercises. The reliability of the test-retest was measured through the intraclass correlation coefficient (ICC) and the Bland-Altman plot. Cronbach's alpha was 0.8715 for the total ETBQ. The ICC of the test-retest was 0.745 and the Bland-Altman plot showed no systematic trend. CONCLUSION: We have obtained the translated version in Spanish of the ETBQ questionnaire.