Determinants of Frame Running Capacity in Athletes With Cerebral Palsy to Improve Training Routines and Classification Strategies: A Cross-sectional Observational Study.

OBJECTIVES: The aim of the study were to (1) investigate what physical and physiological parameters are most important for Frame Running capacity, a parasport for individuals with ambulatory difficulties, and (2) determine whether Frame Running capacity can be predicted in athletes with cerebral palsy. DESIGN: Athletes with cerebral palsy ( N = 62, Gross Motor Classification System I-V; 2/26/11/21/2) completed a 6-min Frame Running test. Before the 6-min Frame Running test, muscle thickness, passive range of motion (hip, knee, ankle), selective motor control, and spasticity (hip, knee, ankle) were measured in both legs. In total, 54 variables per individual were included. Data were analyzed using correlations, principal component analysis, orthogonal partial least square regression, and variable importance in projection analysis. RESULTS: The mean 6-min Frame Running test distance was 789 ± 335 m and decreased with motor function severity. The orthogonal partial least square analysis revealed a modest degree of covariance in the variables analyzed and that the variance in the 6-min Frame Running test distance could be predicted with 75% accuracy based on all the variables measured. Variable importance in projection analysis indicated hip and knee extensor spasticity (negative effect), and muscle thickness (positive effect) arose as the most important factors contributing to Frame Running capacity. CONCLUSIONS: These results are an important resource to enable optimization of training regimes to improve Frame Running capacity and contribute to evidence-based and fair classification for this parasport.

Effectiveness of exercise on pain intensity and physical function in patients with knee and hip osteoarthritis: an umbrella and mapping review with meta-meta-analysis.

PURPOSE: The aim of this review was to provide a qualitative and quantitative overview of the effects of exercise on pain, physical function, and quality of life for patients with knee and hip osteoarthritis. MATERIALS AND METHODS: This study was an umbrella and mapping review with meta-meta-analysis. Meta-analyses of randomized controlled trials were included. The methodological quality and risk of bias were evaluated using the Modified Quality Assessment Scale for Systematic Reviews and the Risk of Bias in Systematic Reviews tool. The quality of evidence was evaluated using the Physical Activity Guidelines Advisory Committee Grading Criteria. RESULTS: 41 meta-analyses were included, 43.9% of the studies had adequate methodological quality, and 56.1% of the studies had a low risk of bias. Moderate evidence was found that exercise decreases pain intensity (33 meta-analyses; SMD = -0.49; 95% CI -0.56 to -0.42), improves function (19 meta-analyses; SMD = -0.50; 95% CI -0.58 to -0.41), strength (6 meta-analyses; SMD = -0.57; 95% CI -0.70 to -0.44) and quality of life (SMD = -0.36; 95% CI -0.46 to -0.27) for patients with hip and knee osteoarthritis. CONCLUSION: Exercise is an effective intervention to decrease pain intensity and improve function in patients with hip and knee osteoarthritis.(PROSPERO, CRD42020221987).

Exercise in hip and knee osteoarthritis has shown improvement in pain, function, strength, and quality of life in different studies, but no differences have been observed in others.The meta-meta-analysis of the present article find that exercise produces significant improvements in pain, function, strength, and quality of life of patients with knee and/or hip osteoarthritis with a small effect size and significant heterogeneity.There is moderate evidence that exercise is effective in reducing pain and increasing function, strength, and quality of life of patients with knee and hip osteoarthritis.

Effects of Self-Efficacy and Outcome Expectations on Motor Imagery-Induced Thermal and Mechanical Hypoalgesia: A Single-Blind Randomised Controlled Trial.

The main aim of this study was to assess whether self-efficacy (SE) and outcome expectations (OEs) modulate the hypoalgesic effect induced by motor imagery (MI). A total of 75 asymptomatic participants were randomly assigned to the positive (SE+, OE+), negative (SE-, OE-) or non-expectation (CG) groups. Heat pain threshold (HPT) and pain pressure threshold (PPT) were the main variables. Cold detection threshold (CDT), warm detection threshold (WDT), heart rate (HR) and perceived fatigue were the secondary variables. The variables were assessed preintervention, immediately postintervention and 10 min postintervention, except for HR, which was measured continuously during the intervention. Regarding HPT, significant within-group pre-post differences were found in the OE+ group, with a low effect size (p = 0.01, d = -0.39). With regard to ΔPPT, significant intergroup differences were found in Δpost-pre between the SE+ and CG groups (p = 0.012, d = 1.04) and also between SE+ and OE- (p = 0.006, d = 1.08), both with a large effect size. CG, SE-, and OE- groups had poorer CDT and WDT. Regarding HR, significant intergroup differences were found in the postintervention measurement between OE+ and SE-, with a large effect size (p = 0.016, d = 1.34). Lastly, no between-group differences were found regarding perceived fatigue (p > 0.05). The results obtained showed that positive expectations have a slight influence on the increase in heat and mechanical pain detection thresholds. Positive and non-expectancy groups showed an autonomic activation. The results also showed that negative expectations led to poorer perceptual processes.

Cross-Sectional Comparative Study on Central Sensitization-Psychosocial Associated Comorbidities and Psychological Characteristics in Breast Cancer Survivors with Nociceptive Pain and Pain with Neuropathic Features and without Pain.

The frequency of a high Central Sensitization Inventory (CSI) total score and the prevalence of pain have already been established among breast cancer survivors (BCS). However, the psychological factors' influence based on the clinical features of pain is still unknown, as well as BCS characteristics with no pain. Thus, our main aim was to evaluate the presence of a high CSI total score in BCS with pain and compare it with BCS without pain and to evaluate the influence of psychosocial factors. A cross-sectional comparative study was designed to compare BCS with nociceptive pain (n = 19), pain with neuropathic features (n = 19) or no pain (n = 19), classified by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). CSI, pain catastrophizing, fear of movement, anxiety and depression symptoms were analyzed and compared among the three groups. The CSI total score was higher in both BCS pain groups compared to BCS without pain, but there were no statistical differences between the pain groups. The same observation was made when comparing pain catastrophizing. The neuropathic feature group showed greater levels of fear of movement, anxiety and depression compared to the no pain group. Thus, CS-psychosocial associated comorbidities and pain-catastrophizing thoughts were more prevalent among BCS with pain, regardless of the clinical features of pain. BCS with neuropathic pain features showed greater psychological disturbances.

Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial.

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed an active approach for dealing with it. Objectives: To determine and characterize musculoskeletal pain in female family caregivers (FFCs) and assess the effects of adding a therapeutic exercise program to a family caregiver care program (FCCP) on the quality of life, physical conditions, and psychological well-being of FFCs. Methods: A multicenter randomized controlled clinical trial was conducted with 68 FFCs recruited in two public healthcare areas. The intervention and control groups received the same conventional FCCP for 6 h across 4 sessions. The intervention group received an additional 36 sessions of physical therapeutic exercise (PTE) program over 12 weeks. Results: All caregivers reported having pain in particular locations. Lower back pain and neck pain were the locations most frequently cited, with a prevalence of 69.4% and 56.7%, respectively. In total, 80% of participants presented moderate pain intensity. The intervention group showed a significant decrease in the intensity of the pain (p < 0.001), as well as in anxiety, depression, subjective burden perception (p < 0.01), and quality-of-life variables, including MCS (mental component summary) (p < 0.05) and PCS (physical component summary) (p < 0.001). Conclusions: A PTE program improved the musculoskeletal pain of FFCs in a clinically relevant way. The caregivers who improved the most were those who initially presented the most intense pain, had the greatest levels of disability, and had the lowest quality of life.

Effects of a Family Caregiver Care Programme in Musculoskeletal Pain and Disability in the Shoulder-Neck Region-A Randomised Clinical Trial.

Life expectancy in Spain has increased and older people need more health care to improve their quality of life. The high demands of the population sometimes collapse health services, making them insufficient to cover their needs, which leads to the development of "non-professional caregivers". These caregivers have suffered musculoskeletal injuries of the cervical spine and shoulders and should be guided and assessed on ergonomics, biomechanics, or kinesiotherapy. However, there are no interventions to help them care for themselves. This study presents the application of a physical exercise programme to prevent these disorders in women caregivers of dependent patients. It consists of a randomised controlled clinical trial with two groups: both received a family caregiver care programme, and the intervention group also received a physical therapeutic exercise programme for 12 weeks. A total of 62 caregivers completed the study, who were mostly daughters or wives of dependents. Of these, 70.97% presented a "moderate" pain intensity and a cervical disability of 13.72 ± 7.64 points in the NDI questionnaire in the initial evaluation. In the intervention group of caregivers, there was a significant decrease in the pain intensity and a significant increase (p < 0.05) in all cervical joint amplitude movements. Caregivers present a high prevalence of musculoskeletal disorders. The physical exercise programme was effective in reducing the intensity of pain, lumbar disability, and cervical disability of the family caregivers.

Ejercicio activo en la fase aguda posquirúrgica de una reconstrucción del ligamento cruzado anterior: revisión sistemática / Active exercise in the acute postoperative phase of an anterior cruciate ligament reconstruction: a systematic review

La rotura del ligamento cruzado anterior (LCA) es una de las lesiones más comunes, que constituyen casi el 50% del total de las lesiones ligamentosas de rodilla. A lo largo de los años se han creado diversas guías prácticas y protocolos para su tratamiento. Sin embargo, aunque varios estudios confirman los beneficios que aporta una rehabilitación precoz, no existe consenso sobre qué ejercicios activos se deberían realizar en fases tempranas. Por ello, en este estudio se ha llevado a cabo una revisión sistemática con el objetivo de analizar ensayos clínicos aleatorizados que han aplicado ejercicios en la rehabilitación precoz de una reconstrucción del LCA. Este estudio pretende determinar si el ejercicio activo en fase aguda posquirúrgica reporta beneficios y acorta el tiempo de tratamiento. Los resultados mostraron diferencias significativas en las diferentes variables (fuerza, dolor, rango de movimiento, laxitud ligamentaria y circunferencia del miembro inferior) en comparación con la valoración inicial de los respectivos protocolos. Por lo tanto, el ejercicio activo parece ser efectivo para favorecer la recuperación en fases tempranas posquirúrgicas, destacando el trabajo de potenciación de cuádriceps en fase precoz para la ganancia de rango de movimiento y disminución de la sintomatología. Actualmente no existen suficientes estudios realizados durante las dos primeras semanas posquirúrgicas para confirmar los beneficios del ejercicio activo

Rupture of the anterior cruciate ligament (ACL) is one of the most common injuries, accounting for almost 50% of the total knee ligament injuries. Over the years, several practical guides and protocols have been created for it treatment. However, although several studies confirm the benefits of early rehabilitation, there is no consensus on what active exercises should be performed in early stages. Therefore, in this study a systematic review has been carried out with the objective of analyzing randomized clinical trials that have applied exercises in the early rehabilitation of an ACL reconstruction. This study aims to determine if active exercise in the post-surgical acute phase reports benefits and shortens the treatment time. The results showed significant differences in the different variables (strength, pain, range of motion, ligament laxity and circumference of the lower limb) compared to the initial assessment of the respective protocols. Therefore, active exercise seems to be effective for the recovery in early postsurgical phases, highlighting the work of strengthening quadriceps in the early phase for the gain of range of motion and decrease of symptomatology. There are currently not enough studies done during the first two weeks after surgery to confirm the benefits of active exercise