Effects of Telerehabilitation on Pain and Disability in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis.

(1) Background: This systematic review and meta-analysis explores the effectiveness of telerehabilitation in patients suffering from chronic neck pain, specifically on pain and disability. The research delves into an area of growing significance within the realm of healthcare, aiming to understand the impact of digital interventions on the rehabilitation process for individuals with prolonged neck pain. (2) Methods: The comprehensive review encompasses a wide array of studies evaluating the collective outcomes of numerous trials focused on telerehabilitation strategies. In this systematic review, PubMed/MEDLINE, Scopus, and Web of Science databases were systematically searched to identify studies on telerehabilitation's impact on pain. (3) Results: Eight studies met the inclusion criteria. Using the Downs and Black quality assessment, three studies were classified as good and five as fair. The authors identify specific modalities within telerehabilitation, such as remote exercise programs and virtual consultations, that contribute significantly to positive patient outcomes. Meta-analysis indicated a significant overall effect of telerehabilitation on pain reduction (MD = -1.27; 95% CI = -2.06; -0.47; p = 0.002). These findings support telerehabilitation's efficacy in pain management. (4) Conclusions: The synthesis of evidence presented in this systematic review and meta-analysis underscores the potential of telerehabilitation as an effective and accessible means of managing chronic neck pain, offering valuable insights for both healthcare practitioners and policymakers in advancing patient-centered care.

Early Effects of a Pain-Informed Movement Program in Patients with Post-COVID-19 Condition Experiencing Persistent Pain: Protocol for a Randomized Controlled Trial.

(1) Background: The COVID-19 pandemic has generated 771 million confirmed cases. Of these patients, 60% have developed persistent symptoms including pain. This pain is a complex symptom that needs comprehensive therapeutic strategies to address it holistically. The main objective of this study will be to evaluate the early impact of the Pain Informed Movement (PIM) program in patients with post-COVID-19 conditions experiencing new-onset persistent pain. (2) Methods: A randomized, single-blind clinical trial will be performed. Patients will be randomly assigned (1:1) to the experimental or control group. The experimental group will undergo a PIM program consisting of low-intensity functional exercises, pain neuroscience education, and relaxation techniques. The control group will receive no intervention. (3) Results: The results will be published as a peer-reviewed article. (4) Conclusions: This study will provide a basis for future research to support the implementation of comprehensive therapeutic approaches in the care of patients with post-COVID-19 persistent pain.

Effectiveness of Self-Care Education for Chronic Neck Pain: A Systematic Review and Meta-Analysis.

Self-care programs for chronic neck pain are relevant to everyday life and can lead to long- term improvement. More studies on their effectiveness, key components and appropriate duration are needed. The aim of this study was to determine the effectiveness of self-care programs for patients with chronic neck pain. A systematic review and meta-analysis of randomized controlled trials was conducted according to the PRISMA guidelines. After searching in PubMed, Web of Science, Scopus and ScienceDirect, eleven studies met the inclusion criteria. Self-care education interventions typically consisted of education (i.e., pain neuro-science education or general educational concepts) accompanied by exercise or manual therapy. The most frequent components were addressing physical and psychological symptoms and engaging in self-care strategies. The least frequent ones were monitoring and recording symptoms and discussing with providers of medical care. The duration of the interventions ranged from three sessions to six months. Finally, individual and supervised modalities were the most frequent. After pooling the data, a meta-analysis was carried out according to four variables (i.e., pain, disability, kinesiophobia and catastrophization) and showed significant results (p < 0.05) in favor of self-care interventions. This systematic review and meta-analysis suggests that self-education interventions improve pain, psychological pain-related variables and disability in patients with chronic neck pain. The most frequently used components were addressing physical and psychological symptoms and engaging in self-care strategies. Future trials should focus on including other components, such as discussing symptoms with providers of medical care or self-monitoring symptoms. Additional areas of focus include more homogeneous doses and comparator treatments, as well as studies with better evidence to reach more solid conclusions.

Ventilatory, phonatory and swallowing impairments in advanced neuromuscular disease patients / Alteraciones ventilatorias, fonatorias y deglutorias en pacientes con enfermedad neuromuscular avanzada

Purpose: To analyze the ventilatory, phonatory and swallowing impairments and their relation with physical status in a group of advanced Neuromuscular Disease (NMD).Methods: A cross-sectional observational study was utilized 48 participants from the Association of NMD of Granada (Granada, España), university clinical research, University of Granada. A total of 24 advanced NMD patients and 24 healthy controls matched for age and sex were recruited. Advanced NMD patients were divided in two groups according to the level of their overall physical status (NMD higher physical status group or NMD lower physical status group). Hand grip strength, ventilatory, phonatory and swallowing features were analyzed.Results: There were significant differences (p<.05) among NMDs groups in ventilatory function. There were significant differences (p<.05) between NMDs groups in ventilatory, phonatory and swallowing function. Finally, there were significant differences (p<.05) among advanced NMDs groups in swallowing function and orofacial evaluation. Conclusion: Patients with lower physical status have higher risk of suffer ventilatory, phonatory and swallowing complications after diagnosis of NMD.(AU)

Propósito: Analizar las alteraciones ventilatorias, fonatorias y deglutorias y su relación con el estado físico en un grupo de Enfermos Neuromusculares (ENM) avanzados.Métodos: Se realizó un estudio observacional transversal con 48 participantes de la Asociación de ENM de Granada (Granada, España), y de la facultad de ciencias de la salud de la Universidad de Granada. Se reclutaron un total de 24 pacientes con ENM avanzada y 24 controles sanos emparejados por edad y sexo. Los pacientes con ENM avanzada se dividieron en dos grupos según el nivel de su estado físico general (grupo de ENM de mayor estado físico o grupo de ENM de menor estado físico). Se analizó la fuerza de agarre de las manos y las características ventilatorias, fonatorias y deglutorias.Resultados:Se encontraron diferencias significativas (p<0,05) entre los grupos de ENM en la función ventilatoria. También, se observaron diferencias significativas (p<0,05) entre los grupos de ENM en la función fonatoria y deglutoria. Por último, existieron diferencias significativas (p<0,05) entre los grupos de ENM avanzados respecto a la condición miofuncional orofacial.Conclusiones: Los pacientes con menor estado físico tienen mayor riesgo de sufrir complicaciones ventilatorias, fonatorias y deglutorias tras el diagnóstico de ENM.(AU)

Implicit Motor Imagery for Chronic Pelvic Pain: A Cross-Sectional Case-Control Study.

Implicit motor imagery (IMI), with an image laterality discrimination (LD) task, has been proposed as a useful therapeutic tool to restore body schema in patients with chronic pelvic pain (CPP). The aim of this study was to analyse the existence of differences between patients with CPP and healthy individuals in order to justify the use of IMI. An observational, cross-sectional study with non-probabilistic sampling was designed as a one-to-one matched case-control study. Through a web link designed for this purpose, a total of 40 abdominoperineal images were shown to 130 participants during the laterality task. Outcome measures were pain intensity (visual analogue scale, VAS), accuracy, response time (RT), and CPPQ-Mohedo score (Chronic Pelvic Pain Questionnaire-Mohedo). This was an observational, cross-sectional study with a total of 64 CPP patients and 66 healthy individuals. The comparative analysis between groups revealed significant differences in accuracy, CPPQ-Mohedo and VAS (p < 0.001), but not in RT; in patients with CPP, accuracy was correlated with a lower CPPQ-Mohedo score and RT and, the greater the pain intensity, the higher the CPPQ-Mohedo score and RT, and the lower the accuracy. In the LD task, the patients with CPP made more mistakes than the healthy individuals. IMI could be a useful and complementary tool in the therapeutic approach for patients with CPP.

Agreement between telerehabilitation and face-to-face orofacial myofunctional assessment in persons with acquired brain injury.

BACKGROUND AND OBJECTIVE: Orofacial myofunctional disorders are common in persons with acquired brain injury. A new way for early detection of orofacial myofunctional disorders via information and communication technologies may improve accessibility. The purpose of this study was to evaluate the level of agreement between face-to-face and tele-assessment of an orofacial myofunctional protocol in a sample of persons with acquired brain injury. METHODS: A masked comparative evaluation was conducted in a local association of patients with acquired brain injury. Twenty-three participants (39.1% female, mean age of 54 years) with a diagnosis of acquired brain injury were included in the study. The patients followed a face-to-face and a real-time online assessment using the Orofacial Myofunctional Evaluation with Scores protocol. This is a protocol for evaluation with numerical scales that assess the physical characteristics and the main orofacial functions of patients including appearance, posture, and mobility of lips, tongue, cheeks, and jaws, respiration, mastication, and deglutition. RESULTS: The analysis showed excellent interrater reliability (ρ ≥ 0.85) for all the categories. In addition, most confidence intervals were narrow. CONCLUSIONS: This study reveals excellent interrater reliability of an orofacial myofunctional tele-assessment in patients with acquired brain injury in comparison with a traditional face-to-face evaluation.

Pain Experiences of People Diagnosed With Autism Spectrum Disorder: A Systematic Review of Case-Control Studies.

IMPORTANCE: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and is characterized by compromised social interactions, reduced verbal communication, stereotyped repetitive behaviors, restricted interests, and sensory abnormalities. Yet absent from the knowledge base is information about sensory abnormalities related to pain experiences. Exploring the pain experiences of people with ASD may provide occupational therapy practitioners with a baseline to determine areas of need and effective interventions. OBJECTIVE: To conduct a systematic review of the literature to summarize current evidence from case-control studies comparing sensory abnormalities with regard to pain experiences of people diagnosed and not diagnosed with ASD. DATA SOURCES: A systematic literature search of the CINAHL, Cochrane, MEDLINE (PubMed), OTseeker, and Web of Science databases, using MeSH terms and broad keywords. STUDY SELECTION AND DATA COLLECTION: A search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of the included studies. FINDINGS: A total of 27 case-control studies involving 865 people with ASD and 864 control participants were included. Several methods were used to explore pain experiences, such as threshold detection or pain threshold. CONCLUSION AND RELEVANCE: The results indicate that people with ASD may have an abnormal sensory experience with regard to pain sensitivity. Occupational therapy practitioners should develop an intervention to focus on pain. What This Article Adds: This study adds to the body of literature indicating that people with ASD have sensory abnormalities with regard to pain experiences. Results highlight the need for occupational therapy interventions to focus on pain experiences.

Effects of Exercise-Based Interventions on Physical Activity Levels in Persons With Parkinson's Disease: A Systematic Review With Meta-analysis.

BACKGROUND AND PURPOSE: Parkinson's disease (PD) is the most common neurodegenerative movement disorder. Symptom severity leads to devastating consequences such as falls, immobility, impaired quality of life, and reduced general activity. Adopting a sedentary lifestyle creates a vicious circle, as physical inactivity can negatively affect the clinical domains of PD. Despite the recognition of the disease-modifying potential of physical activity (PA), achieving adequate exercise levels can be challenging for individuals with PD. This study aimed to investigate the repercussions of exercise-based interventions to improve PA levels in persons with PD through a systematic review with meta-analysis. METHODS: A search was conducted from database inception to February 2021 across 3 databases: PubMed, Web of Science, and Scopus. Randomized controlled trials were included if they involved persons with PD, outcome measures associated with PA levels, and an exercise-based intervention. Two reviewers performed independent data extraction and methodologic quality assessment of the studies using the Downs and Black quality checklist. RESULTS: A total of 6 studies were included in the study (1251 persons with PD). Four intervention types were identified: balance, strength, aerobic, and multimodal exercise (combination of several types of exercise programs). The meta-analysis showed that exercise interventions have a positive effect on PA (standard mean difference = 0.50, 95% CI =-0.02, 1.00; P = .06). The risk of bias was generally low. CONCLUSIONS: The findings support the use of exercise-based interventions (aerobic exercise, balance exercise, strength exercise, and/or multimodal exercise) to improve PA levels. However, the limited number of studies and the heterogeneity of the interventions do not allow us to draw a definitive conclusion.

Effectiveness of aquatic therapy on sleep in persons with fibromyalgia. A meta-analysis.

CONTEXT: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by persistent, widespread pain, myofascial tenderness, negative affect, fatigue, memory problems and sleep disturbances. OBJECTIVE: To summarize the evidence of the effects of aquatic therapy on sleep quality in patients with FMS. METHODS: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2020 (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), whit the registration number CRD42021249982. Cochrane library, Medline (PubMed), Science Direct Web of Science (WOS), Scopus, and PEDro were searched from inception until September 2021. The search included only randomized clinical trials. RESULTS: Of the 7711 studies identified in the initial search, a total of 7 trials (361 participants) satisfied the eligibility criteria. Finally, a meta-analysis was conducted with 6 studies (311 participants). The overall pooled effect favored aquatic therapy interventions in improving sleep quality in patients with FMS (pooled MD, -2.05; 95% CI, -4.35 to 0.25). CONCLUSIONS: The results of this systematic review and meta-analysis provide evidence that aquatic therapy improved sleep quality in patients with FMS. This study highlights the importance of aquatic therapy for sleep. Nonetheless, although an aquatic therapy intervention may represent a good option to improve sleep, given the low number of studies the evidence should be taken with caution.

Relationship between Pain Intensity, Physical Factors, Pronociceptive Pain Modulation Profile and Psychological Vulnerability on Upper Limb Disability in Older Patients with Chronic Shoulder Pain.

BACKGROUND: Chronic shoulder pain is a very prevalent condition causing disability and functional impairment. The purpose of the study was to evaluate the relationship between pain intensity, physical variables, psychological vulnerability, pronociceptive pain modulation profile and disability in older people with chronic shoulder pain. METHODS: A cross-sectional study was carried out. A total of 56 participants with non-specific chronic shoulder pain of the "Complejo Hospitalario Universitario" (Granada) and 56 healthy controls were included. The outcomes evaluated were pain intensity (visual analogue scale), physical factors (dynamometry for grip strength), psychological vulnerability (Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia), pronociceptive pain modulation profile (pain pressure algometry) and disability (Quick Disability Arm Shoulder Hand questionnaire). RESULTS: Disability showed a positive correlation with pain and psychological vulnerability (p < 0.05) and a negative correlation with pronociceptive pain variables and dynamometry (p < 0.001). Psychological vulnerability also presented a strong negative correlation with proprioceptive pain variables and dynamometry and a positive correlation with pain (p < 0.05). In regard to the pronociceptive pain modulation profile, a strong negative correlation with pain (p < 0.001) and a positive moderate correlation with dynamometry (p < 0.001) were shown. CONCLUSIONS: Our results support a strong association between disability, psychological vulnerability and pronociceptive pain modulation profile in older adults with chronic shoulder pain.

Balance Ability and Occupational Performance in Patients With Parkinson's Disease and On-Medication-State Freezing of Gait.

PURPOSE: The aim of this study was to examine balance ability and occupational performance in patients with Parkinson's disease (PD) and on-medication-state freezing of gait (FOG). DESIGN: A cohort study with three groups was conducted. METHODS: Seven patients with PD and on-medication-state FOG with optimized pharmacological therapy; seven patients with PD matched by age, gender, length of time since diagnosis, and Hoehn and Yahr stage; and seven controls were included. Outcomes included balance and occupational performance. Nonparametric analyses were used. FINDINGS: Significant differences were found between the two subgroups of patients with PD in the Timed Up & Go Test when adding a cognitive task, dual-task interference, and self-confidence in balance. CONCLUSIONS: Patients with PD and on-medication-state FOG had lower scores on dual-task interference and self-confidence than matched PD patients. CLINICAL RELEVANCE: The assessment and rehabilitation approach for patients with PD and on-medication-state FOG should include balance confidence and dual-task interference.

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review.

Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles' asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.

Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial.

BACKGROUND: While neck pain can be severely disabling and costly, treatment options have shown moderate evidence of effectiveness. OBJECTIVE: The objective of this study was to explore the effects of a 4-week active program based on myofascial release and neurodynamics on trigger point (TrP) examination, pain, and functionality in patients with chronic neck pain. METHODS: Randomized controlled trial. A total of 40 patients with chronic neck pain were randomly allocated to an experimental or a control group (n = 20). The primary outcome measure was TrP examination. Secondary outcomes were pain, assessed with the Brief Pain Inventory and a visual analogue scale, and functionality, evaluated with the Neck Outcome Score. RESULTS: A between-group analysis showed significant differences (p < .05) in the percentage of active TrPs in the following muscles: suboccipital (50 vs. 92.4% in the right muscle and 37.5 vs. 89.6% in the left muscle), left scalene and levator scapulae. Significant differences (p < .05) were also found in pain severity, average pain, and functionality (i.e. symptoms, sleep, and participation). CONCLUSIONS: A 4-week self-administered program for patients with chronic neck pain was effective in reducing the presence of active TrPs. Pain severity, average pain, and some aspects of functionality also improved significantly after the intervention.

Global functional impairment in head and neck cancer survivors after completing radiotherapy treatment.

PURPOSE: Improvements in diagnosis and treatment of head and neck cancer (HNC) patients have resulted in improved long-term survival rates. However, a variety of symptoms and comorbidities, often secondary to the cancer and its treatments, are experienced by a relevant number of survivors. So, the aim of this study was to determine the global functional impairment in HNC survivors 1 year after radiotherapy treatment. MATERIALS AND METHODS: A descriptive case-control study was performed. HNC survivors were recruited from San Cecilio Clinical University Hospital in Granada. The main variables included were functionality and quality of life. RESULTS: 30 HNC survivors were included in our study. Significant differences were found in the WHO-DAS 2.0 test, with a worse score in the HNC group in most subscales (p < 0.05), and poorer scores in the COMP test, performance (p < 0.001) and satisfaction (p < 0.001). Significant differences were also found in most QLQ-30 subscales (p < 0.05) and the QLQ-H&N35. In regard to the EQ-5D, significant differences were found between groups, with worse results in the HNC group (p < 0.05). CONCLUSION: HNC survivors presented a poorer global function and a worse quality of life and health status 1 year after the radiotherapy treatment. Moreover, a good correlation was found between functionality and quality of life outcomes.IMPLICATIONS FOR REHABILITATIONA worse quality of life and health status are shown in head and neck survivors 1 year after radiotherapy.Global functionality is related to quality of life outcomes in head and neck cancer survivors.There is a need to recognise the need for and to provide longer term rehabilitation.

Exploring perceived occupational balance in women with fibromyalgia. A descriptive study.

BACKGROUND: People with chronic pain conditions such as fibromyalgia may experience occupational limitations and imbalances in their basic and instrumental occupations of daily living, leisure, work, and social participation. OBJECTIVE: To describe occupational balance in persons with fibromyalgia and to analyze whether it is associated with self-reported disability and self-efficacy to manage symptoms. METHODS: A cross-sectional study was carried out. Individuals with fibromyalgia were invited to participate. Occupational balance was assessed with the Occupational Balance Questionnaire; self-reported disability was assessed with the World Health Organization Disability Assessment Schedule, WHODAS 2.0-12; and self-efficacy was evaluated with the 8-item version of the Arthritis Self-Efficacy Scale. Data were analyzed using multiple linear regression with a forward stepwise procedure. RESULTS: One hundred women with fibromyalgia were included. Occupational balance was 26.96 ± 12.09; however, scores differed between the mild disability group and the moderate disability group (33.11 ± 9.99 vs. 20.29 ± 10.61, p < 0.001). Multiple linear regression analyses revealed that self-reported disability and self-reported pain management explained 58.1% of the variance in occupational balance. CONCLUSION: Women with fibromyalgia showed low occupational balance. Self-reported disability and self-reported pain management were associated with occupational balance. SIGNIFICANCE: Occupational therapy practitioners can design intervention programs focussing on occupational balance and self-efficacy to manage symptoms.

Effects of the COVID-19 Pandemic on Physical Activity in Chronic Diseases: A Systematic Review and Meta-Analysis.

The management of chronic diseases (CD) includes physical activity (PA). It is necessary to determine the effects of COVID-19 restrictions in CD. The aim was to review the research related to PA levels before and during the COVID-19 pandemic in people with CD. This review was designed according to PRISMA guidelines and registered in PROSPERO: CRD42020218825. The search was performed in CINAHL, Medline, Scopus, and Web of Science up to January 2021. The PICOS recommendations were applied. The search was conducted by two reviewers, who completed the data extraction of included articles. Methodological quality was assessed using the STROBE checklist, and a meta-analysis was conducted. The literature search strategy identified 227 articles. Five studies remained and were included. Only three studies were included in the meta-analysis. Two articles used accelerometers to objectively compare PA levels before and during the pandemic. Three studies made this comparison using an online survey. All articles showed a decrease in PA levels during the COVID-19 pandemic. The meta-analysis showed a significant reduction in PA levels during pandemic. PA levels during the COVID-19 pandemic have been reduced with respect to previous levels of PA in patients with CD.

Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = -1.92; 95% CI = -2.73, -1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = -6.34; 95% CI = -9.12, -3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = -8.96; 95% CI = -17.52, -0.40; p = 0.04) and followup (2 trials; n = 149; MD = -12.04; 95% CI = -20.58, -3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.

Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection.

BACKGROUND: Lung resection represents the main curative treatment modality of non-small cell lung cancer. Patients with high-risk to develop postoperative pulmonary complications have been classified as "high-risk patients." Characterizing this population could be important to improve their approach and rehabilitation. AIM: To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization. METHODS: A longitudinal observational prospective cohort study was carried out. Patients undergoing lung resection were recruited from the "Hospital Virgen de las Nieves" (Granada) and divided into two groups according to the risk profile criteria (age ≥ 70 years, forced expiratory volume in 1 s ≤ 70% predicted, carbon monoxide diffusion capacity ≤ 70% predicted or scheduled pneumonectomy). Outcomes included were exercise capacity (Fatigue Severity Scale, Unsupported Upper-Limb Exercise, handgrip dynamometry, Five Sit-to-stand test, and quadriceps hand-held dynamometry) and patient-reported outcome (Euroqol-5 dimensions 5 Levels Visual Analogue Scale). RESULTS: In total, 115 participants were included in the study and divided into three groups: high-risk, low-risk and control group. At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status (P < 0.05). One month after discharge patients in the high-risk group maintained these differences compared to the other groups. CONCLUSION: Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery, with lower self-perceived health status and a poorer upper and lower limb exercise capacity. These results are important in the rehabilitation field.

Symptom severity is associated with signs of central sensitization in patients with asthma.

INTRODUCTION: Asthma is characterized by recurrent episodes of wheezing, dyspnoea, chest tightness and cough. In addition to respiratory symptoms, previous studies have reported the presence of pain. OBJECTIVE: To analyse the nociceptive processing of young adults with well-controlled asthma. METHODS: A cross-sectional case-control study was performed. Patients diagnosed with persistent well-controlled asthma were recruited from the 'Complejo Hospitalario Universitario' (Granada). Main outcomes included pain processing, measured by the pressure-pain thresholds (PPTs) and temporal summation and latency of pain; symptoms, including cough (Leicester Cough Questionnaire) and dyspnoea (Borg scale); and catastrophic cognitions about breathlessness, assessed by the Breathlessness Catastrophizing Scale (BCS). RESULTS: Seven-two participants were finally recruited in our study. Patients with asthma presented lower pressure thresholds (p < 0.05) and significant differences in latency and summation tests. These patients also presented a greater cough level, with significant differences in all subscales (p < 0.05). Significant differences were also found in the BCS between groups (p < 0.001). CONCLUSION: Our results show a decrease of PPTs and a greater pain intensity in latency and summation tests, suggesting an abnormal pain processing in patients with asthma.