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INTRODUCTION: The objectives of this study were to determine the effects of the Mézières Method (MM) on pain and disability related to low back pain (LBP), compared to a program of heat, massage and exercise, and to understand the meaning of the bodily experience with the MM. PATIENTS AND METHODS: Mixed methods convergent parallel design, combining an equivalent randomized clinical trial with a qualitative phenomenological approach. Sixty-one participants aged 18-65 years with chronic non-specific LBP lasting more than 3 months. Patients were randomized into two groups: the MM group (n = 29) and the comparison group (CG) who received heat, massage plus flexibility and strengthening exercises (n = 31). MM and CG participants underwent 10 one-hour physical therapy sessions over a 5-week period and were evaluated three times: pre-intervention, post-intervention and follow-up at 6 weeks after the end of treatment. RESULTS: Both groups reported positive effects on LBP . MM group showed superior effects in pain relief in the short term (Cohen's D 0.80; p = 0.004). Participants interpreted the interaction with the MM as a teaching-learning process that allowed body awareness. CONCLUSION: Both treatment were similarly beneficial but MM had superior effects on pain in the short term. MM is perceived by the participants as a teaching-learning process focused on body awareness that facilitate effective management of LBP.
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Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Terapia por Ejercicio/métodos , Ejercicio FísicoRESUMEN
BACKGROUND: Deviations occur in the neuropsychomotor development of premature infants; early interventions minimize delay motor. This study aimed to determine the effect of an interdisciplinary hospital-home intervention addressing motor development adaptation in premature infants in Colombia in comparison with traditional interventions. METHODS: This study was based on a parallel design, with two groups, namely, experimental and control. The experimental group, hospital-home intervention (HHI) performed in two settings (i.e., hospital neonatal care units and homes), and the control group, traditional intervention, (TI) performed in institutions for premature infants. The sample will be composed of 130 randomly-allocated infants, 65 in the experimental group (HHI) and 65 in the control group (TI) of moderate to late preterm infants (gestational age between 34 and 37 weeks), weighing more than or equal to 1.800 g, who are hemodynamically stable and reside in the cities of Tunja and Bogotá-Colombia recruited between 2021 and 2022. For the pre- and post-intervention assessments, the TIMPSI and the CapDMP are the instruments used to assess motor development and the degree of parents' or caregivers' knowledge about motor development. The HHI is composed of 10 intervention strategies based on stimulation of motor development, performed twice a day for 10 min for two months, in combination with calls to a mobile device, using software (Baby Motor Skills) and an instant messaging system (WhatsApp). RESULTS: This hospital-home intervention program proposes an approach focused on the motor development of premature infants, based on sensory and motor stimulation strategies, in addition to follow-up performed at home with the use of a mobile application that improves the motor development of premature infants. Register Clinical Trial: NCT04563364. CONCLUSION: The HHI provides the opportunity to determine whether the individualized four-week from admission to follow up at home with parent training will improve the motor skills of premature infants.
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Recien Nacido Prematuro , Padres , Lactante , Recién Nacido , Humanos , Recien Nacido Prematuro/fisiología , Edad Gestacional , Destreza Motora , HospitalesRESUMEN
Abstract Introduction: The use of clinical cases in simulated environments allows for a more realistic approach to the simulated health condition, which results in a more effective training experience for students, as they are immersed in situations they may encounter in their professional practice. Objective: To determine the face validity of a low back pain clinical case as a clinical simulation tool in the training of physical therapy students. Materials and methods: Study conducted to determine the face validity of a low back pain clinical case presented to physical therapy students. The case has 9 items, which were evaluated by 5 expert raters. Agreement between raters regarding the pertinence, relevance, coherence, clarity, and sufficiency of the case was established using the Fleiss' Kappa coefficient. Results: Fleiss ' Kappa for the simulated case was 0.67 (substantial agreement), and for items 1, 2, 4, and 9 was 0.97, 1.0, 0.89, and 1.0, respectively (almost perfect agreement). Furthermore, the percentage of case comprehensibility (9 items) was 95.2. Conclusion: The face validity of the low back pain clinical case was confirmed, so its use in clinical simulation practices in the physical therapy programs offered by the Universidad de La Sabana and Universidad de Boyacá in Colombia is valid.
Resumen Introducción. El uso de casos clínicos en ambientes simulados brinda un mejor acercamiento a la condición de salud que se intenta simular, lo que permite una mejor formación de los estudiantes al verse inmersos en situaciones a las que podrían enfrentarse en su práctica profesional. Objetivo. Determinar la validez aparente de un caso clínico de dolor lumbar como herramienta de simulación clínica en la formación de estudiantes de fisioterapia. Materiales y métodos. Estudio realizado para determinar la validez de apariencia de un caso clínico de dolor lumbar para ser abordado por estudiantes de fisioterapia, el cual presenta nue -ve elementos evaluados por cinco jueces expertos. La concordancia entre los jueces respecto a la pertinencia, relevancia, coherencia, claridad y suficiencia del caso se estableció mediante el coeficiente Kappa de Fleiss. Resultados. El Kappa de Fleiss para el caso simulado fue 0.67 (acuerdo sustancial), y para los elementos 1, 2, 4 y 9 fue 0.97, 1.0, 0.89 y 1.0, respectivamente (acuerdo casi perfecto). Además, el porcentaje de comprensibilidad del caso (9 ítems) fue 95.2. Conclusión. La validez aparente del caso clínico fue confirmada, por lo que su uso en prácticas de simulación clínica en los programas de fisioterapia de la Universidad de La Sabana y la Universidad de Boyacá en Colombia es válido.
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BACKGROUND: Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals' attention, including physiotherapists as they must have the skills to provide treatment that increases the patient's quality of life. Clinical simulations could be a pedagogic strategy that facilitates adequate training for students to acquire skills to improve their professional reasoning in this clinical situation. OBJECTIVE: This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students' clinical decision-making within a role-playing (RP) scenario while caring of LBP patients. METHODS: This experimental study included 42 participants from two Colombian universities, randomized into two groups (SP, n = 21; RP, n = 21). The clinical skill of performing the Objective Structured Clinical Examination (OSCE-LBP) was evaluated while students cared for patients with LBP; after that, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups. RESULTS: Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (p value 0.01; 95%CI - 0.21 to 0.23). CONCLUSION: Both types of simulation favor decision-making in professional reasoning in physiotherapy students during interactions with individuals with LBP. Trial registration https://clinicaltrials.gov/ct2/show/NCT04428892 Identifying number: NCT04428892. It was retrospectively registered.
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Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Modalidades de Fisioterapia , Calidad de Vida , Desempeño de Papel , EstudiantesRESUMEN
Objetivo: determinar la validez de contenido del procedimiento ejercicio físico para mujeres embarazadas 2018. La prescripción del ejercicio físico en mujeres embarazadas es una de las actividades que mayores beneficios fisiológicos y psicosociales trae a la mujer y al niño. Materiales y métodos: estudio descriptivo. Valoración de contenido con la técnica de juicio de expertos. Resultados: se obtuvo un valor promedio de coeficientes kappa para la dimensión de examen de 0,64 y para la dimensión de intervención de 0,75. El índice kappa para el instrumento fue de 0,69 (acuerdo sustancial).Adicionalmente, para la dimensión de examen fisioterapéutico se obtuvieron valores de proporción de acuerdo medio (Ì P a) que superan el umbral de concordancia sustancial, excepto la propiedad de claridad. En la dimensión de intervención los valores de (Ì Pa) indican que todas las propiedades de la intervención fisioterapéutica superan el umbral de concordancia sustancial. Conclusiones: el ejercicio físico es una práctica fundamental durante el embarazo, su aplicación requiere de un examen riguroso que conlleve a una intervención individualizada donde se reconozcan los antecedentes de la mujer para así determinar la intensidad adecuada de la prescripción. A partir del procedimiento "lineamientos de ejercicio físico en mujeres embarazadas" los profesionales contarán con una herramienta basada en evidencia científica que incluye una fase de examen y una fase de intervención..Au
Objective: to determine the content validity of the procedure guidelines for physical exercise for pregnant women 2018. Prescribing physical exercise in pregnant women is one of the recommendations that brings the greatest physiological and psychosocial benefits to women and children. Materials and methods: descriptive study. Content validity with expert judgment technique. Results: an average value of kappa coefficients was obtained for the examination dimension of 0.64 and for the intervention dimension of 0.75. The Kappa index for the instrument was 0.69 (substantial agreement). Additionally, for the physiotherapeutic examination dimension, mean agreement ratio (Ì P a) values were obtained that exceed the threshold of substantial agreement except the property of clarity. In the intervention dimension, the values of (Ì Pa) indicate that all the properties of the physiotherapeutic intervention exceed the threshold of substantial agreement. Conclusions: physical exercise is a fundamental practice during pregnancy, its application requires a rigorous examination that leads to an individualized intervention where the woman's history is recognized in order to determine the appropriate intensity of the prescription. Starting with the procedure "Guidelines for physical exercise in pregnant women", professionals will have a tool based on scientific evidence that includes an examination phase and an intervention phase..Au
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Embarazo , Ejercicio Físico , Mujeres EmbarazadasRESUMEN
Los escenarios de simulación clínica han sido explorados en medicina y enfermería como estrategia de aprendizaje y han demostrado ser efectivos para la adquisición de competencias acercando a los estudiantes a su práctica clínica real. En fisioterapia, su utilización ha sido recientemente incluida y aún no se ha documentado su potencial como estrategia de fortalecimiento curricular. Este trabajo buscó revisar en la literatura el empleo de la simulación clínica como estrategia pedagógica para la fisioterapia. Para ello, se desarrolló un proceso integrativo con base en el análisis de competencias transversales o específicas. Sus resultados señalan que la simulación mejora la calidad y competencia del fisioterapeuta en formación; el dominio donde más se usa la simulación es el cardiovascular pulmonar, seguido del musculoesquelético. Sin embargo, en fisioterapia se requiere incrementar el uso de simulación en todos los dominios para poder cualificar aún más la formación
Clinical simulation scenarios have been explored in medicine and nursing as a learning strategy. They have shown to be effective for the acquisition of skills, bringing students closer to their actual clinical practice. Its use has recently been included in physiotherapy, but its potential as a curriculum strengthening strategy has not yet been documented. This work aims to carry out a review of the literature on the use of clinical simulation as a pedagogical strategy for physiotherapy. To do this, an integrated process was developed, based on the analysis of cross-sectional or specific skills. The results indicate that simulation improves the quality and skills of the physiotherapist in training. The domain where the simulation is most used is pulmonary cardiovascular, followed by the musculoskeletal system. However, in physiotherapy it is necessary to increase the use of simulation in all domains in order to qualify the training even more
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Humanos , Entrenamiento Simulado/métodos , Medicina Física y Rehabilitación/educación , Enseñanza Mediante Simulación de Alta Fidelidad/métodos , Enseñanza Mediante Simulación de Alta Fidelidad/tendencias , Competencia ClínicaRESUMEN
Resumen Introducción. La población con prematuridad o bajo peso al nacer requiere de planes de atención que reconozcan los factores sociodemográficos influyentes en su pronóstico. Objetivo. Comprobar la asociación de los factores sociodemográficos en el desarrollo motor de niños con prematurez o bajo peso al nacer. Materiales y métodos. Se contó con una población de 49 infantes con prematurez o bajo peso al nacer, se evaluó su desarrollo motor con la Escala Motora del Infante de Alberta (EMIA) y se relacionó su estado con los aspectos sociodemográficos reportados por la madre. Resultados. El 82% de los niños presentó atraso en su desarrollo motor, determinado por la diferencia entre la edad motora puntuada a través de la EMIA y la edad cronológica en los niños nacidos a término; para los niños nacidos pretérmino se usó la edad corregida. La población se dividió en tres grupos según la edad de los niños: de 0 a 4 meses, de 5 a 7 meses, y mayores de 7 meses; se calculó la diferencia de promedio de retraso motor según el estrato, la edad, la ocupación y el nivel educativo de la madre, y se encontró mayor retraso motor para los niños cuyas madres son menores a 25 años (p<0.05). Conclusión. La edad de la madre se asoció con el desarrollo motor de infantes con prematurez o bajo peso al nacer en el grupo de 4 a 7 meses.
Abstract Introduction: Premature or low birth weight population require care plans that recognize the socio-demographic factors influencing prognosis. Objective: To prove the association of sociodemographic factors in the motor development of premature or low birth weight children. Materials and methods: Motor development of 49 premature or low birth weight infants was evaluated using the Alberta Infant Motor Scale (AIMS) and their status was associated to socio-demographic aspects reported by mothers. Results: 82% of children presented delays in motor development, which was determined by differentiating the motor age scored through AIMS and the chronological age in full-term children. A corrected age was used for preterm children. The population was divided into three groups according to age: 0 to 4 months, 5 to 7 months, and 7 months and older. The difference in average motor retardation was calculated by socio-economic stratum, age, occupation and educational level of the mother. Increased motor delays were found in children whose mothers were younger than 25 (p <0.05). Conclusion: The age of the mother was associated with the motor development of premature or low birth weight infants in the group of 4 to 7 months.
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Antecedentes. El desarrollo motor en niños prematuros es reconocido como un desarrollo lento y con diferente calidad de movimiento (1); por tal motivo, se hace necesario que en la valoración de las habilidades motoras de esta población se utilicen herramientas sensibles a la detección de sus características motrices. Objetivo. Identificar la diferencia entre la edad corregida versus edad motora en los infantes pertenecientes al Programa Madre Canguro del Hospital de Suba, de la ciudad de Bogotá, durante el segundo periodo del 2013. Materiales y métodos. Estudio descriptivo correlacional con una muestra n=15 infantes prematuros o con bajo peso al nacer, valorados a través de la Escala Motora del Infante de Alberta (EMIA). Se realizaron correlaciones entre variables, como edad cronológica en meses, edad corregida, semanas de gestación y peso. Resultados. Se encontró relación entre la edad cronológica del infante, la edad corregida y el peso (p<0,05); a medida que cualquiera de estas variables incrementa, la edad motora también lo hace. Se encontró 1,5 meses de diferencia entre la edad corregida y la edad motora (p<0,05). Conclusiones. La edad motora y la edad corregida de los infantes pertenecientes al Programa Madre Canguro del Hospital de Suba presenta diferencias significativas, ratificándose que las intervenciones desde fisioterapia necesitan ser constantes y tempranas.
Background. Motor development in premature infants is recognised as being slow and involves a different quality of movement. Tools which are sensitive in detecting motor development-related characteristics should thus be used in assessing this population's motor skills. Objective. Identifying the difference between corrected age and motor development age in a group of infants involved in the Suba Hospital's Kangaroo Mother programme during the second half of 2013. Materials and methods. This was a descriptive correlational study; sample n=15 premature infants and/or low birth weight children measured by the Alberta infant motor scale. Correlations were made with variables such as chronological age (in months), corrected age, weeks of gestation, height and weight. Results. The relationship between infants' chronological age, corrected age and weight was found (p<0.05); if any variable increased then motor age increased. There was 1.5 months difference between chronological age and motor development corrected age (p<0.05). Conclusions. The motor development age and corrected age of infants involved in Suba Hospital's Kangaroo Plan had significant differences, ratifying the idea that, when needed, physiotherapy must be constant and provided early on.