Clinical relevance of resistance training in women with fibromyalgia: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: There has been an increase in the number of papers assessing the effects of resistance training (RT) in patients with fibromyalgia. Therefore, the objective of our study was to evaluate the clinical relevance and effectiveness of RT for pain intensity, functionality and severity of the disease specifically in women with fibromyalgia through a systematic review with meta-analysis. DATABASES AND DATA TREATMENT: Seven databases were searched. Randomized controlled trials conducted in women over 18 years of age with fibromyalgia were included. Fifteen trials were included in the systematic review and 14 of these studies were included in the three meta-analyses performed. Study quality assessment was performed using the PEDro scale. In addition, the GRADE recommendations were used. RESULTS: The global meta-analysis revealed statistically significant differences in the RT group versus the control group on pain intensity (SMD = -0.49; 95% CI [-0.74, -0.24], p = 0.0001), functionality (SMD = -0.23; 95% CI [0.01, 0.45], p = 0.04) and on severity of the disease (SMD = -0.58; 95% CI [-0.90, -0.26], p = 0.0005). Clinically relevant improvements in the overall outcome of the three variables studied in favour of RT were obtained. CONCLUSIONS: RT is effective to improve pain intensity, functionality and severity of the disease in women with fibromyalgia. These improvements are clinically relevant. More clinical trials of RT are needed in women with fibromyalgia to support our results due to the low strength of evidence. SIGNIFICANCE: This systematic review with meta-analysis provides evidence that RT produces clinically relevant improvements in women with fibromyalgia. The absence of immediate benefit is often a major barrier to adherence to treatment. Our findings will help clinicians to empower patients that if they continue treatment, they will achieve improvement in their disease.

Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial.

PURPOSE: To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS: A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS: The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. CONCLUSIONS: Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02721914).IMPLICATIONS FOR REHABILITATIONMassage Therapy (MT) and Abdominal Hypopressive Gymnastics (AHG), reduce pain, improve mobility and quality of life, and reduce disability in the short term.These results are clinically relevant.The combination of manual and active therapy (MT + AHG) seems to be more effective and produces clinically relevant changes.

Efficacy of Conservative Therapy in Overhead Athletes with Glenohumeral Internal Rotation Deficit: A Systematic Review and Meta-Analysis.

BACKGROUND: To evaluate the effectiveness of conservative therapy in range of movement (ROM), strength, pain, subacromial space and physical function, in overhead athletes with glenohumeral internal rotation deficit (GIRD). METHODS: A systematic review and meta-analysis was designed, and the protocol was registered in PROSPERO (CRD42021281559). The databases searched were: PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, Web of Science and SCOPUS. Randomized controlled trials (RCTs) involving conservative therapy applied in overhead athletes with GIRD were included. Two independent assessors evaluated the quality of the studies with the PEDro scale, and with the Cochrane Risk-of-Bias tool. The overall quality of the evidence was assessed using GRADE. Data on outcomes of interest were extracted by a researcher using RevMan 5.4 software. Estimates were presented as standardized mean differences (SMD) with 95% confidence intervals (CIs). RESULTS: A total of eleven studies involving 514 overhead athletes were included in the systematic review; of these 8 were included in the meta-analysis. The methodological quality of the included RCTs ranged from high to low. Conservative therapy showed significant improvements in internal rotation, adduction, physical function and subacromial space. CONCLUSIONS: Conservative therapy based on stretch, passive joint and muscular mobilizations can be useful to improve the internal rotation and adduction ROM, subacromial space, and physical function of the shoulder in overhead athletes with glenohumeral internal rotation deficit.

Visual Binocular Disorders and Their Relationship with Baropodometric Parameters: A Cross-Association Study.

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p < 0.05), forefoot area (p < 0.05), forefoot load (p < 0.05), and rearfoot load (p < 0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard's criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p < 0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters.

Effects of Massage Therapy on the Development of Babies Born with Down Syndrome.

OBJECTIVE: To determine the short-term effects of infant massage on the development of Down syndrome babies. MATERIALS AND METHODS: The study compared two groups (intervention and control), each with 16 babies with Down syndrome between 4 and 8 months old. The variables developmental age and developmental quotient were measured at two distinct time points, at pretest and after 5 weeks, using the Brunet-Lézine Early Childhood Psychomotor Development revised scale. This scale measures the variables of age and development quotient in a partial way (motor, visual-motor coordination, language, and social development) and in a global way. The experimental group received infant massage, applied by the parents, during these 5 weeks, every day for at least 10 minutes. The massage protocol was based on the methodology created by Vimala McClure. The control group received it after 5 weeks. RESULTS: All developmental variables were improved in the experimental group but not in the control group. There were significant differences in developmental age between the two groups, and this outcome was better in the experimental group (p < 0.001). The 2-by-2 mixed-model analysis of variance indicates a statistically significant group-by-time interaction for all development quotients, both partial and global (p < 0.001), which was significantly higher in the experimental group than in the control group. CONCLUSION: Infant massage therapy improves the development of babies with Down syndrome in the short term.

Visual system disorders and musculoskeletal neck complaints: a systematic review and meta-analysis.

Accommodation disorders and nonstrabismic binocular dysfunctions affect patients' binocular system and visual performance. These visual disorders could be associated with musculoskeletal discomfort in the neck and shoulder area. The purpose of this systematic review and meta-analysis was to ascertain the relationship between visual system disorders and the musculoskeletal system of the neck. The review protocol is available in PROSPERO (CRD42018112771). All articles selected examined the relationship between neck conditions (chronic neck pain and whiplash) and the visual system in adult populations. Studies with optometric or physiotherapeutic measurements were included. Bias risk was evaluated with the modified Cochrane Collaboration Tool and Study Quality Assessment Tool. To provide complete quality assessment evidence, the authors applied the GRADEpro Guideline Development Tool. The literature search was conducted in November 2018 and yielded 745 studies among all the databases. Out of these studies, 21 were finally included. Most of the studies presented a moderate methodological quality. Only one high-quality trial was found. Based on a qualitative assessment, our systematic review and meta-analysis revealed that all included studies established a relationship between the visual system and musculoskeletal system of the neck. However, the methods for the measurement of the visual system lacked uniformity.

Nonstrabismic binocular dysfunctions and cervical complaints: The possibility of a cross-dysfunction.

The aim of this study is to establish a relationship between non-strabismic binocular dysfunction and neck pain. One hundred twelve participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges and vergence facility. The subjects were classified into two groups: binocular anomalies and normal binocular function. Neck complaints were measured with the Neck Disability Index, visual analogue scale, cervical range of motion, deep-flexor muscle activation score (AS) and performance index (PI). Our results showed that participants with low AS had significantly altered values of lateral phoria (near) (mean = -6.99 SD ± 6.96 PD) and PFV (near) blur (mean = 9.49 SD ± 5.45 PD) against those who presented normal AS (lateral phoria (near) mean = -3.64 SD ± 6.37 PD; PFV (near) blur mean = 12.84 SD ± 6.20 PD). In addition, participants with NFV (near) recovery outside the norm had a significantly lower right side-bending (mean = 35.63 SD ± 8.35 PD) than those within the standard (mean = 39.64 SD ± 9 PD). The subjects with binocular vision impairment showed a diminished response to the deep cervical musculature, with low AS and PI, as well as a tendency to suffer from cervicalgia of more than three months' evolution and a lower range of motion.

Is it possible to relate accommodative visual dysfunctions to neck pain?

The aim of this study was to establish whether there is a relationship between conditions of accommodative visual dysfunctions and cervical complaints. Fifty-two participants were included. Variables were accommodative amplitude, positive and negative relative accommodation (NRA), accommodative response, and accommodative facility. Subjects were classified as accommodative insufficiency, accommodative excess, or normal. Neck complaints were measured with the Neck Disability Index, the Visual Analogue Scale, and by cervical range of motion, deep flexor muscle activation score, and performance index. We found the following significant relationships: between NRA and both performance index and left-side bending; accommodative amplitude right-eye with right-side bending and with left-side bending; accommodative amplitude left-eye with right-side bending; and accommodative facility left-eye with both performance index and left-side bending. In accommodative amplitude right-eye, aIl participants showed significant values and greater than those with accommodative excess. In both groups, performance index values were decreased. Greater pain and lower right-rotation were found in participants with accommodative excess than in those with accommodative insufficiency. We conclude that accommodative dysfunctions are related to low performance index, decreased range of motion, as well as greater neck pain.

The efficacy of capacitive radio-frequency diathermy in reducing buttock and posterior thigh cellulite measured through the cellulite severity scale.

BACKGROUND: Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. OBJECTIVES: To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. METHODS: Design: Experimental clinical study consists of two parallel groups. SAMPLE: Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patient's two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. VARIABLES: Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. RESULTS: A significance of p less than 0.01 was observed for all the variables in both groups, thereby demonstrating the effectiveness of both the treatments; no significant differences were observed between groups (p > 0.05). CONCLUSIONS: Monopolar static application of CRFD is effective in reducing buttock and posterior thigh cellulite. It appears that there is not necessarily any relationship between weight loss, decreased BMI and reduction in cellulite.