Efectividad de la intervención motora temprana en el desarrollo motor de los niños con parálisis cerebral entre 3 y 5 años de edad. Revisión sistemática / Effectiveness of early motor interventions in children with cerebral palsy between 3 to 5 years of age: Systematic review

La intervención motora temprana es esencial en niños con parálisis cerebral; sin embargo, se desconoce su efectividad entre los 3 y los 5años. El objetivo fue determinar la efectividad de la intervención motora temprana en el desarrollo motor de dicha población. Se realizó una revisión sistemática de literatura acerca de intervenciones motoras tempranas realizada en diferentes bases de datos como Pubmed/Medline, PEDro, OTSeeker, Embase y LILACS. Finalmente se seleccionaron 18 artículos, de los cuales 4 presentaron cambios a favor del grupo experimental en los desenlaces desarrollo motor global y función motora manual, con la terapia de integración sensorial y la terapia de movimiento inducido por restricción, respectivamente; no obstante, los resultados no fueron estadísticamente significativos y el nivel de evidencia fue bajo. La intervención motora temprana podría incluirse con precaución para la mejoría del desarrollo motor global y la función manual. Es necesario realizar estudios de mayor calidad metodológica. (AU)

Early motor intervention is essential in children with cerebral palsy; however, it is unknown its effectiveness between 3 to 5years. The objective was to determinate the effectiveness of early motor intervention in the motor development of this population. A systematic literature search was performed in Pubmed/Medline, PEDro, OTSeeker, Embase, and LILACS. Finally, 18 articles were selected, of which 4 showed favorable changes in the experimental group in the outcomes of overall motor development and manual motor function, with sensory integration therapy and movement-induced restriction therapy, respectively; however, the results were not statistically significant, and the level of evidence was low. Early motor intervention could be cautiously considered for improving overall motor development and manual function. Higher-quality methodological studies are necessary. (AU)

Is more always better? Effectiveness of constraint-induced movement therapy in children with high-risk or unilateral cerebral palsy (0-6 years): Systematic review and meta-analysis.

BACKGROUND: While constraint-induced movement therapy is strongly recommended as an intervention for infants with unilateral cerebral palsy, the optimal dosage remains undefined. This systematic review aims to identify the most effective level of intensity of constraint-induced movement therapy to enhance manual function in infants at high risk of asymmetric brain lesions or unilateral cerebral palsy diagnosis. METHODS: This systematic review with meta-analysis encompassed a comprehensive search across four electronic databases to identify articles that met the following criteria: randomised controlled trials, children aged 0-6 with at high risk or with unilateral cerebral palsy, and treatment involving constraint-induced movement therapy for upper limb function. Studies with similar outcomes were pooled by calculating the standardised mean difference score for each subgroup, and subgroups were stratified every 30 h of total intervention dosage (30-60, 61-90, >90 h). Risk of bias was assessed with Cochrane Collaboration's tool. RESULTS: Seventeen studies were included. Meta-analyses revealed significant differences among subgroups. The 30-60 h subgroup showed a weak effect for spontaneous use of the affected upper limb during bimanual performance, grasp function, and parents' perception of how often children use their affected upper limb. Additionally, this subgroup demonstrated a moderate effect for the parents' perception of how effectively children use their affected upper limb. CONCLUSIONS: Using a dosage ranging from 30 to 60 h when applying a constraint-induced movement therapy protocol holds promise as the most age-appropriate and cost-effectiveness approach for improving upper limb functional outcomes and parent's perception.

Experiences of people with Long Covid with a digital physiotherapy intervention: A qualitative study.

PURPOSE: Long Covid syndrome is a multiorgan condition with multiple sequelae affecting quality of life, capacity to work and daily activities. The advantages that new technologies can offer are presented as an opportunity in the current healthcare framework. OBJECTIVE: This research aimed to explore people with Long Covid's experiences with a digital physiotherapy practice intervention, during four weeks. METHODS: Qualitative semistructured interviews were conducted by video call. Thirty-two Long Covid participants were invited to join an in-depth interview once the intervention was completed. Participants were queried on their intervention experiences and perceptions, as well as any lifestyle changes made, as a result of receiving digital physiotherapy practice. The interviews were transcribed and analysed using inductive qualitative content analysis. RESULTS: In-depth qualitative analysis has revealed four themes that reflect participants' perceptions of digital physiotherapy intervention. The helpfulness of the exercises, interaction with the physiotherapist, the domestic use of technology and the future of digital health practice were the topics highlighted by Long Covid participants. Some improvements have been suggested including video sounds and the need to introduce face-to-face sessions. Participants stated that interventions were helpful and superior to printed exercise sheets, mobile phone apps and usual care received. This intervention did not present major barriers, highlighting the importance of personalized care and continuity in the provision of health services. CONCLUSION: The digital physiotherapy practice is perceived by people with Long Covid as an appropriate method for the care of their health needs. Participants stated the need for this type of intervention in the public health system, where it would eliminate waiting lists, facilitate accessibility and improve existing care. PATIENT AND PUBLIC CONTRIBUTION: Participants contributed to the interpretation of the data acquired in the interview. CLINICAL TRIAL REGISTRATION: Trial registration NCT04742946.

Study on the variable length simple pendulum oscillation based on the relative mode transfer method.

In this study, we employed the principle of Relative Mode Transfer Method (RMTM) to establish a model for a single pendulum subjected to sudden changes in its length. An experimental platform for image processing was constructed to accurately track the position of a moving ball, enabling experimental verification of the pendulum's motion under specific operating conditions. The experimental data demonstrated excellent agreement with simulated numerical results, validating the effectiveness of the proposed methodology. Furthermore, we performed simulations of a double obstacle pendulum system, investigating the effects of different parameters, including obstacle pin positions, quantities, and initial release angles, on the pendulum's motion through numerical simulations. This research provides novel insights into addressing the challenges associated with abrupt and continuous changes in pendulum length.

The effect of physical therapy and mechanical stimulation on dysfunction of lower extremities after total pelvic exenteration in cervical carcinoma patient with rectovesicovaginal fistula induced by radiotherapy: a case report.

BACKGROUND: Total pelvic exenteration is the ultimate solution for rectovesicovaginal fistula caused by radiation therapy, yet total pelvic exenteration frequently causes intraoperative complications and postoperative complications. These complications are responsible for the dysfunction of lower extremities, impaired quality of life, and even the high long-term morbidity rate, thus multidisciplinary cooperation and early intervention for prevention of complications are necessary. Physical therapy was found to reduce the postoperative complications and promote rehabilitation, yet the effect on how physiotherapy prevents and treats complications after total pelvic exenteration and pelvic lymphadenectomy remains unclear. CASE PRESENTATION: A 50-year-old Chinese woman gradually developed perianal and pelvic floor pain and discomfort, right lower limb numbness, and involuntary vaginal discharge owing to recurrence and metastasis of cervical cancer more than half a year ago. Diagnosed as rectovesicovaginal fistula caused by radiation, she received total pelvic exenteration and subsequently developed severe lower limb edema, swelling pain, obturator nerve injury, and motor dysfunction. The patient was referred to a physiotherapist who performed rehabilitation evaluation and found edema in both lower extremities, right inguinal region pain (numeric pain rate scale 5/10), decreased temperature sensation and light touch in the medial thigh of the right lower limb, decreased right hip adductor muscle strength (manual muscle test 1/5) and right hip flexor muscle strength (manual muscle test 1/5), inability actively to adduct and flex the right hip with knee extension, low de Morton mobility Index score (0/100), and low Modified Barthel Index score (35/100). Routine physiotherapy was performed in 2 weeks, including therapeutic exercises, mechanical stimulation and electrical stimulation as well as manual therapy. The outcomes showed that physiotherapy significantly reduced lower limb pain and swelling, and improved hip range of motion, motor function, and activities of daily living, but still did not prevent thrombosis. CONCLUSION: Standardized physical therapy demonstrates the effect on postoperative complications after total pelvic exenteration and pelvic lymphadenectomy. This supports the necessity of multidisciplinary cooperation and early physiotherapy intervention. Further research is needed to determine the causes of thrombosis after standardized intervention, and more randomized controlled trials are needed to investigate the efficacy of physical therapy after total pelvic exenteration.

A Novel Experimental Approach for the Measurement of Vibration-Induced Changes in the Rheological Properties of Ex Vivo Ovine Brain Tissue.

Increased incidence of traumatic brain injury (TBI) imposes a growing need to understand the pathology of brain trauma. A correlation between the incidence of multiple brain traumas and rates of behavioural and cognitive deficiencies has been identified amongst people that experienced multiple TBI events. Mechanically, repetitive TBIs may affect brain tissue in a similar way to cyclic loading. Hence, the potential susceptibility of brain tissue to mechanical fatigue is of interest. Although temporal changes in ovine brain tissue viscoelasticity and biological fatigue of other tissues such as tendons and arteries have been investigated, no methodology currently exists to cyclically load ex vivo brain tissue. A novel rheology-based approach found a consistent, initial stiffening response of the brain tissue before a notable softening when subjected to a subsequential cyclic rotational shear. History dependence of the mechanical properties of brain tissue indicates susceptibility to mechanical fatigue. Results from this investigation increase understanding of the fatigue properties of brain tissue and could be used to strengthen therapy and prevention of TBI, or computational models of repetitive head injuries.

Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here.

In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.

The role of depression in the association between mobilisation timing and live discharge after hip fracture surgery: Secondary analysis of the UK National Hip Fracture Database.

PURPOSE: The aim was to compare the probability of discharge after hip fracture surgery conditional on being alive and in hospital between patients mobilised within and beyond 36-hours of surgery across groups defined by depression. METHODS: Data were taken from the National Hip Fracture Database and included patients 60 years of age or older who underwent hip fracture surgery in England and Wales between 2014 and 2016. The conditional probability of postsurgical live discharge was estimated for patients mobilised early and for patients mobilised late across groups with and without depression. The association between mobilisation timing and the conditional probability of live discharge were also estimated separately through adjusted generalized linear models. RESULTS: Data were analysed for 116,274 patients. A diagnosis of depression was present in 8.31% patients. In those with depression, 7,412 (76.7%) patients mobilised early. In those without depression, 84,085 (78.9%) patients mobilised early. By day 30 after surgery, the adjusted odds ratio of discharge among those who mobilised early compared to late was 1.79 (95% CI: 1.56-2.05, p<0.001) and 1.92 (95% CI: 1.84-2.00, p<0.001) for those with and without depression, respectively. CONCLUSION: A similar proportion of patients with depression mobilised early after hip fracture surgery when compared to those without a diagnosis of depression. The association between mobilisation timing and time to live discharge was observed for patients with and without depression.

Enhancing the quality of life for physical therapists: insights from a cross-sectional study.

Background: Physical Therapy profession is known for its demanding physical requirements. This increases the risk of attrition and work-related accidents and disorders that affect physical therapists' quality of life and work performance. This study aimed to evaluate the effect of physical activity level and other contributing factors on quality of life of physical therapists. Methods: A cross-sectional study was conducted among practicing physical therapists (n = 258). The International Physical Activity Questionnaires-Short Form was used to measure physical activity levels and the World Health Organization Quality of Life Questionnaire short form was used to measure the quality of life among physical therapists. Data was collected through a self-administered online survey using Microsoft Forms. Results: The eligible participants were 258 out of 297. The highest percentage of physical therapists had a moderate physical activity level (45.35%) and the median for overall quality of life score was 63.27(52.73-73.59). There was a significant positive correlation between physical activity and age with overall quality of life score (rs = 0.41, p < 0.001; rs = 0.13, p < 0.036) respectively and a significant negative correlation between body mass index and overall quality of life score (rs = -0.13, p < 0.04). Conclusion: The results obtained revealed that physical therapists mostly have moderate physical activity level and relatively good perceived quality of Life. Furthermore, our study identified significant correlations between physical activity, age, body mass index, and the overall quality of life among practicing physical therapists.

The importance of Epley maneuver in posterior canal benign paroxysmal positional vertigo.

OBJECTIVE: We investigated symptom scores and quality of life in unilateral posterior canal benign paroxysmal positional vertigo (BPPV) patients. PATIENTS AND METHODS: In this retrospective and multicentric study, 78 patients with unilateral posterior canal BPPV (47 right-sided and 31 left-sided) were included. All patients have performed the Standard Epley maneuver. Features of the nystagmus [nystagmus duration (second), latent period (second)] and features of the disease [side (right or left-sided), disease duration (years), and recurrence of disease (present or absent)] were noted. Before and 1 week after the Epley maneuver, all patients were evaluated using the Vertigo Symptom Scale (VSS), Vertigo Dizziness Imbalance Symptom Scale (VDI-SS), and Vertigo Dizziness Imbalance health-related quality of life scale (VDI-HQoL). RESULTS: Our results showed that VSSs of the right-sided group were significantly higher than those in the left-sided group before and 1 week after the maneuver (p<0.05). One week after the maneuver, VDI-HQoLs of the left-sided group were significantly higher than those in the right-sided group (p<0.05). In all right-sided and left-sided groups, at 1 week after the maneuver, VSSs were significantly lower, and VDI-SSs and VDI-HQoLs were significantly higher than those before the maneuver (p<0.05). As VSS values increased, VDI-SS and VDI-HQoL values decreased (p<0.05). In the left-sided group, VSS values decreased, and VDI-HQoL values increased. As disease duration increased, VSS values increased before the maneuver (p<0.05). In females, VSS values increased, and VDI-SS and VDI-HQoL values decreased before the maneuver (p<0.05). CONCLUSIONS: In posterior canal BPPV, the Epley maneuver effectively decreased VSS values and increased VDI-SS and VDI-HQoL values. In the left-sided BPPV group, there were lower VSS values and higher VDI-HQoL values that showed better quality of life of the patients. Older age and female gender are other factors related to lower quality of life with higher symptom scores.

Physical Therapy Services During COVID-19 Pandemic: Perception of Families of Brazilian Children With Physical Disabilities.

PURPOSE: To describe the perspective of caregivers about physical therapy (PT) during the COVID-19 pandemic and the effect of social distancing on the health of children with physical disabilities. METHODS: This survey research used a remote questionnaire to identify the perceptions of caregivers about the effect of the COVID-19 pandemic on the health of children and adolescents with physical disabilities and on PT services. Data were analyzed using the frequency of responses; open-ended questions were analyzed through a hybrid approach to thematic analysis. RESULTS: Caregivers of 47 children with cerebral palsy were included. Although most received regular PT services during the pandemic, worsened children's physical conditions and anxiety were prevalent. Caregivers believed that they lacked technical skills. CONCLUSIONS: Social distancing impacted the health of children with physical disabilities, especially their physical conditions. Identifying facilitators and barriers for PT services can be helpful in future similar scenarios.Video abstract Supplemental Digital Content available at:http://links.lww.com/PPT/A503.

The results of the corrective rehabilitation program on the gait of amateur athletes with long-term consequences of brain injury.

OBJECTIVE: Aim: To study the results of the quality of life, the state of vestibular disorders and the nature of walking of amateur athletes with the consequences of a combat craniocerebral injury after rehabilitation treatment according to a correctional program. PATIENTS AND METHODS: Materials and Methods: The study was conducted on the basis of the Ukrainian Scientific Research Institute of Prosthetics in Kharkov. Under observation were 38 men aged 25-42 years with long-term consequences of a closed craniocerebral injury in the late long-term period. In all patients, complications after TBI were persistent headache, decreased muscle strength in the lower extremities, impaired coordination and balance, and walking patterns. All patients were involved in amateur sports before injury. The following research methods were used during the examination: visual analogue pain scale (VAS), Lovett manual muscle test, Bohannon test, ≪Timed Up and Go test≫. RESULTS: Results: All patients were randomly divided into two groups. Patients Gr.1 (n=20) were trained according to the developed program, which included training according to the PNF method, kinesiotherapy, classes on the C-mill sensory treadmill and the Hunova computer device, segmental reflex massage. Patients Gr. 2 (n=18) underwent a course of physical rehabilitation according to the generally accepted methodology of the Ministry of Health of Ukraine. After working with patients according to the developed correction and rehabilitation program, the following dynamics were observed: the quality of life on the VAS scale in Gr.1 patients had a statistically significant difference (p<0.05) compared to the primary indicator. The dynamics of the Lovett manual muscle test indicated an increase in the muscle strength of the extensor and flexor muscle groups of the lower extremities, the dynamics of the balance indicator in the standing position behind Bohann in all Gr.1 patients and acquired statistical significance (p<0,05). According to the test "Timed Up and Go" patients Gr.1 approached the standard value (p<0,05). In all patients of Gr. 2, the studied characteristics had a positive trend (p>0,05). CONCLUSION: Conclusions: Individual selection of physical exercises, development of correctional and rehabilitation programs, multidisciplinary approach has a positive impact on changes in the functional state of amateur athletes, quality of life and contributes to the return to an active social life.

Physical therapy interventions for people experiencing homelessness to improve pain and self-perceived health status.

BACKGROUND: Homeless shelters have emerged as components of the social services network, playing an important role in providing health care to the homeless population. The aim of this study was to evaluate an individualized physical therapy intervention for people experiencing homelessness and to determine the relationship between self-perceived variables. METHODS: Pre and post study, setting at the "Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad" homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7). RESULTS: Sixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention. CONCLUSIONS: This study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.

Role of physical therapy intervention in acute disseminated encephalomyelitis.

We reported a case of a school-going child, diagnosed with acute disseminated encephalomyelitis (ADEM) who presented with symptoms such as high fever, acute hemiplegia and ataxia and was referred for physiotherapeutic intervention. This case report aims to document the assessment and management of ADEM from the intensive care unit to the home setting by physical therapy. Also, the child developed ventilator-associated pneumonia and a right lower motor neuron facial injury for which the child was referred to paediatric physical therapy. Since then, continuing for 8 months has helped the child to be independent in all aspects of mobility with no complaints. The child showed improvement in WeeFIM scores and Sunnybrook facial grading after 99 sessions of intensive physical therapy for approximately 83 hours along with the home programme. It has been proven an efficient treatment method along with other medical lines of treatment for neurological impairment associated with ADEM.

Reducing wait times and medical costs for patients: the physiotherapy-led Spine Triage and Rehabilitation (STAR) Clinic.

The Sengkang General Hospital Orthopaedic Spine Outpatient Service is facing a growing challenge of increasing number of referrals and waiting times, placing a significant burden on the system. Primary care referrals have an average wait time of 61.1 days, with 34.5%f patients waiting longer than 60 days from referral to appointment, to see a spine physician.Back pain is a very common presentation, with the vast majority resolving after conservative management which commonly includes analgesia, physiotherapy and reassurance. Unfortunately, many referrals from primary care involve patients who have yet to explore the avenues of conservative management with 90% of our referrals being managed without surgery. Globally, triage services in Western countries conducted by allied health professionals have shown to be an effective method at addressing the escalating wait times with high satisfaction rates. We have endeavoured to emulate this within our department through the implementation of the Spine Triage and Rehabilitation (STAR) Clinic. The STAR clinic aims to empower physiotherapists with the ability to triage patients into surgical and non-surgical categories with their primary physiotherapy expertise to reduce waiting times and increase outpatient capacity.More than 300 patients were recruited, and their progress was tracked over 13 months under the four Ss of: waiting timeS, cost Savings, Safety and patient Satisfaction. This pilot study has been overwhelmingly positive, with significantly reduced waiting times and high cost savings, without any compromise on patient safety and satisfaction.

Efficacy of a high-intensity home stretching device and traditional physical therapy in non-operative management of adhesive capsulitis - a prospective, randomized control trial.

BACKGROUND: Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate. METHODS: Thirty-four patients with idiopathic adhesive capsulitis and a minimum of 12 months follow-up were included in this study. Patients were randomized into one of the three groups: HIS device, PT alone, or HIS device + PT. Passive range of motion (ROM), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were measured. Additionally, patient satisfaction, compliance and complications were recorded. Paired t-test, ANOVA and Chi-squared tests were used in analysis. RESULTS: Final ROM in all planes improved for all groups compared to baseline (p < 0.001), with only HIS device group able to restore > 95% of contralateral ROM in all planes at final follow-up. Patients with PT alone were on average slowest to improve ROM from baseline, at 3 months, 6 months, and 1 year in all planes except internal rotation. ASES and SST scores improved for all groups when compared to baseline (p < 0.001). Use of HIS-device resulted in greater improvement in SST and ASES Total scores compared to PT alone (p = 0.045, and p = 0.048, respectively). CONCLUSIONS: Use of an at-home high-intensity stretching device for conservative treatment of idiopathic adhesive capsulitis improves outcomes in ROM and in ASES and SST scores both when used as an adjunct to physical therapy and when used alone. TRIAL REGISTRATION: The study protocol was registered at www. CLINICALTRIALS: gov (20/05/2022, NCT05384093).

Efectividad de la entrevista motivacional en la atención fisioterápica de los trastornos musculoesqueléticos de la espalda / Effectiveness of the motivational interview in the physiotherapy care of musculoskeletal disorders of the back: A quasi-experimental study

Objetivo: Evaluar la efectividad de la entrevista motivacional (EM) junto al tratamiento fisioterapéutico habitual en pacientes con trastornos musculoesqueléticos (TME) de la espalda en atención primaria (AP). Métodos: Estudio cuasiexperimental en pacientes que iniciaron su tratamiento en el año 2020 en una unidad de fisioterapia tras diagnóstico médico de TME en la espalda, con seguimiento prospectivo de 2grupos con actuación terapéutica: grupo experimental (GE) y grupo de control (GC). Se empleó la EM solo en el GE. A ambos grupos se les entrevistó telefónicamente a los 3y 6meses de finalizar el tratamiento fisioterápico, preguntando por el cumplimiento de pautas domiciliarias y por la percepción subjetiva del estado de salud (escala de Barthel). Se ajustaron modelos de regresión lineales (coeficiente de regresión, IC del 95%) y logísticos (OR, IC del 95%). Resultados: La población de estudio fue de 154 personas (76,6% mujeres). La salud percibida fue significativamente mejor (p<0,001) en el GE que en el GC, tanto a los 3meses de seguimiento (7,4 versus 5,0, respectivamente) como a los 6(7,1 versus 4,6, respectivamente). Hubo una fuerte asociación entre percepción de salud y cumplimiento (coeficiente de regresión 3,0 [IC del 95%=2,5-3,4]). La asociación entre la EM y el cumplimiento terapéutico se mantuvo tras ajustes multivariados (OR a 6meses=383,6 [IC del 95% = 31,0-4.742,4]). Conclusiones: la incorporación de la EM como complemento de los tratamientos de fisioterapia es una herramienta factible y efectiva para mejorar el cumplimiento de las pautas domiciliarias y la percepción subjetiva de salud. (AU)

Objective: To evaluate the effectiveness of motivational interviewing (MI) combined with the usual physiotherapy treatment in patients with back musculoskeletal disorders (MSD) in primary care (PC). Methods: Quasi-experimental study with 2groups with therapeutic action (control group and experimental group) and prospective follow-up, in a physiotherapy unit in PC, in patients who began their treatment in 2020, with a medical diagnosis of MSD in the back. MI was used only in the face-to-face visits of the experimental group. Both groups were interviewed by telephone about 3and 6months after finishing the physiotherapy treatment. For this purpose, the Barthel scale was used for the subjective perception of the state of health, and the scale of compliance with home guidelines. Linear (regression coefficient, 95% CI) and logistic (OR, 95% CI) regression models were fitted. Results: The study population was 154 people (76.6% women). Perceived health was significantly better (P<.001) in the experimental group than in the control group, both at 3(7.4 versus 5.0, respectively) and at 6months of follow-up (7.1 versus 4.6, respectively). There was a strong association between perceived health and compliance (regression coefficient 3.0 [95% CI=2.5–3.4]). The strong association between MI and treatment adherence was maintained after multivariate adjustments (6-month OR=383.6 [95% CI 31.0–4742.4]). Conclusions: MI is a feasible and effective complement to physiotherapy treatments to improve compliance with home recommendations and subjective perception of health. (AU)

Salud mental asociada a la pandemia de COVID-19 en estudiantes de fisioterapia de la Universidad Nacional Autónoma de México / Mental health associated with the COVID-19 pandemic in physiotherapy students at the National Autonomous University of Mexico

Antecedentes y objetivo: A nivel mundial la pandemia por el COVID-19 ha interrumpido el aprendizaje de más de mil millones de estudiantes, quienes reportan alteraciones en la salud mental, niveles altos de estrés académico y carga de trabajo. En la Licenciatura en Fisioterapia de la Universidad Nacional Autónoma de México, 331 estudiantes dejaron de asistir a clases presenciales indispensables para su formación académica y, tras un año de confinamiento, se desconoce el impacto psicológico y académico en esta población. El objetivo fue evaluar la salud mental, carga de trabajo y estrés académico de los estudiantes e identificar la asociación entre variables. Materiales y métodos: Se aplicó el Cuestionario de Salud Emocional por la Pandemia de COVID-19 - Fisioterapia, la escala de carga de trabajo UNIPSICO Battery y el Cuestionario de estrés estudiantil COVID-19. Se incluyeron los alumnos inscritos entre el primer y cuarto año de la Licenciatura en Fisioterapia de la Universidad Nacional Autónoma de México mayores de 18 años que contestaron la encuesta vía online y otorgaron su consentimiento informado. Resultados: El 62,7% de los estudiantes reportaron ansiedad, el 61,8% reportaron depresión, el 51,0% indicaron una percepción moderada del estrés académico y el 42,2% percibieron una carga de trabajo alta. La ansiedad y depresión tuvieron una asociación estadísticamente significativa con el estrés académico y carga de trabajo (p<0,05). Conclusiones: El estudio evidencia los efectos psicológicos y académicos derivados de la pandemia del COVID-19 en estudiantes de fisioterapia, que amerita medidas de intervención fisioterapéuticas y académicas que mitiguen los efectos del confinamiento.(AU)

Background and objective: Worldwide, the COVID-19 pandemic has disrupted the learning of over a billion students, who report mental health disorders, high levels of academic stress, and workload. In the bachelor's degree in physical therapy at the National Autonomous University of Mexico, 331 students stopped attending essential face-to-face classes for their academic training, and after a year of confinement, the psychological and academic impact on this population is unknown. The objective was to evaluate the mental health, workload, and academic stress of students in the bachelor's degree and identify the association between variables. Materials and methods: The Emotional Health Questionnaire for the COVID-19 pandemic – physical therapy was applied, including the UNIPSICO battery workload scale and the COVID-19 student stress questionnaire. Students enrolled between the first and fourth year of the Bachelor's degree in Physical Therapy at the National Autonomous University of Mexico over 18 years old who completed the survey online and provided informed consent were included. Results: 62.7% of students reported anxiety, 61.8% reported depression, 51.0% indicated a moderate perception of academic stress, and 42.2% perceived a high workload. Anxiety and depression had a statistically significant association with academic stress and workload (P<.05). Conclusions: The study demonstrates the psychological and academic effects of the COVID-19 pandemic on physical therapy students, which warrants physiotherapeutic and academic intervention measures to mitigate the effects of confinement.(AU)

Efectividad de los protocolos de fisioterapia para pacientes con dolor lumbar crónico. Una revisión sistemática / Effectiveness of physiotherapy protocols for patients with chronic low back pain: A systematic review

Introducción: El dolor lumbar crónico es una de las principales causas de incapacidad laboral en el mundo. Requiere un abordaje interdisciplinario para la evolución del paciente. Hasta el momento, no existe consenso en el manejo del dolor lumbar crónico, lo que generó la inquietud de esta revisión sistemática. Objetivo: Identificar la efectividad de los protocolos de fisioterapia en el manejo del dolor lumbar crónico. Metodología: Se realizó una búsqueda sistemática en las bases de datos Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari y LILACS, Google Scholar, Teseo y PROSPERO, desde el inicio de las bases hasta agosto de 2021. Los criterios de selección se definieron según la intervención y el tema del artículo. Resultados: Se incluyeron 26 estudios en la síntesis cualitativa, se excluyeron artículos que no cumplieran con los criterios de inclusión. Se encontró efecto en el control del dolor y la disminución de la discapacidad y las principales intervenciones son: fortalecimiento muscular del Core y miembros inferiores, estiramiento de miembros inferiores, movilidad lumbopélvica y educación o escuela de espalda. La frecuencia en el tratamiento osciló entre 2 y 3 veces por semana durante 5 semanas. Conclusiones: Se encontró mayor efectividad en el tiempo de control del dolor y la disminución de la discapacidad, relacionados principalmente con el fortalecimiento muscular del Core y las estrategias educativas.(AU)

Introduction: Chronic low back pain is one of the main causes of incapacity for work in the world. It requires an interdisciplinary approach for the evolution of the patient. Until now, there is no consensus on the management of chronic low back pain, which generated the concern of this systematic review. Aim: To identify the effectiveness of physiotherapy protocols in the management of chronic low back pain. Methodology: A systematic search was carried out in the Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari and LILACS, Google Scholar, Teseo and PROSPERO databases, from the beginning of the databases until August, 2021. The selection criteria were defined according to the intervention and topic of the article. Results: Twenty-six studies were included in the qualitative synthesis, articles that did not meet the inclusion criteria were excluded. An effect was found in the control of pain and the reduction of disability and the main interventions are: muscular strengthening of the core and lower limbs, stretching of the lower limbs, lumbopelvic mobility and education or back school. The treatment frequency ranged from 2 to 3 times per week for 5 weeks. Conclusions: Greater effectiveness was found in pain control time and disability reduction, mainly related to core muscle strengthening and educational strategies.(AU)