The association between sleep quality, low back pain and disability: A prospective study in routine practice.

BACKGROUND: The objective of this study was to estimate the association between sleep quality (SQ) and improvements in low back pain (LBP) and disability, among patients treated for LBP in routine practice. METHODS: This prospective cohort study included 461 subacute and chronic LBP patients treated in 11 specialized centres, 14 primary care centres and eight physical therapy practices across 12 Spanish regions. LBP, leg pain, disability, catastrophizing, depression and SQ were assessed through validated questionnaires upon recruitment and 3 months later. Logistic regression models were developed to assess: (1) the association between the baseline score for SQ and improvements in LBP and disability at 3 months, and (2) the association between improvement in SQ and improvements in LBP and disability during the follow-up period. RESULTS: Seventy-three per cent of patients were subacute. Median scores at baseline were four points for both pain and disability, as assessed with a visual analog scale and the Roland-Morris Questionnaire, respectively. Regression models showed (OR [95% CI]) that baseline SQ was not associated with improvements in LBP (0.99 [0.94; 1.06]) or in disability (0.99 [0.93; 1.05]), although associations existed between 'improvement in SQ' and 'improvement in LBP' (4.34 [2.21; 8.51]), and 'improvement in SQ' and 'improvement in disability' (4.60 [2.29; 9.27]). CONCLUSIONS: Improvement in SQ is associated with improvements in LBP and in disability at 3-month follow-up, suggesting that they may reflect or be influenced by common factors. However, baseline SQ does not predict improvements in pain or disability. SIGNIFICANCE: In clinical practice, sleep quality, low back pain and disability are associated. However, sleep quality at baseline does not predict improvement in pain and disability.

Eficacia de un programa intensivo y continuado de fisioterapia para la mejoría clínica en pacientes con enfermedad de Parkinson / Efficacy of an intensive and continued program of physiotherapy for the clinical improvement in patients with Parkinson's disease

ObjetivoDemostrar el efecto beneficioso a largo plazo de la fisioterapia en pacientes de Parkinson.DiseñoEstudio prospectivo, controlado, doble ciego.LugarAsociación Enfermos de Parkinson, Astorga (España).Participantes26 pacientes (69,50±10,34 años) fueron evaluados aplicando la escala Unified Parkinson's Disease Rating Scale (UPDRS).IntervenciónGrupo control (n=9, terapia farmacológica), grupo experimental (n=17, fisioterapia y tratamiento farmacológico).Medidas realizadasAnálisis de los resultados obtenidos del examen motor en la escala UPDRS.Resultados y discusiónSon presentados usando el software SPSS® 16.0. Las medidas de tendencia central en la puntuación global registradas en la estadios pre y postintervención fueron: fase on, la media pasó de 64,22±16,383 antes de la intervención fisioterapéutica a 50,89±19,499 después de la intervención; fase off, el valor de la media pasó de 85,78±12,549 a 75,78±17,745, respectivamente. Si incrementamos el rango a 7–12 sesiones los resultados en el examen motor son más altos, lo cual indica que la rigidez, postura, equilibrio y marcha mejoran y que esta mejoría es más prolongada en el tiempo.ConclusiónLa relevancia clínica de los programas de rehabilitación para paciente con enfermedad de Parkinson (EP) es estimada como suficiente si los siguientes criterios están presentes: efectividad, importancia en la vida diaria, efecto a largo plazo, frecuencia y seguimiento de la terapia, duración de las sesiones, cambios en la calidad de vida, intervalo entre el cuestionario y la medicación; lo relevante nuestro trabajo es haber demostrado la eficiencia a largo plazo de un programa de fisioterapia en EP (AU)

ObjectiveTo demonstrate the long-term beneficial effect of physiotherapy in patients with Parkinson's Disease.DesignA prospective, controlled, double-blind study.SettingAssociation of Parkinson disease Patients. Astorga (Spain).Participants26 patients (69.50±10.34 years of age) were evaluated applying the Unified Parkinson's Disease Rating Scale (UPDRS).InterventionControl group (n=9, drug treatment), experimental group (n=18, physiotherapy and drug treatment).Main outcome measuresAnalysis of the results obtained from the motor examination on the UPDRS scale.ResultsThey are presented by means of the SPSS® 16.0 software. The central trend measurements in the global score recorded for the pre- and post-intervention stages were: phase on, the mean went from 64.22±16.383 before physiotherapy intervention to 50.89±19.499 after intervention; phase off, the value of the mean changed from 85.78±12.549 to 75.78±17,745, respectively. If we increase the range to 7–12 sessions, the scores for the motor examination are higher. This indicates that the rigidity, posture, postural stability and gait improve, and that such improvement is longer lasting.ConclusionThe clinical relevance of rehabilitation programs for PD patients is estimated to be sufficient if the following criteria are present: efficacy, everyday life relevance, long-term effect, therapy frequency and follow-up, duration of therapy sessions, quality of life, intervals between the questionnaire and medication. The relevance of our work is that it has demonstrated the long-term efficacy of a physiotherapy program in PD patients (AU)

Ataxia de friedreich: variabilidad fenotípica. A propósito de cuatro casos (dos parejas de hermanos) / Friedreich's Ataxia: Phenotypic variability: 4-case reports (two sets of siblings)

ObjetivoEl objetivo de este estudio es valorar la diversidad en el fenotipo clínico de la ataxia de Friedreich y la interferencia de esta enfermedad en las actividades de la vida diaria y en la calidad de vida relacionada con la salud de los sujetos que la padecen.Material y métodosEstudio longitudinal prospectivo realizado con 4 sujetos afectados de ataxia de Friedreich.ResultadosDisminución en la puntuación global de los 4 sujetos durante la duración del estudio en la medida de la independencia funcional y en el cuestionario de salud SF-36.ConclusionesEl fenotipo clínico de la ataxia de Friedreich está caracterizado por una amplia heterogeneidad; entendiendo la patogénesis de esta enfermedad y su implicación multisistémica, se puede evaluar el impacto sobre la calidad de vida de estos enfermos (AU)

ObjectiveThe objective of this study has been to evaluate diversity of the clinical phenotype of Friedreich's Ataxia and the interference that disease has in the Activities of Daily Life and in the Health Related Quality of Life of the subjects who suffer it.Material and methodsA prospective, longitudinal study conducted with four subjects affected by Friedreich's Ataxia.ResultsDecrease in the global score of the 4 subjects during the study in the Functional Independence Measure and in the Questionnaire of Health SF-36.ConclusionsThe clinical phenotype of Friedreich's Ataxia is characterized by wide heterogeneity. When the pathogenesis of this disease and its multisystem involvement is understood, it becomes possible to evaluate its impact on the quality of life of these patients (AU)

Independencia funcional para el manejo autónomo de la silla de ruedas. A propósito de un caso / Functional independence for the autonomous managing of the wheelchair. A case report

La calidad de vida de las personas con movilidad reducida se incrementa con la utilización de las diversas adaptaciones. Nuestro caso es una paciente tetrapléjica espástica que tras la intervención fisioterapéutica logra una independencia funcional en sus desplazamientos al conseguir manejar una silla de ruedas eléctrica que ha sido personalizada específicamente para sus necesidades.ResumenLa exploración física y el tratamiento fisioterapéutico son muy importantes para la obtención de esa independencia funcional en los desplazamientos de la paciente.ResumenEl periodo de intervención fue desde mayo de 2008 hasta diciembre de 2008(AU)

The quality of life of persons with limited mobility increases with the utilization of the diverse adjustments. We are presenting the case of a female patient with spastic tetraplegia who has achieved functional independence in moving after the physiotherapeutic intervention as she has been successful in handling an electrical wheelchair that has been adapted for her specific case.AbstractThe physical examination and the physiotherapy are very important to obtain this functional independence in the moving of the patient.AbstractThe intervention period was from May 2008 to December 2008(AU)

Actuación fisioterapéutica con personas en situación de dependencia. A propósito de un caso con artritis reumatoide / Physiotherapy action in dependent persons. Based on a case with rheumatoid arthritis

La labor del fisioterapeuta en la atención integral de personas dependientes constituye un pilar fundamental dentro del trabajo realizado por un equipo interdisciplinar, ya que como profesional sanitario, el fisioterapeuta aporta los conocimientos adquiridos tanto para el establecimiento de medidas de prevención y promoción de la salud de estos pacientes, como para su tratamiento. El caso que proponemos (E.R.) supone un claro ejemplo de lo expuesto. Se trata de una paciente con artritis reumatoide que ingresa en un centro de atención para minusválidos físicos por la situación de discapacidad que le produce esta enfermedad. El equipo del centro, formado por un médico general, una fisioterapeuta, un psicólogo y una enfermera, acuerda como objetivo general conseguir una mejora de la calidad de vida de esta residente. La duración del estudio fue desde febrero de 2005 hasta febrero de 2006(AU)

The work of the physiotherapists in the integral care of dependent persons is afundamental cornerstone within the work performed by an interdisciplinary team. Thisis because as a health care professional, the physiotherapist contributes to the knowledgeacquired both for the establishment of preventive measures as well as promotion of thehealth of these patients and in their treatment.The case presented herein (ER) is a clear example of the above. This deals with a femalepatient suffering rheumatoid arthritis who was admitted to a care center for physicallyhandicapped due to the situation of incapacity caused by her disease.The center’s team was formed by a general physician, physiotherapist, psychologist andnurse who established the general objective as that of achieving improvement in thequality of life of this resident.The duration of the study was from February 2005 to February 2006(AUing