Adaptación lingüística y cultural del Oxford Cognitive Screen (OCS) en población española / Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population

Introducción: En España el ictus es la sexta causa de discapacidad. Sus secuelas producen alteraciones motoras, sensoriales y cognitivas, que pueden minimizarse con una actuación terapéutica temprana. Por ello se necesitan instrumentos de evaluación rápida que detecten déficits en estas áreas. El Oxford Cognitive Screen Test (OCS) es un test breve diseñado para la valoración de funciones cognitivas en pacientes con ictus. Nuestro objetivo fue generar una versión española (OCS-E) realizando una adaptación lingüística y cultural.Material y métodosDiseño de validación lingüística con doble traducción y 10 reuniones de consenso del equipo investigador multidisciplinar. Tres estudios piloto administrando el test respectivamente a 5 usuarios potenciales, 23 personas sanas y 23 diagnosticadas de ictus isquémico (61%) o hemorrágico, con edades entre 31-88 años.ResultadosEl OCS-E mantiene las 10 tareas originales, la codificación de respuestas y el sistema de puntuación. Se modificaron y ampliaron las instrucciones de administración, lo que asegura la fiabilidad del contenido y de su aplicación. En 5 tareas se han modificado imágenes, números y frases. La tarea praxia se amplió para evaluar ambos miembros superiores. Los estudios piloto confirmaron que las personas de la población diana comprendían de forma adecuada las tareas, con independencia de la existencia de problemas cognitivos.ConclusionesLa adaptación cultural ha generado una versión lingüística y conceptualmente equivalente, permitiendo su estudio psicométrico y posterior aplicación en población española. El OCS-E puede ser un instrumento de cribado útil para evaluación rápida de funciones cognitivas postictus. (AU)

Introduction: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S).Material and methodsThe linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years.ResultsThe OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems.ConclusionsThe OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke. (AU)

Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population.

INTRODUCTION: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S). METHODS: The linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years. RESULTS: The OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems. CONCLUSION: The OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke.

Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population. / Adaptación lingüística y cultural del Oxford Cognitive Screen (OCS) en población española.

INTRODUCTION: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S). MATERIAL AND METHODS: The linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years. RESULTS: The OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems. CONCLUSIONS: The OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke.

Fractura en silla de montar inveterada en paciente sin traumatismo previo / Inveterate pelvic ring fracture in patient without prior trauma

La osteoporosis es una enfermedad silenciosa, que debuta en muchas ocasiones con fracturas que se localizan sobre todo en columna vertebral. Se ha considerado interesante publicar este caso no solo por su excepcionalidad, sino también para resaltar que se debe considerar la fractura por insuficiencia ósea de pelvis en el diagnóstico diferencial de la lumbalgia y coxalgia, que con tanta frecuencia vemos en las consultas de Rehabilitación (AU)

Osteoporosis is a silent disease, which often initiates with fractures located mainly in the spine. It has been consider to be of interest to publish this clinical case not only because it is exceptional, but also to consider the insufficiency fracture of the pelvis in the differential diagnosis of the low back and hip pain. This is a very common pathology in the Rehabilitation clinic (AU)

Eficacia de un programa de escuela de espalda hospitalario / Efficacy of a hospital back school program

Introducción. Las escuelas de espalda sonuna de las intervenciones utilizadas en los programas derehabilitación. El objetivo de nuestro estudio es describirlas características del programa de espalda del Hospital deSan Juan y valorar su eficacia.Material y métodos. Se incluyeron 897 pacientes con dorsalgiay/o lumbalgia, durante el período de enero de 2004 adiciembre de 2006. El programa se desarrolló en 6 sesionescolectivas a lo largo de 3 meses. Se completaron los testsde la ganancia de flexión lumbar protegida (medida como ladistancia en centímetros manos-suelo) y la mejoría subjetivaen actividades de la vida diaria (AVD) (nada, insuficienteo suficiente).Resultados y conclusiones. Completaron el protocolo261 pacientes. El programa mejora el dolor raquídeo medidocon la escala visual analógica (EVA) del dolor en 0,61 mm(intervalo de confianza [IC] 95 %: 0,32-0,9) y la ganancia deflexión lumbar protegida en 5,13 cm (IC 95 %: 4,21-6,05). Lamayoría de los pacientes mejoraron de forma suficiente(51,7 %) sin requerir ningún otro tipo de tratamiento fisioterápico.Estas mejorías encontradas fueron estadísticamen tesignificativas (p < 0,000)(AU)

Introduction. Back school is one of the interventionsused in the Rehabilitation programs. The aim of ourstudy is to describe the characteristics of a program of rachialgiaof San Juan’s Hospital, as well as its effectiveness.Methods. Eight-hundred and ninety-seven patients withdorsalgia and/or lumbalgia were included, during the periodJanuary 2004-December 2006. The program was developedin 6 collective sessions of three months’ duration. The test ofVisual Analogue Scale of the pain, the gain in flexion lumbarprotected (measured in cm as the distance between handsand ground) and the subjective improvement in activity dailylife (nothing, inadequate or sufficient) were completed.Results and conclusions. Two-hundred and sixty-one patientscompleted the protocol. The program improved 0.61 mm (IC95 % ± 0.29) of Visual Analogue Scale measuring spinal pain;5.13 cm (IC 95 % ± 0.92) improvement in protected lumbarflexion. Most patients improved sufficiently (51.7 %), withoutrequiring any other type of physiotherapy treatment. Theseimprovements were statistically significant (p < 0.000)(AU)

Actualización sobre el diagnóstico y tratamiento de la osificación heterotópica / An update on the diagnosis and management in heterotopic ossification

Objetivo. La osificación heterotópica (OH) es una complicación vinculada a diversas patologías que origina una alteración funcional significativa hasta en el 20 % de los casos. El auge de la cirugía protésica en las últimas décadas incrementa su repercusión. Se trata, por tanto, de una patología relevante frente a la que tenemos una actitud diagnóstica y terapéutica controvertida. El objetivo de este artículo es revisar los estudios publicados y establecer unas recomendaciones basadas en estos y en la experiencia de un grupo de especialistas integrado por los Servicios de Rehabilitación, Medicina Nuclear y Oncología Radioterápica de nuestro hospital. Estrategia de búsqueda. Se ha realizado una revisión de los artículos publicados entre los años 1991-2006 en las principales bases de datos (Medline, Biomedical Reference Collection Comprenhensive, MedicLatina, Cochrane, Scopus, PeDro). Síntesis de resultados y conclusiones. Se han hallado 1.932 artículos de los que se han seleccionado 215. En todas las revisiones se incide sobre el papel fundamental de la prevención. La indicación de los antiinflamatorios no esteroideos (AINE) y la radioterapia en la profilaxis primaria y secundaria de la OH es la única intervención avalada por un nivel de evidencia A. La resección de la OH en la fase madura de la misma parece la única opción terapéutica actualmente disponible. Se recomienda asociar la administración de AINE, radioterapia o incluso bifosfonatos para mejorar los resultados de la cirugía

Objective. Heterotopic ossification (HO) is a complication related to several diseases with significant functional repercussion in up to 20 % of the cases. The increase of prosthetic surgery in the last decades has increased its incidence. Therefore, this is a relevant disease in which there is no consensual diagnostic and therapeutic attitude. The objective of this article is to review the studies published and establish some recommendations based on these and on the experience of a group of specialists forming part of the Rehabilitation, Nuclear Medicine and Radiotherapist Oncology Departments of our hospital. Search strategy. We have reviewed the articles published between 1991-2006 in the main databases (Medline, Biomedical Reference collection comprehensive, MedicLatina and Cochrane, Scopus, PeDro). Synthesis of results and conclusions. A total of 1,932 articles were found, 215 of which were selected. All these studies stress the fundamental role of prevention. Nonsteroid anti-inflammatory drugs (NSAIDs) and radiotherapy are the only interventions endorsed by an A evidence level in primary and secondary prevention of HO. Resection of the ossification seems to be the only therapeutic option available at present in the mature phase. It is recommended to associate NSAIDs , radiotherapy or even bisphosphonates to improve the results of the surgery

Protective effect of viscoelastics against retina lipid peroxidation.

Viscoelastics or ophthalmic viscosurgical devices are routinely used during anterior segment surgery and also in posterior segment surgery. Studies of the harmful effects of phacoemulsification on corneal endothelial cells suggest that much of this damage is mediated by free radicals. In this study, we compare the possible effects against lipid peroxidation in the retina of three different viscoelastic substances: Viscoat, Healon and Visiol. Herein we demonstrate for the first time that viscoelastics are effective to protect the retina against lipid peroxidation, as can be seen by the slight increase of malondialdehyde in the homogenates incubated with viscoelastic exposed to light and to a temperature of 37 degrees C when compared with the control homogenates.

Tratamiento rehabilitador en el adulto con secuelas de poliomielitis / Rehabilitating treatment in the adult with poliomyelitis sequels

Introducción. Los casos de poliomielitis anterior aguda actualmente son excepcionales como resultado de la vacunación obligatoria, pero con cierta frecuencia hay que tratar a pacientes portadores de secuelas, que se pueden manifestar en el aspecto ortopédico, muscular y respiratorio. Material y métodos. Se revisaron los casos de poliomielitis remitidos al servicio de rehabilitación en los últimos 13 años. Se estudiaron las historias clínicas, y se completó el trabajo con una encuesta telefónica, para evaluar la efectividad del tratamiento recibido, mediante la mejoría subjetiva en la marcha y la disminución del dolor según la Escala Analógica Visual (EAV). Se analizaron las diversas formas clínicas de la enfermedad, el motivo de consulta, la incidencia de enfermedad ortopédica secundaria, la existencia de cirugía u ortesis previas y los resultados después del tratamiento. Resultados y discusión. Se concluye con la necesidad de un adecuado seguimiento de las secuelas ortopédicas en los pacientes con poliomielitis por parte de los servicios de rehabilitación, así como con la importancia de elaborar un censo de pacientes poliomielíticos a tal efecto

Introduction. Acute anterior poliomyelitis is presently rare as a result of the obligatory vaccination, but it is sometimes necessary to treat patients with sequels, that may be seen in the orthopedic, muscular and respiratory aspect. Material and methods. Polio cases referred to the Rehabilitation Service in the last 13 years were reviewed. We studied the clinical histories and completed the study with a telephone survey to assess the effectiveness of the treatment received by subjective improvement in gait and decrease in pain according to the Visual Analogue Scale. The different clinical forms of the disease, reason for medical visit, secondary orthopedic condition incidence, existence of surgery or previous or thesis and results after the treatment were analyzed. Results and discussion. It is concluded that adequate follow-up by the Rehabilitation Service of the orthopedic sequels is necessary in patients with poliomyelitis and that it is important to elaborate a census of poliomyelitic patients for this

Mejoría funcional tras prótesis total de codo en artritis reumatoide: a propósito de un caso / Functional improvement after total elbow prosthesis in rheumatoid arthritis: based on one case

Los pacientes afectos de artritis reumatoide (AR) juvenil a menudo precisan de una evaluación y tratamientos muy precoces, debido a severas rigideces y dolores en varias articulaciones. La artroplastia total de codo se ha convertido en una solución válida para todos aquellos pacientes con artritis reumatoide, cuya afectación de codo es lo suficientemente severa para impedirles realizar sus actividades de vida diaria. Presentamos el caso de una mujer de 36 años, cuya artritis reumatoide juvenil le había producido una rigidez articular muy severa asociada a un dolor constante, que le imposibilitaba para su vida cotidiana. Los resultados de la cirugía y el protocolo de Rehabilitación diseñado, se evaluaron mediante el test de Mayo específico para funcionalidad del codo, y el test de función clínica del miembro superior (AU)

Brown-Sequard syndrome associated with Horner's syndrome after a penetrating trauma at the cervicomedullary junction.

STUDY DESIGN: Case report of a 21-year-old man that had concurrence of Brown-Sequard syndrome and Horner's syndrome after a penetrating trauma in the neck. OBJECTIVES: This report analyzes the location of lesions that cause a combination of Horner's and Brown-Sequard syndrome. It is important to know the anatomic structure of spinal cord and the sympathetic nerve chain. SETTING: Spinal Cord Unit, Department of Physical Medicine and Rehabilitation, Hospital La Fe, Valencia, Instituto Oftalmologico de Alicante, Alicante, Spain. METHODS: Description of a single patient case report. RESULTS: The clinical findings and MRI showed a good correlation. The Horner's syndrome was confirmed with a 4% cocaine test. The patient received a conservative treatment with high-dose steroid therapy (NASCIS-3). CONCLUSION: The patient presented with Brown-Sequard syndrome and Horner's syndrome. Clinical examination and MRI made a quick and correct diagnosis. The patient recovered completely after the conservative treatment.

Bilateral lumbosacral plexopathy after mesenteric thrombosis.

OBJECTIVE: A case of lumbosacral plexopathy (LSP) following operation for mesenteric thrombosis. DESIGN: Case report of a 64-year-old man who developed weakness and numbness of the distal legs after an operation for mesenteric thrombosis. SETTING: Department of Physical Medicine and Rehabilitation, University Hospital La Fe, Valencia, Spain. SUBJECT: Single patient case report. MAIN OUTCOME MEASURE: Clinical and electromyography follow-up of the patient between October 1996 and August 1997. RESULTS: Physical examination revealed marked lower extremity weakness, hypotonia, hyporreflexia and normal bowel and bladder function. Electromyography demonstrated marked denervation of all major muscle groups, and sensory nerve conduction showed absence of responses in all peripheral nerves, in both legs. CONCLUSION: To our knowledge, bilateral LSP following an intervention of mesenteric thrombosis, has never been reported in the literature. Diagnosis of LSP might be based on electromyography and nerve conduction studies that demonstrate electrodiagnostic criteria for LSP, including denervation in muscles innervated by at least two lumbosacral segmental levels and involving at least two different peripheral nerves, without paraspinal involvement.