The Impact of Social Distancing Due to COVID-19 on Activities of Daily Living in Parkinson's Disease.

INTRODUCTION: To explore the impact of the lockdown and social distancing measures, applied for one year, due to the COVID-19 pandemic on Activities of Daily Living in patients with Parkinson's disease, as well as to determine the association between daily performance and tasks requiring more manipulative dexterity. METHODS: Data collection was carried out between 18 January and 22 March 2021 through telephone interviews. Patients were recruited from associations of patients with Parkinson's disease in Spain. A questionnaire was designed including items from standardized tools of the Activities of Daily Living Questionnaire to measure the level of independence and from the Dexterity Questionnaire for manipulative dexterity. RESULTS: There were 126 participants aged 36-89 years, 58% of whom were male. The results of our study reveal a significant decline in almost all the ADLs assessed. There is a moderate correlation between the degree of dependence in ADLs and the difficulty in performing activities requiring manipulative dexterity. CONCLUSIONS: Social isolation related to the COVID-19 pandemic and its consequences may have contributed to an increase in the deterioration of manipulative ability, leading to a loss of ability to perform ADLs. These results show specific needs to be considered in the rehabilitation treatment of these patients.

Association of Neuropathic Pain Symptoms with Sensitization Related Symptomatology in Women with Fibromyalgia.

We aimed to analyze potential correlations between S-LANSS and PainDETECT with proxies for pain sensitization, e.g., the Central Sensitization Inventory (CSI) and pressure pain hyperalgesia (construct validity), pain-related or psychological variables (concurrent validity) in women with fibromyalgia (FMS). One-hundred-and-twenty-six females with FMS completed demographic, pain-related variables, psychological, and sensitization outcomes as well as the S-LANSS and the PainDETECT questionnaires. S-LANSS was positively associated with BMI (r = 0.206), pain intensity (r = 0.206 to 0.298) and CSI score (r = 0.336) and negatively associated with all PPTs (r = -0.180 to -0.336). PainDETECT was negatively associated with age (r = -0.272) and all PPTs (r = -0.226 to -0.378) and positively correlated with pain intensity (r = 0.258 to 0.439), CSI (r = 0.538), anxiety (r = 0.246) and depression (r = 0.258). 51.4% of the S-LANSS was explained by PainDETECT (45.3%), posterior iliac PPT (0.2%) and mastoid PPT (5.9%), whereas the 56.4% of PainDETECT was explained by S-LANSS (43.4%), CSI (10.4%), and pain intensity (2.6%). This study found good convergent association between S-LANSS and PainDETECT in women with FMS. Additionally, S-LANSS was associated with PPTs whereas PainDETECT was associated with pain intensity and CSI, suggesting that both questionnaires assess different spectrums of the neuropathic and pain sensitization components of a condition and hence provide synergistic information.

Construct validity and test-retest reliability of a free mobile application for spatio-temporal gait analysis in Parkinson's disease patients.

BACKGROUND: Mobile applications may be used to assess gait pattern deviation through mobile smartphones in people with Parkinson's disease (PD). However, few studies have investigated their psychometrics properties. RESEARCH QUESTION: To study the construct validity and test-retest reliability of the RUNZI® free mobile application in people with mild to moderate PD. METHODS: Thirty individuals were evaluated with the RUNZI® app and with the 10-meter walking test (10 MW), simultaneously. In addition, the Timed Up & Go test (TUG), Tinetti scale, and the Berg Balance Scale (BBS) were used to study the construct validity. Also, test-retest reliability of the mobile for spatio-temporal gait parameters was explored. RESULTS: The correlation indices of the 10 MW test with the RUNZI® app at fast speeds was moderate to excellent (r = .588-.957). At a comfortable speed, the correlation was excellent for walking speed (r = 0.944), moderate for steps (r = 0.780) and stride length (r = 0.760), and poor for cadence (r = .424). Results showed significant correlations between TUG and spatio-temporal gait parameters at fast and comfortable speeds. There were no significant correlations or consistent associations between Tinetti and BBS and RUNZI®. The test-retest reliability was good to excellent for parameters measured with the RUNZI®. SIGNIFICANCE: Our findings highlight specific opportunities for a free smartphone-based spatio-temporal gait analysis to serve as a complement to conventional gait analysis methods in clinical practice with a moderate to excellent construct validity with the 10 MW test and good to excellent test-retest reliability in PD patients.

Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.

OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P < 0.001). CONCLUSIONS : The presence of foot pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain.

Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity.

OBJECTIVES: To determine whether the local and referred pain from active myofascial trigger points (MTrPs) reproduce the overall spontaneous fibromyalgia syndrome (FMS) pain pattern and whether widespread pressure hypersensitivity is related to the presence of widespread active MTrPs in FMS. METHODS: Forty-four women with FMS (mean age: 47±8 y) and 50 comparable healthy women (age: 48±7 y) participated in the study. MTrPs in the temporalis, masseter, upper trapezius, splenius capitis, sternocleidomastoid, suboccipital, levator scapulae, scalene, pectoralis major, extensor carpi radialis brevis, extensor digitorum communis, gluteus maximus, piriformis, vastus medialis, and tibialis anterior muscles were explored. Pressure pain thresholds over 18 tender points specified in the 1990 American College of Rheumatology for FMS were also assessed by an assessor blinded to the condition of the participants. RESULTS: The mean±SD number of MTrPs for each woman with FMS was 11±3, of which 10±2 were active MTrPs and the remaining 1±1 were latent. Healthy controls only had latent MTrPs (mean±SD: 2±1). The combination of the referred pain patterns from active MTrPs fully reproduced the overall spontaneous clinical pain area in patients with FMS. Patients with FMS had significant lower PPT compared with controls (P<0.001). Within FMS, a significant positive correlation was found between the number of active MTrPs and spontaneous pain intensity (rs=0.455; P=0.002). CONCLUSIONS: The local and referred pain elicited from widespread active MTrPs fully reproduced the overall spontaneous clinical pain area in patients with FMS. Widespread mechanical pain hypersensitivity was related to a greater number of active MTrPs. This study suggests that nociceptive inputs from active MTrPs may contribute to central sensitization in FMS.

Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.

OBJECTIVE: The purpose of this clinical trial was to evaluate the impact of a 4-month comprehensive protocol of strengthening and flexibility exercises developed by our research group versus conventional exercises for patients with Ankylosing Spondylitis (AS) on functional and mobility outcomes. DESIGN: Randomized controlled trial. Forty-five patients diagnosed with AS according to the modified criteria of New York were allocated to control or experimental groups using a random numbers table. The control group was treated with a conventional protocol of physical therapy in AS, whereas the experimental group was treated with the protocol suggested by our research group. The conventional intervention consisted of 20 exercises: motion and flexibility exercises of the cervical, thoracic, and lumbar spine; stretching of the shortened muscles; and chest expansion exercises. The experimental protocol is based on the postural affectation of the AS and the treatment of the shortened muscle chains in these patients according to the Global Posture Reeducation (GPR) method. This intervention employs specific strengthening and flexibility exercises in which the shortened muscle chains are stretched and strengthened. The study lasted 4 mos. During this period, patients received a weekly group session managed by an experienced physiotherapist. Each session lasted an hour, and there were 15 total sessions. Changes in activity, mobility, and functional capacity were evaluated by an assessor blinded to the intervention, using the following previously validated scores from the Bath group: BASMI (tragus to wall distance, modified Schober test, cervical rotation, lumbar side flexion, and intermalleolar distance), BASDAI (The Bath Ankylosing Spondylitis Disease Activity Index), and BASFI (The Bath Ankylosing Spondylitis Functional Index). RESULTS: Both groups showed an improvement (prepost scores) in all the outcome measures, mobility measures of the BASMI index, as well as in BASFI and BASDAI indexes. In the control group, the improvement in tragus to wall distance (P=0.009) and in lumbar side flexion (P=0.02) was statistically significant. Although the rest of the outcomes also improved, they did not reach a significant level (P>0.05). In the experimental group, the improvement in all the clinical measures of the BASMI index (P<0.01) and in the BASFI index (P=0.003) was statistically significant. The intergroup comparison between the improvement (prepost scores) in both groups showed that the experimental group obtained a greater improvement than the control group in all the clinical measures of the BASMI index, except in tragus to wall distance, as well as in the BASFI index. CONCLUSIONS: The experimental protocol developed by our research group, based on the GPR method and specific strengthening and flexibility exercises of the muscle chains, offers promising results in the management of patients suffering from AS. Further trials on this topic are required.