Proprioceptive rehabilitation strategies in posttraumatic wrist injuries. Scoping review.

Background: The proprioceptive approach can effectively improve strength, mobility, edema reduction, and pain reduction, which in turn has a positive impact on functionality. Objective: To identify proprioceptive rehabilitation strategies reported in the literature in adults with traumatic wrist injuries. Methods: A scoping review was performed following the parameters of the Prisma ScR strategy. We included research with adult patients diagnosed with posttraumatic wrist injuries who used proprioceptive rehabilitation. Pain, functionality, strength, joint mobility ranges, and edema were evaluated. Results: After removing duplicates and applying the exclusion criteria, a total of 123 articles were found, which left six articles, including 125 patients. Rehabilitation protocols based on proprioceptive neuromuscular facilitation and using sensorimotor tools that promote wrist recovery have been generated. In addition, other approaches have been established, such as motor imagery, which generates a work of identification and organization of movement, improving pain and manual function. However, longer follow-ups, standardization of the instruments used during proprioceptive intervention, and increasing the observed population are needed to generate a recommendation for early intervention and cost-benefit estimates. Conclusion: Proprioceptive rehabilitation has demonstrated benefits in the recovery of the lower limb and hip or back. However, for the rehabilitation of traumatic wrist injuries, it is research pending. Well-described data and good quality designs are needed to routinely propose this strategy in the clinic.

Antecedentes: El enfoque propioceptivo puede mejorar de manera efectiva la fuerza, la movilidad, la reducción del edema y la disminución del dolor; lo que a su vez tiene un impacto positivo en la funcionalidad. Objetivo: Identificar las estrategias de rehabilitación propioceptiva reportadas en la literatura, en adultos con lesiones traumáticas de muñeca. Metódos: Se efectuó una revisión de alcance siguiendo los parámetros de la estrategia Prisma ScR. Se incluyeron investigaciones con pacientes adultos, diagnóstico de lesión postraumática de muñeca, que utilizaron rehabilitación propioceptiva. Se evaluó el dolor, la funcionalidad, la fuerza, los rangos de movilidad articular y el edema. Resultados: Se incluyeron seis artículos, que involucraron 125 pacientes al aplicar los criterios de exclusión. Se han generado protocolos de rehabilitación basados en facilitación neuromuscular propioceptiva y el uso de herramientas sensoriomotoras que promueven la recuperación de la muñeca. Además, se han establecido otros abordajes como la imaginería motora, que genera un trabajo de identificación y organización del movimiento, mejorando el dolor y la función manual. Faltan seguimientos de mayor tiempo, estandarización de los instrumentos utilizados durante la intervención propioceptiva y aumentar la población observada para generar una recomendación de intervención temprana y estimaciones entre el costo y el beneficio. Conclusión: La rehabilitación propioceptiva ha demostrado beneficios en la recuperación del miembro inferior y la cadera o espalda. Para la rehabilitación de las lesiones traumáticas de muñeca, es un pendiente de la investigación. La información bien descrita y los diseños de buena calidad son necesarios para proponer rutinariamente esta estrategia en la clínica.

Aerobic Physical Exercise for Pain Intensity, Aerobic Capacity, and Quality of Life in Patients With Chronic Pain: A Systematic Review and Meta-Analysis.

BACKGROUND: Currently, chronic pain is a disabling condition that is difficult to manage, which generates a high burden on health systems. The objective is to determine the effects of aerobic physical exercise in adults with chronic pain. METHODS: A systematic review of searches in databases including MEDLINE, LILACS, ScienceDirect, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar was conducted. The search process was carried out until July 31, 2020, and the study selection process was independently carried out through a criteria analysis for each phase. Outcome measures were chosen: aerobic capacity, physical function, quality of life, and pain. RESULTS: Twenty-seven studies were included in which aerobic exercise was considered as an option to treat chronic pain. These studies showed significant results compared with other treatment options in terms of pain measurements (-0.22 [-0.42 to -0.03]) and aerobic capacity. For quality of life, there were significant improvements in the physical function component over the mental health component evaluated with the short form health survey-36/12. CONCLUSION: Aerobic exercise is a nonpharmacological therapeutic option for treatment. Also, aerobic capacity and endurance improved when this type of exercise was prescribed, thus resulting in a substantial improvement in the quality of life of people suffering from chronic pain.

Asociación de la fuerza prensil con el riesgo cardiovascular en trabajadores sedentarios / Association of grip strength with cardiovascular risk in sedentary workers

RESUMEN Objetivo Evaluar la fuerza prensil en trabajadores sedentarios como escrutinio de riesgo cardiovascular. Método Se realizó un estudio transversal con personal administrativo. Se midió la fuerza prensil y se relacionó con las variables antropométricas, el nivel de estilo de vida adoptado por los trabajadores, estimado con la prueba FANTÁSTICO, y el nivel de Actividad física, valorado con el Cuestionario IPAQ. Resultados En 152 participantes, no se encontró asociación de la fuerza prensil con las mediciones de actividad física y estilos de vida. Tampoco con marcadores tempranos de riesgo cardiovascular. La población tenía buenos estilos de vida con alto nivel de sedentarismo. A diferencia de otras investigaciones, nuestra población tenía índices de comorbilidad muy bajos y no eran ancianos. Esto podría explicar los resultados diferentes. Conclusión La fuerza prensil no parece ser útil en las evaluaciones de programas de estilos de vida en trabajadores sedentarios adultos con bajo nivel de comorbilidades.

ABSTRACT Objective To assess prehensile strength in administrative personnel as screening for cardiovascular risk. Method A cross-sectional study was carried out with administrative personnel. Prehensile strength was measured and was related to anthropometric variables, the level of lifestyle adopted by the workers, estimated with the FANTASTIC Test, and the level of physical activity, assessed with the IPAQ Questionnaire. Results In 152 participants, no association of prehensile strength was found with physical activity and lifestyles measurements. Nor with early cardiovascular risk markers. The population had good lifestyles with a high level of sedentary behavior. Unlike other investigations, our population had very low comorbidity rates and were not elderly. This could explain the different results. Conclusion Prehensile force does not seem to be useful in evaluating lifestyle programs in administrative personnel with a low level of comorbidities.