Análisis de la presión plantar durante la carrera en el sitio en diferentes superficies / Analysis of Plantar Pressure during the Running in Place over Different Surfaces

El objetivo de este trabajo es evaluar en 36 corredores aficionados, la fuerza y las presiones del pie sobre tres superficies comúnmente empleadas para el entrenamiento de la carrera en el sitio (césped artificial, suelo técnico de caucho y trampolín plano). Los valores de fuerza y presión se registraron mediante plantillas instrumentadas (Gebiomized® Munster, Germany). Se obtuvieron los siguientes parámetros: Fuerza máxima (N) y picos de presión (N/cm2) en 6 zonas específicas del pie. Según los resultados, la fuerza máxima ejercida por el pie dominante en césped artificial (657 N) y en suelo técnico de caucho (692,5 N) fue significativamente superior al registrado sobre el trampolín (262 N). Respecto a la presión, la mayor parte de la presión ejercida por el pie en superficies duras (césped artificial y suelo técnico de caucho), se observó en las cabezas de los metatarsianos, mientras que en el trampolín la presión se repartió entre estas y el calcáneo. (AU)

The objective of this study is to evaluate the Maximum Force and Peak Pressure of the foot on three surfaces commonly used for running in place training (artificial turf, rubber floor and flat trampoline). Force and pressure were recorded in 36 amateur runners using instrumented insoles (Gebiomized® Munster, Germany). The following parameters were obtained: Maximum Force (N) and Peak Pressure (N/cm2) in 6 specific areas of the foot. According to the results, the maximum force exerted by the dominant foot on artificial turf (657 N) and rubber floor (692.5 N) was significantly higher than the recorded on the trampoline (262 N). Regarding the pressure, most of the pressure exerted by the foot on hard surfaces (artificial turf and technical floor), was observed in the heads of the metatarsals, while in the trampoline the pressure was distributed in the heads of the metatarsals and the calcaneus. (AU)

Activación muscular de la extremidad inferior durante la carrera / Lower Limb Muscle Activation During Running

El objetivo del presente estudio es comprobar las diferencias en los patrones de activación muscular de la extremidad inferior entre las distintas modalidades de carrera (velocidad, medio fondo y fondo) al aire libre, observando determinados parámetros de activación muscular y espacio-temporales en las fases de contacto inicial y despegue. Se obtuvo como resultados diferencias significativas en la actividad muscular del Bíceps Femoral, en la fase de contacto inicial entre mediofondistas y fondistas (p=0,02), y en determinadas variables espaciotemporales. Los resultados muestran la existencia de diferencias en los patrones de activación muscular de la extremidad inferior y en ciertos parámetros espaciotemporales durante la carrera al aire libre. (AU)

The objective of the present study was to verify the differences in the lower limb muscle activation patterns between the different running modalities (sprinters, middle distance runners and long distance runners) during outdoor running, observing certain muscle and spatiotemporal activation parameters in the initial contact and toe off phases. Results suggest significant differences in the muscular activity of the Biceps Femoris in the initial contact phase between middle distance runners and long distance runners (p = 0.02), and in certain spatiotemporal variables. These results show differences in the lower limb muscle activation patterns and in certain spatiotemporal parameters during outdoor running. (AU)

Efecto del vendaje neuromuscular a corto plazo sobre el equilibro y la marcha en la enfermedad de Parkinson: estudio piloto / Short-term effect of neuromuscular bandaging on balance and gait in Parkinson's disease: Pilot study

Introducción: La enfermedad de Parkinson es un proceso neurodegenerativo progresivo e irreversible caracterizado por temblor de reposo, bradicinesia, rigidez y alteraciones del control postural, del equilibrio y de la marcha. El vendaje neuromuscular tiene un efecto de estimulación somatosensorial, con beneficios en el control postural. Método: Estudio piloto con grupo de intervención fisioterapia y grupo experimental (se añade el vendaje neuromuscular) en gastrocnemios y paravertebrales lumbares. Variables: escala de Berg, escala de Tinetti (subescala marcha), test 10m, TUG test, PDQ-39 y registro electromiográfico de gastrocnemios. Se realizaron 3 mediciones: T0 (basal), T1 (2 días postintervención) y T2 (a la semana postintervención); el PDQ-39 se administró en T0 y al mes postintervención. Resultados: Trece voluntarios (estadio III Hoehn y Yahr) fueron seleccionados tras aplicar los criterios de inclusión (9 mujeres y 4 varones). N=7 grupo experimental y N=6 grupo fisioterapia. El contraste intra-grupos mostró mejoras significativas a favor del grupo experimental en la escala de Berg (T1 y T2), la prueba de 10m (T2) y en la menor actividad muscular media de gastrocnemios (T1). El contraste inter-grupos evidenció, únicamente, diferencias en el registro electromiográfico de la contracción muscular del miembro inferior derecho, tras la aplicación del vendaje neuromuscular, en T1. Conclusiones: La aplicación del vendaje neuromuscular en los erectores del raquis lumbar y los gastrocnemios de manera bilateral, podría mejorar la marcha y el equilibrio, en sujetos con enfermedad de Parkinson en el estadio III de Hoehn y Yahr, pero su efecto no es superior al tratamiento fisioterápico convencional.(AU)

Introduction: Parkinson's disease is a progressive and irreversible neurodegenerative process characterized by tremor at rest, bradykinesia, stiffness, disorders in postural control, balance and gait. Kinesiology tape has a somatosensory stimulating effect, with benefits in postural control. Method: A pilot study with a Physiotherapy Intervention Group and an Experimental Group (kinesiology tape was added) in gastrocnemius and lumbar spinal erectors. Outcome assessments were Berg scale, Tinetti scale (walking subscale), 10m test, TUG test, PDQ-39 and gastrocnemius electromyographic record. Three measurements were made: T0 (baseline), T1 (two days post-intervention) and T2 (one week post-intervention); PDQ-39 was administered at T0 and one month after the intervention. Results: Thirteen participants (stage III Hoehn and Yahr) were selected after applying the inclusion criteria (nine women and four men). N=7 Experimental Group and N=6 Physiotherapy Group. The intra-group contrast showed significant improvements in favor of the Experimental Group in Berg scale (T1 and T2), 10m test (T2) and in lower mean gastrocnemius muscle activity (T1). The inter-group contrast only evidenced differences in electromyographic recording of the muscle contraction of the right lower limb, after the application of kinesiology tape, in T1. Conclusions: The application of kinesiology tape in the lumbar spinal erectors and gastrocnemius bilaterally could improve gait and balance, in subjects with Parkinson's disease in Hoehn and Yahr stage III, but its effect is not superior to conventional physiotherapy treatment.(AU)

[Short-term effect of neuromuscular bandaging on balance and gait in Parkinson's disease: Pilot study]. / Efecto del vendaje neuromuscular a corto plazo sobre el equilibro y la marcha en la enfermedad de Parkinson: estudio piloto.

INTRODUCTION: Parkinson's disease is a progressive and irreversible neurodegenerative process characterized by tremor at rest, bradykinesia, stiffness, disorders in postural control, balance and gait. Kinesiology tape has a somatosensory stimulating effect, with benefits in postural control. METHOD: A pilot study with a Physiotherapy Intervention Group and an Experimental Group (kinesiology tape was added) in gastrocnemius and lumbar spinal erectors. Outcome assessments were Berg scale, Tinetti scale (walking subscale), 10m test, TUG test, PDQ-39 and gastrocnemius electromyographic record. Three measurements were made: T0 (baseline), T1 (two days post-intervention) and T2 (one week post-intervention); PDQ-39 was administered at T0 and one month after the intervention. RESULTS: Thirteen participants (stage III Hoehn and Yahr) were selected after applying the inclusion criteria (nine women and four men). N=7 Experimental Group and N=6 Physiotherapy Group. The intra-group contrast showed significant improvements in favor of the Experimental Group in Berg scale (T1 and T2), 10m test (T2) and in lower mean gastrocnemius muscle activity (T1). The inter-group contrast only evidenced differences in electromyographic recording of the muscle contraction of the right lower limb, after the application of kinesiology tape, in T1. CONCLUSIONS: The application of kinesiology tape in the lumbar spinal erectors and gastrocnemius bilaterally could improve gait and balance, in subjects with Parkinson's disease in Hoehn and Yahr stage III, but its effect is not superior to conventional physiotherapy treatment.

Manual therapy in adults with tension-type headache: A systematic review.

INTRODUCTION: Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache. DEVELOPMENT: We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients' well-being and improving the outcome measures analysed. CONCLUSIONS: Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach.

Terapia manual en adultos con cefalea tensional: revisión sistemática / Manual therapy in adults with tension-type headache: A systematic review

Introducción: La cefalea tensional es la cefalea primaria más usual, con una prevalencia elevada y unas consecuencias socioeconómicas de gran impacto. Las técnicas de terapia manual, desde la fisioterapia, son muy utilizadas en el abordaje del conjunto de síntomas que puede provocar. El propósito fue realizar una revisión sistemática sobre la efectividad de las terapias manuales y no invasivas en el tratamiento de pacientes que presentan cefalea tensional en sus actuales formas.DesarrolloSe llevó a cabo una revisión sistemática de la literatura en busca de ensayos controlados y aleatorizados. Se emplearon las siguientes bases de datos: Brain, PubMed, Web of Science, PEDro, Scopus, CINHAL y Science Direct. Se analizaron 10 estudios, todos ellos ensayos controlados y aleatorizados. Según los estudios individuales, la intervención logra mejorar la clínica, aportando bienestar al paciente y mejorando las distintas medidas de resultado analizadas.ConclusionesLa terapia manual logra efectos positivos sobre la intensidad y la frecuencia del dolor, la discapacidad, el impacto, la calidad de vida y el rango de movimiento craneocervical en adultos con cefalea tensional. No se encuentra superioridad entre una técnica con respecto a otra, siendo más efectivo el tratamiento combinado de estas. (AU)

Introduction: Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache.DevelopmentWe conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients’ well-being and improving the outcome measures analysed.ConclusionsManual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach. (AU)

Lower limb muscle activation during outdoor running: differences between sprinters, middle-distance and long-distance runners.

Running is one of the most popular sport practices in the world. However, to our knowledge, none of the previous research about the characteristics of outdoor running makes a distinction between the different modalities of runners. Sixty-five healthy runners classified in sprinters, middle distance and long-distance runners performed five series of 100 metres on the synthetic outdoor track at competition pace. Muscle activity of lower limb muscles at initial contact and toe-off, involving the gluteus medius (GMED), gluteus maximus (GMAX), biceps femoris (BF), rectus femoris (RF), tiabilis anterior (TA) and medial gastrocnemius (MGAS), and spatiotemporal parameters were analysed. Sprinters showed high percentages of muscle activity at initial contact, in particular, the TA activity was the highest. The RF activity was significantly the lowest activity registered. At toe-off, sprinters showed the highest activity in all muscles analysed. Middle-distance runners had the highest activity of GMAX, BF and MGAS during the initial contact. In long-distance runners, the GMED and RF activity during the initial contact is highlighted, showing the highest activity of this phase. Different patterns of lower limb muscle activity and spatiotemporal parameters exist depending on the modality of the runner.

[Observational gait scale for persons with lower extremity amputation. Design and content validity]. / Escala observacional de la marcha del sujeto con amputación de la extremidad inferior: diseño y validez de contenido.

INTRODUCTION: Gait pattern is altered in persons with lower extremity amputation. To assess gait pattern, it is important to use observational gait scales with a good content validity. OBJECTIVES: To design an observational gait scale and to analyze its content validity. MATERIAL AND METHODS: An expert committee was formed to obtain a version of the scale. The same committee was responsible for evaluating the scale. The content validity index (CVI) was calculated, both for each item and for the global scale. RESULTS: The main kinematic and spatiotemporal alterations were selected to design the items. The scale consists of 2sections and 25 items, with a maximum score of 35 points. An overall CVI score of 0.90 was obtained, and an index of validity for most items with values higher than 0.78. CONCLUSION: The Observational gait scale for persons with amputation of the lower extremity showed excellent content validity according to the CVI obtained. Future studies should evaluate its reliability and construct validity.

[Top-down and bottom-up approaches for the treatment of unilateral spatial neglect in stroke patients: A systematic review]. / Enfoques top-down y bottom-up para el tratamiento de la heminegligencia espacial en sujetos con ictus: revisión sistemática.

OBJECTIVE: To evaluate the effectiveness of top-down and bottom-up approaches in the rehabilitation of unilateral spatial neglect in stroke patients. METHODOLOGY: We carried out a systematic review of randomized controlled trials from January of 2013 to March of 2017. The following databases were searched: Scopus, Science Direct, Web of Science, Pubmed and CINHAL. The methodological quality, level of scientific evidence and the strength of recommendation were evaluated. RESULTS: We included 13 studies (294 subjects): nine studies (188 patients) carried out therapies with a bottom-up approach such us eye patching, virtual reality, optokinetic stimulation, transcranial magnetic stimulation and prism adaption; three studies (94 patients) evaluated therapies with a top-down approach such us visual scanning, sensory feedback and mental practice; one study incorporated both approaches. Nine of these studies showed improvements in spatial neglect scales; five of these used bottom-up approaches, another three used top-down approaches and the remaining study combined both approaches. Disability was evaluated by nine studies, and only three reported improvements. Three studies reported significant improvements in motor function in the intervention groups. CONCLUSIONS: Top-down and bottom-up approaches could improve unilateral spatial neglect, disability and motor function in patients with stroke.

Electroencephalography as a post-stroke assessment method: An updated review. / Electroencefalografía como método de evaluación tras un ictus. Una revisión actualizada.

Given that stroke is currently a serious problem in the population, employing more reliable and objective techniques for determining diagnosis and prognosis is necessary in order to enable effective clinical decision-making. EEG is a simple, low-cost, non-invasive tool that can provide information about the changes occurring in the cerebral cortex during the recovery process after stroke. EEG provides data on the evolution of cortical activation patterns which can be used to establish a prognosis geared toward harnessing each patient's full potential. This strategy can be used to prevent compensation and maladaptive plasticity, redirect treatments, and develop new interventions that will let stroke patients reach their new maximum motor levels.

Terapia robótica para la rehabilitación de la marcha en patología neurológica / Robotic systems for gait rehabilitation in neurological disorders

Objetivo. El objetivo del presente trabajo es proporcionar una clasificación y descripción de las características principales de los distintos sistemas robóticos utilizados para la rehabilitación funcional del miembro inferior. Estrategia de búsqueda. Se realizó una revisión sistemática en las siguientes bases de datos: BRAIN, IEEE, SCIENCE DIRECT, SPRINGER, JNER, PROQUEST y específicas del ámbito de la ingeniería. Selección de los estudios. El idioma de los artículos incluidos debía ser el inglés o el español, sin límite en los años de búsqueda en las diferentes bases de datos. Síntesis de resultados. La información suministrada por las distintas bases de datos permitió distinguir un total de 50 dispositivos robóticos diseñados hasta la actualidad. Estos dispositivos se clasificaron en varios niveles: a) robots de aplicación clínica o prototipos; y b) aquellos que poseen una estructura tipo exoesqueleto, sistemas de efector final o sistemas híbridos. Conclusiones. Existe una amplia variedad de dispositivos robóticos para la recuperación funcional del miembro inferior. Se debe mejorar el desarrollo de estos dispositivos, aproximándose cada vez más a los movimientos fisiológicos que el ser humano realiza durante la marcha, teniendo en cuenta no solo aspectos relacionados con la movilidad. Por último, es fundamental fomentar la elaboración de estudios con adecuado diseño metodológico y con elevados tamaños muestrales que puedan respaldar los efectos de esta modalidad de tratamiento (AU)

Objective. To describe and classify the main characteristics of the various robotic systems used for functional rehabilitation of the lower limb. Search strategy. A systematic review was conducted in the following databases: BRAIN, IEEE, SCIENCE DIRECT, SPRINGER, JNER, Proquest and databases specifically for the field of engineering. Selection of the articles. The articles had to be written in English or Spanish with no limit on publication year. Summary of results. The information provided by the various databases showed that a total of 50 robotic devices have been designed to date. These devices were classified into several levels: a) prototypes or robots for clinical application; b) those with an exoskeleton-type structure, end-effector systems or hybrid systems. Conclusions. There is a wide variety of robotic devices for lower limb recovery. The development of these devices should be improved so that they become closer to the physiological movements made by humans when walking, taking into account factors other than those related to mobility. It is essential to promote the development of appropriately-designed studies with large sample sizes that could support the effects of this treatment modality (AU)

Theories and control models and motor learning: clinical applications in neuro-rehabilitation.

INTRODUCTION: In recent decades there has been a special interest in theories that could explain the regulation of motor control, and their applications. These theories are often based on models of brain function, philosophically reflecting different criteria on how movement is controlled by the brain, each being emphasised in different neural components of the movement. The concept of motor learning, regarded as the set of internal processes associated with practice and experience that produce relatively permanent changes in the ability to produce motor activities through a specific skill, is also relevant in the context of neuroscience. Thus, both motor control and learning are seen as key fields of study for health professionals in the field of neuro-rehabilitation. DEVELOPMENT: The major theories of motor control are described, which include, motor programming theory, systems theory, the theory of dynamic action, and the theory of parallel distributed processing, as well as the factors that influence motor learning and its applications in neuro-rehabilitation. CONCLUSIONS: At present there is no consensus on which theory or model defines the regulations to explain motor control. Theories of motor learning should be the basis for motor rehabilitation. The new research should apply the knowledge generated in the fields of control and motor learning in neuro-rehabilitation.

Effectiveness of equine therapy in children with psychomotor impairment.

INTRODUCTION: Equine therapy, an intervention method that has been practiced for decades around the world, is used to treat patients susceptible to psychomotor delays. OBJECTIVES: We examine development of gross motor function compared to other psychomotor skills in patients undergoing this therapy, and analyse how this improvement affects general health status and quality of life. MATERIAL AND METHODS: The study includes 11 children with delayed psychomotor development (aged 8.82 ± 3.89; 6 boys, 5 girls). The main study variables were gross motor function (GMFM-88) and perceived quality of life (Pediatric Quality of Life Inventory, PedsQL). Three measurements were performed: before and after a period of inactivity, and once again 2 months after the second measurement, following completion of a sustained period of therapy. RESULTS: We observed significant differences in overall results on the GMFM-88 between the initial and final tests and between the intermediate and final tests. Regarding the PedsQL quality of life scale, no statistically significant results were recorded. CONCLUSIONS: Noticeable changes in motor control were recorded throughout the course of the intervention, which suggests that equine therapy may be appropriate treatment in cases of delayed psychomotor development.

Effect of ankle-foot orthosis on postural control after stroke: a systematic review.

INTRODUCTION: Stroke is currently the main cause of permanent disability in adults. The impairments are a combination of sensory, motor, cognitive and emotional changes that result in restrictions on the ability to perform basic activities of daily living (BADL). Postural control is affected and causes problems with static and dynamic balance, thus increasing the risk of falls and secondary injuries. The purpose of this review was to compile the literature to date, and assess the impact of ankle-foot orthosis (AFO) on postural control and gait in individuals who have suffered a stroke. DEVELOPMENT: The review included randomised and controlled trials that examined the effects of AFO in stroke patients between 18 and 80 years old, with acute or chronic evolution. No search limits on the date of the studies were included, and the search lasted until April 2011. The following databases were used: Pubmed, Trip Database, Cochrane library, Embase, ISI Web Knowledge, CINHAL and PEDro. Intervention succeeded in improving some gait parameters, such as speed and cadence. However it is not clear if there was improvement in the symmetry, postural sway or balance. CONCLUSIONS: Because of the limitations of this systematic review, due to the clinical diversity of the studies and the methodological limitations, 0these results should be considered with caution.

Use of virtual reality systems as proprioception method in cerebral palsy: clinical practice guideline.

INTRODUCTION: The limitations in performing functional activities in children and adolescents with cerebral palsy are important. The use of virtual reality systems is a new treatment approach that reinforces task-oriented motor learning. The purpose of this guide is to study the impact of the use of virtual reality systems in the improvement and acquisition of functional skills, and to evaluate the scientific evidence to determine the strength of recommendation of such interventions. DEVELOPMENT: All available full-text articles, regardless of their methodology, were included. The following data bases were consulted: PubMed (Medline), PEDro, EMBASE (OVID-Elsevier), Cochrane Library, Medline (OVID), CINAHL, ISI Web Knowledge. An assessment was made of methodological quality, the level of scientific evidence, and the strength of recommendations using the tools: Critical Review Form - Quantitative Studies and the Guidelines for Critical Review Form - Quantitative Studies and U.S. Preventive Services Task Force. Finally, we included 13 articles and 97 participants were recruited. We obtained significant improvements in outcome measures that assessed postural control and balance, upper limb function, the selective joint control, and gait. CONCLUSIONS: The guide has some limitations: the limited number of patients enrolled, clinical diversity and age range, as well as the methodological quality of existing trials. Virtual reality is a promising tool in the treatment of children with cerebral palsy. There is strong scientific evidence of an acceptable recommendation for the use of virtual reality systems in the treatment of cerebral palsy.

Análisis del movimiento de la extremidad superior hemiparética en pacientes con accidente cerebrovascular: estudio piloto / Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study

Introducción: Consecuentemente a la lesión neurofisiológica, los pacientes con ictus presentan limitaciones motoras principalmente en el hemicuerpo contralateral al hemisferio lesionado. El objetivo de este trabajo es cuantificar las estrategias motoras de compensación que ocurren en la extremidad superior afectada en pacientes con ictus durante la actividad de beber agua de un vaso.Material y métodos: Cuatro pacientes con ictus y cuatro sujetos controles, sin patología y diestros. El análisis del movimiento se realizó usando el sistema VICONmotion System® y el equipo de electromiografía de superficie Aurion ZeroWire®. Se analizaron los movimientos articulares del codo, el hombro y el tórax. Se realizó un análisis cualitativo de la secuencia de activación muscular. Resultados: Se observó una disminución de las amplitudes articulares en el plano sagital del codo y el hombro durante la actividad de beber en el grupo de casos; sin embargo, las amplitudes articulares del tronco y el hombro en el plano frontal fueron mayores con respecto a los sujetos controles. En cuanto a la secuencia de activación muscular, deltoides anterior, medio y posterior, se contrajeron en el grupo de pacientes conjuntamente durante la tarea, mientras que el trapecio superior mantuvo su activación durante toda la actividad. Conclusiones: El análisis cuantitativo del movimiento ofrece información cuantitativa acerca de las estrategias de compensación que realizan los pacientes con ictus, y por tanto, su relevancia clínica es importante (AU)

Introduction: As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. Material and methods: Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System® and surface electromyography equipment ZeroWire Aurion®. We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. Results: Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. Conclusions: Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant (AU)

Efectos de la vibroterapia sobre el control postural, la funcionalidad y la fatiga en pacientes con esclerosis múltiple. Ensayo clínico aleatorizado / Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients. A randomised clinical trial

Introducción: Los trastornos del equilibrio, junto con las alteraciones de la funcionalidad y la fatiga, constituyen los síntomas más incapacitantes en los pacientes con esclerosis múltiple (EM). La vibroterapia de cuerpo entero o whole body vibration (WBV), a través de la transmisión de estímulos mecánicos, se presenta como una herramienta terapéutica útil en el tratamiento de las alteraciones del control postural en diversas patologías neurológicas. El objetivo del presente estudio es valorar el efecto a corto plazo de la vibroterapia sobre el control postural, la funcionalidad y la fatiga en pacientes con EM. Material y métodos: Treinta y cuatro pacientes con EM con afectación leve-moderada, distribuidos aleatoriamente en un grupo control y un grupo experimental, participaron en el estudio. El grupo experimental fue sometido a WBV durante 5 días consecutivos (series diarias de 5 periodos de 1min de duración) a una frecuencia de 6Hz. Previamente y post-intervención, fueron realizadas valoraciones con posturografía dinámica computarizada, mediante el test de organización sensorial (SOT) y el test de control motor (MCT), así como con el test timed up and go, la escala de equilibrio de Berg, la prueba los 10 metros y la escala de severidad de fatiga de Krupp.Resultados: El análisis comparativo de datos pre y post-intervención de los grupos mostró mejoras en el grupo experimental para las condiciones SOT 1, SOT 3 y la latencia en el MCT. Realizada la comparación entre grupos, únicamente la latencia o tiempo de reacción en el MCT mejoró significativamente a favor del grupo experimental (de 173,78±12,46 a 161,25±13,64ms; p=0,04). No se registraron efectos adversos derivados (AU)

Introduction: Postural and balance disorders, functionality impairment and fatigue, are the most incapacitating problems in multiple sclerosis (MS) patients. Whole Body Vibration (WBV), through the transmission of mechanical stimuli, appears to be a useful therapeutic tool in the treatment of neurological diseases. The objective of this study is to assess the effect of the WBV on postural control, balance, functionality and fatigue in patients with MS. Material and methods: A total of 34 patients with mild-moderate MS were randomised into a control group and an intervention group. For the intervention group, the protocol consisted of 5 consecutive days, daily series of 5 periods of 1minute of duration of WBV at a frequency of 6Hz. Posturographic assessment using the Sensory Organization Test (SOT) and Motor Control Test (MCT), the Timed Get Up and Go Test, 10 metres Test, the Berg Balance Scale and Krupp's Fatigue Severity Scale were used before and after intervention. Results: The analysis showed improvements in the intervention group for conditions SOT 1, SOT 3 and latency in MCT. In the comparison between groups, only the latency or reaction time in MCT improved significantly in favour of the intervention group (from 173.78±12.46 to 161.25±13.64ms; P=.04). No side-effects were found. Conclusions: The results of this pilot study show that WBV can improve, in the short-term, the time of response to recover the uprightness after sudden disturbances, appearing as a possible therapeutic tool maintaining balance and posture (AU)

[Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study]. / Análisis del movimiento de la extremidad superior hemiparética en pacientes con accidente cerebrovascular: estudio piloto.

INTRODUCTION: As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. MATERIAL AND METHODS: Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System(®) and surface electromyography equipment ZeroWire Aurion(®). We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. RESULTS: Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. CONCLUSIONS: Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant.

[Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients. A randomised clinical trial]. / Efectos de la vibroterapia sobre el control postural, la funcionalidad y la fatiga en pacientes con esclerosis múltiple. Ensayo clínico aleatorizado.

INTRODUCTION: Postural and balance disorders, functionality impairment and fatigue, are the most incapacitating problems in multiple sclerosis (MS) patients. Whole Body Vibration (WBV), through the transmission of mechanical stimuli, appears to be a useful therapeutic tool in the treatment of neurological diseases. The objective of this study is to assess the effect of the WBV on postural control, balance, functionality and fatigue in patients with MS. MATERIAL AND METHODS: A total of 34 patients with mild-moderate MS were randomised into a control group and an intervention group. For the intervention group, the protocol consisted of 5 consecutive days, daily series of 5 periods of 1 minute of duration of WBV at a frequency of 6 Hz. Posturographic assessment using the Sensory Organization Test (SOT) and Motor Control Test (MCT), the Timed Get Up and Go Test, 10 metres Test, the Berg Balance Scale and Krupp's Fatigue Severity Scale were used before and after intervention. RESULTS: The analysis showed improvements in the intervention group for conditions SOT 1, SOT 3 and latency in MCT. In the comparison between groups, only the latency or reaction time in MCT improved significantly in favour of the intervention group (from 173.78±12.46 to 161.25±13.64 ms; P=.04). No side-effects were found. CONCLUSIONS: The results of this pilot study show that WBV can improve, in the short-term, the time of response to recover the uprightness after sudden disturbances, appearing as a possible therapeutic tool maintaining balance and posture.

Modular control of mediolateral postural sway.

Is voluntary motor control of mediolateral rhythmic sway ruled by modular organization? Answering this question has potential implications in diagnosis and rehabilitation of neurologically impairments. Superficial EMG and computerized dynamic posturography has been used in this study to investigate modular control of six healthy subjects. Postural movements have been performed at three different frequencies to also test the influence of speed on the composition of synergies and activations. Results showed that two synergies account for more than 75% of EMG variance and are shared by all subjects across all frequency conditions. These evidences, together with a functional interpretation of computed muscle synergies, support the existence of consistent modular control across healthy subjects during mediolateral voluntary movements.