Efectos en población sana de la terapia con oscilación de alta frecuencia sobre la pared torácica (HFCWO) a nivel de la dinámica de gases pulmonares y de la mecánica respiratoria / Effects of high frequency chest wall oscillatory (HFCWO) therapy on gas exchange and ventilation in healthy participants

Introducción La fisioterapia respiratoria es parte imprescindible del tratamiento de las patologías hipersecretoras o con compromiso de la capacidad tusígena. Hasta el momento se desconoce el efecto del dispositivo de terapia de oscilación de alta frecuencia en la pared torácica (HFCWO) sobre la fuerza de los músculos respiratorios y los efectos sobre la mecánica respiratoria y la dinámica de los gases respiratorios. Por ello, el objetivo de este estudio fue describir estos tres aspectos en sujetos sanos. Métodos Se midió la fuerza de los músculos respiratorios en 25 sujetos antes e inmediatamente después de terapia con HFCWO. Durante la sesión, se midieron continuamente los parámetros de ventilación, la dinámica de los gases respiratorios y la frecuencia cardiaca. Se llevaron a cabo dos sesiones idénticas por sujeto, separadas 24h. Se registraron los síntomas durante la sesión y las molestias experimentadas mediante escala analógica visual (EVA). Resultados La terapia con HFCWO produce un incremento de la ventilación asociado con una alteración de la dinámica de los gases respiratorios. También se aumenta la frecuencia cardiaca, sin modificación de la oxigenación tisular. No se observaron efectos sobre la fuerza de los músculos respiratorios. Hasta un 20% de los participantes indicó molestias importantes (EVA≥5/10) durante la sesión. Conclusiones Durante la aplicación de HFCWO en sujetos sanos se produce incremento en la ventilación y ritmo cardiaco. Sin embargo, aparecen efectos indeseables sobre la dinámica de los gases respiratorios y un grado elevado de intolerancia por parte de los voluntarios y no hay efectos sobre la fuerza de los músculos respiratorios (AU)

Introduction Chest physiotherapy is an essential part of the treatment of respiratory diseases with increased respiratory secretion and ineffective cough. To date, there have been no studies on the effect of high frequency chest wall oscillatory (HFCWO) therapy on respiratory muscle strength, ventilation and gas exchange. The aim of this study was therefore to assess these three factors in healthy participants. Methods Respiratory muscle strength was measured before and immediately after HFCWO therapy in 25 healthy participants. During the treatment, we continuously measured ventilation parameters, gas exchange, oxygen saturation and heart rate. All participants underwent HFCWO sessions twice (with 24hours difference) with the same procedure. Symptoms during the session and discomfort were measured with the visual analog scale (VAS). Results HFCWO therapy produced a change in breathing pattern with increased ventilation associated with altered gas exchange. Heart rate also increased, with no changes in oxygenation. There was no effect, either beneficial or deleterious, on the strength of respiratory muscles. Up to 20% of participants reported substantial discomfort (VAS≥5/10) during the session. Conclusions This study shows that, during the application of HFCWO therapy in healthy participants, ventilation and heart rate increased. However, there were undesirable effects on gas exchange with a high degree of intolerance among volunteers, with no effects on respiratory muscle strength (AU)

[Effects of high frequency chest wall oscillatory (HFCWO) therapy on gas exchange and ventilation in healthy participants]. / Efectos en población sana de la terapia con oscilación de alta frecuencia sobre la pared torácica (HFCWO) a nivel de la dinámica de gases pulmonares y de la mecánica respiratoria.

INTRODUCTION: Chest physiotherapy is an essential part of the treatment of respiratory diseases with increased respiratory secretion and ineffective cough. To date, there have been no studies on the effect of high frequency chest wall oscillatory (HFCWO) therapy on respiratory muscle strength, ventilation and gas exchange. The aim of this study was therefore to assess these three factors in healthy participants. METHODS: Respiratory muscle strength was measured before and immediately after HFCWO therapy in 25 healthy participants. During the treatment, we continuously measured ventilation parameters, gas exchange, oxygen saturation and heart rate. All participants underwent HFCWO sessions twice (with 24hours difference) with the same procedure. Symptoms during the session and discomfort were measured with the visual analog scale (VAS). RESULTS: HFCWO therapy produced a change in breathing pattern with increased ventilation associated with altered gas exchange. Heart rate also increased, with no changes in oxygenation. There was no effect, either beneficial or deleterious, on the strength of respiratory muscles. Up to 20% of participants reported substantial discomfort (VAS≥5/10) during the session. CONCLUSIONS: This study shows that, during the application of HFCWO therapy in healthy participants, ventilation and heart rate increased. However, there were undesirable effects on gas exchange with a high degree of intolerance among volunteers, with no effects on respiratory muscle strength.

Nuevos datos normativos de la versión española de la Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) forma A / New normative data from the Spanish-language version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), form A

INTRODUCCIÓN: Repeatable Battery for the Asessment of Neuropsychological Status (RBANS) es utilizada habitualmente en la práctica clínica para la evaluación de funciones cognitivas. Se caracteriza por su corta duración, 20-30 minutos de administración, por la ausencia de efecto aprendizaje, dispone de 4 versiones paralelas y por su capacidad discriminativa de diferentes enfermedades. Se presentan datos normativos de la RBANS-E (versión española forma A de la batería) para población española de 20-89 años. MÉTODOS: Seiscientos nueve individuos accedieron a participar. Se les sometió a una valoración previa mediante anamnesis que incluía el Mini Mental State Examination como instrumento de cribado cognitivo y la Blessed Disability Rating Scale como escala funcional. A los 609 sujetos sanos de entre 20 y 89 años de edad se les administró la batería RBANS-E en una sola sesión. RESULTADOS: Los resultados muestran la influencia de la escolaridad en las puntuaciones de todos los subtest. No se observa influencia del género en ninguno de ellos. CONCLUSIONES: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación cognitiva de población joven y adulta

INTRODUCTION: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used in clinical practice to evaluate cognitive function. It is quick to administer (20-30 minutes) and is not influenced by a learning effect. The RBANS includes 4 parallel versions and has a high discriminative ability. Our study provides normative data from the RBANS-E (Spanish-language version of RBANS form A) for a Spanish population aged 20 to 89 years. METHODS: The study included 609 subjects aged 20 to 89 years. Participants were evaluated at baseline with a short interview, a cognitive screening test (Mini-Mental State Examination), and a functional scale (Rapid Disability Rating Scale). The RBANS-E was then administered to all 609 participants. RESULTS: Our results show the influence of education on all subtest scores. Sex was observed to have no impact on any subtest. CONCLUSION: Our study provides highly useful normative data for the cognitive evaluation of young and adult populations

New normative data from the Spanish-language version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), form A. / Nuevos datos normativos de la versión española de la Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) forma A.

INTRODUCTION: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used in clinical practice to evaluate cognitive function. It is quick to administer (20-30minutes) and is not influenced by a learning effect. The RBANS includes 4 parallel versions and has a high discriminative ability. Our study provides normative data from the RBANS-E (Spanish-language version of RBANS form A) for a Spanish population aged 20 to 89 years. METHODS: The study included 609 subjects aged 20 to 89 years. Participants were evaluated at baseline with a short interview, a cognitive screening test (Mini-Mental State Examination), and a functional scale (Rapid Disability Rating Scale). The RBANS-E was then administered to all 609 participants. RESULTS: Our results show the influence of education on all subtest scores. Sex was observed to have no impact on any subtest. CONCLUSION: Our study provides highly useful normative data for the cognitive evaluation of young and adult populations.

Diagnostic validity of the Alzheimer's disease functional assessment and change scale in mild cognitive impairment and mild to moderate Alzheimer's disease.

BACKGROUND: The Alzheimer's Disease Functional Assessment and Change Scale (ADFACS) is a functional assessment instrument widely used in clinical research. AIMS: To test the diagnostic and concurrent validity of the Spanish version of this scale and to describe the functional deficit pattern for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. METHODS: The ADFACS, the Interview for Deterioration in Daily Living Activities in Dementia (IDDD), and the Mini Mental State Examination (MMSE) were administered to 146 control subjects (CS) and 165 patients (67 MCI and 98 AD). Nonparametric tests were used to compare the diagnostic groups. Cronbach's α and correlations with the MMSE and the IDDD were calculated. Sensitivity, specificity and predictive values were studied. RESULTS: The ADFACS had a high internal consistency (α = 0.95). Three cutoff points of 1, 4, and 17 were provided to separate CS and MCI patients, MCI and mild AD patients, and mild AD and moderate AD patients, respectively. The ADFACS strongly correlated with functional (IDDD, 0.927) and cognitive (MMSE, 0.747) measures. A similar pattern of dysfunction, but in different grades, was found for the MCI and AD groups. CONCLUSION: The ADFACS is a reliable, valid, and sensitive instrument to assess functional abilities; it is useful in dementia assessment for elderly populations.