Grado de implementación en España de las recomendaciones terapéuticas para la hipotonía de origen central según el consenso de expertos de la AACPDM / Degree of implementation in Spain of the therapeutic recommendations for hypotonia of central origin according to the consensus of experts of the American Academy for Cerebral Palsy and Developmental Medicine

Introducción: En la primera infancia existen diferentes condiciones y síndromes neurológicos que presentan hipotonía de origen central. La American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) elaboró una guía en 2019 sobre recomendaciones terapéuticas para esta población de 0 a 6 años, basadas en un consenso de expertos y en la evidencia científica. El objetivo de este estudio fue ver cómo esas recomendaciones terapéuticas se están implementando en España. Sujetos y métodos: Se realizó una encuesta a fisioterapeutas pediátricos que tratan niños con hipotonía central de 0 a 6 años a través de un cuestionario que constaba de 31 preguntas: 10 preguntas sobre datos sociodemográficos y relativos al ejercicio de la profesión, y las 21 restantes relacionadas con el uso de las recomendaciones terapéuticas basadas en la guía de la AACPDM dirigidas a niños con hipotonía de origen central. Resultados: A partir de una muestra de 199 fisioterapeutas, se pudo objetivar que el conocimiento de la guía de la AACPDM se asociaba de forma significativa con los años de experiencia clínica, el nivel de titulación y la comunidad donde ejercen.Conclusión: Esta guía puede servir para concienciar y unificar los criterios en cuanto al abordaje terapéutico de los niños con hipotonía central. Los resultados indican que, excepto algunas técnicas, la mayoría de las estrategias terapéuticas se está implementado en nuestro país en el marco de la atención temprana.

Introduction: In early childhood, there are a number of different neurological conditions and syndromes that present with hypotonia of central origin. In 2019, the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) drew up a set of guidelines on therapeutic recommendations for the population aged from 0 to 6 years, based on the consensus of experts and on scientific evidence. The aim of this study is to determine how those therapeutic recommendations are being implemented in Spain. Subjects and methods: A survey of paediatric physiotherapists treating 0-6-year-old children with central hypotonia was carried out by means of a questionnaire consisting of 31 questions: 10 questions on sociodemographic and practice-related data, and the remaining 21 related to the use of the therapeutic recommendations based on the AACPDM guidelines for children with hypotonia of central origin. Results: From a sample of 199 physiotherapists, it was found that familiarity with the AACPDM guidelines was significantly associated with the number of years of clinical experience, level of qualification and the community in which the professionals practise. Conclusion: These guidelines can serve to raise awareness and unify criteria regarding the therapeutic approach to children with central hypotonia. The results indicate that, with the exception of a few techniques, in our country most of the therapeutic strategies are being implemented within the framework of early care.(AU)

[Degree of implementation in Spain of the therapeutic recommendations for hypotonia of central origin according to the consensus of experts of the American Academy for Cerebral Palsy and Developmental Medicine]. / Grado de implementación en España de las recomendaciones terapéuticas para la hipotonía de origen central según el consenso de expertos de la AACPDM.

INTRODUCTION: In early childhood, there are a number of different neurological conditions and syndromes that present with hypotonia of central origin. In 2019, the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) drew up a set of guidelines on therapeutic recommendations for the population aged from 0 to 6 years, based on the consensus of experts and on scientific evidence. The aim of this study is to determine how those therapeutic recommendations are being implemented in Spain. SUBJECTS AND METHODS: A survey of paediatric physiotherapists treating 0-6-year-old children with central hypotonia was carried out by means of a questionnaire consisting of 31 questions: 10 questions on sociodemographic and practice-related data, and the remaining 21 related to the use of the therapeutic recommendations based on the AACPDM guidelines for children with hypotonia of central origin. RESULTS: From a sample of 199 physiotherapists, it was found that familiarity with the AACPDM guidelines was significantly associated with the number of years of clinical experience, level of qualification and the community in which the professionals practise. CONCLUSION: These guidelines can serve to raise awareness and unify criteria regarding the therapeutic approach to children with central hypotonia. The results indicate that, with the exception of a few techniques, in our country most of the therapeutic strategies are being implemented within the framework of early care.

TITLE: Grado de implementación en España de las recomendaciones terapéuticas para la hipotonía de origen central según el consenso de expertos de la AACPDM.Introducción. En la primera infancia existen diferentes condiciones y síndromes neurológicos que presentan hipotonía de origen central. La American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) elaboró una guía en 2019 sobre recomendaciones terapéuticas para esta población de 0 a 6 años, basadas en un consenso de expertos y en la evidencia científica. El objetivo de este estudio fue ver cómo esas recomendaciones terapéuticas se están implementando en España. Sujetos y métodos. Se realizó una encuesta a fisioterapeutas pediátricos que tratan niños con hipotonía central de 0 a 6 años a través de un cuestionario que constaba de 31 preguntas: 10 preguntas sobre datos sociodemográficos y relativos al ejercicio de la profesión, y las 21 restantes relacionadas con el uso de las recomendaciones terapéuticas basadas en la guía de la AACPDM dirigidas a niños con hipotonía de origen central. Resultados. A partir de una muestra de 199 fisioterapeutas, se pudo objetivar que el conocimiento de la guía de la AACPDM se asociaba de forma significativa con los años de experiencia clínica, el nivel de titulación y la comunidad donde ejercen. Conclusión. Esta guía puede servir para concienciar y unificar los criterios en cuanto al abordaje terapéutico de los niños con hipotonía central. Los resultados indican que, excepto algunas técnicas, la mayoría de las estrategias terapéuticas se está implementado en nuestro país en el marco de la atención temprana.

[Spanish translation and validation of the Neuromuscular Module of the Pediatric Quality of Life Inventory (PedsQL): evaluation of the quality of life perceived by 5-7 years old children with neuromuscular disorders and by their parents]. / Traducción y validación al español del módulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluación de la calidad de vida autopercibida por niños de 5-7 años con enfermedades neuromusculares y sus padres.

INTRODUCTION: The recent advances in the therapies for some neuromuscular disorders imply a better prognosis. As a consequence, health-related quality of life has emerged as a core outcome. It is particularly important to know both the self-perceived health-related quality of life by children, as soon as possible, as well as the parental perception. Therefore, it is essential to have valid and specific scales for proper assessment. AIM: To assess the validity and reliability of the Spanish version of Pediatric Quality of Life Inventory (PedsQL) Neuromuscular Module for self-perceived and parent perceived quality of life of children aged 5-7 with neuromuscular disorders. SUBJECTS AND METHODS: Cross-cultural validity of the Spanish version was carried out with the permission of the Mapi-Research-Trust. Subsequently, a test-retest was administered to 27 children aged 5-7 and 37 parents in order to evaluate internal consistency, intra-observer reliability and construct validity. RESULTS: The Cronbach alpha coefficient showed good internal consistency for children and was rated as excellent by parents. Furthermore, the intra-observer correlation indicated an excellent reliability for both. Construct validity analysis suggested that a new scale structure with more dimensions might be more adequate. Moreover, said structure will also explain a greater percentage of variability. CONCLUSION: The Spanish version of PedsQL Neuromuscular Module for the self-perceived and parent-perceived quality of life of children aged 5-7 showed good internal consistency and reliability.

TITLE: Traducción y validación al español del módulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluación de la calidad de vida autopercibida por niños de 5-7 años con enfermedades neuromusculares y sus padres.Introducción. Los recientes avances en el abordaje terapéutico de las enfermedades neuromusculares pediátricas han permitido un mejor pronóstico y, en consecuencia, surge la necesidad de medir la calidad de vida relacionada con la salud como parte de un abordaje integral. Es importante disponer de instrumentos válidos y específicos para su correcta valoración que contemplen la calidad de vida relacionada con la salud tanto autopercibida por los niños como por los padres. Objetivo. Evaluar la validez y la fiabilidad de la versión española del módulo neuromuscular de la Pediatric Quality of Life Inventory (PedsQL) para la medición de la calidad de vida autopercibida por niños de 5 a 7 años con enfermedades neuromusculares y la de sus padres. Sujetos y métodos. Con autorización de Mapi-Research-Trust, se procedió a la adaptación transcultural de la versión española de la escala. Posteriormente, se realizó un test-retest a 27 niños de 5 a 7 años y a 37 padres para evaluar la consistencia interna, la fiabilidad y la validez de constructo. Resultados. El coeficiente alfa de Cronbach mostró una consistencia interna buena para los niños y excelente para los padres. La correlación intraobservador indicó una excelente fiabilidad para ambos. La validez de constructo sugirió que una estructura de más dimensiones podría ser más adecuada y explicaría un mayor porcentaje de variabilidad. Conclusiones. La versión española del módulo neuromuscular de la PedsQL para evaluar calidad de vida de niños de 5 a 7 años con enfermedades neuromusculares y de sus padres tiene buena consistencia interna y fiabilidad.

[Spanish translation and validation of the Neuromuscular Module of the Pediatric Quality of Life Inventory (PedsQL): evaluation of the quality of life perceived by 8-18 years old children with neuromuscular diseases and by their parents]. / Traduccion y validacion al español del modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluacion de la calidad de vida autopercibida por niños de 8-18 años con enfermedades neuromusculares y sus padres.

INTRODUCTION: The quality of life related to health of children with pediatric neuromuscular diseases is studied from the perspective of self-perception and parent-perception. It is therefore essential to dispose valid scales such as Pediatric Quality of Life inventory (PedsQL) Neuromuscular Module for its correct assessment. AIM: To assess the validity and reliability of the Spanish version of PedsQL Neuromuscular Module for self-perceived and parent-perceived quality of life of children aged 8-18 with neuromuscular disorders. SUBJECTS AND METHODS: The cognitive validity of the Spanish version of PedsQL was carried out with Mapi Research Trust permission. Subsequently, a test-retest was performed with 90 children volunteers with neuromuscular diseases, 50 aged 8-12 and 40 aged 13-18, and 85 of those children's parents. This allowed an evaluation of PedsQL intra-observer concordance and internal consistency. Finally, construct validity was evaluated through factor analysis. RESULTS: The Cronbach alpha and all correlation intra-observer coefficients were higher than 0.8, indicating excellent validity and reliability and a higher internal consistency. The construct validity analysis suggested that a new construct with more might be a better fit than three and it will be able to explain a higher percentage of variability. CONCLUSIONS: The Spanish version of PedsQL Neuromuscular Module for self-perceived and parent-perceived quality of life of children aged 8-18 presented excellent validity and reliability.

TITLE: Traduccion y validacion al español del modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluacion de la calidad de vida autopercibida por niños de 8-18 años con enfermedades neuromusculares y sus padres.Introduccion. La calidad de vida relacionada con la salud de los niños con enfermedades neuromusculares pediatricas se estudia desde la perspectiva de la autopercepcion y la percepcion de sus padres. Por ello, es esencial disponer de instrumentos validos, como el modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL), para su correcta valoracion. Objetivo. Evaluar la validez y fiabilidad de la version española del modulo neuromuscular de la PedsQL para la medicion de la calidad de vida autopercibida por niños de 8-18 años con enfermedades neuromusculares y por sus padres. Sujetos y metodos. Una vez autorizados por Mapi Research Trust, se procedio a la validacion cognitiva de la version española del modulo neuromuscular. Posteriormente, se realizo un test-retest a 90 niños, de los cuales 50 tenian entre 8 y 12 años y 40 tenian entre 13 y 18 años, y a 85 padres de dichos niños, lo que permitio evaluar la consistencia interna, la fiabilidad y la validez de constructo. Resultados. El coeficiente alfa de Cronbach y todos los de correlacion interclase mostraron valores superiores a 0,8, lo que indica una consistencia y una fiabilidad excelentes. La validez de constructo sugirio que una estructura de mas dimensiones podria ajustarse mejor que una de tres y explicaria un mayor porcentaje de variabilidad. Conclusiones. La version española del modulo neuromuscular de la PedsQL para la autopercepcion de la calidad de vida de ni­ños de 8-18 años con enfermedades neuromusculares y percibida por sus padres presenta una excelente validez y fiabilidad.

[Spanish translation and validation of the neuromuscular module of the Pediatric Quality of Life Inventory (PedsQL): evaluation of the quality of life perceived by the parents of 2-4-year-old children with neuromuscular diseases]. / Traduccion y validacion al español del modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluacion de la calidad de vida percibida por padres de niños de 2-4 años con enfermedades neuromusculares.

INTRODUCTION: Paediatric neuromuscular disorders, which negatively impact on children's health-related quality of life (HRQoL), are a frequent cause of parental consultation with a physiotherapist. Parents' stress overload triggers a poor perception of their children's HRQoL. For this reason, it is essential to have psychometrically sound instrument to measure parent's perceptions such as the Pediatric Quality of Life Inventory (PedsQL) Neuromuscular Module. AIM: To assess the validity and reliability of the Spanish version of PedsQL Neuromuscular Module for parent perceived quality of life of children aged 2-4 with neuromuscular disorders. SUBJECTS AND METHODS: The cognitive validity of the Spanish version of PedsQL was carried out with Mapi Research Trust permission. Subsequently, a test-retest was performed with 42 parent volunteers of children aged 2-4 with paediatric neuromuscular disorders. This allowed an evaluation of PedsQL intra-observer concordance and internal consistency. Finally, construct validity was evaluated through factor analysis. RESULTS: The Cronbach alpha and all correlation intra-observer coefficients were higher than 0.8, indicating excellent validity and reliability. The construct validity analysis presented 63.5% variability and such analysis suggested that a seven-dimension construct might be a better fit than three. CONCLUSIONS: The Spanish version of PedsQL Neuromuscular Module for parent perceived quality of life of children aged 2-4 presented excellent validity and reliability.

TITLE: Traduccion y validacion al español del modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL): evaluacion de la calidad de vida percibida por padres de niños de 2-4 años con enfermedades neuromusculares.Introduccion. Las enfermedades neuromusculares pediatricas, que repercuten negativamente en la calidad de vida relacionada con la salud de los niños, son causa frecuente de consulta de los padres al fisioterapeuta. La sobrecarga de los padres desencadena una baja percepcion de dicha calidad de vida. Por ello, es esencial disponer de instrumentos validos, como el modulo neuromuscular de la escala Pediatric Quality of Life Inventory (PedsQL) para su correcta valoracion. Objetivo. Evaluar la validez y fiabilidad de la version española del modulo neuromuscular de la PedsQL para la medicion de la calidad de vida percibida por padres de niños de 2-4 años con enfermedades neuromusculares. Sujetos y metodos. Una vez autorizados por Mapi Research Trust, se procedio a la validacion cognitiva de la version española del modulo neuromuscular. Posteriormente, se realizo un test-retest a 42 padres voluntarios de niños de 2-4 años con enfermedades neuromusculares, que permitio evaluar la consistencia interna y la concordancia intraobservador. Finalmente, la validez de constructo fue evaluada con un analisis factorial. Resultados. El coeficiente alfa de Cronbach y todos los de correlacion intercalase mostraron valores superiores a 0,8, lo que indica una consistencia y una fiabilidad excelentes. La validez de constructo explico un 63,5% de la variabilidad y sugirio que una estructura de siete dimensiones podria ajustarse mejor que una de tres. Conclusiones. La version española del modulo neuromuscular de la PedsQL para la percepcion de la calidad de vida por los padres de niños de 2-4 años con enfermedades neuromusculares presenta una excelente validez y fiabilidad.

Fiabilidad de la versión española del Cuestionario de actividad física PAQ-C / Reliability of the Spanish Version of Questionnaire of Physical Activity PAQ-C

Objetivo. El objetivo de esta investigación ha sido valorar en niños españoles la fiabilidad del cuestionario de actividad física en niños mayores (PAQ-C). Método. Se utilizó como referencia la validación de la versión traducida al castellano del cuestionario de actividad física para adolescentes PAQ-A. En una muestra de 72 niños entre 8 y 14 años, se evaluó la fiabilidad test-retest del cuestionario PAQ-C en 3 mediciones, antes de la clase de educación física (M1), 2 horas después (M2) y al cabo de una semana (M3). La fiabilidad se calculó mediante el coeficiente de correlación intraclase (ICC) y la consistencia interna mediante el Coeficiente α de Cronbach. Resultados: Los valores obtenidos en la puntuación total del cuestionario reflejan un ICC superior a 0.73 en todas las comparaciones, con un intervalo de confianza al 95% que sigue indicando una fiabilidad buena o excelente. La consistencia interna mostró un coeficiente de α = 0,83 (AU)

Background: The aim of this study was to assess the reliability of the PAQ-C questionnaire in spanish older children (PAQ-C). Methods: A proof translation in Spanish of the physical activity questionnaire for teenager PAQ-A, was used as reference. Reliability of the test-retest questionnaire PAQ-C, was evaluated on 72 children aged between 8 and 14 years. Measurements were taken at three different stages: before the physical education class (M1), 2 hours after the lecture (M2) and one week later (M3). Reliability was calculated using the intraclass correlation coefficient (ICC) while the inner consistency by Cronbach's αcoefficient. Results: The results obtained in the overall score of the questionnaire reflect an intraclass coefficient (ICC) higher than 0,73 in every possible comparison giving a confidence interval of 95% which still indicates a good or very good reliability. The inner consistency showed a coefficient of α = 0,83 (AU)

[Translation and validation of the Individualised Neuromuscular Quality of Life scale for the Spanish population: quality of life assessment for persons with neuromuscular diseases]. / Traduccion y validacion de la escala Individualized Neuromuscular Quality of Life para la poblacion española: evaluacion de la calidad de vida para personas afectas de enfermedades neuromusculares.

INTRODUCTION: The Individualized Neuromuscular Quality of Life (INQoL) is a questionnaire that evaluates the quality of life related to the health of adults with neuromuscular diseases. AIM: To validate and analyze the reliability of the Spanish version of the INQoL scale as an instrument for measuring quality of life related to health in individuals with neuromuscular diseases. PATIENTS AND METHODS: A translation-back translation of the INQoL in the Spanish population is performed and, subsequently, for the analysis of reliability, two measurements are carried out; test retest, with 50 patients aged between 19 and 67 years. In this way we assess the intraobserver concordance and assess the internal consistency of the scale. RESULTS: The study of the reliability of the intraobserver concordance index has a value of excellent in seven of the ten subdimensions as well as in the total score of the quality of life. It has a value of good in two and of moderate in one subdimension. The analysis of Cronbach's alpha for the subdimensions of the INQoL has a value of excellent (> 0.818) in seven of them, as well as in the total score of the quality of life related to health (0.928), a value of good internal consistency in three of the subdimensions, and of moderate in one. CONCLUSIONS: The Spanish version of the INQoL is a valid and reliable instrument as a tool for measuring quality of life in adult patients with neuromuscular diseases.

TITLE: Traduccion y validacion de la escala Individualized Neuromuscular Quality of Life para la poblacion española: evaluacion de la calidad de vida para personas afectas de enfermedades neuromusculares.Introduccion. La escala Individualized Neuromuscular Quality of Life (INQoL) es un cuestionario que valora la calidad de vida relacionada con la salud de personas adultas con enfermedades neuromusculares. Objetivo. Validar y analizar la fiabilidad de la version española de la INQoL, como instrumento de medicion de la calidad de vida relacionada con la salud en individuos con enfermedades neuromusculares. Pacientes y metodos. Se realiza una traduccion-retrotraduccion de la INQoL en la poblacion española y, posteriormente, para el analisis de fiabilidad se llevan a cabo dos mediciones, test-retest, a 50 pacientes de 19 a 67 años. De este modo se evalua la concordancia intraobservador y se evalua la consistencia interna de la escala. Resultados. El estudio de la fiabilidad del indice de concordancia intraobservador tiene un valor de excelente en siete de las diez subdimensiones y en la puntuacion total de la calidad de vida; de buena, en dos; y de moderada, en una. El analisis del alfa de Cronbach para las subdimensiones de la INQoL tiene un valor de excelente (> 0,818) en siete de ellas, asi como en la puntuacion total de la calidad de vida relacionada con la salud (0,928), un valor de buena consistencia interna en tres de las subdimensiones y de moderada en una. Conclusiones. La version española de la INQoL es un instrumento valido y fiable como herramienta de medicion de la calidad de vida en individuos adultos con enfermedades neuromusculares.

[Evolution of functional capacity, assessed with the Egen Klassifikation scale, in the Spanish population with spinal muscular atrophy or Duchenne muscular dystrophy. A three year longitudinal study]. / Evolucion de la capacidad funcional valorada con la escala Egen Klassifikation en personas afectas de atrofia muscular espinal o distrofia muscular de Duchenne de la poblacion española: estudio longitudinal de tres años.

INTRODUCTION: Spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are two neuromuscular diseases which evolve with a progressive loss of muscle strength and, therefore, the loss of functional capacity. The valuation measurement scales are used to understand better and to quantify this involution as well as making treatment to anticipate problems and improve the quality of life of people suffering from these diseases. AIM: To study the changes in the functional capacity of a group of patients with SMA and DMD, over a period of three years. PATIENTS AND METHODS: Nineteen individuals of the Spanish population affected with SMA and DMD, which were assessed with the Egen Klassifikation scale twice, with a time interval of three years. RESULTS: The results show a decrease in the functional capacity of these persons during this time period, with a significant difference in the total amount of the scale (p = 0.003). All scale items showed lower valuations after three years, reaching statistical significance during the assessment, containing the ability to move his hands and coughing. CONCLUSION: The functional capacity of patients with SMA and DMD decreases significantly within three years.

TITLE: Evolucion de la capacidad funcional valorada con la escala Egen Klassifikation en personas afectas de atrofia muscular espinal o distrofia muscular de Duchenne de la poblacion española: estudio longitudinal de tres años.Introduccion. La atrofia muscular espinal (AME) y la distrofia muscular de Duchenne (DMD) son dos enfermedades neuromusculares que evolucionan con perdida progresiva de la fuerza muscular y, en consecuencia, perdida de la capacidad funcional. La valoracion con escalas de medicion permite conocer mejor y cuantificar esta involucion, asi como tomar decisiones terapeuticas para anticiparse a los problemas y mejorar la calidad de vida de las personas afectas de estas patologias. Objetivo. Estudiar los cambios de la capacidad funcional de un grupo de pacientes con AME y DMD en un periodo de tres años. Pacientes y metodos. Diecinueve personas de la poblacion española afectas de AME o DMD, a las que se valoro con la escala Egen Klassifikation en dos ocasiones, en un periodo de tres años. Resultados. Los resultados obtenidos reflejan una disminucion de la capacidad funcional de estas personas durante este periodo de tiempo, con una diferencia significativa en la suma total de la escala (p = 0,003). Todos los items de la escala tuvieron valoraciones inferiores despues de tres años, y se llego a la significacion estadistica en la valoracion de la capacidad de mover las manos y de toser. Conclusion. La capacidad funcional de los pacientes con AME y DMD disminuye de forma significativa en tres años.

Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials.

BACKGROUND/AIM: Groin injuries are common in football and ice hockey, and previous groin injury is a strong risk factor for future groin injuries, which calls for primary prevention. The aim of this systematic review was to evaluate the effect of specific groin-injury prevention programmes in sports. METHODS: A comprehensive search was performed in May 2014 yielding 1747 potentially relevant references. Two independent assessors evaluated randomised controlled trials for inclusion, extracted data and performed quality assessments using Cochrane's risk of bias tool. Quantitative analyses were performed in Review Manager 5.3. RESULTS: Seven trials were included: six on football players (four male and two female populations) and one on male handball players. In total there were 4191 participants with a total of 157 injuries. The primary analysis, including all participants, did not show a significant reduction in the number of groin injuries after completing a groin injury prevention programme (relative risk (RR) 0.81; 95% CI 0.60 to 1.09). Subgroup analysis based on type of sports, gender and type of prevention programme showed similar non-significant estimates with RR ranging from 0.48 to 0.81. CONCLUSION: Meta-analysis revealed a potential clinically meaningful groin injury reduction of 19%, even though no statistical significant reduction in sport-related groin injuries could be documented. TRIAL REGISTRATION: PROSPERO registration ID CRD42014009614.

The impact of high level basketball competition, calcium intake, menses, and hormone levels in adolescent bone density: a three-year follow-up.

AIM: The main goal of the present work is to establish the positive influence high-impact physical exercise, specifically high-level basketball, on bone acquisition in adolescent female and verify if the long-term exposure to such programs is the major modifiable factor explaining bone acquisition during adolescence. METHODS: A prospective cohort study comparing the development of bone mass in the lumbar spine, proximal femur and distal radius was carried out over a three-year period in two groups of adolescents: elite basketball players and age-matched controls. Baseline hormone levels and bone remodelling were evaluated. Bone mass, hours of physical exercise, diet, unhealthy habits, anthropometry and menstrual cycle were assessed at baseline and yearly. Differences in acquisition of bone mass were assessed by two-way repeated measures analysis of variance (ANOVA). RESULTS: Elite basketball training and competition appears to increase bone mass in girls aged 14-18 years. The most pronounced benefits were observed in lumbar spine and proximal femur, sites most directly involved in the exercise and subjected to greatest impact. CONCLUSION: The intensive basketball training and competition in adolescent females increases bone mass in the lumbar spine and femur, skeletal sites submitted to high impact in this sport. No significant gain in bone mass was observed in age-matched, normally active, controls.

Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay: a report of a Cochrane systematic review and meta-analysis.

UNLABELLED: Delayed motor development may occur in children with Down syndrome, cerebral palsy or children born preterm, which in turn may limit the child's opportunities to explore the environment. Neurophysiologic and early intervention literature suggests that task-specific training facilitates motor development. Treadmill intervention is a good example of locomotor task-specific training. AIM: The aim of this paper was to assess the effectiveness of treadmill intervention on locomotor motor development in pre-ambulatory infants and children under six years of age who are at risk for neuromotor delay. DESIGN: A Cochrane systematic review with meta-analysis. METHODS: We employed a comprehensive search strategy. We included randomised, quasi-randomised and controlled clinical trials that evaluated the effect of treadmill intervention in children up to six years of age with delays in gait development or the attainment of independent walking or who were at risk of neuromotor delay. We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, Science Citation Index, PEDro, CPCI-S and LILACS; and also ICTRP, ClinicalTrials.gov, mRCT and CenterWatch. Four authors independently extracted the data using standardized forms. RESULTS: We included five studies, which reported on treadmill intervention in 139 children. Of the 139 children, 73 were allocated to treadmill intervention groups. The studies varied in the type of population studied, the type of comparison, the time of evaluation and the parameters assessed. Due to the diversity of the studies, we were only able to use data from three studies in meta-analyses and these were limited to two outcomes: age of onset of independent walking and gross motor function. Evidence suggested that treadmill intervention could lead to earlier onset of independent walking when compared to no treadmill intervention (effect estimate -1.47; 95% CI: -2.97, 0.03), though these trials studied two different populations: Down syndrome and children at risk of neuromotor disabilities. Children with Down syndrome seemed to benefit while it was not clear if this was the case for children at high risk of neuromotor disabilities. Two other studies, both in children with Down syndrome, compared different types of treadmill intervention (high versus low intensity training). Both were inconclusive regarding the impact of these different protocols on the age at which children started to walk. There is insufficient evidence to determine whether treadmill intervention improves gross motor function (effect estimate 0.88; 95% CI: -4.54, 6.30). CONCLUSION: The current review provided only limited evidence of the efficacy of treadmill intervention in children up to six years of age. Few studies have assessed treadmill interventions in young children using an appropriate control group. The available evidence indicates that treadmill intervention may accelerate the development of independent walking in children with Down syndrome. Further research is needed to confirm this and should also address whether intensive treadmill intervention can accelerate walking onset in young children with cerebral palsy and high risk infants, and whether treadmill intervention has a general effect on gross motor development in the various subgroups of young children at risk for developmental delay.

Nutrición, actividad física y masa ósea en el adolescente / Nutrition, physical activity and bone mass in adolescence

La adolescencia es una etapa crítica en el establecimiento de la salud ósea, que representa la oportunidad de influir en los factores que determinen la magnitud de las ganancias óseas. Hay una serie de factores ambientales importantes que cabe tener en cuenta, como la ingesta de calcio y la actividad física habitual, que interactúan entre ellos. Parece que el esqueleto responde mejor a los complementos de calcio en las primeras etapas de la vida, antes del inicio de la pubertad; después del desarrollo puberal los efectos no son tan importantes. Sin embargo, diferentes autores subrayan que la administración de un complemento de calcio que no vaya acompañado de unos hábitos físicamente activos y/o de la práctica de ejercicio físico no tiene repercusiones relevantes sobre la masa ósea durante la adolescencia

Adolescence is a critical stage in the establishment of bone health, providing an opportunity to influence those factors that determine the amount of bone acquired. There are a series of important environmental factors that have to be taken in consideration, including calcium intake and regular physical activity, which have been found to interact with each other. It seems that the skeleton responds better to calcium supplements in the early stages of life, prior to puberty; after puberty, the effects are less important. Different authors also stress that providing calcium supplements without habitual physical activity and/or physical exercise has no significant effects on bone mass in adolescence