Addition of tDCS and TENS to an education and exercise program in subjects with knee osteoarthritis: A study protocol.

BACKGROUND: Knee osteoarthritis often leads to chronic pain that frequently becomes disabling.Osteoarthritis has been linked to maladaptive plasticity in the brain, which can contribute to chronic pain. Therapies including neuromodulation and peripheral electrical stimulation are used to counteract the maladaptive plasticity of the brain. OBJECTIVE: To determine the efficacy of the addition of tDCS and TENS to an education and exercise program in reducing pain. METHODS: Over a 2-week study period, 60 participants will complete an exercise and educational intervention. Eligible participants accepting to participate will be subsequently randomized into one of the three treatment groups: 1) Active Transcranial Direct Current Stimulation (tDCS) and active Transcutaneous Electrical Nerve Stimulation (TENS); 2) Active tDCS and sham TENS; 3) Sham tDCS and sham TENS. RESULTS: The primary outcome will be subjective pain intensity. SECONDARY OUTCOMES: quality of life, physical function, central sensitization, and pain adjuvants (uncertainty, catastrophizing kinesiophobia, adverse events). CONCLUSION: This clinical trial will provide data on the effect that the addition of tDCS and/or TENS to an education and exercise program may have to counteract maladaptive plastic changes and improve the benefits of exercises, and whether the combination of both neuromodulator techniques may have a higher magnitude of effect.

Knowledge and Attitudes towards Patient Safety among Students in Physical Therapy in Spain: A Longitudinal Study.

(1) Background: Patient safety is a discipline of health care management aiming to prevent and reduce errors and harm to patients. The assessment of knowledge and attitudes on patient safety among students in physical therapy is still scarce; no studies have yet explored the changes that internship periods may produce. Objectives: 1. to determine the attitudes and knowledge of students in physical therapy with respect to patient safety in a Spanish University; and 2. to explore changes following a practical internship period. (2) Methods: Longitudinal study. Data from the Attitudes to Patient Safety Questionnaire III (APSQ-III) before and after the internship period were obtained from an initial sample of 125 students and average positive response rates were compared. (3) Results: "Team functioning", "Importance of patient safety in the curriculum", and "Error inevitability" displayed the highest scores, in accordance with the current literature. After the internship period, the dimensions "Patient safety training received" (p = 0.001), "Error reporting confidence" (p = 0.044), and "Professional incompetence as an error cause" (p = 0.027) showed significant changes. (4) Conclusions: The current study, highlighting areas of strengths and weaknesses in the knowledge and attitudes of students in physical therapy towards patient safety, may be a foundation to adopt tailored programs to enhance students' competencies in patient safety.

Relación entre el sexo, edad e índice de masa corporal y el Foot Function Index en pacientes con fascitis plantar / Relationship between sex, age and body mass index and the Foot Function Index in patients with plantar fasciitis

La fascitis plantar es una de las patologías de miembro inferior que más impacto causan en la persona produciendo dolor, discapacidad y limitación funcional. Una serie de factores incrementan el riesgo de sufrir fascitis plantar tales como predominio del sexo femenino, edad avanzada y un índice de masa corporal (IMC) elevado. El impacto que produce la fascitis plantar en la persona ser cuantificado por escalas para darnos información en la clínica acerca del estado de nuestros pacientes. Métodos y objetivos: Se realizó un estudio observacional transversal con 28 participantes que sufrían fascitis plantar y se les administra la encuesta FFI-sp con el propósito de determinar la relación entre las subescalas incluidas en el FFI-sp con el sexo, edad e IMC en pacientes con fascitis plantar. Resultados: No se han obtenido resultados significativos que indiquen relación del sexo, edad e IMC con las subescalas incluidas en el FFI-sp. Conclusión: No se ha encontrado relación entre FFI-sp y las variables sexo, edad e IMC

Background: Plantar fasciitis is one of the lower limb pathologies that causes more impact on the person and it produces pain, disability and functional limitation. Some factors which increase the risk of plantar fasciitis such as female predominance, advanced age, and high body mass index (BMI). The impact of plantar fasciitis on people is quantified by scales to give us information in the clinic about the state of our patients. Methods and Objetives: A cross-sectional observational study was performed with 28 participants who are suffering plantar fasciitis and administered the FFI-sp in order to determine the relationship between the subcategories included in the FFI-sp with gender, age and BMI in patients with plantar fasciitis. Results: There have not been significant results indicating a relationship between gender, age and BMI with the subscales included in the FFI-sp. Conclusion: There's no relationship between gender, age and body mass index with the Foot Function Index in patients with plantar fasciitis

Valor del Test de Silfverskiöld para el diagnóstico de la fascitis plantar / Value of the Silfverskiöld Test for the diagnosis of plantar fasciitis

La fascitis plantar (FP) está descrita como la causa más común de dolor en el talón. Aunque se considera una patología multifactorial, la limitación de la dorsiflexión del tobillo es uno de los factores más determinantes, predisponiendo al desarrollo de patologías en el miembro inferior. Objetivo: Determinar la exactitud del test de Silfverskiöld como herramienta diagnóstica de la FP a partir del análisis de varios indicadores (sensibilidad, especifidad, valor predictivo positivo y negativo, y razones de verosimilitud positiva y negativa). Método: Se realizó un estudio de validez transversal en 16 sujetos (9 mujeres y 7 hombres) diagnosticados de fascitis plantar unilateral de al menos 3 meses de evolución. Un fisioterapeuta se encargó de evaluar el déficit de dorsiflexión en ambos tobillos mediante el Test de Silfverskiöld. Resultados: Fueron descartados aquellos pies sin problemas de movilidad en dorsiflexión de tobillo, por lo que finalmente fueron analizados 14 pies afectos y 8 sanos. los indicadores de eficacia diagnóstica del test de Silfverskiöld en la FP. Al determinar la eficacia del test de Silfverskiöld como predictor de FP encontramos una sensibilidad de 93,7%, especificidad del 75%, valor predictivo positivo (VPP) de 86,6% y valor predictivo negativo (VPN) de 85,7%. La razón de verosimilitud positiva (RV+) fue de 3,74, mientras que la negativa (RV-) resultó 12,5. Conclusión: El test de Silfverskiöld puede ser considerado una prueba eficaz para el diagnóstico de la FP. Existe una importante asociación entre la limitación en la dorsiflexión de tobillo por restricción de gemelos y la probabilidad de padecer FP

Background: Plantar fasciitis (PF) is described as the most common cause of heel pain. Although it is considered a multifactorial pathology, the limitation of dorsiflexion of the ankle is one of the most determining factors, predisposing to the development of pathologies in the lower limb. Objective: To determine the accuracy of the Silfverskiöld test as a diagnostic tool for PF, based on the analysis of several indicators (sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios). Method: A cross-sectional validity study was conducted in 16 subjects (9 women and 7 men) diagnosed with unilateral plantar fasciitis of at least 3 months evolution. A physiotherapist was responsible for assessing the deficit of dorsiflexion in both ankles by the Silfverskiöld test. Outcome: Those feet without mobility problems in ankle dorsiflexion were discarded, so finally 14 affected feet and 8 healthy ones were analyzed. the indicators of diagnostic efficacy of the Silfverskiöld test in PF. When determining the efficacy of the Silfverskiöld test as a predictor of PF, we found a sensitivity of 93.7%, specificity of 75%, positive predictive value (PPV) of 86.6% and negative predictive value (NPV) of 85.7%. The positive likelihood ratio (LR+) was 3.74, while the negative (LR-) ratio was 12.5. Conclusion: The Silfverskiöld test can be considered an effective test for the diagnosis of PF. There is an important association between limitation in dorsiflexion of the ankle due to restriction of twins and the probability of suffering PF