[Cerebral palsy in literature, cinema and television]. / La paralisis cerebral en la literatura, el cine y la television.

INTRODUCTION: Cerebral palsy is defined as a group of developmental disorders affecting movement and posture that limit a person's activity. They due to non-progressive alterations that occurred in the developing foetal or infant brain in the early years of life and are often accompanied by epilepsy and cognitive, sensory, communication or behavioural disorders. Cerebral palsy has been portrayed in literature, cinema and television, and this study aims to explore how it has been represented in these media. DEVELOPMENT: Cerebral palsy has frequently been represented in literature, cinema and television and with varying degrees of realism. The symptoms, the experiences of patients, relatives and caregivers, treatments, supporting products, architectural barriers or social and labour relations have all been portrayed. Sometimes they have been represented in a way that is very close to reality, while in other cases the most dramatic aspects have been amplified to add to the plot. CONCLUSIONS: Cerebral palsy has been widely represented in works of fiction and testimonies, comics, films, short films, documentaries and television series, sometimes in a very realistic way, while in others it has been done in a way that may increase the stigma surrounding this condition by offering a distorted vision of reality. Nevertheless, in any event they have helped to make this condition more visible.

TITLE: La paralisis cerebral en la literatura, el cine y la television.Introduccion. La paralisis cerebral se define como un grupo de trastornos del desarrollo del movimiento y la postura que limitan la actividad de la persona, que se deben a alteraciones no progresivas que se produjeron en el cerebro fetal o infantil en desarrollo en los primeros años de vida y que se acompaña con frecuencia de epilepsia, alteraciones cognitivas, sensoriales, de la comunicacion o el comportamiento. La paralisis cerebral se ha mostrado en la literatura, el cine y la television, y este estudio tiene por objetivo conocer como se ha representado en estos medios. Desarrollo. La paralisis cerebral se ha representado en la literatura, el cine y la television de manera exhaustiva y con mayor o menor acierto. Se ha mostrado la sintomatologia, las vivencias de pacientes, familiares y cuidadores, los tratamientos, los productos de apoyo, las barreras arquitectonicas o las relaciones sociales y laborales. En ocasiones, la representacion se ha realizado de forma muy ajustada a la realidad, mientras que en otros casos se han amplificado los aspectos mas dramaticos para dar consistencia a la trama. Conclusiones. La paralisis cerebral se ha representado ampliamente en obras de ficcion y testimonio, comics, peliculas, cortometrajes, documentales y series de television, en ocasiones de manera muy realista, mientras que en otras se ha podido contribuir a incrementar el estigma ofreciendo una vision distorsionada de la realidad, pero que en cualquier caso han contribuido a dar visibilidad a este cuadro patologico.

[Muscular dystrophies in literature, cinema and television]. / Las distrofias musculares en la literatura, el cine y la television.

INTRODUCTION: Muscular dystrophies are inherited disorders, produced by a genetic mutation, with a slow or rapid progression, that basically affect striated muscle tissue. There are several clinical forms, the most frequent being Duchenne's muscular dystrophy and Becker muscular dystrophy. AIM: To analyse how muscular dystrophies have been portrayed in literature, cinema and television. DEVELOPMENT: Muscular dystrophy is a disorder that has been reflected in literature, cinema and television. In some cases it is only mentioned, sometimes it plays a secondary role in the plot, and in others it is the lead character who suffers from the disease. In general, reference is made to Duchenne's disease and, albeit less frequently, to Becker muscular dystrophy, although in some cases the patient is just said to be suffering from muscular dystrophy, without specifying what clinical variety it belongs to. Testimonials, novels, comics, fiction films, documentaries, short films and television programmes have all been produced with the aim of making the disease and its implications more widely known, as well as making the public aware of the need to invest resources in research. CONCLUSIONS: Muscular dystrophy has been portrayed quite realistically in literature, cinema and television, and Duchenne's muscular dystrophy is the clinical variety that has been shown most often. Aspects that have been reflected include its symptoms, progression, prognosis, the role of the family and caregivers, sexuality, palliative care, patients' will to overcome difficulties and the need to raise society's awareness of the condition and to invest more resources in research.

TITLE: Las distrofias musculares en la literatura, el cine y la television.Introduccion. Las distrofias musculares son enfermedades hereditarias, producidas por una mutacion genetica, lentas o rapidamente progresivas, que afectan fundamentalmente a la musculatura estriada. Existen diversas formas clinicas, y las mas frecuentes son la distrofia muscular de Duchenne y la distrofia muscular de Becker. Objetivo. Analizar como se han representado las distrofias musculares en la literatura, el cine y la television. Desarrollo. La distrofia muscular ha sido reflejada en la literatura, el cine y la television. En algunos casos solo se menciona, en otros tiene un papel secundario en la trama y en otros es un personaje principal el que sufre la enfermedad. Generalmente se hace referencia a la enfermedad de Duchenne, y con menos frecuencia a la de Becker, aunque en algunos casos solo se menciona que el paciente presenta distrofia muscular, sin especificar a que variedad clinica pertenece. Podemos encontrar obras de testimonio, novelas, comics, largometrajes de ficcion, documentales, cortos y programas televisivos que pretenden dar a conocer la enfermedad y sus implicaciones, y concienciar a la poblacion sobre la necesidad de invertir recursos en la investigacion. Conclusiones. La distrofia muscular ha sido representada con realismo en la literatura, el cine y la television, y la distrofia muscular de Duchenne es la variedad clinica que se ha mostrado mas habitualmente. Se han reflejado los sintomas, la evolucion, el pronostico, el papel de la familia y los cuidadores, la sexualidad, los tratamientos paliativos, el espiritu de superacion, y la necesidad de concienciar a la sociedad y de invertir mas recursos en investigacion.

Apps en neurorrehabilitación. Una revisión sistemática de aplicaciones móviles / Neurorehabilitation and apps: A systematic review of mobile applications

INTRODUCCIÓN: La mHealth, definida como la prestación de información o asistencia sanitaria a través del uso de dispositivos móviles o tabletas, se postula como una de las grandes apuestas para pacientes, proveedores e inversores. Una app es un programa, con unas características especiales, que se instala en un dispositivo móvil, ya sea tableta digital o teléfono inteligente, y que suele tener un tamaño reducido, y cuyo objetivo es facilitar la consecución de una tarea determinada o asistir en gestiones diarias, siendo el modo de interacción entre el usuario y la aplicación el tacto. OBJETIVO: El objetivo del presente trabajo fue realizar una revisión sistemática acerca de la información publicada sobre las apps enfocadas al campo de la neurorrehabilitación, con el fin de clasificarlas y llevar a cabo una descripción de las principales características de las mismas. MATERIAL Y MÉTODOS: Se realiza una revisión sistemática mediante búsqueda bibliográfica en bases de datos biomédicas, así como en otras fuentes de información propias del ámbito de las aplicaciones tipo apps. Se clasificaron las apps en 5 categorías: hábitos saludables, informativas, valoración, tratamiento y específicas. CONCLUSIONES: Existe gran cantidad de apps con potencial uso en el campo de la neurorrehabilitación, por lo que es importante que los desarrolladores y diseñadores apps conozcan cuáles son las necesidades de la población con patología neurológica para que sus productos sean válidos y eficaces en dicho contexto. Del mismo modo, los profesionales, pacientes, familiares y cuidadores deberían disponer de criterios claros e indicadores que pudieran ayudarles a seleccionar las aplicaciones óptimas para sus necesidades concretas

INTRODUCTION: Mobile health or mHealth, defined as the provision of health information or healthcare by means of mobile devices or tablets, is emerging as a major game-changer for patients, care providers, and investors. An app is a program with special characteristics installed on a small mobile device, either a tablet or smartphone, with which the user interacts via a touch-based interface. The purpose of the app is to facilitate completion of a certain task or assist with daily activities. OBJECTIVE: The aim of this study was to conduct a systematic review of published information on apps directed at the field of neurorehabilitation, in order to classify them and describe their main characteristics. MATERIAL AND METHODS: A systematic review was carried out by means of a literature search in biomedical databases and other information sources related to mobile applications. Apps were classified into five categories: health habits, information, assessment, treatment, and specific uses. CONCLUSIONS: There are numerous applications with potential for use in the field of neurorehabilitation, so it is important that developers and designers understand the needs of people with neurological disorders so that their products will be valid and effective in light of those needs. Similarly, professionals, patients, families, and caregivers should have clear criteria and indicators to help them select the best applications for their specific situations

Neurorehabilitation and apps: A systematic review of mobile applications. / Apps en neurorrehabilitación. Una revisión sistemática de aplicaciones móviles.

INTRODUCTION: Mobile health or mHealth, defined as the provision of health information or healthcare by means of mobile devices or tablets, is emerging as a major game-changer for patients, care providers, and investors. An app is a program with special characteristics installed on a small mobile device, either a tablet or smartphone, with which the user interacts via a touch-based interface. The purpose of the app is to facilitate completion of a certain task or assist with daily activities. OBJECTIVE: The aim of this study was to conduct a systematic review of published information on apps directed at the field of neurorehabilitation, in order to classify them and describe their main characteristics. MATERIAL AND METHODS: A systematic review was carried out by means of a literature search in biomedical databases and other information sources related to mobile applications. Apps were classified into five categories: health habits, information, assessment, treatment, and specific uses. CONCLUSIONS: There are numerous applications with potential for use in the field of neurorehabilitation, so it is important that developers and designers understand the needs of people with neurological disorders so that their products will be valid and effective in light of those needs. Similarly, professionals, patients, families, and caregivers should have clear criteria and indicators to help them select the best applications for their specific situations.

[Commercial video games in the rehabilitation of patients with sub-acute stroke: a pilot study]. / Videojuegos comerciales en la rehabilitacion de pacientes con ictus subagudo: estudio piloto.

INTRODUCTION: Stroke generates dependence on the patients due to the various impairments associated. The use of low-cost technologies for neurological rehabilitation may be beneficial for the treatment of these patients. AIM: To determine whether combined treatment using a semi-immersive virtual reality protocol to an interdisciplinary rehabilitation approach, improve balance and postural control, functional independence, quality of life, motivation, self-esteem and adherence to intervention in stroke patients in subacute stage. PATIENTS AND METHODS: A longitudinal prospective study with pre and post-intervention evaluation was carried out. Fourteen were recruited at La Fuenfria Hospital (Spain) and completed the intervention. Experimental intervention was performed during eight weeks in combination with conventional treatment of physiotherapy and occupational therapy. Each session was increased in time and intensity, using commercial video games linked to Xbox 360° videoconsole and Kinect sensor. RESULTS: There were statistical significant improvements in modified Rankin scale (p = 0.04), baropodometry (load distribution, p = 0.03; support surface, p = 0.01), Barthel Index (p = 0.01), EQ-5D Questionnaire (p = 0.01), motivation (p = 0.02), self-esteem (p = 0.01) and adherence to the intervention (p = 0.02). CONCLUSIONS: An interdisciplinary rehabilitation approach supplemented with semi-immersive virtual reality seems to be useful for improving balance and postural control, functional independence in basic activities of daily living, quality of life, as well as motivation and self-esteem, with excellent adherence. This intervention modality could be adopted as a therapeutic tool in neurological rehabilitation of stroke patients in subacute stage.

TITLE: Videojuegos comerciales en la rehabilitacion de pacientes con ictus subagudo: estudio piloto.Introduccion. El ictus genera dependencia por los numerosos deficits asociados. El uso de tecnologias de bajo coste para la rehabilitacion neurologica podria ser beneficioso para el tratamiento de estos pacientes. Objetivo. Determinar si el tratamiento combinado mediante un protocolo con realidad virtual semiinmersiva, junto con un abordaje rehabilitador interdisciplinar, mejora el equilibrio y el control postural, la independencia funcional, la calidad de vida, la motivacion, la autoestima y la adhesion a la intervencion en pacientes que han sufrido un ictus en fase subaguda. Pacientes y metodos. Estudio piloto prospectivo longitudinal con valoracion pre y postintervencion. Se seleccionaron 14 participantes ingresados en el Hospital La Fuenfria. La intervencion experimental se realizo durante ocho semanas en combinacion con el tratamiento convencional de fisioterapia y terapia ocupacional. Cada sesion fue incrementandose en tiempo-intensidad y requerimientos motores mediante videojuegos comerciales vinculados a la videoconsola Xbox 360° y el dispositivo Kinect. Resultados. Se obtuvieron mejorias estadisticamente significativas en la escala de Rankin modificada (p = 0,04), baropodometria (distribucion de carga, p = 0,03; superficie de apoyo, p = 0,01), indice de Barthel (p = 0,01), cuestionario EuroQoL 5D (p = 0,01), motivacion (p = 0,02), autoestima (p = 0,01) y adhesion a la intervencion (p = 0,02). Conclusiones. El abordaje rehabilitador complementado con realidad virtual semiinmersiva parece ser util para mejorar el equilibrio y el control postural, la independencia funcional en las actividades basicas de la vida diaria, la calidad de vida, asi como la motivacion y la autoestima, con excelente adhesion a las intervenciones, por lo que podria constituir una herramienta terapeutica coadyuvante en la rehabilitacion neurologica del ictus en fase subaguda.

[Multiple sclerosis in literature, cinema and television]. / La esclerosis multiple en la literatura, el cine y la television.

INTRODUCTION: Today, the care of patients with multiple sclerosis and those around them represents a clinical and therapeutic challenge for healthcare professionals. The aim of this study is to analyse the appearance of multiple sclerosis in literature, cinema and television, and to reflect upon the image it has in these media. DEVELOPMENT: Several representative works that have addressed multiple sclerosis were reviewed, and many of them were seen to offer a very true-to-life vision of the disease. Likewise, a review was also conducted of the most relevant films and TV series that, on occasions, offer the general public a close look at the impact of the disease on patients or relatives, although they are sometimes somewhat exaggerated for the sake of increased dramatic effect and offer a slightly distorted view of reality. CONCLUSIONS: Literature largely reflects the real epidemiology, the symptoms and development of the disease, while less attention seems to be given to the diagnostic and therapeutic options open to patients. Cinema and television have offered a correct image but sometimes with the addition of more dramatic effects. It is important for literature, cinema and television to offer a realistic view of this neurological disease so as to make it better known among the public and to help lessen the stigma attached to it.

TITLE: La esclerosis multiple en la literatura, el cine y la television.Introduccion. En la actualidad, la atencion del paciente con esclerosis multiple y su entorno supone un reto clinico y terapeutico para los profesionales de la salud. El objetivo del presente trabajo es analizar la aparicion de la esclerosis multiple en la literatura, el cine y la television, y reflexionar sobre su imagen en dichos medios. Desarrollo. Se han revisado algunas obras representativas que han abordado la esclerosis multiple, y se ha observado que en muchas de ellas se ofrece una vision muy fidedigna de la enfermedad. Del mismo modo, se han revisado las principales peliculas y series de television que, en ocasiones, son un reflejo cercano al publico general de la vision e impacto de la enfermedad sobre los pacientes o familiares, no exentas de excesos dramaticos y distorsiones de la realidad. Conclusiones. La literatura refleja, en gran medida, la epidemiologia real, los sintomas y la progresion de la enfermedad, mientras que las opciones diagnosticas y terapeuticas parecen estar en un segundo plano. El cine y la television han ofrecido una imagen correcta, pero en ocasiones atendiendo mas a efectos dramaticos. Es importante que la literatura, el cine y la television ofrezcan una vision ajustada a la realidad de esta enfermedad para dar a conocer esta afeccion neurologica y contribuir a disminuir su estigma.

[Santiago Ramon y Cajal in literature, cinema and television]. / Santiago Ramon y Cajal en la literatura, el cine y la television.

INTRODUCTION: The life and work of Santiago Ramon y Cajal has been portrayed in scientific papers, biographical and autobiographical works, comics, films, television series or documentaries that have attempted to reflect upon his life or his contributions to science and to bring him closer to the general public. AIMS: To analyse the different ways Santiago Ramon y Cajal has been represented in literature, cinema and television, and to become more closely acquainted with this scientist through his fictional writings. DEVELOPMENT: A number of biographical works have been written about Santiago Ramon y Cajal, including scientific papers, comics, books for children and youngsters, as well as the autobiographical writings, essays and even science fiction stories, which provide a good introduction to the life of the scientist and his work. His life has also been adapted to film (Leap to fame) or television (Ramon y Cajal, historia de una voluntad; The butterflies of the soul), which have, with varying degrees of success and accuracy, made him better known to the general population. CONCLUSIONS: The numerous biographical writings, historical notes, articles, the scientific work itself, the essays and fictional works by Cajal, as well as the portrayals of the Spanish Nobel Prize winner produced for films and television, can be used to obtain some interesting insights into the scientist, teacher, science populariser, humanist physician and, in short, the man who made such important contributions to neuroscience.

TITLE: Santiago Ramon y Cajal en la literatura, el cine y la television.Introduccion. La vida y obra de Santiago Ramon y Cajal ha sido recogida en articulos cientificos, obras biograficas y autobiograficas, comics, peliculas, series televisivas o documentales que han intentado reflexionar sobre su vida o sus aportaciones a la ciencia y acercarlo a la poblacion general. Objetivo. Analizar como ha sido representada la figura de Santiago Ramon y Cajal en la literatura, el cine y la television, y conocer al cientifico a traves de su obra de ficcion. Desarrollo. Son multiples las obras biograficas escritas sobre Santiago Ramon y Cajal, articulos cientificos, comics, libros para niños y jovenes, sin olvidar las obras autobiograficas, ensayos, e incluso literatura de ciencia ficcion, que permiten una buena aproximacion a la vida del cientifico y a su obra. Su figura ha sido tambien llevada al cine (Salto a la gloria) o a la television (Ramon y Cajal, historia de una voluntad; Las mariposas del alma), que han acercado a Cajal, con mayor o menor acierto y exactitud, a la poblacion general. Conclusiones. A traves de los numerosos escritos biograficos, apuntes historicos, articulos, la propia obra cientifica, de ensayo y de ficcion de Cajal, asi como de las representaciones que el cine y la television han hecho del Nobel español, podemos realizar una interesante aproximacion al cientifico, al profesor, al divulgador, al medico humanista y, en suma, al hombre que realizo tan importantes aportaciones a la neurociencia.

Balzac y el análisis de la marcha humana / Balzac and human gait analysis

Introducción: Desde tiempos remotos, el hombre se ha interesado por el análisis del movimiento y especialmente por el estudio de la marcha. Aristóteles, Hipócrates, Galeno, Leonardo Da Vinci u Honoré de Balzac analizaron, mediante la observación, la forma de andar del ser humano. El objetivo de este trabajo es mostrar la relación de Honoré de Balzac con el análisis científico de la marcha humana. Fuentes: Teoría del andar de Honoré de Balzac y otras obras de este autor que hacen referencia al modo de andar. Desarrollo: Honoré de Balzac se sintió atraído por el análisis de la marcha, aspecto que se demuestra en las descripciones de sus personajes que incluyen, con frecuencia, referencias a la forma de caminar. Además, escribió un tratado sobre la marcha titulado Teoría del andar, en el que con un estilo literario y con gran capacidad de observación definió la marcha, mencionó que se divide en fases, indicó cuáles son los factores que la modifican como la personalidad, el estado de ánimo, la estatura, el peso, la profesión o la clase social, y describió cuál es la forma correcta de andar. Conclusiones: Balzac considera muy importante el análisis de la marcha y esto se manifiesta tanto en sus descripciones de personajes como en su Teoría del andar, en la que realiza una observación analítica de la manera de caminar. En una época dominada por la tecnología como la nuestra nos recuerda la importancia de la observación

Introduction: People have been interested in movement analysis in general, and gait analysis in particular, since ancient times. Aristotle, Hippocrates, Galen, Leonardo da Vinci and Honoré de Balzac all used observation to analyse the gait of human beings. The purpose of this study is to compare Honoré de Balzac's writings with a scientific analysis of human gait. Sources: Honoré de Balzac's Theory of walking and other works by that author referring to gait. Development: Honoré de Balzac had an interest in gait analysis, as demonstrated by his descriptions of characters which often include references to their way of walking. He also wrote a treatise entitled Theory of walking(Théorie de la demarche) in which he employed his keen observation skills to define gait using a literary style. He stated that the walking process is divided into phases and listed the factors that influence gait, such as personality, mood, height, weight, profession and social class, and also provided a description of the correct way of walking. Conclusions: Balzac considered gait analysis to be very important and this is reflected in both his character descriptions and Theory of walking, his analytical observation of gait. In our own technology-dominated times, this serves as a reminder of the importance of observation

Balzac and human gait analysis.

INTRODUCTION: People have been interested in movement analysis in general, and gait analysis in particular, since ancient times. Aristotle, Hippocrates, Galen, Leonardo da Vinci and Honoré de Balzac all used observation to analyse the gait of human beings. The purpose of this study is to compare Honoré de Balzac's writings with a scientific analysis of human gait. SOURCES: Honoré de Balzac's Theory of walking and other works by that author referring to gait. DEVELOPMENT: Honoré de Balzac had an interest in gait analysis, as demonstrated by his descriptions of characters which often include references to their way of walking. He also wrote a treatise entitled Theory of walking (Théorie de la demarche) in which he employed his keen observation skills to define gait using a literary style. He stated that the walking process is divided into phases and listed the factors that influence gait, such as personality, mood, height, weight, profession and social class, and also provided a description of the correct way of walking. CONCLUSIONS: Balzac considered gait analysis to be very important and this is reflected in both his character descriptions and Theory of walking, his analytical observation of gait. In our own technology-dominated times, this serves as a reminder of the importance of observation.

La trepanación craneal en Sinuhé, el Egipcio / Cranial trepanation in The Egyptian

Introducción: La Medicina y la Literatura han estado unidas desde antiguo, prueba de ello es que muchos médicos se han dedicado a la Literatura y muchos escritores han plasmado en sus obras la actividad médica y la enfermedad. Un ejemplo es la obra Sinuhé, el egipcio de Mika Waltari, que narra magistralmente la actividad médica del protagonista y describe la técnica de trepanación Desarrollo: El presente trabajo comienza con el análisis de las trepanaciones desde la Prehistoria y se ilustra la práctica de la trepanación en Sinuhé, el egipcio. En esta obra se hace referencia en múltiples ocasiones a la trepanación y se detalla la forma de practicarla y el instrumental necesario. La trepanación es una de las intervenciones quirúrgicas más antiguas llevada a cabo con fines terapéuticos en traumatismos craneales y patologías neurológicas, pero también con una finalidad mágico-religiosa, para expulsar los espíritus malignos causantes de enfermedades mentales o de los síntomas de epilepsias y migra˜nas. Conclusiones: La trepanación es una práctica quirúrgica realizada desde la Prehistoria en traumatismos craneales, epilepsias, cefaleas y enfermedades psiquiátricas. En la novela Sinuhé, el egipcio se describe con detalle la figura del trepanador, la técnica de trepanación y el instrumental necesario

Introduction: Medicine and literature have been linked from ancient times; proof of this shown by the many doctors who have made contributions to literature and the many writers who have described medical activities and illnesses in their works. An example is The Egyptian, the book by Mika Waltari that provides a masterly narration of the protagonist’s medical activity and describes the trepanation technique. Development: The present work begins with the analysis of trepanations since prehistory and illustrates the practice of the trepanation in The Egyptian. The book mentions trepanation frequently and illustrates how to practice it and which instruments are required to perform it. Trepanation is one of the oldest surgical interventions carried out as treatment for cranial trauma and neurological diseases, but it also had the magical and religious purpose of expelling the evil spirits which caused the mental illness, epilepsy, or migraine symptoms. Conclusions: Trepanation is a surgical practice that has been carried out since prehistory to treat post-traumatic epilepsy, migraine, and psychiatric illness. The Egyptian is a book that illustrates the trepan, the trepanation technique, and the required set of instruments in full detail

Cranial trepanation in The Egyptian.

INTRODUCTION: Medicine and literature have been linked from ancient times; proof of this shown by the many doctors who have made contributions to literature and the many writers who have described medical activities and illnesses in their works. An example is The Egyptian, the book by Mika Waltari that provides a masterly narration of the protagonist's medical activity and describes the trepanation technique. DEVELOPMENT: The present work begins with the analysis of trepanations since prehistory and illustrates the practice of the trepanation in The Egyptian. The book mentions trepanation frequently and illustrates how to practice it and which instruments are required to perform it. Trepanation is one of the oldest surgical interventions carried out as treatment for cranial trauma and neurological diseases, but it also had the magical and religious purpose of expelling the evil spirits which caused the mental illness, epilepsy, or migraine symptoms. CONCLUSIONS: Trepanation is a surgical practice that has been carried out since prehistory to treat post-traumatic epilepsy, migraine, and psychiatric illness. The Egyptian is a book that illustrates the trepan, the trepanation technique, and the required set of instruments in full detail.

[Obstetric brachial palsy, a historical review]. / Paralisis braquial obstetrica, una revision historica.

INTRODUCTION: Lesions of the peripheral nerves have been known since ancient times, but there are few references to the treatments that were used in the past. AIM. To analyse obstetric brachial palsy and its treatments throughout history. DEVELOPMENT: There are a number of different references to the peripheral nerves and their lesions, although little is known about the treatments that were applied in the past. William Smellie first reported obstetric brachial palsy in 1764 and the term was coined by Duchenne de Boulogne in 1872. In 1877, Erb analysed four cases of obstetric brachial palsy and conducted studies on the excitation of the brachial plexus with electric currents. In 1885, Klumpke described palsy of the lower roots of the brachial plexus. In the late 19th century pathophysiology studies were carried out and at the beginning of the 20th century the first surgical interventions were performed. Today, microsurgery techniques, protocols on how to proceed, and rehabilitation treatment of this lesion are all available and offer good outcomes. CONCLUSIONS: Since the first clinical description of obstetric brachial palsy by Smellie and the reports of the different types of brachial palsy by Duchenne, Erb and Klumpke, many pathophysiological studies have been conducted. Notable developments have been made in conservative and surgical treatments, with very favourable recoveries being observed in children with obstetric brachial palsy.

Parálisis braquial obstétrica, una revisión histórica / Obstetric brachial palsy, a historical review

Introducción. Las lesiones de los nervios periféricos se conocen desde antiguo, pero existen escasas referencias acerca de los tratamientos utilizados en el pasado. Objetivo. Analizar la parálisis braquial obstétrica y sus tratamientos a lo largo de la historia. Desarrollo. Existen diversas referencias sobre los nervios periféricos y sus lesiones, aunque se conoce poco sobre los tratamientos practicados en el pasado. William Smellie realizó la primera descripción de la parálisis braquial obstétrica en 1764 y Duchenne de Boulogne acuñó el término en 1872. En 1877, Erb analizó cuatro casos de parálisis braquial obstétrica y realizó estudios acerca de la excitación del plexo braquial con corrientes eléctricas. Klumpke describió, en 1885, la parálisis de las raíces inferiores del plexo braquial. A finales del siglo xix se realizaron estudios sobre la fisiopatología, y a principiosdel siglo xx se empezaron a practicar intervenciones quirúrgicas. En la actualidad se cuenta con técnicas de microcirugía, protocolos de actuación y tratamiento rehabilitador de esta lesión, con buenos resultados. Conclusiones. Desde la primera descripción clínica de la parálisis braquial obstétrica por Smellie y la descripción de los distintos tipos de parálisis braquial por Duchenne, Erb y Klumpke, se han llevado a cabo múltiples estudios fisiopatológicos y se han desarrollado de manera notable los tratamientos conservador y quirúrgico, observándose recuperaciones muy favorables en los niños con parálisis braquial obstétrica (AU)

Introduction. Lesions of the peripheral nerves have been known since ancient times, but there are few references to the treatments that were used in the past. Aim. To analyse obstetric brachial palsy and its treatments throughout history. Development. There are a number of different references to the peripheral nerves and their lesions, although little is known about the treatments that were applied in the past. William Smellie first reported obstetric brachial palsy in 1764 and the term was coined by Duchenne de Boulogne in 1872. In 1877, Erb analysed four cases of obstetric brachial palsy and conducted studies on the excitation of the brachial plexus with electric currents. In 1885, Klumpke described palsy of the lower roots of the brachial plexus. In the late 19th century pathophysiology studies were carried out and at the beginning of the 20th century the first surgical interventions were performed. Today, microsurgery techniques, protocols on how to proceed, and rehabilitation treatment of this lesion are all available and offer good outcomes. Conclusions. Since the first clinical description of obstetric brachial palsy by Smellie and the reports of the different types of brachial palsy by Duchenne, Erb and Klumpke, many pathophysiological studies have been conducted. Notable developments have been made in conservative and surgical treatments, with very favourable recoveries being observed in children with obstetric brachial palsy (AU)

Efectos de un programa de hidroterapia en el tratamiento de la distonía cervical. Estudio piloto / Effects of an hidrotherapy program in the treatment of cervical dystonia. A pilot study

Introducción. La distonía cervical puede causar alteraciones de la movilidad y del equilibrio, ambas, acompañadas de dolor. Objetivo. Valorar si la hidroterapia produce disminución del dolor, incremento de movilidad y mejora del equilibrio en la distonía cervical. Pacientes y métodos. Estudio piloto pre y postratamiento sin grupo de control, con 16 pacientes (13 mujeres y tres varones) con distonía cervical. Los pacientes recibieron tres sesiones individuales y tres sesiones grupales de ejercicios acuáticos. Se evaluó la discapacidad, la gravedad y el dolor con la Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), el equilibrio mediante el test Get up & Go y la escala de Tinetti, y el rango de movilidad activa del cuello con cinta métrica. Las evaluaciones se midieron pre y postratamiento. Resultados. El análisis de la t de Student de muestras relacionadas mostró diferencias significativas en todas las variables (p < 0,01). La movilidad activa del cuello mejoró en todos los movimientos: flexión (1,3 ± 1,0 cm), lateralización derecha (3,4 ± 1,7 cm) e izquierda (4,0 ± 3,0 cm), y rotación derecha (1,6 ± 2,5 cm) e izquierda (2,2 ± 1,5 cm). A su vez, todos los cuestionarios también mejoraron: Tinetti (3,0 ± 2,2), Get up & Go (2,3 ± 1,6) y TWSTRS (8,4 ± 5,4). Conclusiones. La hidroterapia es bien aceptada por los pacientes, ofrece alto grado de alivio subjetivo y podría tener una influencia positiva en la distonía cervical, aunque se requieren estudios confirmatorios controlados (AU)

Introduction. Cervical dystonia may also cause limitation in articulation mobility and alteration of the balance, both accompanied with pain. Aim. To evaluate if hydrotherapy produces decrease of pain, increase in mobility and balance in patients diagnosed with cervical dystonia. Patients and methods. A pre-post treatment pilot study was carried out without group control, with a sample of 16 patients (13 female and 3 male) diagnosed with cervical dystonia. The patients received an hydrotherapy treatment consisted of three individual sessions and three grupal sessions of aquatic exercises. In the pre-treatment phase the disability, severity and pain were evaluated by means of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS); the balance was evaluated by means of the Get up & Go and Tinetti tests. In addition, the range of active mobility of the neck was measured with tape. The test were measured pre and post-treatment. Results. The Student t showed a significant difference (p < 0, 01) in all the values. The range of active mobility of the neck improved in all movements: flexion (1.3 ± 1.0 cm), right lateralization (3.4 ± 1.7 cm) and left (4.0 ± 3.0 cm) and right rotation (1.6 ± 2.5 cm) and left (2.2 ± 1.5 cm). At the same time, all test improved too: Tinetti (3.0 ± 2.2), Get up & Go (2.3 ± 1.6) and TWSTRS (8.4 ± 5.4). Conclusions. The outcomes of this pilot study show that hydrotherapy can be related a positive influence in cervical dystonia, producing neck mobility and balance improvements and pain decrease. Future studies are necessary (AU)