Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial.

The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012.

The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study.

BACKGROUND: Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. METHODS: A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. RESULTS: The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. CONCLUSIONS: It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients.

Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study.

BACKGROUND: Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS: A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS: Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION: The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.

Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome.

OBJECTIVE: Obesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months. METHODS: 273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF). RESULTS: At the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS. CONCLUSIONS: Obesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough.

Lifestyle change recommendations in major depression: Do they work?

BACKGROUND: Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. METHODS: The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. RESULTS: Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). LIMITATIONS: We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. CONCLUSIONS: Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation.

Eficacia del kinesiotaping en la sialorrea en niños con necesidades educativas especiales: un ensayo clínico abierto / No disponible

Objetivo Estudiar la eficacia del kinesiotaping en el control de la deglución de la saliva en niños afectados por sialorrea. Material y métodos Ensayo clínico no controlado antes-después en el que se reclutaron niños con problemas de sialorrea. El tratamiento consistió en la aplicación de kinesiotaping en la zona de hioides. Se valoró la eficacia mediante una escala que valora la frecuencia del babeo, irritación de la piel, olor desagradable, necesidad de limpiar la barbilla, dificultad para la alimentación, necesidad de cambiar de babero y necesidad de cambiar de ropa. Se realizó una medición basal, al mes, a los 3 meses y a los 7 meses de haber comenzado la intervención. Los datos de la evaluación fueron recogidos por las auxiliares de educación especial y por los padres. Resultados En la valoración realizada por el personal auxiliar de educación especial hay una menor irritación en la piel, hay que limpiar un menor número de veces la barbilla y hay una menor dificultad en la alimentación. En la valoración realizada por los padres solo hay diferencias significativas en el ítem de cambio del babero y en el olor. Conclusión Hay escasos estudios sobre este tema, pero los resultados coinciden con 2 estudios previos existentes; no obstante, es necesario profundizar en la eficacia del kinesiotaping en la sialorrea (AU)

Objective: To study the efficacy of Kinesiotaping in the control of the deglutition of the salivain children affected by ptyalism. Material and methods: Uncontrolled clinical trial before-after in which 10 children with problems of ptyalism were recruited. The treatment consisted of the application of Kinesiotaping in the area of the hyoid bone. Efficacy was assessed by a scale measuring frequency of dribbling, skin irritation, unpleasant smell, need for cleaning the chin, feeding difficulty, need for changing the bib and need for changing clothes. Basal measurements were made at the beginning ,at one month, at three months, and seven months after starting the trial. The assessment data assessment were collected by the Special Needs Assistants and the parents. Results: In the assessment carried out by the Special Needs Assistants there is less irritation of the skin, the chin has to be cleaned fewer times and it is less difficult to feed children. In the assessment carried out by the parents significant differences are only found in the items of changing the bib and of the smell. Conclusion: There are few studies on this topic but our results coincide with two previous studies. Nevertheless, it is necessary to further study the efficacy of Kinesiotaping in ptyalism (AU)

Efectos terapéuticos de la hipoterapia en la parálisis cerebral: una revisión sistemática / Therapeutic effects of hippotherapy in cerebral palsy: a systematic review

Objetivo: Revisar la evidencia científica existente respecto al tratamiento de hipoterapia en niños con parálisis cerebral en función de diferentes variables. Métodos Se ha realizado una búsqueda bibliográfica en las bases de datos Pubmed/Medline, Web of Knowledge, Cochrane, PEDro, Enfispo, y en los metabuscadores Trip Data Base y Excelencia clínica. Los términos utilizados en la búsqueda fueron: equine-assisted therapy, cerebral palsy, hippotherapy y horseback riding, combinados generalmente con el operador boleano AND. Resultados Después de eliminar artículos duplicados de las diferentes bases de datos se obtuvieron 25 artículos. Siete de ellos eran revisiones sistemáticas o metaanálisis, 7 eran ensayos clínicos y 11 estudios eran series clínicas no controladas o estudios descriptivos. La calidad de la evidencia científica proporcionada por los estudios utilizados en esta revisión sistemática fue de nivel I para 7 de ellos, de nivel III (evidencia científica proporcionada buena a regular) para otros 7 artículos, y de nivel VIII (evidencia científica proporcionada pobre) para los restantes 11 artículos. Discusión Las principales limitaciones encontradas en los estudios revisados han sido el tamaño muestral reducido, el uso de herramientas de valoración no estandarizadas y/o la heterogeneidad de los protocolos de tratamiento utilizados. Conclusión Resulta difícil encontrar evidencia científica del tratamiento de hipoterapia en niños con parálisis cerebral como consecuencia de diferentes factores, como son los reducidos tamaños muestrales utilizados por los estudios, la diversidad de escalas de valoración y de protocolos de tratamiento utilizados (AU)

Objective: To review the current scientific evidence regarding hippotherapy treatment in children with cerebral palsy through the analysis of different study variables.Methods: A bibliographic research of Pubmed/Medline, Web of Knowledge, Cochrane, PEDro,Enfispo databases and Trip Data Base and Excelencia clínica metasearchers was carried out. The terms used in the search were: Equine-Assisted Therapy, Cerebral Palsy, Hippotherapy and Horseback riding, usually combined with the Boolean operator AND. Results: After eliminating duplicated articles in the different databases, 25 articles were found. Seven of them were systematic reviews or meta-analysis, 7 articles were clinical trials and11 studies were uncontrolled clinical series or descriptive studies. The quality of scientific evidence provided by the studies used in this systematic review was level I for seven of them, level III for seven articles (scientific evidence provided good to regular) and level VIII (scientificevidence provided poor) for the remaining eleven articles. Discussion: The main limitations found in the studies reviewed have been small sample sizes, use of non-standardized assessment tools and/or heterogeneity of the treatment protocolsused. Conclusion: It is difficult to find scientific evidence regarding hippotherapy treatment in children with cerebral palsy due to different factors such as the small sample sizes used in the studies, the diversity of assessment scales and treatment protocols used (AU)

Predicting the onset of major depression in primary care: international validation of a risk prediction algorithm from Spain.

BACKGROUND: The different incidence rates of, and risk factors for, depression in different countries argue for the need to have a specific risk algorithm for each country or a supranational risk algorithm. We aimed to develop and validate a predictD-Spain risk algorithm (PSRA) for the onset of major depression and to compare the performance of the PSRA with the predictD-Europe risk algorithm (PERA) in Spanish primary care. METHOD: A prospective cohort study with evaluations at baseline, 6 and 12 months. We measured 39 known risk factors and used multi-level logistic regression and inverse probability weighting to build the PSRA. In Spain (4574), Chile (2133) and another five European countries (5184), 11 891 non-depressed adult primary care attendees formed our at-risk population. The main outcome was DSM-IV major depression (CIDI). RESULTS: Six variables were patient characteristics or past events (sex, age, sex×age interaction, education, physical child abuse, and lifetime depression) and six were current status [Short Form 12 (SF-12) physical score, SF-12 mental score, dissatisfaction with unpaid work, number of serious problems in very close persons, dissatisfaction with living together at home, and taking medication for stress, anxiety or depression]. The C-index of the PSRA was 0.82 [95% confidence interval (CI) 0.79-0.84]. The Integrated Discrimination Improvement (IDI) was 0.0558 [standard error (s.e.)=0.0071, Zexp=7.88, p<0.0001] mainly due to the increase in sensitivity. Both the IDI and calibration plots showed that the PSRA functioned better than the PERA in Spain. CONCLUSIONS: The PSRA included new variables and afforded an improved performance over the PERA for predicting the onset of major depression in Spain. However, the PERA is still the best option in other European countries.

Estrés y otros factores psicológicos asociados en estudiantes de fisioterapia / Stress and other associated psychological factors in physiotherapy students

ResumenLa implantación del Plan Bolonia ha supuesto cambios en el proceso de enseñanza-aprendizaje.ObjetivosAnalizar la asociación entre la percepción del estrés y satisfacción de los alumnos de fisioterapia, tanto de grado como de diplomatura.Material y métodosEstudio descriptivo transversal. Las variables del estudio y los instrumentos utilizados fueron: 1. variables sociodemográficas; 2. variables relacionadas con el estrés y ansiedad de los alumnos mediante la utilización del Inventario SISCO de Estrés Académico y el Cuestionario de ansiedad estado-rasgo de Spielberg (STAI), y 3. satisfacción de los alumnos en relación con el aprendizaje, evaluada mediante la Escala de Engagement en el Trabajo de Utrecht. (UWES-S).ResultadosLa media obtenida del nivel de intensidad del estrés académico de los estudiantes es de 3,65 sobre 5, que se puede considerar media-alta. Las situaciones estresoras destacadas son la sobrecarga de trabajos, la evaluación de los profesores y al tiempo limitado para la realización de los trabajos. Respecto a las reacciones al estrés destacadas son la somnolencia o una mayor necesidad de dormir y la inquietud. La satisfacción de los estudiantes se encuentra en valores medios (3,03 puntos). La única diferencia significativa entre los estudiantes de grado y diplomatura aparece en la ansiedad estado, evaluada mediante el cuestionario STAI, siendo superior en los primeros.ConclusionesLa identificación y análisis de la presencia de estrés puede ayudar, a establecer programas de ayuda y entrenamiento para que los alumnos aprendan a manejar la ansiedad, lo que permitirá mejorar su salud física y mental y su rendimiento académico (AU)

AbstractThe implementation of the Bologna Process has led to several changes in the teaching-learning process.ObjectivesTo analyze the association between perceived stress and satisfaction of both degree and diploma physiotherapy students. Methods: Cross-sectional study. The study variables and instruments used were: 1. Demographic variables, 2. Variables related to stress and anxiety of students, measured by SISCO Academic Stress Inventory and Spielberg State-Trait Anxiety Inventory (STAI) and 3. Student satisfaction in relationship to learning, measured by the Utrecht Work Engagement Scale (UWES-S).ResultsThe average intensity level obtained from the students’ academic stress is 3.65 out of 5, which can be considered as medium-high. Top stressor situations are overwork, evaluation of the teachers and the limited time to perform the work. Regarding stress reactions, these are drowsiness or greater need for sleep and worry. The satisfaction values of the students were average (3.03 points). The only significant difference between degree and diploma students is the anxiety state, assessed by the STAI questionnaire, this being higher in the degree students.ConclusionsIdentification and analysis of the presence of stress can help to provide assistance and training programs so that the students can learn how to manage anxiety, which will improve their physical, mental and academic performance (AU)

Efectividad de la neuroestimulación eléctrica percutánea en la desactivación de los puntos gatillo miofasciales en la lumbalgia crónica / Effectiveness of percutaneous electrical nerve stimulation in myofascial trigger point deactivation for chronic low back pain

ObjetivoEl objetivo del presente estudio es evaluar la efectividad del tratamiento del dolor lumbar crónico con la neuroestimulación eléctrica percutánea (PENS) y asociar su eficacia a la desactivación de los puntos gatillo miofasciales (PGM) activos.Material y métodosSe trataron 64 personas con lumbalgia crónica inespecífica elegidas aleatoriamente mediante PENS y se realizó un diagnóstico de los PGM activos que presentaban en los rotadores profundos lumbares, el cuadrado lumbar y el glúteo medio. Se midieron cuatro variables: el dolor percibido y la calidad del sueño mediante escala visual analógica, el dolor en los PGM activos mediante algómetro y la calidad de vida con la escala de disfunción para la lumbalgia de Oswestry.ResultadosSe realizó un ensayo antes-después en el que la mejoría obtenida fue significativa en todas las variables medidas en tan sólo nueve sesiones de tratamiento.ConclusionesLa PENS, además de ser una herramienta útil en el tratamiento de la lumbalgia crónica, es eficaz en la desactivación de los PGM activos de la lumbalgia crónica(AU)

AimThis study has aimed is to evaluate the effectiveness of treating chronic low back pain with percutaneous electrical nerve stimulation (PENS) and to associate its effectiveness with deactivation of active MTrPs.Material and method64 randomly chosen persons were treated for non-specific low back pain with PENS and the active MTrPs found on the deep lumbar rotator, quadratus lumborum and gluteus medius muscles were diagnosed. Four variables were measured: perceived pain and quality of sleep by means of a visual analogue scale (VAS), active MTrP pain by Algometry; and quality of life with the Oswestry Low Back Pain Disability Questionnaire.ResultsA before/after test was performed in which the improvement achieved was significant for all of the variables measured after only nine treatment sessions.ConclusionsIt can be concluded that PENS not only is a useful tool in the treatment of chronic low back pain but is also effective in the deactivation of active MTrPs(AU)

Efectividad de la punción seca en los puntos gatillo miofasciales en la lumbalgia crónica / Effectiveness of the dry needling in the treatment of chronic low back pain

Introducción. Nadie duda hoy de que el tratamiento actual de la lumbalgia crónica inespecífica es multidisciplinario y debe abordarse desde varias perspectivas. Muchos autores consideran el dolor de la lumbalgia crónica inespecífica como un dolor miofascial con la existencia de puntos gatillo activos (PGM). Objetivo. El objetivo del presente estudio es evaluar la efectividad del tratamiento del dolor lumbar crónico con punción seca (PS) y ayudar a determinar la posible importancia de los puntos gatillo miofasciales en la lumbalgia crónica. Metodología. Se trataron 58 personas con lumbalgia crónica inespecífica elegidas aleatoriamente mediante punción sin introducir ninguna sustancia (punción seca) del punto gatillo miofascial de los rotadores profundos lumbares, cuadrado lumbar y glúteo medio. Se midieron cuatro variables: el dolor percibido o subjetivo y la calidad del sueño mediante escala visual análoga (EVA), el dolor medido de forma objetiva mediante presión tolerada en los puntos gatillo activos con algómetro; y la calidad de vida con la escala de disfunción para la lumbalgia de Oswestry. Resultados. Se realizó un ensayo clínico antes-después en el que se encontró en todos los pacientes, al menos, un punto gatillo activo, que frecuentemente se situaba en el cuadrado lumbar. La mejoría obtenida fue significativa en todas las variables medidas, en tan sólo tres sesiones de tratamiento. Conclusiones. Se puede concluir que la punción seca podría constituir una herramienta útil dentro del abordaje multidisciplinario que requiere el manejo de la lumbalgia crónica inespecífica

Introduction. There is no doubt that current treatment for non-specific chronic lower back pain (cLBP) is multidisciplinary and should be approached from a number of different perspectives. Many authors consider the pain of non-specific chronic low back pain (cLBP) to be myofascial, with the existence of active myofascial trigger points (MTrPs). Objetive. The aim of this study is to evaluate the effectiveness of treatment with dry needling (DN) and to contribute to the elimination of the non-specific nature of cLBP by identifying its cause in relation to myofascial pain. Methods. 58 people suffering from non-specific cLBP, randomly selected, were treated with DN of MTrPs on the deep lumbar paraspinal muscles (multifidi and rotators), quadratus lumborum and gluteus medius. Four variables were measured: perceived pain and quality of sleep using a visual analogue scale (VAS), pressure-pain tolerance threshold on MTrPs with an algometer, and quality of life with the Oswestry Disability Index. Results. A clinical trial before-after was done. In which study, at least one MTrP was found in all patients, most commonly situated on the quadratus lumborum muscle. The improvement achieved was similar in all the measured variables in only three sessions of treatment. Conclusion. It can be concluded that the effectiveness of dry needling may be considered a useful tool within the multidisciplinary approach required in the management of non-specific cLBP