Effectiveness of a cardiac rehabilitation program on biomechanical, imaging, and physiological biomarkers in elderly patients with heart failure with preserved ejection fraction (HFpEF): FUNNEL + study protocol.

BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) have a low functional status, which in turn is a risk factor for hospital admission and an important predictor of survival in HFpEF. HFpFE is a heterogeneous syndrome and recent studies have suggested an important role for careful, pathophysiological-based phenotyping to improve patient characterization. Cardiac rehabilitation has proven to be a useful tool in the framework of secondary prevention in patients with HFpEF. Facilitating decision-making and implementing cardiac rehabilitation programs is a challenge in public health systems for HFpEF management. The FUNNEL + study proposes to evaluate the efficacy of an exercise and education-based cardiac rehabilitation program on biomechanical, physiological, and imaging biomarkers in patients with HFpEF. METHODS: A randomised crossover clinical trial is presented among people older than 70 years with a diagnosis of HFpEF. The experimental group will receive a cardiac rehabilitation intervention for 12 weeks. Participants in the control group will receive one educational session per week for 12 weeks on HFpEF complications, functional decline, and healthy lifestyle habits. VO2peak is the primary outcome. Biomechanical, imaging and physiological biomarkers will be assessed as secondary outcomes. Outcomes will be assessed at baseline, 12 weeks, and 24 weeks. DISCUSSION: Identifying objective functional parameters indicative of HFpEF and the subsequent development of functional level stratification based on functional impairment ("biomechanical phenotypes") may help clinicians identify cardiac rehabilitation responders and non-responders and make future clinical decisions. In this way, future pharmacological and non-pharmacological interventions, such as exercise, could be improved and tailored to improve quality of life and prognosis and reducing patients' hospital readmissions, thereby reducing healthcare costs. TRIAL REGISTRATION: NCT05393362 (Clinicaltrials.gov).

Immediate effects of lumbar fascia stretching on hamstring flexibility: A randomized clinical trial.

BACKGROUND: The hamstring muscles have a great tendency to decrease their extensibility, a phenomenon that presents a distinct clinical entity called short hamstring syndrome (SHS), in addition to problems with adjacent structures. OBJECTIVE: The objective of this study was to evaluate the immediate effect of lumbar fascia stretching on the flexibility of the hamstring musculature. METHODS: A randomized controlled trial was carried out. Forty-one women between 18 and 39 years old were divided into two groups: the experimental group received a technique of fascial stretching in the lumbar area while the control group participated in a magnetotherapy machine that was turned off. Hamstring flexibility in both lower limbs was measured by the straight leg raising test (SLR) and the passive knee extension test (PKE). RESULTS: The results showed statistically significant improvements (p< 0.05) in the SLR and the PKE for both groups. There was a large effect size (Cohen's d) for both tests. There was a statistically significant correlation between the International Physical Activity Questionnaire (IPAQ) and the SLR. CONCLUSION: The inclusion of lumbar fascia stretching might be an effective part of a treatment protocol to increase the flexibility of the hamstring muscle observing an immediate result in healthy participants.

Validation of pain catastrophizing scale on breast cancer survivor.

INTRODUCTION: Pain catastrophizing scale (PCS) is the most used scale to measure pain catastrophizing. In breast cancer survivors (BCS), pain catastrophizing is related to upper-limbs dysfunction and disability. This study aimed to assess the internal consistency, internal structure, and convergent validity of the Spanish version of the PCS in Spanish BCS. MATERIAL AND METHODS: Breast cancer survivors were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The psychometric properties were evaluated with analysis factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). RESULTS: Factor structure was three-dimensional, and one item was removed due to cross-loading. The new 12-item PCS showed a high internal consistency for the total score (α = 0.91) and a good homogeneity, and CFA revealed a satisfactory fit. PCS showed an acceptable correlation with FACS (r = 0.53, p < 0.01). CONCLUSION: Pain catastrophizing scale is a valid and reliable instrument to evaluate pain catastrophizing in Spanish BCS. This tool may help clinicians in the management of pain by assessing pain and by measuring the effect of interventions.

Feasibility of an Activity Control System in Patients with Diabetes: A Study Protocol of a Randomised Controlled Trial.

Purpose: Patients with diabetes mellitus have an increased risk of developing various serious health problems that could be life-threatening. These problems are associated with the difficulty of these patients in managing their lifestyle, which may even lead to the abandonment of treatment. The present study was designed to evaluate the feasibility of a multipurpose activity control solution for home activity (home activity control system), which will provide information on the activities of daily living carried out outside in real time, to improve adherence to each of the therapeutic objectives agreed on with the diabetic patient. Patients and Methods: A pilot randomised controlled feasibility study will be carried out to evaluate a home activity control system (Beprevent) in managing patients with type 2 diabetes mellitus. Twenty patients with type 2 diabetes mellitus will be included (10 in the intervention group and 10 in the control group). Data on satisfaction with the tool will be collected from professionals and patients, as well as other clinical/epidemiological data from their digital health records and several questionnaires, at baseline and six months. In addition, data will also be recorded regarding the degree of adherence to the behaviors agreed on with the patients before starting the study to assess changes throughout the study and their relationship with clinical results (glycosylated haemoglobin (HbA1c), cholesterol, etc), and to compare these outcomes between two study groups. Discussion: This project involves the incorporation of telemedicine in the management of patients with diabetes. Thus, according to the currently published bibliography, the use of smart devices in this population could help improve the quality of life of these people, reduce medical visits and improve adherence to home care patterns for diabetes mellitus. There are currently no published clinical trials or protocols that monitor activities of daily living in patients with diabetes individually using artificial intelligence (AI) devices.

Cancer-related fatigue measures in palliative care: A psychometric systematic review.

INTRODUCTION: In palliative care, the prevention and relief of fatigue are regarded as crucial goals in patients with cancer. METHODS: A systematic review was carried out according to the COnsensus-based Standards for the selection of health status Measurement INstruments methodology. Searches were conducted in Medline (through PubMed), Web of Science, Open Gray, Scielo, Cochrane, CINAHL and EMBASE. All instruments found in each study were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS: A total of 5598 articles were identified in the different databases. In total, 57 studies describing 19 instruments were included in this study. The main properties evaluated were internal consistency, cross-cultural validity, hypotheses testing and responsiveness. All studies were evaluated with the Strobe scale with a score greater than 6 points. CONCLUSIONS: According to the quality methodological results, Edmonton Symptom Assessment System, Problems and Needs in Palliative Care Questionnaire, European Organisation for Research and Treatment of Cancer Quality of Life 15-item Questionnaire for Palliative Care and Palliative Care Quality of Life Instrument are the recommended instruments used for assessing cancer-related fatigue in palliative care. PROPESRO registration number: CRD42020206783.

The Effect of Proprioception Training on Pain Intensity in Thumb Basal Joint Osteoarthritis: A Randomized Controlled Trial.

A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) post-intervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance. The study was registered at ClinicalTrials.gov NCT04738201. No funding was provided for this study.

Simulación con pacientes estandarizados en ciencias de la salud: una revisión sistemática / Human patient simulation in health sciences: a systematic review

Introducción: Los métodos de enseñanza utilizados en terapia ocupacional son numerosos y podrían clasificarse en dos grupos: métodos de enseñanza tradicionales y alternativos. La simulación es un método alternativo que permite el aprendizaje autónomo y el desarrollo de habilidades de pensamiento crítico de los estudiantes durante su participación activa en una práctica segura. Objetivo: Analizar la efectividad del aprendizaje a través de la simulación con pacientes estandarizados frente a la enseñanza tradicional en ciencias de la salud. Método: La estrategia de búsqueda fue: ("Patient Simulation" OR "Role Playing" OR "Simulation Scenario" OR "Simulation Education") AND ("Program Evaluation" OR Effectiveness) AND (Student OR Postgraduate). El análisis de validez interna de los artículos incluidos en la revisión se realizó mediante la escala PEDro. Resultados: Se incluyeron catorce estudios y las variables evaluadas se organizaron en cuatro categorías: adquisición de conocimiento, aprendizaje de la práctica clínica, autoeficacia y desarrollo de habilidades de comunicación. Las muestras estuvieron compuestas por estudiantes de las profesiones de la salud y las simulaciones tuvieron una duración de entre 10 y 40 minutos por sesión (4-24 sesiones). Conclusión: No se encontraron diferencias significativas entre ambas metodologías en la adquisición de habilidades prácticas por parte de los estudiantes. Aun así, la visualización de videos explicativos al principio y el resumen al final del proceso de simulación, han demostrado ser etapas fundamentales para mejorar la efectividad de este método de enseñanza. Futuros estudios son necesarios para analizar los posibles beneficios de la simulación en la titulación de terapia ocupacional.

Introduction: Teaching methods used in occupational therapy are numerous and could be classified into two groups: traditional and alternative teaching methods. Simulation is an alternative method that allows autonomous learning while developing the critical thinking skills of students during their active participation in safe practice. Objective: To analyze the effectiveness of learning through simulation with standardized patients compared to traditional teaching in health sciences. Method: The search strategy was: ("Patient Simulation" OR "Role Playing" OR "Simulation Scenario" OR "Simulation Education") AND ("Program Evaluation" OR Effectiveness) AND (Student OR Postgraduate). The analysis of internal validity of the articles included in the review was performed using the PEDro scale. Results: Fourteen studies were included and variables measured were organized into four categories: acquisition of knowledge, learning of clinical practice, self-efficacy and development of communication skills. The samples were health professions students and simulations had a duration from 10 to 40 minutes per session (4­24 sessions). Conclusion: No significant differences were found between both methodologies in the acquisition of practical skills by students. Even so, the visualization of explanatory videos at the beginning and the summary at the end of the simulation process have proven to be fundamental steps to improve the effectiveness of this teaching method. Future studies are needed to analyze the possible benefits of simulation in the occupational therapy degree.

Systematic Review of Therapeutic Alliance Measurement Instruments in Physiotherapy.

Purpose: Interest in measuring the therapeutic alliance has grown in recent years in both the clinical field and the literature. Several instruments can be used to measure the therapeutic alliance in physiotherapy, and choosing the most appropriate one is challenging. The purpose of this systematic review was to (1) identify the instruments that have been used to evaluate the therapeutic alliance in physiotherapy and (2) appraise the methodological quality of studies of the psychometric properties of these instruments. Method: The researchers carried out a systematic search in MEDLINE, SciELO, PsycINFO, Theseus, Cochrane Library, and Open Grey. Only articles published in English and Spanish were included. The articles were evaluated by two independent reviewers in accordance with the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) and Preferred Reporting items for Systematic Review and Meta-Analysis standards, using the four-point COSMIN checklist. Results: Four studies were included in this review, and four instruments evaluated the therapeutic alliance in physiotherapy. The methodological quality of the studies was fair for most of the psychometric characteristics analyzed. Conclusions: The Working Alliance Inventory is the best instrument to measure therapeutic alliance and the measure that had the greatest number of psychometric properties evaluated against the COSMIN standard. More studies of high methodological quality are required to evaluate the psychometric properties of the instruments used to assess the therapeutic alliance in physiotherapy.

Objectif : l'intérêt à mesurer l'alliance thérapeutique s'est accru ces dernières années, tant sur le terrain que dans les publications. Plusieurs instruments peuvent servir à mesurer l'alliance thérapeutique en physiothérapie, et il est difficile de choisir le plus approprié. La présente analyse systématique visait à 1) déterminer les instruments utilisés pour évaluer l'alliance thérapeutique en physiothérapie et 2) évaluer la qualité méthodologique des études sur les propriétés psychométriques de ces instruments. Méthodologie : recherche systématique dans MEDLINE, SciELO, PsycINFO, Theseus, la Bibliothèque Cochrane et Open Grey. Les chercheurs n'ont retenu que les articles publiés en anglais et en espagnol. Deux analystes indépendants ont évalué les articles, conformément aux normes consensuelles pour la sélection des instruments de mesure de la santé (COSMIN, selon l'acronyme de COnsensus-based Standards for the selection of health Measurement Instruments) et celles des points de déclaration favorisés pour l'analyse systématique et la méta-analyse (PRISMA, selon l'acronyme anglais de Preferred Reporting items for Systematic Review and Meta-Analysis) au moyen de la liste COSMIN en quatre points. Résultats : quatre études ont fait partie de l'analyse, et quatre instruments ont servi à évaluer l'alliance thérapeutique en physiothérapie. La plupart des caractéristiques psychométriques évaluées dans les études présentaient une qualité méthodologique modérée. Conclusion : Le Working Alliance Inventory est le meilleur instrument pour mesurer l'alliance thérapeutique. Ce questionnaire possédait le plus grand nombre de caractéristiques psychométriques évaluées par rapport à la norme COSMIN. Plus d'études de qualité méthodologique élevée s'imposent pour évaluer les propriétés psychométriques des instruments utilisés pour évaluer l'alliance thérapeutique en physiothérapie.

The dietary knowledge measurement instruments in diabetes: A systematic psychometric review.

AIMS: To identify, critically appraise, and summarize instruments to measure dietary knowledge in patients with diabetes mellitus type 1 or 2. DESIGN: Psychometric systematic review. DATA SOURCES: A comprehensive search was carried out during March 2020 in the followed databases: Medline, Web of Science, Open Grey, Cochrane Library, COSMIN database, and Scielo. REVIEW METHODS: In accordance with the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments methodology (COSMIN) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. A systematic review of the measurement properties of the instruments that assess the level of dietary knowledge in the diabetic population was carried out. The COSMIN checklist was used to assess the measurement properties of existing patient-reported outcome measures to select the most appropriate outcome measurement instrument. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020186516). RESULTS: Nine instruments were identified. The Michigan Diabetes Knowledge Test (DKT) was the questionnaire included in the largest volume of studies. The Diabetes Knowledge Questionnaire (DKQ) was the questionnaire with the most evaluated psychometric characteristics. The Personal Diabetes Questionnaire (PDQ) was the second with the highest number of psychometric characteristics evaluated and with a better score regarding the quality of the evidence. CONCLUSION: According to the quality methodological results; DKT, DKQ and PDQ are the recommended instruments to assess dietary knowledge in people with diabetes types 1 and 2. IMPACT STATEMENT: What problem did the study address? One of the main factors that lead to greater difficulty for patients with diabetes mellitus is dietary management, and it is necessary to evaluate whether the patient has sufficient knowledge about dietetics to practice a healthy diet. What were the main findings? Nine instruments were identified that were specifically designed to assess dietary knowledge in patients with diabetes mellitus (DM) type 1 or 2. Michigan Diabetes Knowledge Test, Diabetes Knowledge Questionnaire, and Personal Diabetes Questionnaire are the recommended instruments to assess dietary knowledge in people with diabetes. Where and on whom will the research have impact? The evaluation of this construct is very useful both in clinical practice; at hospital, community and primary care levels, in patients with type 1 and / or 2 diabetes mellitus (DM), as in research.

Effects of obesity on balance in people with intellectual disabilities.

BACKGROUND/AIM: To know the differences in balance of people with intellectual disability with and without obesity. METHOD: 549 people with intellectual disability were evaluated. Participants were categorized as obese or non-obese according to their body mass index. All participants were evaluated with tests for static and semi-static balance. RESULTS: There were significant differences in the static balance between obese and non-obese people with intellectual disability. For women, there were not significant differences for any tests; in contrast for men, there were only significant differences in the SLSCE in people aged 37-46 years. CONCLUSIONS: Significant differences were found in static balance between non-obese and obese people. In the analyses, in consideration of gender and age range, significant differences were only found in one static balance test, in the young adult men´s group. No significant differences were found in women, either in middle-aged adults or in older adults.

Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review.

Aquatic therapy is one of the most common treatments for alleviating musculoskeletal pathologies. Its effectiveness has been evaluated with functional tests and questionnaires. Functional tests are used in aquatic therapy; however, in most cases, they are carried out in a non-aquatic environment and, as such, their results may differ from those of tests performed in an aquatic environment. A systematic review was performed to assess the accuracy of functional tests and patient-reported outcomes to assess aquatic therapy interventions. The authors conducted a literature search in July 2019. In total, 70,863 records were identified after duplicates removed. Of these, 14 records were included about functional tests assessment in aquatic environment and 725 records for questionnaires. The majority of the tests had also been assessed in a dry environment, allowing differences and similarities between the tests in the two environments to be observed. Different variables have been assessed in tests included in the present systematic review (cardiorespiratory, neuromuscular, kinematic, physiological, kinetic responses and rating of perceived exertion) which are included in the manuscript. Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and the 12-item Short Form Health Survey were the assessments most commonly used by the different authors.

Nutritional Status Measurement Instruments for Diabetes: A Systematic Psychometric Review.

BACKGROUND: Diabetes is a serious chronic disease associated with a large number of complications and an increased risk of premature death. A dietary evaluation is of utmost importance for health promotion, disease prevention and individual treatment plans in patients with diabetes. METHODS: An exhaustive search was carried out in various databases-Medline, Web of Science, Open Gray Cochrane Library and Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN)-for systematic review of the measurement properties of instruments that evaluate the dietary intake of people with diabetes mellitus type 1 and/or 2 according to COSMIN standards. RESULTS: Seven instruments were identified. There was no instrument measuring nutritional status for which all the psychometric properties were evaluated. The methodological quality for each of the psychometric properties evaluated was 'inadequate' or 'doubtful' for all instruments. The Food Frequency Questionnaire (FFQ) evaluated the most psychometric characteristics and with a better score in terms of quality of the evidence. CONCLUSIONS: Several instruments have been developed for the evaluation of dietary intake in people with diabetes. Evaluation of this construct is very useful, both in clinical practice and in research, requiring new knowledge in this area. The FFQ is the best instrument available to assess dietary intake in people with diabetes.

The suffering measurement instruments in palliative care: A systematic review of psychometric properties.

BACKGROUND: The relief of suffering is considered one of the main goals to reach at the end of life, and nurses play an essential role in the prevention and relief of suffering. Validated instruments for assessing suffering can be useful, and selection of the most appropriate measure is crucial. To date, no systematic review has been performed that contrasts the measurement properties of instruments assessing suffering in the palliative care population, according to the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments methodology. OBJECTIVES: The aim of this systematic review is twofold: (1) identify the measures assessing suffering in the palliative care population, and (2) assess the measurement properties of these measures. DESIGN: A systematic review of the measurement properties of instruments assessing suffering in palliative care was carried out. DATA SOURCES: The search strategy was conducted in Medline, CINAHL, PsycINFO, Web of Science, Cochrane Library, SciELO, Scopus, Cosmin database of systematic reviews and Open gray. REVIEW METHODS: The following methodologies were applied: updated COnsensus-based Standards for the selection of health status Measurement INstruments, the Meta-Analysis of Observational Studies in Epidemiology, and the Assessing the Methodological Quality of Systematic Reviews tool. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42018106488). Eligible studies were those that satisfied the following criteria: a) validation studies of measures assessing suffering in the palliative care population, b) assessing at least one measurement property of a measure, c) published in English or Spanish and d) published between January 1980 and September 2019. The included studies were assessed for the methodological quality of the measurement properties and then compared in terms of both the measurement properties and the methodological quality of the processes used. The evidence for each measurement property was summarised and the quality of the evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS: The search strategy yielded a total of nine studies and six instruments assessing suffering. The methodological quality of the studies was doubtful and the quality of the evidence was moderate for most of the measurement properties analysed. The Suffering Pictogram was the instrument with the best rating for methodological quality and quality of evidence, for most of the measurement properties evaluated. CONCLUSIONS: Instruments assessing suffering in palliative care have been identified in this systematic review. The Suffering Pictogram seems to be the most useful instrument identified. Tweetable abstract: The relief of suffering is one of the main goals to reach at the end of life, and the selection of the most appropriate measure for assessing this construct is crucial.

Muscle Activation and Distribution during Four Test/Functional Tasks: A Comparison between Dry-Land and Aquatic Environments for Healthy Older and Young Adults.

BACKGROUND: The use of rehabilitation protocols carried out in water has been progressively increasing due to the favorable physical properties of the water. Electromyography allows one to register muscle activity even under water. AIM: To compare muscle activity between two groups (healthy young adults (HYA) and healthy older adults (HOA)) in two different environments (dry land and aquatic) using surface electromyography during the execution of four different test/functional movements. METHODS: Analytical cross-sectional study. HYA and HOA carried out four functional tasks (Step Up and Down, Sit To Stand test, Gait Initiation and Turns During Gait) in two different environments (dry land and aquatic). Absolute and relative muscle activation was compared between each group and between each environment. In addition, the stability of the measured was calculated through a test-retest (ICC 2:1). RESULTS: Within the same environment there were significant differences between young and older adults in three of the four functional tasks. In contrast, in the gait initiation, hardly any significant differences were found between the two groups analysed, except for the soleus and the anterior tibial. Measurement stability ranged from good to excellent. CONCLUSIONS: Level of the musculature involvement presents an entirely different distribution when the test/functional task is performed on dry land or in water. There are differences both in the relative activation of the musculature and in the distribution of the partition of the muscles comparing older and young adults within the same environment.

Instruments for Measuring Satisfaction With Physical Therapy Care: A Systematic Review.

OBJECTIVE: Several instruments to measure patient satisfaction have been developed to assess satisfaction with physical therapy care. The selection of the most appropriate instrument is very important. The purpose of this study was to identify instruments for assessing satisfaction with physical therapy care and their psychometric properties and to evaluate the methodological quality of studies on psychometric properties. METHODS: A systematic search was conducted in ProQuest Medline, SciELO, ProQuest PsycINFO, Theseus, Cochrane Library, and Google Scholar. Articles published from 1990 to 2019, in English and Spanish, were used as limits. This systematic review followed the Consensus-based Standards for the Selection of Health Measurement Instruments and Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The articles were evaluated by 2 independent reviewers using the Consensus-based Standards for the Selection of Health Measurement Instruments 4-point checklist. Eighteen studies were included. RESULTS: Nine instruments were found to be specifically designed to assess satisfaction with physical therapy care. The methodological quality of the studies was "fair" for most of the psychometric characteristics analyzed (43 items), with 24 properties scored as "poor," 5 as "good," and 3 as "excellent." CONCLUSIONS: Different instrument characteristics-such as the scope and population with which the instrument will be used, its dimensions, the number of items, and the evidence shown in the evaluation of each psychometric property-should be considered by clinicians and researchers to decide which instrument is the best to measure the construct of patient satisfaction with physical therapy. IMPACT: Evaluating patient satisfaction is very useful in clinical practice at the hospital, community, and primary care levels. Physical therapist clinicians and researchers can use this systematic review to select instruments whose characteristics will best measure their patients' satisfaction with physical therapy care.

Comunicación en terapia ocupacional / Communication in occupational therapy

En la siguiente recesión se presenta un artículo del antropólogo Gregory Bateson, que pretende mostrar cuán importante es tanto la modalidad del tratamiento como la capacidad de comunicación del profesional para incidir de manera positiva en el cambio intrínseco de la persona. A través de su lectura se pueden extraer otras reflexiones como son la identidad de la profesión, el nacimiento de la misma y su contexto, los paradigmas a lo largo de su historia, todos los cambios acontecido y sus causas y sobre todo el momento en el que estamos y hacia donde queremos dirigirnos sin perder la esencia de la terapia ocupacional, lo que nos diferencia del resto de profesionales, en vez de acercarnos cada vez más a ellos

In the following critical review, an opinion article by anthropologist Gregory Bateson, which aims to show how important is both the treatment modality and the professional's ability to communicate in a positive way in the intrinsic change of the person. Through its reading, other reflections can be detected, such as the identity of the profession, the birth of the profession and its context, the paradigms throughout its history, all the changes that have occurred and its causes and, above all, the moment in which that we are and where we are heading without losing the essence of occupational therapy, which differentiates us from other professionals, instead of getting closer and closer to them

Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study.

OBJECTIVE: Chronic musculoskeletal pain disorders (CMPDs) are among the leading causes of disabilities across populations, resulting in high social and financial burden. This persistent pain condition may include the central sensitization (CS) phenomenon, which implies a wide range of symptoms and that may be taken into account in CMPD treatment. CS symptoms can be measured by the Central Sensitization Inventory (CSI). The aims of the study were to describe CS symptoms in patients suffering from several CMPDs and to analyze differences due to gender, age, and body mass index (BMI). DESIGN: This cross-sectional study recruited a total of 395 Spanish participants suffering from several CMPDs. SETTING: CS symptoms were measured with the Spanish Version of the CSI. The total score (0-100) and a cutoff score of 40 were recorded. SUBJECTS: A total of 395 participants were included. RESULTS: The mean CSI total score for the whole sample was 24.6 ± 12.0 points. CSI total score had subclinical values in the whole sample, whereas participants with scores >40 were found across different CMPDs, such as low back pain (37.8%) and neck pain (32.4%); 14.6% of females and 1.7% of males presented CSI scores >40. Patients showed significant differences in CSI cutoff point by gender (P = 0.010) and CSI total score by age (P = 0.014). CONCLUSIONS: Given the high prevalence of clinically relevant CSI scores (>40) in people with a CMPD, especially low back pain and neck pain, we recommend that clinicians supplement their assessment with the CSI for improved decision-making during treatment.

Development of a new index of strength in adults with intellectual and developmental disabilities.

Background: Given the increase in the prevalence of muscular strength problems in people with intellectual and developmental disability and the potentially serious consequences for their day-to-day life, there is a need for comprehensive evaluations of strength.Aims: To design a new index of the muscular strength of people with intellectual and developmental disability using principal components analysis.Methods and procedures: The sample consisted of 978 individuals with intellectual and developmental disability, 637 men and 341 women, with a mean age of 34.8 years (±11.2) who were recruited from the European Special Olympics Games. All participants were measured with the following functional tests: timed stand test, partial sit-up test, seated pushup and handgrip test.Outcomes and results: Data was analyzed using principal components analysis with Oblimin rotation and Kaiser normalization. The Component Plot and Rotated Space indicated that a one-factor solution was optimal. The principal component analysis revealed a satisfactory percentage of total variance explained.Conclusions: Based on the data analyzed above we believe that the strength index developed in this study could help to facilitate the assessment and follow-up of people with intellectual and developmental disability in the clinical setting, because it offers a broad measure of an individual's muscular response generated to the various stimuli presented by the evaluator. In addition, because it is economical, and easy and quick to administer, this index could easily be applied in clinical and research settings.Implications for rehabilitationThe developed index allows to classify people with intellectual and developmental disability according to their strength, knowing, in addition, the variance that each of the four tests explains about that index.The strength index developed in this study could help to facilitate the assessment and follow-up of people with intellectual and developmental disability due to its ease of use, economy and time required for its execution, could lead to an easy transfer and use in clinical setting.

Adaptation and validation of a scale of self-efficacy and social support for physical activity in Spanish patients with severe mental disorders.

BACKGROUND: People with severe mental disorders (SMDs) suffer problems of obesity, a sedentary life, and poor physical condition, mainly due to low levels of physical activity. Self-efficacy (SE) and social support (SS) are important components that influence participation in physical activity. METHODS: This study adapted a scale to assess SE and SS in promoting physical activity in Spanish people with SMDs, as well as provide preliminary evidence of its validity. One hundred Spanish patients (23% female) with SMDs, between 26 and 61 years old, completed the SE/SS assessment for SMD (SE/SS-ASMD). RESULTS: The instrument seemed to capture a four-factor structure in people with SMDs. Due to the lack of a gold standard, the scale was related to other instruments with which it might be expected to show a correlation, such as those for physical activity and its quality; however, the levels of correlation found were low (≈0.3). The Internal consistency (Cronbach's α) for the SE-ASMD, SS-ASMD staff, SS-ASMD peers, and SS-ASMD family scales were 0.76, 0.76, 0.80, and 0.80, respectively. CONCLUSIONS: The psychometric analysis of the SE/SS-ASMD supported its suitability as a new tool for researchers in the area of physical activity among people with SMDs.