Efectividad del trabajo de resistencia y de cicloergómetro a alta velocidad sobre la bradicinesia en la enfermedad de Parkinson: revisión sistemática / Effectiveness of endurance exercises and high-speed cycling on bradykinesia in Parkinson's disease: A systematic review

Antecedentes y objetivo Los ejercicios de resistencia y de cicloergómetro a alta intensidad se han utilizado en los últimos años para tratar la bradicinesia en la enfermedad de Parkinson (EP). El objetivo es determinar la efectividad del ejercicio de resistencia y de cicloergómetro a alta intensidad para disminuir la bradicinesia en pacientes con EP. Sujetos y métodos Se realizó una búsqueda hasta el año 2020 en las bases de datos PubMed, Web of Science, Medline, Cochrane Library, Google Scholar y ScienceDirect. Para evaluar la calidad metodológica y validez interna de los estudios se utilizó la escala PEDro. Resultados Se incluyeron 10 estudios en nuestra revisión. Cinco estudios llevaron a cabo un trabajo con cicloergómetro de alta intensidad cuya duración fue de una a cinco semanas, mejorando la bradicinesia cuatro de ellos, siendo tres de manera significativa. Cuatro estudios realizaron un trabajo con resistencia (desde nueve semanas hasta 24 meses) mejorando todos la bradicinesia, siendo significativos tres de ellos. Un estudio realizó un trabajo de resistencia y cicloergómetro demostrando mejorar la bradicinesia tras 12 semanas de tratamiento. Conclusión Aunque los dos tratamientos son beneficiosos para mejorar la bradicinesia en EP con severidades leves-moderadas, en un periodo mínimo de una semana, el tratamiento con cicloergómetro a alta velocidad tiene mejoras significativas, mientras que el trabajo con resistencia lo hace a partir de nueve semanas, siendo necesarios más estudios con mejores evidencias (AU)

Background and objective Endurance and high-intensity stationary cycling exercises have been used in recent years to treat bradykinesia in Parkinson's disease (PD). The aim is to determine the effectiveness of endurance and high-intensity stationary cycling in reducing bradykinesia in people with PD. Subjects and methods A search was conducted up to 2020 in the PubMed, Web of Science, Medline, Cochrane Library, Google Scholar and ScienceDirect databases. The PEDro scale was used to assess the methodological quality and internal validity of the studies. Results 10 studies were included in our review. Five studies carried out high intensity stationary cycling workouts with a duration of 1 to 5 weeks, 4 of them showed improved bradykinesia, 3 of them significantly. Four studies carried out endurance exercises (from 9 weeks to 24 months) all cases of bradykinesia improved, 3 significantly. One study looked at endurance exercises and stationary cycling showing, an improvement in bradykinesia after 12 weeks of treatment. Conclusion Although both treatments are beneficial for improving bradykinesia in PD of mild-moderate severity, in a minimum period of one week, treatment with high-speed stationary cycling shows significant improvements, while endurance exercises do so from 9 weeks onwards. Further studies with better evidence are needed (AU)

Results of a self-management program added to standard physical therapy in chronic neck pain.

OBJECTIVE: To evaluate the effectiveness of a self-management treatment added to a physical therapy program compared to a physical therapy program in patients with chronic neck pain. METHODS: Fifty-three patients with chronic neck pain were randomly allocated to a physical therapy intervention (control group) or an individualized self-management combined with physical therapy intervention (experimental group). Both interventions were developed over a four-week period. Outcome measures included were Disability, Fear-Avoidance Beliefs, Health-Related Quality of Life, Pain, and Anxiety and Depression. All outcomes were measured before and after the treatment and at three-month follow-up. RESULTS: There were not significant differences between groups at baseline. After the intervention both groups obtained better results in the Neck Disability Index but there were not significant differences between them (p > 0.05). At follow-up, the self-management group obtained significant better results compared to the control group (95 % CI: -5.20(-6.8 to -1.5), p = 0.032). CONCLUSIONS: An individualized self-management program added to a physical therapy program led to a greater improvement in disability at 3 months follow up compared to a physical therapy program alone. Catastrophizing, pain, and health-related quality of life improved significantly after the intervention and at follow-up compared to the standard care alone. PRACTICAL IMPLICATIONS: This study indicates that physical therapy for patients with chronic neck pain preferably should include self-management education.

Relación entre el perfil clínico y la tensión neural en personas con dolor cervical crónico / Relationship between clinical profile and neural tension in people with chronic neck pain

Introducción y objetivos: El dolor cervical crónico (DCC) confluye con una gran variedad de signos y síntomas, tales como la tensión neural y las alteraciones conductuales. Este estudio pretende evaluar la relación entre la tensión neural y el perfil clínico de los pacientes con DCC. Materiales y métodos: Se llevó a cabo un estudio observacional de corte transversal. Se incluyeron 25 pacientes con DCC y 25 personas sin dolor. Se evaluó el perfil clínico incluyendo las variables físicas (dolor, discapacidad), y las variables psicológicas y/o comportamentales (ansiedad, depresión, calidad de vida, miedo al movimiento y conductas de miedo-evitación). La tensión neural se midió a través de pruebas de neurodinamia. Resultados: Los sujetos con DCC presentaron una alteración significativa de la tensión neural, en comparación con las personas sin dolor. Se halló una correlación significativa entre los test de neurodinamia y las conductas y creencias sobre el dolor, así como su interferencia en la vida diaria. Adicionalmente se mostró una relación significativa entre las creencias y actitudes sobre el dolor y la intensidad e interferencia del mismo, la discapacidad y el estado de salud percibido. Conclusiones: Los pacientes con DCC muestran peores resultados que el grupo sin dolor en los test de neurodinamia del miembro superior. La neurodinamia se relaciona con las variables psicológicas y comportamentales medidas

Introduction and objectives: Chronic neck pain includes a wide variety of signs and symptoms, such as neural tension and behavioural changes. The aim of this study was to evaluate the relationship between neural tension and the clinical profile of patients with chronic neck pain. Materials and methods: We carried out a cross-sectional observational study. We included 25 patients with chronic neck pain and 25 without pain. The clinical profile was evaluated including physical variables (pain, disability), and psychological and / or behavioural variables (anxiety, depression, quality of life, fear of movement and fear-avoidance behaviours). Neural tension was measured through neurodynamic tests. Results: The subjects with chronic neck pain had worse neural tension results compared with the controls. A significant correlation was found between the neurodynamic tests and the psychological and behavioural variables. Additionally, there was a significant relationship between beliefs and attitudes about pain and daily life interference, disability and perceived health status. Conclusions: The patients with chronic neck pain had worse results than the painless group in the upper limb neurodynamic tests. Neurodynamics related to the psychological and behavioural variables

Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial.

OBJECTIVE: To investigate the effects of a Pilates exercise program on disability, pain, lumbar mobility, flexibility and balance in patients with chronic non-specific low back pain. DESIGN: Randomized controlled trial. SETTING: University laboratory. PARTICIPANTS: A total of 54 patients with chronic non-specific low back pain. INTERVENTION: Patients were randomly allocated to an experimental group ( n=27) included in a Pilates exercise program or to a control group ( n=27) receiving information in a form of a leaflet. MAIN OUTCOME MEASURES: Disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), current, average and pain at it least and at its worst (Visual Analogue Scales), lumbar mobility (modified Shober test), flexibility (finger-to-floor test) and balance (single limb stance test) were measured at baseline and after the intervention. RESULTS: A between-group analysis showed significant differences in the intervention group compared to the control group for both disability scores, the Rolland-Morris questionnaire (mean change±standard deviation of 5.31±3.37 and 2.40±6.78 respectively and between-groups mean difference of 3.2 ± 4.12, p=0.003) and the Oswestry Disability Index ( p<0.001), current pain ( p=0.002) and pain at it least ( p=0.033), flexibility (0.032) and balance (0.043). CONCLUSIONS: An 8-week Pilates exercise program is effective in improving disability, pain, flexibility and balance in patients with chronic non-specific low back pain.

International approach to eradication and surveillance for foot-and-mouth disease in the Americas.

Foot-and-mouth disease (FMD) was introduced into the Americas in 1870. At that time the disease was described simultaneously in the North coast of the United States of North America, the Province of Buenos Aires in Argentina, the central region of Chile, Uruguay, and South Brazil. At the beginning of the twentieth century the disease spread to the rest of Brazil, Bolivia, Paraguay, and Perú. In 1950 the disease was introduced into Venezuela, and in the same year to Colombia, and from there to Ecuador. The United States of America eradicated an outbreak of FMD in 1929. Outbreaks of FMD were also eradicated from Mexico in 1947 and from Canada in 1952. The last outbreak that occurred in Mexico in 1954 was also eradicated. In 1951 the Americas Animal Health Authorities decided to establish a Pan-American Foot-and-Mouth Disease Center (PANAFTOSA), initially as a special program within the American States Organization (OAS). The center was later transferred to the Pan-American Health Organization (PAHO). In the early 1970s PANAFTOSA developed a proposal for a continental surveillance system for vesicular diseases, which was approved by Agriculture Ministers at an International Meeting for FMD and Zoonoses (RICAZ). Since then, PANAFTOSA dedicated all efforts to collaborate with each country in the implementation of the system and to receive, analyze, and distribute a weekly report of vesicular diseases. The model was elaborated using coordinate grid maps, one for the South American Continent, others for each country in the region. The reports from each country consist of the grid location for any suspicious outbreak of vesicular disease. Using the information gathered during visits to the countries, as well as weekly reports, and by studying the most frequent animal movements within the region, PANAFTOSA developed a proposal for FMD eradication. This plan was approved by the Government of South America and implemented in cooperation with PANAFTOSA. The hemispheric plan for FMD eradication (PHEFA), has been implemented and today Chile and Uruguay are FMD free without vaccination; Argentina, Paraguay, and the states of Rio Grande do Sul and Santa Catarina in Brazil are also recognized by the OIE to be FMD Free, with vaccination. The use of the continental surveillance system is the main strategy for achieving the eradication of FMD in South America. At this time PANAFTOSA is working to improve the system, and to add other diseases indicated by the governments of the Americas.

Costo de la atencion a personas mordidas por perros en Ciudad Juarez, Mexico. / The cost of medical care for persons bitten by dogs in Ciudad Juarez, Mexico

La incidencia de rabia humana en Ciudad Juarez, Chihuahua, llevo a efectuar un estudio del costo del tratamiento de las personas que acudieron al Centro Antirrabico de esa ciudad por haber tenido contacto o haber sido mordidas por un animal que se sospechaba rabioso