Efectividad de la inhibición suboccipital combinada con corriente interferencial en pacientes con cefalea tensional crónica: un ensayo clínico controlado aleatorizado / Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial

Introducción: Se ha demostrado que la terapia manual reduce los síntomas autoreportados en pacientes con cefalea tensional crónica (CTC). Sin embargo, la aplicación simultánea de la técnica de inhibición muscular suboccipital y corriente interferencial no se ha investigado previamente. Este estudio evalúa la efectividad de la inhibición muscular suboccipital y la corriente interferencial en comparación con los cuidados habituales sobre el dolor, la discapacidad y el impacto de la cefalea en pacientes con CTC.MétodosLos pacientes se asignaron al azar al grupo de cuidados habituales (n = 13) o experimental (n = 12) que consistió en 20 minutos de inhibición muscular suboccipital y corriente interferencial dos veces por semana durante cuatro semanas. El resultado primario fue el dolor, y los resultados secundarios incluyeron la discapacidad producida por el dolor de cabeza y el impacto del dolor de cabeza que se valoraron por un evaluador cegado al inicio y después de cuatro semanas.ResultadosLos análisis mostraron diferencias entre los grupos a favor del grupo experimental a las cuatro semanas para la discapacidad producida por el dolor de cabeza (Neck Disability Index: g-Hedges = 1,01; p = 0,001; Headache Disability Inventory: g-Hedges = 0,48; p = 0,022) e impacto del dolor de cabeza (HIT-6: g-Hedges = 0,15; p = 0,037) pero no para el dolor autoreportado (Numerical Rating Scale: g-Hedges = 1,13; p = 0,18).ConclusionesLa aplicación simultánea de inhibición muscular suboccipital y corriente interferencial en pacientes con CTC no reduce significativamente el dolor autoreportado a las cuatro semanas. Sin embargo, mejora la discapacidad y el impacto del dolor de cabeza en la vida diaria. Estas mejoras superaron el mínimo cambio clínicamente importante de las mediciones, destacando su relevancia clínica. (AU)

Introduction: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH.MethodsPatients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater.ResultsStatistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges’ g = 1.01, P = .001; and Headache Disability Inventory: Hedges’ g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges’ g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges’ g = 1.13, P = .18).ConclusionsCombined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings. (AU)

Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial.

INTRODUCTION: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS: Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS: Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS: Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

Use of commercial video games to improve postural balance in patients with multiple sclerosis:a systematic review and meta-analysis of randomised controlled clinical trials.

INTRODUCTION: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. OBJECTIVES: To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. MATERIAL AND METHOD: We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: "multiple sclerosis", videogames, "video games", exergam*, "postural balance", posturography, "postural control", balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale (BBS). RESULTS: Five randomised controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: -.74; 95% CI, -2.79 to 1.32; P=.48; I2=0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, -1.06 to .76; P=.75; I2=0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P<.001; I2=0%), but these were not greater than the minimum detectable change reported in the literature. CONCLUSIONS: The effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited.

Efectos de la terapia con videojuegos comerciales sobre el equilibrio postural en pacientes con esclerosis múltiple: revisión sistemática y metaanálisis de ensayos clínicos controlados aleatorizados / Use of commercial video games to improve postural balance in patients with multiple sclerosis: A systematic review and meta-analysis of randomised controlled clinical trials

Introducción: El uso de videojuegos comerciales ha sido considerado una herramienta eficaz para mejorar el equilibrio postural en diferentes poblaciones. Sin embargo, los beneficios reportados en pacientes con esclerosis múltiple (PEM) no están claros.ObjetivosAnalizar la evidencia existente sobre los efectos de las terapias con videojuegos comerciales en el equilibrio postural en PEM.Material y métodoSe realizó una búsqueda en las bases de datos Academic-Search-Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, ScienceDirect utilizando los términos multiple sclerosis, videogames, video games, exergam*, postural balance, posturography, postural control, balance. El riesgo de sesgo fue analizado por 2 revisores independientes. Se realizaron 3 metaanálisis modelos de efectos fijos calculando la diferencia de medias (DM) y el intervalo de confianza (IC) del 95% para las variables Four-Step-Square-Test, Timed-25-Foot-Walk y Berg-Balance-Scale.ResultadosCinco ensayos clínicos controlados aleatorizados fueron incluidos en la síntesis cualitativa, mientras que 4 fueron incluidos en el metaanálisis. No se observaron diferencias entre las terapias con videojuegos y los grupos controles para la variable Four-Step-Square-Test (DM: –0,74; IC 95%: –2,79 a 1,32; p = 0,48; I2 = 0%) y Timed-25-Foot-Walk (DM: –0,15; IC 95%: –1,06 a 0,76; p = 0,75; I2 = 0%). Sin embargo, la variable Berg-Balance-Scale mostró diferencias a favor del grupo de videojuegos (DM: 5,30; IC 95%: 3,39 a 7,21; p < 0,001; I2 = 0%), aunque estos resultados no fueron superiores al mínimo cambio detectable reportado en la literatura científica.ConclusionesLa eficacia de las terapias con videojuegos comerciales sobre el equilibrio postural en PEM es escasa. (AU)

Introduction: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear.ObjectivesTo analyse existing evidence on the effects of commercial video games on postural balance in patients with MS.Material and methodWe conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: “multiple sclerosis”, videogames, “video games”, exergam*, “postural balance”, posturography, “postural control”, balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale.ResultsFive randomized controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: –.74; 95% CI, –2.79-1.32; P = .48; I2 = 0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, –1.06-.76; P = .75; I2 = 0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P < .001; I2 = 0%), but these were not greater than the minimum detectable change reported in the literature.ConclusionsThe effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited. (AU)

Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial. / Efectividad de la inhibición suboccipital combinada con corriente interferencial en pacientes con cefalea tensional crónica: un ensayo clínico controlado aleatorizado.

INTRODUCTION: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS: Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS: Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS: Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

Use of commercial video games to improve postural balance in patients with multiple sclerosis: A systematic review and meta-analysis of randomised controlled clinical trials. / Efectos de la terapia con videojuegos comerciales sobre el equilibrio postural en pacientes con esclerosis múltiple: revisión sistemática y metaanálisis de ensayos clínicos controlados aleatorizados.

INTRODUCTION: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. OBJECTIVES: To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. MATERIAL AND METHOD: We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: "multiple sclerosis", videogames, "video games", exergam*, "postural balance", posturography, "postural control", balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale. RESULTS: Five randomized controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: -.74; 95% CI, -2.79-1.32; P=.48; I2=0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, -1.06-.76; P=.75; I2=0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P<.001; I2=0%), but these were not greater than the minimum detectable change reported in the literature. CONCLUSIONS: The effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited.

Relationship between jumping abilities and skeletal muscle architecture of lower limbs in humans: Systematic review and meta-analysis.

The aim of this study was to examine the influence of skeletal muscle architecture (SMA) features measured by 2-D ultrasonography on jumping performance in humans. A systematic review and meta-analysis was conducted, registry number: CRD42016043602. The scientific literature was systematically searched in eight databases, last run on March 14th, 2017. Cross-sectional studies focused on the association between SMA features and vertical jumping performance were selected. A random-effects model was used to analyze the influence of lower-limb SMA and maximal jump height. A total of 11 studies were included in the qualitative synthesis and 6 studies were selected for meta-analysis. 250 correlations were reviewed across studies. The vast majority were either not statistically significant (185; 74%), weak or very weak (169; 68%) for different jump modalities; counter-movement jump (CMJ), squat jump (SJ), and drop jump. There was insufficient data to perform meta-analysis on muscles other than vastus lateralis for CMJ and SJ. The meta-analyses did not yield any significant association between vastus lateralis SMA and SJ height. Only a significant overall association was shown between vastus lateralis thickness and CMJ height (summary-r = 0.28; 95% confidence interval (CI) = -0.05 to 0.48; p = .059) for a 90% CI level. No differences were found between summary-r coefficients for SMA parameters and jump height during both jumps (CMJ: χ2 = 2.43; df   = 2; p = .30; SJ: χ2 = 0.45; df = 2; p = .80) with a low heterogeneity ratio. Current evidence does not suggest a great influence of lower-limb SMA on vertical jumping performance in humans.

Bilateral deficit in explosive force related to sit-to-stand performance in older postmenopausal women.

The purpose of this study was to determine whether the bilateral deficit (BLD) for maximal voluntary force (MVF) and rate of force development (RFD) influences sit-to-stand in older postmenopausal women. Fourteen women performed unilateral and bilateral maximal voluntary contractions during isometric leg-extension. The MVF and RFD over consecutive 50ms periods (0-50, 50-100 and 100-150ms) after force onset and the time to sit-to-stand test were calculated. There was only a BLD for RFD 0-50ms and 50-100ms. The time of sit-to-stand was moderately correlated to BLD for RFD 0-50ms (r=0.505; 95% CI: -0.035 to 0.817; P=0.06), but after controlling for physical activity level the relationship was stronger and statistically significant (r=0.605; 95% CI: 0.109 to 0.859; P=0.029). These results suggest that the BLD for explosive force (0-50ms) might represent a performance-limiting factor for sit-to-stand transfer in postmenopausal women and could be dependent of the physical activity level. Trial registered at Clinical Trials Gov.: NCT02434185.