Efectos de entrenamiento físico específico y técnicas de relajación sobre los parámetros dolorosos de la cefalea tensional en estudiantes universitarios: un ensayo clínico controlado y aleatorizado / Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial

INTRODUCCIÓN: Los tratamientos no farmacológicos consiguen controlar la cefalea tensional, sin embargo, la evidencia es todavía limitada. Esta investigación estudia la eficacia de una intervención fisioterápica, basada en cinesiterapia cervical y pautas de higiene postural, que pretende mejorar los resultados obtenidos únicamente con técnicas de relajación (Entrenamiento Autógeno de Schultz [EA]). MÉTODOS: Se seleccionó a 152 estudiantes universitarios (sector poblacional entre quienes esta patología es muy frecuente), 84 mujeres (55,3%) y 68 hombres (44,7%), con edad media de 20,42 años (DT = 2,36), diagnosticados de cefalea tensional, según criterios de la International Headache Society. Se diseñó un ensayo clínico, no farmacológico, controlado y aleatorizado, con evaluación ciega de las variables respuesta. Se compararon los resultados de 2 muestras paralelas e independientes, aplicando a una el EA y a la otra la combinación de este con un programa de cinesiterapia cervical y educación postural. Se cuantificaron la mejoría en los parámetros dolorosos (frecuencia, intensidad y duración) y la reducción del consumo de fármacos, en diarios de cefaleas, antes de los tratamientos y después, a las 4 semanas y a los 3 meses. RESULTADOS: Los 2 grupos de intervención evolucionaron positivamente, consiguiéndose una reducción más significativa en la frecuencia e intensidad de las cefaleas con el tratamiento combinado (p < 0,01) (d = 0,4). CONCLUSIONES: Las terapias activas, no invasivas, como el EA y la cinesiterapia cervical, y especialmente la combinación de ambos, consiguen reducir la cefalea tensional, al prevenir y controlar las posibles causas psicofísicas de este trastorno. Como futuras líneas de investigación, sería interesante evaluar el mantenimiento de los beneficios a largo plazo

INTRODUCTION: Despite the impact of cerebrovascular disease (CVD) on global health, its morbidity and time trends in Spain are not precisely known. :Objective The purpose of our study was to characterise the epidemiology and trends pertaining to stroke in Aragon over the period 1998-2010. METHODS: We conducted a retrospective, descriptive study using the data of the Spanish health system's Minimum Data Set and included all stroke patients admitted to acute care hospitals in Aragon between 1 January 1998 and 31 December 2010. We present data globally and broken down by stroke subtype, sex, and age group. RESULTS: The number of cases increased by 13% whereas age- and sex-adjusted hospitalisation rates showed a significant decrease for all types of stroke (mean annual decrease of 1.6%). Men and women in younger age groups showed opposite trends in hospitalisation rates for ischaemic stroke. Case fatality rate at 28 days (17.9%) was higher in patients with intracerebral haemorrhage (35.8%) than in those with subarachnoid haemorrhage (26.2%) or ischaemic stroke (13%). CVD case fatality showed a mean annual decline of 2.8%, at the expense of the fatality rate of ischaemic stroke, and it was more pronounced in men than in women. DISCUSSION: Understanding stroke epidemiology and trends at the regional level will help establish an efficient monitoring system and design appropriate strategies for health planning

Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial. / Efectos de entrenamiento físico específico y técnicas de relajación sobre los parámetros dolorosos de la cefalea tensional en estudiantes universitarios: un ensayo clínico controlado y aleatorizado.

INTRODUCTION: Non-pharmacological treatments help control tension-type headache; however, evidence about their effectiveness is still limited. This study evaluates the effectiveness of physical therapy based on cervical spine kinesiotherapy and posture correction exercises compared to a programme of relaxation techniques only (Schultz's Autogenic Training, AT). METHODS: Tension-type headache is very common among university students. We randomly selected 152 university students with a diagnosis of tension-type headache according to the criteria of the International Headache Society. Eighty-four were women (55.3%) and 68 were men (44.7%). Mean age was 20.42±2.36 years. The study design is a randomised controlled trial of a non-pharmacological intervention with a blinded evaluation of response variables. We compared the results of two independent samples: AT was used in one of the groups while the other group received AT plus cervical spine kinesiotherapy and posture correction training. Patients recorded any changes in the parameters of pain (frequency, intensity, and duration) and drug consumption in a headache diary before treatment, at 4 weeks, and at 3 months. RESULTS: Both interventions achieved a decrease in all the parameters of pain; however, decreases in frequency and intensity were more significant in the combined treatment group (P<0.01) (d=0.4). CONCLUSIONS: Such active, non-invasive therapies as AT and cervical spine kinesiotherapy, and especially the combination of both, effectively reduce tension-type headache by preventing and managing the potential psychophysical causes of this disorder. Future research should aim to assess the long-term effects of these interventions.

Intervenciones asistidas por animales en neurorrehabilitación: una revisión de la literatura más reciente / Animal assisted interventions in neurorehabilitation: A review of the most recent literature

Introducción: Aunque siempre se ha afirmado el valor de los animales en la promoción del bienestar y la salud del ser humano, solo recientemente su papel terapéutico en medicina se ha convertido en el foco de investigación especializada. Las intervenciones asistidas poranimales pueden dividirse en actividades asistidas por animales, terapia asistida por animales y programas de animales de servicio. Objetivo: El objetivo de esta revisión es analizar las publicaciones realizadas entre 2001 y 2012 en las revistas médicas más importantes, relacionadas con el campo de la rehabilitación de las enfermedades neurológicas, y discutir estos hallazgos a la luz de lo que pueda ser de interés para la neurología. Discusión: Se seleccionaron un total de 23 artículos de intervenciones en el campo de la parálisis cerebral infantil, trastornos generalizados del desarrollo, esclerosis múltiple, lesión medular, accidente cerebrovascular y trastornos mentales. Los principales resultados terapéuticos fueron: mejoría en la Gross Motor Function y en el manejo del miembro superior (parálisis cerebral infantil); aumento de la socialización y el contacto con el medio ambiente, reducción del estrés y la ansiedad y sentimientos de soledad (trastornos generalizados del desarrollo y trastornos mentales); disminución de la espasticidad y mejoría del equilibrio (esclerosis múltiple, lesión medular, accidente cerebrovascular). Conclusiones: Estas intervenciones asistidas con un tipo de animales muy limitado utilizadas en grupos clínicos neurológicos muy específicos muestran cada vez más pruebas científicas, como método complementario a otras terapias ya existentes. En estas enfermedades, se necesitan más estudios de alta calidad metodológica que permitan definir los programas más apropiados para la aplicación terapéutica

Introduction: While conventional wisdom has always affirmed the value of animals in promoting human health and well-being, only recently has their therapeutic role in medicine become a topic for dedicated research. Animal assisted interventions (AAI) can be classified as animal-assisted activities, animal-assisted therapy, and service animal programs. Objective: The aim of this review is to analyse original papers addressing AAI and neurological diseases and published in the most influential medical journals between 2001 and 2012, and discuss their findings in the light of what may be of interest in the field of neurology.Discussion: We selected a total of 23 articles on neurorehabilitation in cerebral palsy, pervasive developmental disorders, multiple sclerosis, spinal cord injury, stroke, and mental disorders. The main therapeutic results were improvement on the Gross Motor Function Classification Scale and in upper limb dexterity (cerebral palsy); improvement in social functioning and interaction; reductions in stress, anxiety, and loneliness (pervasive developmental disorders andmental disorders); and decreased spasticity with improved balance (multiple sclerosis, spinal cord injury, stroke). Conclusion: These interventions, performed with highly specialised animals in very specific neurological populations, deliver an increasing body of scientific evidence suggesting that theyare an effective complement to other existing therapies. In these diseases, further high-quality studies are warranted in order to define the most appropriate programmes for therapy

Animal assisted interventions in neurorehabilitation: a review of the most recent literature.

INTRODUCTION: While conventional wisdom has always affirmed the value of animals in promoting human health and well-being, only recently has their therapeutic role in medicine become a topic for dedicated research. Animal assisted interventions (AAI) can be classified as animal-assisted activities, animal-assisted therapy, and service animal programs. OBJECTIVE: The aim of this review is to analyse original papers addressing AAI and neurological diseases and published in the most influential medical journals between 2001 and 2012, and discuss their findings in the light of what may be of interest in the field of neurology. DISCUSSION: We selected a total of 23 articles on neurorehabilitation in cerebral palsy, pervasive developmental disorders, multiple sclerosis, spinal cord injury, stroke, and mental disorders. The main therapeutic results were improvement on the Gross Motor Function Classification Scale and in upper limb dexterity (cerebral palsy); improvement in social functioning and interaction; reductions in stress, anxiety, and loneliness (pervasive developmental disorders and mental disorders); and decreased spasticity with improved balance (multiple sclerosis, spinal cord injury, stroke). CONCLUSION: These interventions, performed with highly specialised animals in very specific neurological populations, deliver an increasing body of scientific evidence suggesting that they are an effective complement to other existing therapies. In these diseases, further high-quality studies are warranted in order to define the most appropriate programmes for therapy.

Role of the physical and rehabilitation medicine specialist regarding of children and adolescents with acquired brain injury.

Acquired brain injury (ABI) is one of the most common causes of mortality and severe disability in children and adolescents. Those with ABI may suffer any of a wide range of disorders that may limit their activity, their participation in family and school life, and their involvement in society in general. This paper describes the different stages of recovery - hospitalisation, preparing for discharge, and long term follow-up, in which PRM specialists are involved. Although the involvement of the PRM specialist is important in all three stages, it is during the latter two stages when his or her expertise is particularly important. An interdisciplinary care team - which the PRM specialist is well placed to lead ­ is required if the best results are to be achieved.