Seventy percent of women with pelvic floor dysfunctions (PFDs) are estimated to present deficient consciousness of their pelvic floor muscles (PFMs) and poor ability to contract them. Improving the proprioception of PFMs, defined as the... more
Seventy percent of women with pelvic floor dysfunctions (PFDs) are estimated to present deficient consciousness of their pelvic floor muscles (PFMs) and poor ability to contract them. Improving the proprioception of PFMs, defined as the capacity to know the status and position of each body part, and adequately contracting them could be a protective factor to prevent the appearance of PFDs in the general female population. This study aimed to identify the effectiveness of educational interventions and verbal instructions on how to contract and exercise the PFMs to improve the proprioception of the PFMs in women. A systematic search of studies published in the last 20 years until March 2022 was conducted in the PubMed, Cochrane Library, Web of Science, Scopus, PEDro, Lilacs, and Dialnet databases. A meta-analysis could not be performed due to the heterogeneity in the types of studies and included populations. This review followed the PRISMA guidelines for the design, search, and reporting of studies. The methodological quality was analysed
via the PEDro and the Newcastle–Ottawa scales in the case of randomised clinical trials and nonrandomised studies, respectively, while the quality of evidence was determined using the SIGN grading system for evidence-based guidelines. Descriptive and experimental studies published in English, Spanish, or Portuguese that evaluated the contractile capability of the PFMs in healthy women or women without a previous diagnosis of PFD were included. Seven articles that included a total of 2507 women were found, three of which were clinical trials with PEDro scores between 5 and 9 points out of 10 and four of which were non-randomised studies with NOS scores between 6 and 8 points out of 10. The outcomes were measured through vaginal palpation, visual observation, questionnaires for PFD symptoms, and self-perception reports. This review discriminated between two types of intervention, educational programmes and verbal instructions, and evaluated the changes observed in PFM strength and knowledgeability and the symptoms of PFDs. The findings showed that educational interventions and verbal instructions improve the proprioception of PFMs in women of all ages that are healthy or without a previous diagnosis of PFDs as well as their knowledge about the pelvic floor, healthy lifestyle habits, and symptoms that are potentially indicative of PFDs.
Further high-quality randomised clinical trials are warranted to draw definitive conclusions about the effectiveness of educational interventions to improve the proprioception of the PFMs in women considered healthy or with mild symptoms that may be indicative of PFDs.
via the PEDro and the Newcastle–Ottawa scales in the case of randomised clinical trials and nonrandomised studies, respectively, while the quality of evidence was determined using the SIGN grading system for evidence-based guidelines. Descriptive and experimental studies published in English, Spanish, or Portuguese that evaluated the contractile capability of the PFMs in healthy women or women without a previous diagnosis of PFD were included. Seven articles that included a total of 2507 women were found, three of which were clinical trials with PEDro scores between 5 and 9 points out of 10 and four of which were non-randomised studies with NOS scores between 6 and 8 points out of 10. The outcomes were measured through vaginal palpation, visual observation, questionnaires for PFD symptoms, and self-perception reports. This review discriminated between two types of intervention, educational programmes and verbal instructions, and evaluated the changes observed in PFM strength and knowledgeability and the symptoms of PFDs. The findings showed that educational interventions and verbal instructions improve the proprioception of PFMs in women of all ages that are healthy or without a previous diagnosis of PFDs as well as their knowledge about the pelvic floor, healthy lifestyle habits, and symptoms that are potentially indicative of PFDs.
Further high-quality randomised clinical trials are warranted to draw definitive conclusions about the effectiveness of educational interventions to improve the proprioception of the PFMs in women considered healthy or with mild symptoms that may be indicative of PFDs.
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This study aimed to investigate changes in the pain sensory profile of women with breast cancer. Five women with unilateral breast cancer were enrolled. Participants were assessed with direct (quantitative sensory testing, QST) and... more
This study aimed to investigate changes in the pain sensory profile of women with breast cancer. Five women with unilateral breast cancer were enrolled. Participants were assessed with direct (quantitative sensory testing, QST) and indirect measures of pain sensitization (self-reported central sensitization inventory, CSI) at baseline (before surgery), 1 week after surgery, and at 1, 6, 9, and 12 months post-surgery. In the event of pain occurrence, the Leeds Assessment of Neuropathic Symptoms and Signs was also used. Nociceptive pain was the predominant pain mechanism in the postoperative period, while an increase in sensitization predominated one year after breast cancer surgery, especially in those participants who had received more treatment procedures. The participants who received more therapies for breast cancer experienced persistent pain and a higher level of sensitization. An assessment protocol including direct measurements (QST) and indirect measurement (self-reported CSI) allows for detecting changes in pain sensitivity, which can be useful for characterizing and/or predicting pain before, during, and up to one year following surgical interventions for breast cancer.
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Objective: The objective of this study is to compare the effectiveness of complex physical therapy combined with intermittent pneumatic compression (CPT + IPC) versus Kinesio taping (KT) for breast cancer-related lymphedema. Methods: A... more
Objective: The objective of this study is to compare the effectiveness of complex physical therapy combined with intermittent pneumatic compression (CPT + IPC) versus Kinesio taping (KT) for breast cancer-related lymphedema. Methods: A cross-over clinical trial was conducted in 43 women with lymphedema. All participants received two interventions: CPT + IPC and KT, both lasting 3 weeks and a washout period. The main outcome variable was the relative volume change (RVC). The secondary variables were Satisfaction Questionnaire about Textile Therapeutic Devices used for Breast Cancer-Related Lymphedema, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, motion range of upper limb and lymphedema-related symptoms. Results: The RVC reduction was greater with CPT + IPC (À2.2%, SD = 4.7) versus KT (À0.9%, SD = 1.7) (P = 0.002). KT was more satisfactory than multilayer bandaging (8.9 points difference, P < 0.001) and improved DASH score more than CPT + IPC (14.3 points difference, P = 0.002). Regarding motion ranges, only shoulder
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This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised,... more
This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised, single-blind, clinical trial was conducted with a total of 80 breast cancer survivors who presented cancer-related fatigue. Women were randomised into a supervised therapeutic exercise group (STE-G) (n = 40) or an unsupervised exercise group (UE-G) (n = 40). Both interventions included patient therapeutic education and were delivered in three sessions per week over eight weeks. The main outcome was perceived fatigue as assessed by the Spanish version of the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F).
Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-MinuteWalk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.
Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-MinuteWalk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.
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Objective. This study aimed to determine the effectiveness of a physical therapist-designed program tailored to axillary web syndrome (AWS) in women after breast cancer surgery. Methods. A prospective, single-center, assessor-blinded,... more
Objective. This study aimed to determine the effectiveness of a physical therapist-designed program tailored to axillary web syndrome (AWS) in women after breast cancer surgery. Methods. A prospective, single-center, assessor-blinded, randomized controlled trial was conducted at the Physiotherapy in Women's Health Research Unit of the Alcalá University (Madrid, Spain). Ninety-six women with AWS were assigned to the physical therapy group (manual lymph drainage [MLD] using resorption strokes and arm exercises as if performing median nerve neurodynamic glide exercises with no neural loading; n = 48) or the control group (standard arm exercises; n = 48), with both groups receiving treatment 3 times a week for 3 weeks. Both interventions included an educational component. Results. Compared with the control group, the physical therapy group showed significant and clinically relevant improvements in the primary outcome (self-reported pain intensity) at the primary and 3-month follow-ups. Significant and clinically relevant differences between groups were also found in the secondary outcomes (shoulder active range of motion, shoulder disability, and physical and functional aspects of health-related quality of life) at the primary follow-up and in the secondary outcomes as well as the trial outcome index at the 3-month follow-up. No significant differences were found at the 6-month follow-up in either primary or secondary outcomes. Conclusion. The physical therapy program tailored to AWS was found to be effective for AWS symptoms in women after breast cancer surgery, both immediately after the program and after 3 months. Impact. To our knowledge, this is the first appropriately designed study to demonstrate the effectiveness of MLD with progressive arm exercises for AWS. Clinicians and health service providers should consider how to provide survivors of breast cancer with AWS the opportunity to participate in physical therapy programs, including MLD with progressive arm exercises. Lay Summary. For axillary web syndrome following breast cancer surgery, a physical therapist can design a treatment program including manual lymph drainage and progressive arm exercises, which has been shown to result in reduced pain and improved motion compared with standard arm exercises.
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This study described the response of the bladder base (BB) by transabdominal ultrasound in primiparous women during movements that activate the abdominopelvic cavity musculature and cause variations in intra-abdominal pressure (IAP). A... more
This study described the response of the bladder base (BB) by transabdominal ultrasound in primiparous women during movements that activate the abdominopelvic cavity musculature and cause variations in intra-abdominal pressure (IAP). A descriptive cross-sectional study was conducted in 64 primiparous women at eight weeks after uncomplicated delivery. BB displacement was measured using a 5-MHz convex transducer in a suprapubic position. Participants were asked to perform the isolated contraction of pelvic floor musculature (PFM) and transverse abdominis (TrA), cough at high lung volume and trunk flexion with and without maximal voluntary contraction of PFM. PFM contraction elevated the BB in all but one participant, whereas TrA contraction caused the BB to ascend in 56% of the women and descend in the rest; their combined contraction rose the BB in 65% of the women although the effect was greater with only PFM contraction (p < 0.01). The BB descended in all participants during coughing and trunk flexion although the descent was inferior with the joint maximal voluntary contraction of PFM (p < 0.01). In conclusion, TrA contraction must be assessed individually in puerperal women since its effect on the BB varies among subjects. During movements increasing IAP, such as coughing or curl-ups, the anticipatory contraction of PFM reduces bladder descent although not sufficiently to counteract bladder displacement.
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The child’s interaction with the natural environment allows different learning opportunities and favors their motor development, which may be affected after a period of environmental deprivation, a consequence of home confinement due to... more
The child’s interaction with the natural environment allows different learning opportunities and favors their motor development, which may be affected after a period of environmental deprivation, a consequence of home confinement due to the COVID-19 pandemic. The main objective of the study was to analyze the different areas of motor development, as well as the quality of life of children aged 0 to 3 years old after home confinement by COVID-19 and the possible correlation between both variables, and the influence of parental stimulation on motor development during this time of exclusive interaction with the immediate environment (home and family). A descriptive study was performed. A simple and anonymous questionnaire was created for parents of children between 0 and 3 years old who lived in Spain during the period of home confinement due to COVID-19 (March to June 2020). The measurement instrument used was a questionnaire made in “Google Forms”, where the variables were collected: Motor development (measured through the Ages &
Stages Questionnaire, ASQ3), Quality of life (assessed with the Pediatric Quality of Life Inventory, PedsQL) and other variables, such as stimulation, performed during home confinement. Eighty-eight questionnaires were validated. The highest score in the motor development domains were obtained in children 2–3 years old. The motor domain of children aged 2–3 years old that obtained the highest score was communication (M = 54.69 10.03) and the highest score in the quality of life was obtained
in children aged 0–1 years old (M = 85.47 12.39), also acquiring the lowest score in the emotional domain in all age groups (0–1, 1–2 and 2–3 years old). The assessment of motor development and quality of life after home confinement due to the COVID-19 pandemic did not determine low values, so it would not have been affected during this period of lack of interaction with the natural environment. Emphasizing that the emotional aspect within quality of life was the lowest score, this indicates that children from 0 to 3 years old need more emotional support in situations of variability of daily routines and of family stress.
Stages Questionnaire, ASQ3), Quality of life (assessed with the Pediatric Quality of Life Inventory, PedsQL) and other variables, such as stimulation, performed during home confinement. Eighty-eight questionnaires were validated. The highest score in the motor development domains were obtained in children 2–3 years old. The motor domain of children aged 2–3 years old that obtained the highest score was communication (M = 54.69 10.03) and the highest score in the quality of life was obtained
in children aged 0–1 years old (M = 85.47 12.39), also acquiring the lowest score in the emotional domain in all age groups (0–1, 1–2 and 2–3 years old). The assessment of motor development and quality of life after home confinement due to the COVID-19 pandemic did not determine low values, so it would not have been affected during this period of lack of interaction with the natural environment. Emphasizing that the emotional aspect within quality of life was the lowest score, this indicates that children from 0 to 3 years old need more emotional support in situations of variability of daily routines and of family stress.
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Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One... more
Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One of the tools used to control symptoms is physiotherapy; however, its application in the child population has not been thoroughly studied. The main objective of this study was to gather, analyze, and critically evaluate the available scientific evidence on physiotherapy in children who require palliative care through a systematic review of the studies published in the last 10 years in the following databases: PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Of a total of 622 studies, the inclusion criteria were only met by seven articles, which were focused on the relationship between physiotherapy and PPC. This study analyzed: (1) the main pathologies treated, with a predominance of cerebral palsy and cancer; (2) the interventions applied, such as respiratory physiotherapy, neurological physiotherapy, therapeutic massage, and virtual reality; (3) the effects achieved in the child and his/her family, highlighting the control of symptoms and the improvement of the quality of life; and (4) the knowledge of the physiotherapists on PPC, observing that most of the professionals had not received training in this scope. The findings of this review indicate a lack of an adequate evidence foundation for physiotherapy in PPC.
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Background: Children with unilateral spastic cerebral palsy (USCP) receive different treatments, including the application of modified constraint induced movement therapy (mCIMT) or bimanual intensive therapy (BIT) to increase affected... more
Background: Children with unilateral spastic cerebral palsy (USCP) receive different treatments, including the application of modified constraint induced movement therapy (mCIMT) or bimanual intensive therapy (BIT) to increase affected upper limb functionality. The aim of this study was to compare the effectiveness of two protocols with different proportions and orders of mCIMT/BIT within combined intensive home-therapy in children with USCP (6-8 years old) with high bimanual functional performance, applied by the family. Methods: The protocols were performed on 20 children with an average age of 7.12 years [standard deviation (SD): 0.70], allocated to two different combined therapies. The protocols were designed by 100 h of dose for 10 weeks: 80 h of mCIMT followed by 20 h of BIT (mCIMT-B group) and 80 h of BIT followed by 20 h of mCIMT (BIT-mCI group). Bimanual functional performance was measured with Assisting Hand Assessment Scale (AHA) and the affected upper limb-use experience with Children's Hand-use Experience Questionnaire (CHEQ). Parent satisfaction and expectations with therapy were measured using a specific questionnaire. There were five assessment timepoints (week 0, week 4, week 8, week 10 and week 34). Results: There were no statistically significant (p > 0.05) inter-and intra-group changes in the bimanual functional performance of both groups. The affected upper limb-use experience obtained significant changes in BIT-mCI group, with statistically significant differences in the pairwise comparisons between week 0-10 and week 4-10 (p = 0.028) for use of the affected hand and the use of the affected hand to grasp between week 4 and week 8 (p = 0.028). Grasp efficacy and discomfort acquired statistically significant differences only in the BIT-mCI group for pairwise comparisons week 0-week 10/week 4-week 10 (p = 0.035). Although task execution time compared with a typically developing child of the same age obtained statistically significant differences only in the group mCIMT-B for pairwise comparisons week 0-week 8 (p = 0.03), week 0-week 10 (p = 0.03), week 4-week 8 (p = 0.04) and week 4-week 10 (p = 0.03). Family satisfaction and expectations acquired an increase between week 0 and week 10 (p ⩽ 0.02). Conclusion: Applying 80 h of BIT for 8 weeks in children with high bimanual functional performance USCP (6-8 years old), executed at home with family involvement would be sufficient to obtain improvements in affected upper limb-use experience, without the need to use combined protocols of 100 h. However, no statistically significant increase in bimanual functional performance would be obtained, with the basal situation of the child being a factor to consider for the execution of mCIMT and BIT.
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Aging processes in the musculoskeletal system lead to functional impairments that restrict participation. Purpose: To assess differences in the force and motor recruitment patterns of shoulder muscles between age groups to understand... more
Aging processes in the musculoskeletal system lead to functional impairments that restrict participation. Purpose: To assess differences in the force and motor recruitment patterns of shoulder muscles between age groups to understand functional disorders. A cross-sectional study comparing 30 adults (20–64) and 30 older adults (>65). Surface electromyography (sEMG) of the middle deltoid, upper and lower trapezius, infraspinatus, and serratus anterior muscles was recorded. Maximum isometric voluntary contraction (MIVC) was determined at 45 glenohumeral abduction. For the sEMG signal registration, concentric and eccentric contraction with and without 1 kg and isometric contraction were requested. Participants abducted the arm from 0 up to an abduction angle of 135 for concentric and eccentric contraction, and from 0 to 45, and remained there at 80% of the MIVC level while isometrically pushing against a handheld dynamometer. Differences in sEMG amplitudes (root mean square, RMS) of all contractions, but also onset latencies during concentric contraction of each muscle between age groups, were analyzed. Statistical differences in strength (Adults > Older adults; 0.05) existed between groups. No significant differences in RMS values of
dynamic contractions were detected, except for the serratus anterior, but there were for isometric contractions of all muscles analyzed (Adults > Older adults; 0.05). The recruitment order varied between age groups, showing a general tendency towards delayed onset times in older adults,
except for the upper trapezius muscle. Age differences in muscle recruitment patterns were found, which underscores the importance of developing musculoskeletal data to prevent and guide geriatric shoulder pathologies.
dynamic contractions were detected, except for the serratus anterior, but there were for isometric contractions of all muscles analyzed (Adults > Older adults; 0.05). The recruitment order varied between age groups, showing a general tendency towards delayed onset times in older adults,
except for the upper trapezius muscle. Age differences in muscle recruitment patterns were found, which underscores the importance of developing musculoskeletal data to prevent and guide geriatric shoulder pathologies.
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Children with hemiplegia have lower spontaneous use and quality of movement in the affected upper limb. The modified constraint-induced movement therapy (mCIMT) is applied to improve the affected upper limb function. The objective of this... more
Children with hemiplegia have lower spontaneous use and quality of movement in the affected upper limb. The modified constraint-induced movement therapy (mCIMT) is applied to improve the affected upper limb function. The objective of this study was to study the efficacy of unaffected hand containment to obtain changes in the function of the affected upper limb after applying two unimanual therapies. A randomized controlled pilot study was performed with 16 children diagnosed with congenital infantile hemiplegia, with eight children randomized in each group (average age: 5.54 years; SD: 1.55). mCIMT and unimanual therapy without containment (UTWC) were applied, with a total of 50 h distributed in five weeks (two h/per day). Two assessments were performed (pre-and post-treatment) to evaluate the affected upper limb spontaneous use, measured with the Shiners Hospital Upper Extremity Evaluation (SHUEE), and the quality of movement, measured with the Quality of Upper Extremity Skills Test (QUEST scale). The progression of the variables was different in both groups. The results are expressed in the median of the improvement percent and interquartile range (IQR). The spontaneous use analysis showed an improvement percent of 31.65 (IQR: 2.33, 110.42) in the mCIMT group with respect to 0.00 (IQR: 0.00, 0.00) in the UTWC group. The quality of movement increased in the mCIMT and UTWC groups, 24.21 (IQR: 13.44, 50.39), 1.34 (IQR: 0.00, 4.75), respectively and the greatest increase was obtained in the grasp variable for both groups. The use of unaffected hand containment in mCIMT would produce improvements in the affected upper limb functionality in children with hemiplegia (4-8 years old) compared to the same protocol without containment (UTWC).
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The abilities of children diagnosed with Obstetric Brachial Palsy (OBP) are limited by brachial plexus injuries. Thus, their participation in the community is hindered, which involves a lower quality of life due to worse performance in... more
The abilities of children diagnosed with Obstetric Brachial Palsy (OBP) are limited by brachial plexus injuries. Thus, their participation in the community is hindered, which involves a lower quality of life due to worse performance in activities of daily living as a consequence of the functional limitations of the affected upper limb. Conventional Mirror Therapy (Conventional MT) and Virtual Therapy improve the affected upper limb functionality. Therefore, the aim of this study was to compare the effects of Conventional MT and Virtual Reality MT on the spontaneous use of the affected upper limb and quality of life of children with upper Obstetric Brachial Palsy between 6 and 12 years of age. A randomized pilot study was performed. Twelve children were randomly assigned to perform Conventional Mirror Therapy or Virtual Reality Mirror Therapy for four weeks. Ten children completed the treatment. Two assessments (pre/post-intervention) were carried out to assess the spontaneous use of the affected upper limb and the quality of life using the Children's Hand-use Experience Questionnaire (CHEQ) and the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL TM 4.0), respectively. There was a statistically significant increment in spontaneous use, observed in independent tasks (p = 0.02) and in the use of the affected hand with grasp (p = 0.04), measured with the CHEQ, for the Virtual Reality MT group. There were no statistically significant changes (p > 0.05) for the Conventional MT group in the spontaneous use of the affected upper limb. Regarding the quality of life, statistically significant changes were obtained in the Physical and Health activity categories of the parents' questionnaire (p = 0.03) and in the total score of the children's questionnaire (p = 0.04) in the Virtual Reality MT group, measured using the PedsQL TM 4.0. Statistically significant changes were not obtained for the quality of life in the Conventional MT group. This study suggests that, compared to Conventional MT, Virtual Reality MT would be a home-based therapeutic complement to increase independent bimanual tasks using grasp in the affected upper limb and improve the quality of life of children diagnosed with upper OBP in the age range of 6-12 years.
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To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer-related lymphedema. Design: Randomized, cross-over, controlled trial. Setting:... more
To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer-related lymphedema. Design: Randomized, cross-over, controlled trial. Setting: Outpatient tertiary-level hospital rehabilitation setting. Subjects: Randomized sample of 30 women with breast cancer-related lymphedema. Interventions: Participants received two interventions, Kinesio taping and compression garment, both lasting four weeks, whose order was randomized by blocks. A four-week washout period was established prior to the interventions and between them. Measurements: The main outcome was the lymphedema Relative Volume Change. Secondary outcomes were range of motion of arm joints, self-perception of comfort, and lymphedema-related symptoms (pain, tightness, heaviness, and hardness). Results: The decrease in the Relative Volume Change was greater in the Kinesio taping intervention (-5.7%, SD = 2.0) compared to that observed using compression garments (-3.4%, SD = 2.9) (P < 0.001). The range of motion of five upper-limb movements increased after applying taping (between 5.8° and 16.7°) (P < 0.05), but not after compression (P > 0.05). In addition, taping was perceived as more comfortable by patients (between 2.4 and 3 points better than compression in four questions with a 5-point scale (P < 0.001)) and further reduced lymphedema-related symptoms compared to compression (between 0.96 and 1.40 points better in four questions with a 6-point scale (P < 0.05)).
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Resumen: OBJETIVOS. Conocer la prevalencia de linfedema postmastectomía en nuestro medio, así como la percepción que del mismo tienen las pacientes y el diagnóstico y tratamiento que de él se realiza. MÉTODOS. Cincuenta y tres pacientes... more
Resumen: OBJETIVOS. Conocer la prevalencia de linfedema postmastectomía en nuestro medio, así como la percepción que del mismo tienen las pacientes y el diagnóstico y tratamiento que de él se realiza. MÉTODOS. Cincuenta y tres pacientes operadas de ...
Research Interests: Medicine and Prevalence
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Cerebral palsy (CP) is a clinical diagnosis based on a combination of clinical and neurological signs, which occurs between the ages of 12 and 24 months. Cerebral palsy or a high risk of cerebral palsy can be accurately predicted before... more
Cerebral palsy (CP) is a clinical diagnosis based on a combination of clinical and neurological signs, which occurs between the ages of 12 and 24 months. Cerebral palsy or a high risk of cerebral palsy can be accurately predicted before 5–6 months, which is the corrected age. This would allow the initiation of intervention at an early stage. Parents must be more involved in the development and implementation of the early therapy, increasing opportunities for parent–child interaction. The aim of this study was to learn from the perspectives of families with children under 12 months with unilateral cerebral palsy (UCP), what ingredients (barriers and facilitators) should be involved in early intervention so that we could co-design (researchers and families) a multidisciplinary guideline for a global intervention addressed to the needs of the child and the family. Semi-structured interviews were conducted at a time and venue convenient for the families. A total of ten families with exp...
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Infantile hemiparesis may be associated with significant morbidity and may have a profound impact on a child’s physical and social development. Infantile hemiparesis is associated with motor dysfunction as well as additional neurologic... more
Infantile hemiparesis may be associated with significant morbidity and may have a profound impact on a child’s physical and social development. Infantile hemiparesis is associated with motor dysfunction as well as additional neurologic impairments, including sensory loss, mental retardation, epilepsy, and vision, hearing, or speech impairments. The objective of this study was to analyze the association between the cause of infantile hemiparesis and birth (gestational age), age of diagnosis, and associated disorders present in children with infantile hemiparesis aged 0 to 3 years. An observational and cross-sectional study was performed. A simple and anonymous questionnaire was created ad hoc for parents of children diagnosed with infantile hemiparesis aged between 0 and 3 years about the situation regarding the diagnosis of hemiparesis, birth, cause of hemiparesis, and presence of other associated disorders. Perinatal stroke (60.1%) was the most common cause of hemiparesis, and the ...
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Background: The capacity of children with hemiplegia to be engaged in anticipatory action planning is affected. There is no balance among spatial, proprioceptive and visual information, thus altering the affected upper limb visuomotor... more
Background: The capacity of children with hemiplegia to be engaged in anticipatory action planning is affected. There is no balance among spatial, proprioceptive and visual information, thus altering the affected upper limb visuomotor coordination. The objective of the present study was to assess the improvement in visuomotor coordination after the application of a unimanual intensive therapy program, with the use of unaffected hand containment compared with not using unaffected hand containment. Methods: A simple blind randomized clinical trial was realized. A total of 16 subjects with congenital infantile hemiplegia participated in the study with an age mean of 5.54 years old (SD:1.55). Two intensive protocols for 5 weeks of modified constraint-induced movement therapy (mCIMT) or unimanual therapy without containment (UTWC) were executed 5 days per week (2 h/day). Affected upper limb visuomotor coordination (reaction time, task total time, active range, dynamic grasp) was measured...
Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to... more
Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to improve the function of the affected upper limb without altering family life and avoiding frustration. In this qualitative study, we aimed to collect the experiences of parents and their children (aged 4–8 years) who did mCIMT at home regarding the application of low-intensity modified constraint-induced movement therapy to improve the affected upper limb functionality in infantile hemiplegia with moderate manual ability. Individual semi-structured interviews were performed to obtain insights into their experience with mCIMT. The experiences of parents and children were described in thematic sections. Eight children with hemiplegia (six years, standard deviation, SD: 1.77) and their parents were asked about their experiences after applying 50 h of mCI...
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Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case... more
Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p<0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participat...
ObjectiveTo assess the content, quality and readability of websites with information on fibromyalgia in Spanish.MethodsWebsites were retrieved entering the keyword ‘fibromyalgia’ in Google, Yahoo! and Bing, and by searching records of... more
ObjectiveTo assess the content, quality and readability of websites with information on fibromyalgia in Spanish.MethodsWebsites were retrieved entering the keyword ‘fibromyalgia’ in Google, Yahoo! and Bing, and by searching records of patients associations in Spain and Latin America. The Bermúdez-Tamayo and DISCERN questionnaires were employed for evaluating quality and content, and INFLESZ for readability. Statistical analysis was conducted using IBM SPSSV.24 (Chicago, USA).ResultsThree hundred and five websites were found. After applying the exclusion criteria, 73 websites were analysed. Websites retrieved by search engines obtained median scores of 27.0 (interquartile interval (IQI): 24.5–32.0) with DISCERN, 35.0 (IQI: 31.0–40.5) with Bermúdez-Tamayo and 53.7 (IQI: 47.4–56.2) with INFLESZ, whereas those from patients associations scored 21.0 (IQI: 19.2–23.8), 26.0 (IQI: 25.0–31.0) and 51.7 (IQI: 47.9–55.1), respectively. In general, content was not up-to-date.ConclusionsOverall q...
Objective: To compare the effects of four types of bandages and kinesio-tape and determine which one is the most effective in women with unilateral breast cancer-related lymphoedema. Design: Randomized, single-blind, clinical trial.... more
Objective: To compare the effects of four types of bandages and kinesio-tape and determine which one is the most effective in women with unilateral breast cancer-related lymphoedema. Design: Randomized, single-blind, clinical trial. Setting: Physiotherapy department in the Women’s Health Research Group at the University of Alcalá, Madrid, Spain. Subjects: A total of 150 women presenting breast-cancer-related lymphoedema. Interventions: Participants were randomized into five groups ( n = 30). All women received an intensive phase of complex decongestive physiotherapy including manual lymphatic drainage, pneumatic compression therapy, therapeutic education, active therapeutic exercise and bandaging. The only difference between the groups was the bandage or tape applied (multilayer; simplified multilayer; cohesive; adhesive; kinesio-tape). Main measurements: The main outcome was percentage excess volume change. Other outcomes measured were heaviness and tightness symptoms, and bandage ...
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Objective: To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer–related lymphedema. Design: Randomized, cross-over, controlled trial.... more
Objective: To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer–related lymphedema. Design: Randomized, cross-over, controlled trial. Setting: Outpatient tertiary-level hospital rehabilitation setting. Subjects: Randomized sample of 30 women with breast cancer–related lymphedema. Interventions: Participants received two interventions, Kinesio taping and compression garment, both lasting four weeks, whose order was randomized by blocks. A four-week washout period was established prior to the interventions and between them. Measurements: The main outcome was the lymphedema Relative Volume Change. Secondary outcomes were range of motion of arm joints, self-perception of comfort, and lymphedema-related symptoms (pain, tightness, heaviness, and hardness). Results: The decrease in the Relative Volume Change was greater in the Kinesio taping intervention (–5.7%, SD = 2.0) compared to tha...
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Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to... more
Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to improve the function of the affected upper limb without altering family life and avoiding frustration. In this qualitative study, we aimed to collect the experiences of parents and their children (aged 4–8 years) who did mCIMT at home regarding the application of low-intensity modified constraint-induced movement therapy to improve the affected upper limb functionality in infantile hemiplegia with moderate manual ability. Individual semi-structured interviews were performed to obtain insights into their experience with mCIMT. The experiences of parents and children were described in thematic sections. Eight children with hemiplegia (six years, standard deviation, SD: 1.77) and their parents were asked about their experiences after applying 50 h of mCI...
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The Prolapse Quality of Life Questionnaire (P-QoL) is a specific questionnaire created to assess the impact of pelvic organ prolapse on women's quality of life. The aim of the present study was to cross-culturally adapt and assess the... more
The Prolapse Quality of Life Questionnaire (P-QoL) is a specific questionnaire created to assess the impact of pelvic organ prolapse on women's quality of life. The aim of the present study was to cross-culturally adapt and assess the psychometric properties of the P-QoL for Spanish women. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Psychometric analysis was performed by assessing the validity, reliability, responsiveness and feasibility. A total of 200 Spanish women were recruited and assigned to symptomatic and asymptomatic groups. The Spanish P-QoL version demonstrated good content validity. Convergent validity showed high intercorrelations with the Pelvic Floor Distress Inventory short form and the Pelvic Floor Impact Questionnaire short form. The discriminant validity showed statistically significant differences between the symptomatic and the asymptomatic groups. The internal consistency was high and of acceptable values. The test-retest reliability was shown to be high in all the cases. Regarding responsiveness, the effect size and standardized response mean demonstrated moderate values. The average time for administration was 10 (3) min. The Spanish P-QoL showed considerable support for the appropriate metric properties of validity, reliability, responsiveness and feasibility to evaluate the symptom severity and its impact on the quality of life in Spanish women with urogenital prolapse.
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Management strategies in myofascial pain syndrome are summarized and most of the conservative therapeutic techniques for myofascial trigger points are briefly described. These can be classified as manual or instrumental. It is concluded... more
Management strategies in myofascial pain syndrome are summarized and most of the conservative therapeutic techniques for myofascial trigger points are briefly described. These can be classified as manual or instrumental. It is concluded that more high quality research is needed to allow for a higher level of scientific evidence regarding the efficacy of techniques.