Perineal Massage during Pregnancy for the Prevention of Postpartum Urinary Incontinence: Controlled Clinical Trial

[EN] Background and objectives: Urinary incontinence is any involuntary loss of urine. It may result in anxiety, depression, low self-esteem and social isolation. Perineal massage has spread as a prophylactic technique for treating complications during labor. Acknowledged effects of perineal massage are reduction of incidence and severity of perineal tear and use of equipment directly related to the intrapartum perineal trauma. The aim of this study was to determine the effectiveness of massage in urinary incontinence prevention and identification of possible differences in its form of application (self-massage or by a physiotherapist), with the previous assumption that it is effective and that there are differences between the different forms of application. Materials and Methods: A controlled clinical trial with a sample of 81 pregnant women was conducted. The participants were divided into three groups: a group that received the massage applied by a specialized physiotherapist, another group that applied the massage to themselves, and a control group that only received ordinary obstetric care. Results: No differences were identified in the incidence or severity of urinary incontinence among the three groups. The severity of the incontinence was only affected by the body mass index and the weight of the baby at the time of delivery. Conclusions: A relationship between perineal massage interventions and development of urinary incontinence has not been observed.S

Prevalence of Perineal Tear Peripartum after Two Antepartum Perineal Massage Techniques: A Non-Randomised Controlled Trial

[EN] Perineal massage increases elasticity of myofascial perineal tissue and decreases the burn-ing and perineal pain during labour, thus optimising child birth, although an application protocol has not been standardised yet. The objective of this study is to determine the efficiency of massage in perineal tear prevention and identification of possible differences in massage application. Total of 90 pregnant participants were divided into three groups: perineal massage and EPI-NO® device group, applied by an expert physiotherapist, self-massage group, where women were instructed to apply perineal massage in domestic household, and a control group, which received ordinary obstetric attention. Results: The results showed significant differences among the control group and the two perineal massage groups in perineal postpartum pain. Correlations in perineal postpartum pain, labour duration and the baby’s weight were not statistically significant. Lithotomy posture was significantly less prevalent in the massage group than in the other two; this variable is known to have a direct effect on episiotomy incidence and could act as a causal covariate of the different incidence of episiotomy in the groups. Perineal massage reduces postpartum perineal pain, prevalence and severity of perineal tear during delivery.S

Perceptions and Degree of Satisfaction with the Health Sciences University Educational Community Regarding the Measures Adopted for the Prevention of COVID-19 in the Academic Year 2020/2021

[EN] The COVID-19 pandemic caused the start of the academic year 2020/2021 to be conditioned by health and safety regulations. The present research was defined with the aim of analyzing the degree of satisfaction and perceptions on the establishment of bubble groups and pairs and on the use of audiovisual platforms for the development of theoretical and practical university teaching in three degrees of health sciences. A cross-sectional descriptive study was carried out on a representative sample of students and teachers of health sciences in Ponferrada (n = 285). Specific questionnaires designed for this study were completed virtually during April and May 2021. The results indicate that that satisfaction was moderate–high. The perception of the influence of bubble pairs on the quality of teaching can be interpreted as very low. These results increase with the age and academic and professional experience of students and faculty members, respectively. However, the participants belonging to physiotherapy considered that the quality of teaching had worsened much more compared to their counterparts in nursing and podiatry.S

Reliability and Validity of the Six Spot Step Test in People with Intellectual Disability

[EN] Clinical tests for the evaluation of balance in people with intellectual disability that have been most commonly used depend on the subjective evaluation of the evaluator, easily reach the ceiling effect and are poorly sensitive to small changes; but new tests have been developed, such as the Six Spot Step Test. The aim of this study was to determine the validity and within-day and day-to-day test–retest reliability of the Six Spot Step Test in people with intellectual disability. A descriptive cross-sectional study was conducted with 18 people with intellectual disability. The participants conducted the Six Spot Step Test three times and a set of five clinical tests for the balance assessment. The relative reliability was excellent (Intraclass Correlation Coefficient (ICC) = 0.86 − 0.97), and the absolute reliability ranged between 4.7% and 7.3% for coefficient variation and between 0.6 and 1.2 for the standard error of measurement. Linear regression models showed that that test can explain the results of the Timed Up & Go, Four Square Step Test and the Berg Balance Scale. The Six Spot Step Test proved to be as valid and reliable for the evaluation of dynamic balance in people with intellectual disability as the most frequently used tests for the clinical evaluation of postural control.SIThis research received funding from the VII Research Grant of the Professional College of Physiotherapist of Castilla y León (Spain)

Analysis of Postural Control in Sitting by Pressure Mapping in Patients with Multiple Sclerosis, Spinal Cord Injury and Friedreich’s Ataxia: A Case Series Study

[EN], The postural control assessments in patients with neurological diseases lack reliability and sensitivity to small changes in patient functionality. The appearance of pressure mapping has allowed quantitative evaluation of postural control in sitting. This study was carried out to determine the evaluations in pressure mapping and verifying whether they are different between the three sample groups (multiple sclerosis, spinal cord injury and Friedreich’s ataxia), and to determine whether the variables extracted from the pressure mapping analysis are more sensitive than functional tests to evaluate the postural trunk control. A case series study was carried out in a sample of 10 adult patients with multiple sclerosis (n = 2), spinal cord injury (n = 4) and Friedreich’s ataxia (n = 4). The tests applied were: pressure mapping, seated Lateral Reach Test, seated Functional Reach Test, Berg Balance Scale, Posture and Postural Ability Scale, Function in Sitting Test, and Trunk Control Test. The participants with Friedreich’s ataxia showed a tendency to present a higher mean pressure on the seat of subject’s wheelchair compared to other groups. In parallel, users with spinal cord injury showed a tendency to present the highest values of maximum pressure and area of contact. People with different neurological pathologies and similar results in functional tests have very different results in the pressure mapping. Although it is not possible to establish a strong statistical correlation, the relationships between the pressure mapping variables and the functional tests seem to be numerous, especially in the multiple sclerosis group.S

Physical Activity, Resilience, Sense of Coherence and Coping in People with Multiple Sclerosis in the Situation Derived from COVID-19

The confinement forced by COVID-19 can have repercussions on the health of people diagnosed with multiple sclerosis. The objective of this study is to analyze the relationships between physical activity, a sense of coherence, resilience and coping among people diagnosed with Multiple Sclerosis during the health emergency situation. To achieve this goal, this transversal descriptive study included 84 patients that belonged to multiple sclerosis associations during the period of confinement. Participants filled out the Physical Activity (IPAQ-SF), Sense of Coherence (SOC-13), Resilience Scale (ER-14) and coping (COPE-28) questionnaires. The results showed that the average age was 46.9 and that 67.9% had Relapsing Remittent Multiple Sclerosis diagnosed on average 13.9 years ago. They had a high degree (33.3%) and moderate degree (34.5%) of physical activity, high levels of resilience, while the level of a sense of coherence was average and the most commonly used strategies for coping were active confrontation and religion. Physical activity was not related to the rest of the studied variables, but there were correlations between the other variables. The people with multiple sclerosis who belong to patient associations have remained physically active during the obligatory confinement period and have elevated degrees of resilience and an average sense of coherence, as well as using suitable coping strategies, which is why the social-health resource of belonging to a patient association could be boosting these variables that are beneficial to their health.S

Thermal Infrared Imaging to Evaluate Emotional Competences in Nursing Students: A First Approach through a Case Study

19 p.During university studies of nursing, it is important to develop emotional skills for their impact on academic performance and the quality of patient care. Thermography is a technology that could be applied during nursing training to evaluate emotional skills. The objective is to evaluate the effect of thermography as the tool for monitoring and improving emotional skills in student nurses through a case study. The student was subjected to different emotions. The stimuli applied were video and music. The process consisted of measuring the facial temperatures during each emotion and stimulus in three phases: acclimatization, stimulus, and response. Thermographic data acquisition was performed with an FLIR E6 camera. The analysis was complemented with the environmental data (temperature and humidity). With the video stimulus, the start and final forehead temperature from testing phases, showed a different behavior between the positive (joy: 34.5 °C–34.5 °C) and negative (anger: 36.1 °C–35.1 °C) emotions during the acclimatization phase, different from the increase experienced in the stimulus (joy: 34.7 °C–35.0 °C and anger: 35.0 °C–35.0 °C) and response phases (joy: 35.0 °C–35.0 °C and anger: 34.8 °C–35.0 °C). With the music stimulus, the emotions showed different patterns in each phase (joy: 34.2 °C–33.9 °C–33.4 °C and anger: 33.8 °C–33.4 °C–33.8 °C). Whenever the subject is exposed to a stimulus, there is a thermal bodily response. All of the facial areas follow a common thermal pattern in response to the stimulus, with the exception of the nose. Thermography is a technique suitable for the stimulation practices in emotional skills, given that it is non-invasive, it is quantifiable, and easy to accessS

Aprendizaje-servicio para la promoción de la salud y la prevención de enfermedad en la población infantil

[ES] El presente proyecto de innovación docente consistió en una actividad de aprendizaje-servicio, basada en la metodología de acción participativa, llevada a cabo con estudiantes de los grados en Enfermería y Fisioterapia del Campus de Ponferrada. Objetivos: Con el diseño y puesta en práctica del proyecto, se pretendió desarrollar un aprendizaje significativo, adquirir diversas competencias transversales y específicas de cada titulación, así como aumentar su nivel de empatía y compromiso social. Descripción de la innovación: Los estudiantes, en el marco de distintas asignaturas de la titulación, diseñaron y llevaron a cabo diversos talleres de educación para la salud y promoción de hábitos de vida saludables destinados a escolares de primero y sexto de primaria de la ciudad de Ponferrada. Los talleres versaron sobre la promoción de la actividad física, la igualdad de géneros, la protección solar, el lavado de manos y los primeros auxilios. Principales resultados: Participaron un total de 67 estudiantes y 236 escolares. El 96,2% de los escolares mostraron satisfacción máxima con los talleres. A nivel de los estudiantes universitarios, los resultados medidos a través de la escala de empatía “Interpersonal Reactivity Index”, mostraron un cambio significativo en la dimensión de estrés personal, en la que hubo una disminución de la puntuación tras la actividad en la muestra total (p=0.006) y en el grupo de las mujeres (p=0.018). Los estudiantes, además de adquirir y consolidar resultados de aprendizaje específicos, manifestaron trabajar competencias relacionadas con la motivación por el trabajo, las relaciones interpersonales y el trabajo en equipo. Conclusiones: El aprendizaje-servicio se presenta como una estrategia interesante a nivel universitario. El aprendizaje significativo aporta a los universitarios una satisfacción y recompensa personal. En esta experiencia, se produjeron cambios significativos en la dimensión de estrés personal, factor fundamental para la toma de decisiones ante situaciones estresantes

La Salud en el Camino de Santiago. Aprendizaje-Servicio

[ES] Objetivos: Fomentar y potenciar el desarrollo personal, académico y profesional del estudiante. Mejorar la Capacidad de aplicar los conocimientos propios de su disciplina a la práctica en usuarios reales. Aprender a organizar y planificar el tratamiento según las características del peregrino el tipo de lesión. Fomentar el trabajo en equipos multidisciplinares en relación con el tratamiento de lesiones en el Camino de Santiago. Descripción de la Actividad: Bajo el formato de un curso de verano, los alumnos han diseñado y desarrollado sus prácticas extracurriculares, en el ámbito de la Salud, (Fisioterapia, Enfermería y Podología), en un medio real, como es un Albergue de Peregrinos, realizando atención sanitaria a los peregrinos en el Camino de Santiago. Previo a la atención sanitaria, el alumnado recibió una formación teórica previa, por parte de diferentes profesores de Ciencias de la Salud, y ayudaron a la realización de una labor de coordinación entre los Albergues de Peregrinos, para pautar un cronograma previo al inicio de la actividad. Además de la labor asistencial, se instruye al alumnado en que realicen una labor formativa y educativa, informando a los peregrinos de diferentes medidas preventivas, para evitar lesiones. Esta actividad se ha realizado conjuntamente entre la ULE y la Universidad Miguel Hernández de Elche (UME)Resultados: Además de la satisfacción de los usuarios, los alumnos manifiestan una mejora en el aprendizaje, en relación con las expectativas y presentan una elevada satisfacción en la interacción con el alumnado de otra universidad y titulación. Conclusiones: El aprendizaje-servicio es un método para unir el aprendizaje con el compromiso social. Es aprender haciendo un servicio a la comunidad. Esta experiencia es un buen ejemplo de esta modalidad, que se consolidad como una forma de aprendizaje en el que el alumno puede desarrollar sus habilidades prácticas en entornos reales

Immediate effects of dynamic elestrostimulation on abdominal muscles : randomized controlled trial

222 p.[ES] La Electroterapia es un procedimiento de Fisioterapia que emplea corrientes eléctricas con el objetivo de obtener determinados efectos fisiológicos beneficiosos en el organismo, como pueden ser la analgesia para provocar una sensación de alivio en el paciente o la electroestimulación muscular con la finalidad de mejorar la fuerza, la resistencia y la funcionalidad muscular. Existen diferentes formas de aplicación de la electroestimulación muscular: local, con la colocación de los electrodos en una determinada zona corporal o global, con la estimulación simultánea de varios grupos musculares. Estas formas de aplicación, a su vez, pueden usarse de forma aislada o combinada con el ejercicio físico. La combinación simultánea de ejercicio físico con corrientes eléctricas excitomotoras, es conocida como electroestimulación dinámica y puede tener efectos beneficiosos sobre la musculatura en términos de ganancia de masa y fuerza muscular. Según la evidencia consultada, se obtienen mejores resultados cuando se combinan ambas que por separado, obteniéndose mejoras similares al entrenamiento convencional, siendo necesarias intensidades menores de entrenamiento. Por tanto, este método podría considerarse una alternativa para aquellas personas que presentan dificultades para realizar un entrenamiento de alta intensidad. La musculatura de la pared abdominal desempeña un papel crucial en la estabilización de la pelvis y de la columna vertebral, por lo cual es esencial su correcto funcionamiento. Incluye a los músculos transverso del abdomen, a los rectos anteriores y a los oblicuos mayores y menores, que trabajan de manera sinérgica para mantener la integridad estructural y funcional de la región abdominal. A pesar de su importancia, aún existen lagunas en el conocimiento sobre su anatomía, sobre sus mecanismos de activación y su funcionamiento preciso. La continua investigación en este campo es fundamental para mejorar su comprensión y el desarrollo de estrategias terapéuticas más eficaces, especialmente en el tratamiento de afecciones y disfunciones que afectan la estabilidad y la función abdominal, lo que puede tener un impacto significativo en la salud y el bienestar de las personas. Asimismo, es escasa la literatura científica que aporte conocimiento sobre los efectos inmediatos de la electroestimulación dinámica y en concreto, sobre la musculatura abdominal y las posibles diferencias entre aplicación local o global. Los objetivos de la presente investigación fueron determinar los efectos inmediatos de una única sesión de electroestimulación dinámica sobre el espesor de la musculatura de la pared abdominal que incluye los músculos rectos anteriores, transverso del abdomen, oblicuos mayor y menor, así como la distancia entre rectos abdominales. Además de conocer su influencia sobre los parámetros fisiológicos correspondientes a la frecuencia cardíaca, la tensión arterial (diastólica y sistólica) y la temperatura corporal. Asimismo, conocer las posibles diferencias en función de la forma de aplicación, local a través de electrodos de superficie colocados en la zona abdominal o global mediante los trajes o chalecos de electroestimulación de cuerpo entero. La muestra del estudio constó de 120 participantes jóvenes y sanos, de edades comprendidas entre los 18 y los 35 años, divididos aleatoriamente en tres grupos de estudio: WB-EMS (electroestimulación global), EMS (electroestimulación local) y control. La intervención consistió en una única sesión de 20 minutos de duración de ejercicios dinámicos dirigidos a estimular la contracción de la musculatura abdominal combinados con la electroestimulación global, local o en el caso del grupo control, con el chaleco de electroestimulación de cuerpo completo apagado. Se utilizó una corriente eléctrica simétrica rectangular bipolar con parámetros eléctricos específicos: 85 Hz de frecuencia de estimulación, 350 μs de anchura de pulso y ciclo de trabajo de 50 % (4 s de estimulación, 4 s de reposo). La intensidad de la parte principal de la sesión fue entre algo fuerte y fuerte en función de la percepción subjetiva del esfuerzo de cada participante. Para evaluar los efectos de la intervención, se empleó la ecografía mediante la técnica Rehabilitative Ultrasound Imaging, procedimiento válido para evaluar los cambios en la morfología y en la función de los músculos, realizando las mediciones del espesor de la musculatura abdominal y de la distancia entre rectos en reposo y durante la contracción muscular a través de la prueba de elevación de la pierna extendida. Además, se registraron parámetros fisiológicos como la frecuencia cardíaca, la tensión arterial y la temperatura corporal. No se hallaron diferencias estadísticamente significativas en las variables analizadas entre los grupos de estudio, excepto para la frecuencia cardíaca. El grupo EMS mostró un menor aumento de la frecuencia cardíaca tras la intervención en comparación con los grupos WB-EMS y control. Este hallazgo sugiere que la electroestimulación muscular de la musculatura abdominal podría ser de interés en la aplicación clínica en poblaciones con trastornos cardiorrespiratorios. No obstante, se requiere más investigaciones para profundizar en este tema y conocer los efectos producidos por su aplicación de la electroestimulación dinámica en un mayor número de sesiones.[EN] Electrotherapy is a physiotherapeutic procedure that utilizes electrical currents to elicit specific beneficial physiological effects within the body. One such effect is analgesia, which aims to induce a sense of relief in the patient. Additionally, muscle electrostimulation is employed to enhance strength, endurance, and overall muscle functionality. Muscular electrostimulation can be applied through different methods: localized, where the electrodes are placed in specific areas of the body, or global, which involves simultaneous stimulation of multiple muscle groups. These application techniques can be used individually or in conjunction with physical exercise. The simultaneous combination of physical exercise with excitomotor electrical currents referred to as dynamic electrostimulation, can yield advantageous outcomes for muscle tissue, including increased muscle mass and strength. Based on available evidence, superior results are achieved when both modalities are combined as opposed to when they are used separately. Furthermore, these combined approaches produce similar improvements to conventional training, albeit with lower training intensities required. Consequently, this method may be considered an alternative for individuals facing challenges in performing high-intensity training. The abdominal wall musculature plays a crucial role in stabilizing the pelvis and spine, making proper function essential. It includes the transverse abdominis, anterior rectus abdominis, and the greater and lesser obliques, which work synergistically to maintain the structural and functional integrity of the abdominal region. Despite their importance, there are still gaps in knowledge about their anatomy, their activation mechanisms, and precise functioning. Continued research in this field is essential to improve its understanding and the development of more effective therapeutic strategies, especially in the treatment of conditions and dysfunctions that affect abdominal stability and function. These advancements can have a significant impact on people's health and well-being. Likewise, there is little scientific literature on the immediate effects of dynamic electrostimulation, specifically on the abdominal musculature, and the possible differences between local and global applications. The objectives of this research were to determine the immediate effects of a single session of dynamic electrostimulation on the thickness of the abdominal wall musculature, as well as the distance between the rectus abdominis muscles. In addition to knowing their influence on the physiological parameters corresponding to heart rate, blood pressure (diastolic and systolic) and body temperature. Also, to know the possible differences depending on the form of application, local employing surface electrodes placed in the abdominal area or global through whole-body electrostimulation. The study sample consisted of 120 young, healthy participants aged between 18 and 35 years, randomly divided into three study groups: WB-EMS (global electrostimulation), EMS (local electrostimulation), and control. The intervention consisted of a single 20-minute session of dynamic exercises aimed at stimulating abdominal muscle contraction combined with global electrostimulation, local electrostimulation, or in the case of the control group, with the whole-body electrostimulation turned off. A symmetrical rectangular bipolar electric current was used with specific electrical parameters: 85 Hz stimulation frequency, 350 μs pulse width and 50 % duty cycle (4 s stimulation, 4 s rest). The intensity of the main part of the session ranged from “somewhat strong” to “strong”, depending on each participant's subjective perception of exertion. To evaluate the effects of the intervention, ultrasound was used using the Rehabilitative Ultrasound Imaging technique, a valid procedure to evaluate changes in the morphology and function of the muscles, measuring the thickness of the abdominal musculature and the distance between rectus muscles at rest and during muscle contraction using the extended leg raise test. In addition, physiological parameters such as heart rate, blood pressure and body temperature were recorded. No statistically significant differences were found in the variables analyzed between the study groups, except for heart rate. The EMS group showed a smaller increase in heart rate after the intervention compared to the WB-EMS and control groups. This finding suggests that muscle electrostimulation of the abdominal musculature could be of interest for clinical application in populations with cardiorespiratory disorders. However, further research is needed to investigate this topic in more depth and to find out the effects produced by the application of dynamic electrostimulation in a greater number of sessions