Add-on Effect of Postural Instructions to Abdominopelvic Exercise on Urinary Symptoms and Quality of Life in Climacteric Women with Stress Urinary Incontinence : A Pilot Randomized Controlled Trial

The aim of this study was to investigate the add-on effect of postural instructions to an abdominopelvic exercise program on incontinence urinary symptoms (UI symptoms) and quality of life (QoL) in climacteric women with stress urinary incontinence (SUI). A randomized controlled trial was performed with a total of 40 climacteric women with SUI aged between 46 and 75 years old. Participants were randomly assigned to two groups: a group performing an abdominopelvic exercise program (AEP) (n = 20) and a group performing abdominopelvic exercise with the addition of postural instructions (AEPPI) (n = 20). Primary outcome measures were UI symptoms, UI impact and QoL related to UI (UI-QoL), measured by 48 h Pad Test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF), which were assessed at baseline, post-intervention and 3 months follow-up. Secondary outcome was patient's satisfaction measured by the 100-point Visual Analogic Scale (VAS) only after the intervention. Between-groups differences were observed in terms of UI-QoL immediately after intervention. Within-groups differences were observed between baseline to 3 months follow-up and between post-intervention to 3 months follow-up in AEPPI group (p < 0.05) for UI-QoL and UI impact. UI symptoms were improved in both groups between baseline to 3-months follow-up (p < 0.05). Patient's satisfaction was higher in the AEPPI group (p < 0.05). The addition of postural instructions to an abdominopelvic exercise programimproves UI impact to QoL and patients' satisfaction in women with SUI

The effect of vibration therapy on neck myofascial trigger points: A randomized controlled pilot study

[EN] Background: The purpose of this study was to evaluate the effect of low-frequency self-administered vibration therapy into myofascial trigger points in the upper trapezius and levator scapulae on patients with chronic non-specific neck pain. Methods: Twenty-eight patients with chronic non-specific neck pain were randomly assigned into a vibration group, receiving 10 self-applied sessions of vibration therapy in the upper trapezius and levator scapulae trigger points; or a control group, receiving no intervention. Self-reported neck pain and disability (Neck Disability Index) and pressure pain threshold were assessed at baseline and after the first, fifth and 10th treatment sessions. Findings: Significant differences were found in the vibration group when compared to the control group after the treatment period: the vibration group reached lower Neck Disability Index scores (F = 4.74, P = .033, eta(2) = 0.07) and greater pressure pain threshold values (F = 7.56, P = .01, eta(2) = 0.10) than the control group. The vibration group reported a significant reduction in Neck Disability Index scores (chi(2) = 19,35, P = .00, Kendall's W = 0.28) and an increase in pressure pain threshold (chi(2) = 87,10, P = .00, Kendall's W = 0.73) between the assessment times over the course of the treatment. The mean increase in pressure pain threshold in the vibration group after the 10 sessions was 8.54 N/cm2, while the mean reduction in Neck Disability Index scores was 4.53 points. Interpretation: Vibration therapy may be an effective intervention for reducing self-reported neck pain and disability and pressure pain sensitivity in patients with chronic non-specific neck pain. This tool could be recommended for people with non-specific neck pain.Dueñas, L.; Zamora, T.; Lluch, E.; Artacho Ramírez, MÁ.; Mayoral, O.; Balasch Parisi, S.; Balasch-Bernat, M. (2020). The effect of vibration therapy on neck myofascial trigger points: A randomized controlled pilot study. Clinical Biomechanics. 78:1-9. https://doi.org/10.1016/j.clinbiomech.2020.1050711978Andrade Ortega, J. A., Delgado Martínez, A. D., & Ruiz, R. A. (2010). Validation of the Spanish Version of the Neck Disability Index. Spine, 35(4), E114-E118. doi:10.1097/brs.0b013e3181afea5dArmstrong, W. J., Grinnell, D. C., & Warren, G. S. (2010). The Acute Effect of Whole-Body Vibration on the Vertical Jump Height. Journal of Strength and Conditioning Research, 24(10), 2835-2839. doi:10.1519/jsc.0b013e3181e271ccBal, M. I., Sattoe, J. N. T., Roelofs, P. D. D. M., Bal, R., van Staa, A., & Miedema, H. S. (2016). Exploring effectiveness and effective components of self-management interventions for young people with chronic physical conditions: A systematic review. Patient Education and Counseling, 99(8), 1293-1309. doi:10.1016/j.pec.2016.02.012Bishop, M. D., Mintken, P., Bialosky, J. E., & Cleland, J. A. (2013). Patient Expectations of Benefit From Interventions for Neck Pain and Resulting Influence on Outcomes. Journal of Orthopaedic & Sports Physical Therapy, 43(7), 457-465. doi:10.2519/jospt.2013.4492Cagnie, B., Dewitte, V., Barbe, T., Timmermans, F., Delrue, N., & Meeus, M. (2013). Physiologic Effects of Dry Needling. Current Pain and Headache Reports, 17(8). doi:10.1007/s11916-013-0348-5Cagnie, B., Castelein, B., Pollie, F., Steelant, L., Verhoeyen, H., & Cools, A. (2015). Evidence for the Use of Ischemic Compression and Dry Needling in the Management of Trigger Points of the Upper Trapezius in Patients with Neck Pain. American Journal of Physical Medicine & Rehabilitation, 94(7), 573-583. doi:10.1097/phm.0000000000000266Celik, D., & Mutlu, E. K. (2013). Clinical Implication of Latent Myofascial Trigger Point. Current Pain and Headache Reports, 17(8). doi:10.1007/s11916-013-0353-8Chan, Y.-C., Wang, T.-J., Chang, C.-C., Chen, L.-C., Chu, H.-Y., Lin, S.-P., & Chang, S.-T. (2015). Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome. Journal of Physical Therapy Science, 27(1), 217-221. doi:10.1589/jpts.27.217Chesterton, L. S., Barlas, P., Foster, N. E., Baxter, D. G., & Wright, C. C. (2003). Gender differences in pressure pain threshold in healthy humans. Pain, 101(3), 259-266. doi:10.1016/s0304-3959(02)00330-5Cummings, M., & Baldry, P. (2007). Regional myofascial pain: diagnosis and management. 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Journal of Orthopaedic & Sports Physical Therapy, 49(4), 212-215. doi:10.2519/jospt.2019.0605Itoh, K., Okada, K., & Kawakita, K. (2004). A Proposed Experimental Model of Myofascial Trigger Points in Human Muscle after Slow Eccentric Exercise. Acupuncture in Medicine, 22(1), 2-13. doi:10.1136/aim.22.1.2Jahr, S., Schoppe, B., & Reisshauer, A. (2008). Effect of treatment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation®) on breast tissue and pain in patients with secondary breast lymphoedema. Journal of Rehabilitation Medicine, 40(8), 645-650. doi:10.2340/16501977-0225Järvinen, T. A. H., Järvinen, T. L. N., Kääriäinen, M., Äärimaa, V., Vaittinen, S., Kalimo, H., & Järvinen, M. (2007). Muscle injuries: optimising recovery. Best Practice & Research Clinical Rheumatology, 21(2), 317-331. doi:10.1016/j.berh.2006.12.004Jonkman, N. H., Schuurmans, M. J., Jaarsma, T., Shortridge-Baggett, L. M., Hoes, A. W., & Trappenburg, J. C. A. (2016). Self-management interventions: Proposal and validation of a new operational definition. Journal of Clinical Epidemiology, 80, 34-42. doi:10.1016/j.jclinepi.2016.08.001Kim, D.-H., Yoon, D. M., & Yoon, K. B. (2015). The Effects of Myofascial Trigger Point Injections on Nocturnal Calf Cramps. The Journal of the American Board of Family Medicine, 28(1), 21-27. doi:10.3122/jabfm.2015.01.140151Kraft, K., Kanter, S., & Janik, H. (2013). Safety and Effectiveness of Vibration Massage by Deep Oscillations: A Prospective Observational Study. Evidence-Based Complementary and Alternative Medicine, 2013, 1-10. doi:10.1155/2013/679248Lauche, R., Cramer, H., Hohmann, C., Choi, K.-E., Rampp, T., Saha, F. J., … Dobos, G. (2012). The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study. Evidence-Based Complementary and Alternative Medicine, 2012, 1-10. doi:10.1155/2012/429718Lluch, E., Arguisuelas, M. D., Coloma, P. S., Palma, F., Rey, A., & Falla, D. (2013). Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain. Journal of Manipulative and Physiological Therapeutics, 36(9), 604-611. doi:10.1016/j.jmpt.2013.08.004Lobbezoo, F., Visscher, C. M., & Naeije, M. (2004). Impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions. European Journal of Pain, 8(1), 23-30. doi:10.1016/s1090-3801(03)00061-2Lu, X., Wang, Y., Lu, J., You, Y., Zhang, L., Zhu, D., & Yao, F. (2018). Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review. Journal of International Medical Research, 47(1), 3-18. doi:10.1177/0300060518814999Lucas, K. R., Polus, B. I., & Rich, P. A. (2004). Latent myofascial trigger points: their effects on muscle activation and movement efficiency. Journal of Bodywork and Movement Therapies, 8(3), 160-166. doi:10.1016/j.jbmt.2003.12.002Lundeberg, T., Nordemar, R., & Ottoson, D. (1984). Pain alleviation by vibratory stimulation. Pain, 20(1), 25-44. doi:10.1016/0304-3959(84)90808-xMacDermid, J. C., Walton, D. M., Avery, S., Blanchard, A., Etruw, E., McAlpine, C., & Goldsmith, C. H. (2009). Measurement Properties of the Neck Disability Index: A Systematic Review. Journal of Orthopaedic & Sports Physical Therapy, 39(5), 400-C12. doi:10.2519/jospt.2009.2930Mansilla-Ferragut, P., Fernández-de-las Peñas, C., Alburquerque-Sendín, F., Cleland, J. A., & Boscá-Gandía, J. J. (2009). Immediate Effects of Atlanto-Occipital Joint Manipulation on Active Mouth Opening and Pressure Pain Sensitivity in Women With Mechanical Neck Pain. Journal of Manipulative and Physiological Therapeutics, 32(2), 101-106. doi:10.1016/j.jmpt.2008.12.003Melzack, R., & Wall, P. D. (1965). Pain Mechanisms: A New Theory. Science, 150(3699), 971-979. doi:10.1126/science.150.3699.971Mintken, P. E., Rodeghero, J., & Cleland, J. A. (2018). Manual therapists – Have you lost that loving feeling?! Journal of Manual & Manipulative Therapy, 26(2), 53-54. doi:10.1080/10669817.2018.1447185Muñoz-Muñoz, S., Muñoz-García, M. T., Alburquerque-Sendín, F., Arroyo-Morales, M., & Fernández-de-las-Peñas, C. (2012). Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Individuals With Mechanical Neck Pain. Journal of Manipulative and Physiological Therapeutics, 35(8), 608-613. doi:10.1016/j.jmpt.2012.09.003Pecos-Martín, D., Montañez-Aguilera, F. J., Gallego-Izquierdo, T., Urraca-Gesto, A., Gómez-Conesa, A., Romero-Franco, N., & Plaza-Manzano, G. (2015). Effectiveness of Dry Needling on the Lower Trapezius in Patients With Mechanical Neck Pain: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 96(5), 775-781. doi:10.1016/j.apmr.2014.12.016Peer, K. S., Barkley, J. E., & Knapp, D. M. (2009). The Acute Effects of Local Vibration Therapy on Ankle Sprain and Hamstring Strain Injuries. The Physician and Sportsmedicine, 37(4), 31-38. doi:10.3810/psm.2009.12.1739Sherman, K. J., Cherkin, D. C., Hawkes, R. J., Miglioretti, D. L., & Deyo, R. A. (2009). Randomized Trial of Therapeutic Massage for Chronic Neck Pain. The Clinical Journal of Pain, 25(3), 233-238. doi:10.1097/ajp.0b013e31818b7912Simons, D. G. (2004). Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. Journal of Electromyography and Kinesiology, 14(1), 95-107. doi:10.1016/j.jelekin.2003.09.018Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy, 96(4), 560-569. doi:10.2522/ptj.20150224Vanderweeën, L., Oostendorp, R. A. B., Vaes, P., & Duquet, W. (1996). Pressure algometry in manual therapy. Manual Therapy, 1(5), 258-265. doi:10.1054/math.1996.0276Vernon, H. (2008). The Neck Disability Index: State-of-the-Art, 1991-2008. Journal of Manipulative and Physiological Therapeutics, 31(7), 491-502. doi:10.1016/j.jmpt.2008.08.006Vernon, H., & Schneider, M. (2009). Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: A Systematic Review of the Literature. Journal of Manipulative and Physiological Therapeutics, 32(1), 14-24. doi:10.1016/j.jmpt.2008.06.012Voogt, L., de Vries, J., Meeus, M., Struyf, F., Meuffels, D., & Nijs, J. (2015). Analgesic effects of manual therapy in patients with musculoskeletal pain: A systematic review. Manual Therapy, 20(2), 250-256. doi:10.1016/j.math.2014.09.001Walton, D., MacDermid, J., Nielson, W., Teasell, R., Nailer, T., & Maheu, P. (2011). A Descriptive Study of Pressure Pain Threshold at 2 Standardized Sites in People With Acute or Subacute Neck Pain. 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Differences in Myoelectric Activity of the Lumbar Muscles between Recurrent and Chronic Low Back Pain : a cross-sectional study

Background: Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods: In 75 subjects (16 continuous CLBP, 15 non-continuous CLBP, 23 RLBP, 21 healthy controls), surface electromyographic (EMG) activity of the lumbar erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) was recorded during the concentric, holding and eccentric phase of a modified Biering Sorenson exercise. Results: Continuous CLBP patients showed higher EMG activity in the ES and MF muscles compared to healthy controls in the concentric (p = 0.011; p = 0.009 respectively) and the holding phase (p = 0.015; p = 0.013). Higher EMG activity was observed in continuous CLBP compared to RLBP in the ES and MF muscles in the holding phase (p = 0.035; p = 0.037), and in the MF in the concentric phase (p = 0.046), but not in the ES (p = 0.062). No differences in muscle activity were established in either the concentric, holding, and eccentric phase for the LD and GM muscles. No differences were found between non-continuous CLBP and the other groups. Conclusions: An enhanced muscle activity of the lumbar muscles during the concentric and holding phase was observed during trunk extension in patients with continuous CLBP compared to patients with RLBP and healthy subjects. No differences between groups are present in the GM and LD muscles during concentric and holding phases and for and muscle in the eccentric phase

An Instrument-Assisted coracoid pain test : an exploratory diagnostic accuracy study

The coracoid pain test (CPT) could contribute to the diagnosis of frozen shoulder (FS) with palpation. However, due to assessor performance these values might be unreliable. Therefore, the aim was to explore the diagnostic accuracy of an instrument-assisted CPT and two alternative approaches (pain severity and side comparison) for assistance in the diagnosis of FS. Patients with FS and healthy age-matched controls were recruited. All participants underwent the instrument-assisted CPT on both shoulders with a pressure algometer. Sensitivity, specificity, and likelihood ratios were determined for the three approaches. In total, 35 patients with FS and 35 healthy participants were included. The original approach was positive in eight participants (11.4%), with only sufficient specificity to draw a conclusion. The pain severity approach was positive in 31 participants (44.3%) with sufficient sensitivity, specificity and likelihood ratios. The side comparison approach was positive in 10 participants (14.3%) with excellent specificity and positive likelihood ratio. The specificity of the instrument-assisted CPT can be used to increase the probability of FS with both the original and alternative approaches. Only the pain severity approach can draw a conclusion with a negative test result. This study should be repeated with a cross-sectional design to strengthen and confirm the conclusions

Differences in Inter-Rectus Distance and Abdominopelvic Function between Nulliparous, Primiparous and Multiparous Women

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women

The Spatial Extent of Pain Is Associated with Pain Intensity, Catastrophizing and Some Measures of Central Sensitization in People with Frozen Shoulder

The aim of this cross-sectional study was to explore the spatial extent of pain and its association with clinical symptoms, psychological features, and pain sensitization in people with frozen shoulder (FS). Forty-eight individuals with FS completed pain drawings (PDs) and reported their clinical symptoms including pain intensity (Visual Analogue Scale) and shoulder disability (Shoulder Pain and Disability Index). Moreover, pain sensitization measurements (pressure pain thresholds, temporal summation, conditioned pain modulation, and Central Sensitization Inventory (CSI)) were assessed. Psychological features were assessed by Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire. Pain frequency maps were generated, Margolis rating scale was used for pain location, and Spearman correlation coefficients were computed. The mean (SD) pain extent was 12.5% (6.7%) and the most common painful area was the anterolateral shoulder region (100%). Women presented a more widespread pain distribution compared with men. Significant positive associations were obtained between pain extent and current pain intensity (rs = 0.421, p < 0.01), PCS (rs = 0.307, p < 0.05) and CSI (rs = 0.358, p < 0.05). The anterolateral region of the shoulder was the most common painful area in people with FS. Women with FS presented more extended areas of pain; and a more widespread distribution of pain was correlated with higher levels of pain, pain catastrophizing and pain sensitization

Kihon Checklist to assess frailty in older adults: Some evidence on the internal consistency and validity of the Spanish version

Aim: The aim of this study was to assess the internal consistency, hypothesis testing and criterion-related validity of the Spanish versions of the Kihon Checklist (KCL) - the original 25-item and reduced 15-item versions - for screening frailty in community-dwelling older adults. Methods: A cross-sectional study was carried out between March and September 2018 in Valencia province (Spain). A sample of 251 participants was recruited. Construct validity was assessed using four different frailty instruments, and alternative measures corresponding to the KCL domains (handgrip strength, gait speed, the Short Physical Performance Battery, skeletal muscle mass index, physical activity level, functional status, cognitive function, depressive mood, health-related quality of life and nutritional status). Fried's Frailty Phenotype was used to evaluate criterion validity. Results: Internal consistency assessed with Kuder-Richardson Formula had a value of 0.69 for the 25-item version, slightly lower than the usual 0.7 for considering good reliability, and 0.71 for the 15-item version. There were significant correlations between KCL versions and Fried's Frailty Phenotype, Edmonton Scale, Tilburg Indicator and FRAIL Scale. Consistent significant correlations were also obtained with all frailty measurements and instrumental activities of daily living, physical strength, eating, socialization, and mood domains of the KCL. The KCL closely correlated with other standardized measurements of physical function, cognitive function, depressive mood, and health-related quality of life. The KCL also showed satisfactory diagnostic accuracy for frailty (area under the curve 0.891 for KCL-25; area under the curve 0.857 for KCL-15). The optimal cut-off points were 5/6 and 3/4, respectively. Conclusions: The findings suggest that both versions of the KCL, especially KCL-15, showed adequate evidence of validity and internal consistency as a preliminary screening of frailty among community-dwelling older adults in Spain

Influence of age, gender and obesity on pressure discomfort threshold of the foot: A cross-sectional study

[EN] Background: Foot pain is a highly prevalent health problem for which measures such as a pattern of Pressure Discomfort Threshold of the foot plantar surface can provide valuable information for orthosis design. This study aimed to describe such pattern as a tool for the assessment of painful conditions of the feet and to analyse how it modifies according to age, gender and obesity. Methods: A cross-sectional study was performed with participants allocated in: Group 1 people aged 20 to 35 years, Group 2 aged 50 to 65 years and Group 3 aged over 65. Pressure Discomfort Threshold on twelve points of the foot plantar surface was measured with an adapted manual dynamometer. Inferential analyses of the data were performed using one-way analysis of variance (ANOVA) considering foot areas, age group, gender and obesity. Findings: 36 participants were analysed. The pattern of Pressure Discomfort Threshold for all individuals showed a significantly higher threshold on the heel and external foot (P < 0.001, eta(2) = 0.124) and was statistical significantly influenced by age (P < 0.001, eta(2) = 0.17), especially in participants aged over 65; by gender, with women having higher values (P < 0.001, eta(2) = 0.13), and by obesity (P < 0.001, eta(2) = 0.19). Interpretation: A Pressure Discomfort Threshold pattern exists in the foot plantar surface. The characteristics of the discomfort pattern of the foot and its association with aging, gender and obesity may have considerable implications for orthosis and footwear design.Dueñas, L.; Arnal-Gómez, A.; Aparicio, I.; Balasch-Bernat, M.; López-Bueno, L.; Gonzalez Garcia, JC.; Solves Camallonga, C.... (2021). Influence of age, gender and obesity on pressure discomfort threshold of the foot: A cross-sectional study. 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A Central Nervous System Focused Treatment Program for People with Frozen Shoulder: A Feasibility Study

Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion (ROM). The aim of this study is to evaluate the feasibility and clinical impact of a CNS-focused treatment program for people with FS. Methods: 10 subjects with primary FS received a 10-week CNS-focused intervention including sensory discrimination training and graded motor imagery techniques delivered as clinic sessions (60 min) and home therapy (30 min five times per week). Measurements were taken at baseline, after a 2-week 'washout' period, after treatment, and at three months followup. The Shoulder Pain and Disability Index (SPADI) was the primary outcome. Secondary measures were feasibility-related outcomes, self-reported shoulder pain, active and passive range of motion, two-point discrimination threshold (TPDT), left/right judgement task (LRJT), fear-avoidance (Tampa Scale for Kinesiophobia), pain catastrophization (Pain Catastrophizing Scale), and pain sensitization (Central Sensitization Inventory). A Student's t-test was used to assess the 'washout' period. A repeated measure analysis of variance (ANOVA) was used to evaluate within-subjects' differences for all outcome measures in the different assessment periods and a pairwise analysis was used to compare between the different assessment points. Statistical significance was set at p < 0.05. Results: 70% of participants completed the treatment. No significant changes were found after 'washout' period except for TPDT (p = 0.02) and SPADI (p = 0.025). Improvements in self-reported shoulder pain (p = 0.028) and active shoulder flexion (p = 0.016) were shown after treatment (p = 0.028) and follow-up (p = 0.001) and in SPADI at follow-up (p = 0.008). No significant changes were observed in TPDT, LRJT, fear-avoidance, pain catastrophization, and pain sensitization. Conclusions: a CNS-focused treatment program might be a suitable approach to improve pain and disability in FS, but further research is needed to draw firm conclusions

The effect of an abdominopelvic exercise program alone VS in addition to postural instructions on pelvic floor muscle function in climacteric women with stress urinary incontinence. A randomized controlled trial

Introduction Scarce literature exists regarding the influence of posture-based interventions for the treatment of stress urinary incontinence (SUI). Objective The aim of this randomized controlled trial with two parallel groups was to investigate whether the addition of postural instructions to a 12-week abdominopelvic exercise program is superior to an abdominopelvic exercise program alone, in terms of PFMs function and symptoms in climacteric women with SUI. Methods Climacteric women aged between 40–75 years old who presented with SUI were included in this parallel study (NCT03727945). Two randomized groups performing one 40-minutes session per week for 12-weeks were compared: one performing an abdominopelvic exercise program (AEP) and a second one performing the same intervention with the addition of postural instructions (AEPPI). PFMs electromyographical (EMG) activity and strength (Oxford Grading Scale) were quantified during a maximal voluntary contraction. SUI symptoms were assessed using a 3-day bladder diary. These outcomes were collected at baseline, immediately after intervention, and 3-months after the intervention. Results A total of 47 women were included in the study (AEP [n = 23], AEPPI [n = 24]). Between-group analysis showed significant differences for post-intervention EMG and strength values, showing higher values for the AEPPI compared to the AEP group. At 3-months follow-up, statistically significant differences were only obtained in strength, with higher values in the AEPPI group. No significant differences were obtained in terms of UI symptoms. Conclusion A 12-session abdominopelvic exercise program supplemented with postural instructions is superior to an abdominopelvic exercise program alone in terms of PFMs function in women with SUI