Conventional Cervical Exercises Compared with a Mixed-Reality-Based Game in Asymptomatic Subjects: An Exploratory Crossover Pilot Study.

Mixed reality presents itself as a potential technological tool for the management of people with musculoskeletal disorders, without having as many adverse side effects as immersive virtual reality. The objective of this study was to explore the possibilities of a mixed-reality game, performing task-oriented cervical exercises compared to conventional therapeutic exercises in sensorimotor outcome measures in asymptomatic subjects. A randomized crossover pilot study was performed with two intervention groups: a mixed-reality group (MRG) and a conventional exercise group (CEG). The cervical joint position error test (CJPET) and deep cervical flexor endurance test (DCFET) were measured as sensorimotor outcomes. Statistically significant differences were found in the pre–post comparison in the DCFET for both groups (MRG: t = �����3.87, p < 0.01; CEG: t = �����4.01, p < 0.01) and in the extension of the CJPET for the MRG (t = 3.50, p < 0.01). The rest of the measurements showed no significant differences comparing both groups pre- and postintervention (p > 0.05). Mixed reality has apparently the same positive effects as conventional exercises in sensorimotor outcomes in asymptomatic subjects. These results could help in future studies with mixed virtual reality in the management of people with musculoskeletal disorders.post-print882 K

Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders—An Observational Study

Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force

Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders—An Observational Study

Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p < 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.This research received no external funding

Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Knee arthroplasty (KA) is a typically successful surgical procedure commonly performed to alleviate pain in participants with end-stage knee osteoarthritis. Despite its beneficial effects, a significant proportion of individuals with KA continue experiencing persistent pain and functional limitations. The purpose of this study was to assess the postoperative outcomes after KA in relation to postoperative pain catastrophizing. Methods. Participants were recruited at a domiciliary physiotherapy service, using a prospective, observational, hypothesis-generating cohort design. Participants were divided into two groups based on their Pain Catastrophizing Scale (PCS) total score (50th percentile), which resulted in high and low PCS groups. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, quality of life, walking speed, physical performance, range of motion, and pain were measured. Outcome measures were collected at baseline (1 week postoperatively) and at follow-up (1, 3, and 6 months postoperatively). Results. A total of 60 participants (21 total KA and 39 unicompartmental KA) were recruited. Individuals with a higher degree of pain catastrophizing showed significantly higher WOMAC total scores at every follow-up, indicating poorer health functioning (p 0.05). Conclusion. The results of the present study suggest that participants with high postoperative pain catastrophizing might have poorer outcomes during the rehabilitation process after KA. Future work should seek to clarify if this relationship is causal

Effectiveness of Virtual Reality on Postoperative Pain, Disability and Range of Movement after Knee Replacement: A Systematic Review and Meta-Analysis

Postoperative pain after knee arthroplasty (TKA) is a reality that continues to be experienced today. Recently, virtual reality (VR) has demonstrated effectiveness in the management of pain. Our aim was to review the original controlled trials evaluating the effectiveness of VR for pain management and quality of life after TKA. Six databases were searched for articles published from inception to September 2023, following (PRISMA) guidelines. The methodological quality was assessed using the Risk of Bias tool for Randomized Trials (ROB2). Five RCTs were included in the systematic review, and four of them in the meta-analysis. The effectiveness of VR for short term pain relief was superior compared to the control (MD = −0.8 cm; CI 95%: −1.3 to −0.4; p p p = 0.049). However, no differences were found in the effect on the ROM between groups (MD = 3.4 grades; CI 95%: −6.0 to 12.8, p = 0.48). Our findings suggest that the use of virtual reality during the postoperative period could be an effective non-pharmacological therapy in relieving acute pain, compared to a control intervention, with a very low degree of certainty according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). However, the low methodological quality of the articles limits our findings

A feasibility study of home-based preoperative multimodal physiotherapy for patients scheduled for a total knee arthroplasty who catastrophize about their pain

Background Preoperative pain catastrophizing (PC) and pain are both risk factors for poor outcomes after a total knee arthroplasty (TKA). Despite that, there is limited evidence about physiotherapy interventions' effectiveness on addressing such factors. Purpose To evaluate the feasibility and clinical impact of a home-based multimodal physiotherapy intervention in reducing pain and PC, in patients scheduled for a TKA who present preoperative moderate-to-severe pain and PC. Methods Three-armed parallel-group randomized controlled feasibility study. Subjects with symptomatic osteoarthritis and a score of >= 20 on the Pain Catastrophizing Scale (PCS) were recruited. The control group received usual care. Both experimental groups received pain neuroscience education, coping skills training and therapeutic exercise, but differ in the number of sessions, dosage, hands-on approach, and grade of supervision. All outcomes were measured before and after the intervention. Results A total of 33,7% were eligible for inclusion, and 97,1% agreed to participate. Every participant completed the treatment. Treatment compliance was higher in the group with additional supervision. Both groups showed significant effects in PC and pain reduction. A total of 33 patients would be required for a full trial. Conclusion Preoperative physiotherapy is a feasible and effective treatment in reducing pain intensity and PC in high PCS osteoarthritis subjects scheduled for a TKA.Part of Hector Beltran-Alacreu'ssalary is financed by the European Regional Development Fund (2020/5154)

Validity and Intra Rater Reliability of a New Device for Tongue Force Measurement

Background. The tongue is made up of multiple muscles both extrinsic and intrinsic. The hyoid, jaw and maxillary complex contain the tongue, which hangs between these structures forming an important biomechanical system. This organ has to work in coordination with craniofacial structures to ensure normal orofacial functioning. There are different devices on the market for tongue force measurement. However, they are not accessible for patients due to their size and very high prices. Likewise, other devices have not yet carried out validity and reliability studies. The purpose of this study was to validate a new device proving that it is accurate compared to the algometer. Moreover, the study wanted to determine the intra-rater reliability of a protocol to assess the maximum tongue force in asymptomatic subjects. Material and methods. This is an observational-longitudinal study with repeated measurements. A prototype device was developed specifically for this study to measure tongue force through force-sensitive resistor sensors. The prototype system was equipped with a device to perform and transmit the measurement and a C++ programming software in the computer to take data from the session. Different formulas were made to calibrate the system. For validity, the force measured by the prototype and the algometer was compared. For intra-rater reliability, 29 asymptomatic Spanish subjects were recruited, and a standardized protocol was carried out for the tests. Results. Experiments to assess validity showed a strong correlation (r>0.97) and an excellent reliability (ICC>0.90) between devices. On the other hand, the intra-rater reliability analysis showed an excellent ICC (0.93) with a 95% CI of 0.86 to 0.97 and a MDC of 6.26N. Conclusion. We demonstrated good validity values and high intra-rater reliability for the prototype device for the maximum tongue force.The authors would like to thank the Centro Superior of Estudios Universitarios La Salle for funding the English language edition of this manuscript. Moreover, we thank the collaboration of Pablo Jordi Perea, the speech language therapist in the Functional Rehabilitation Institute of the Centro Superior of Estudios Universitarios La Salle. HBA would like to thank the European Regional Development Fund (2020/5154)

Reliability and Responsiveness of a Novel Device to Evaluate Tongue Force

Background: Measurements of tongue force are important in clinical practice during both the diagnostic process and rehabilitation progress. It has been shown that patients with chronic temporomandibular disorders have less tongue strength than asymptomatic subjects. Currently, there are few devices to measure tongue force on the market, with different limitations. That is why a new device has been developed to overcome them. The objectives of the study were to determine the intra- and inter-rater reliability and the responsiveness of a new low-cost device to evaluate tongue force in an asymptomatic population. Materials and Methods: Two examiners assessed the maximal tongue force in 26 asymptomatic subjects using a developed prototype of an Arduino device. Each examiner performed a total of eight measurements of tongue force in each subject. Each tongue direction was measured twice (elevation, depression, right lateralization, and left lateralization) in order to test the intrarater reliability. Results: The intrarater reliability using the new device was excellent for the measurements of the tongue force for up (ICC &gt; 0.94), down (ICC &gt; 0.93) and right (ICC &gt; 0.92) movements, and good for the left movement (ICC &gt; 0.82). The SEM and MDC values were below 0.98 and 2.30, respectively, for the intrarater reliability analysis. Regarding the inter-rater reliability, the ICC was excellent for measuring the tongue up movements (ICC = 0.94), and good for all the others (down ICC = 0.83; right ICC = 0.87; and left ICC = 0.81). The SEM and MDC values were below 1.29 and 3.01, respectively, for the inter-rater reliability. Conclusions: This study showed a good-to-excellent intra- and inter-reliability and good responsiveness in the new device to measure different directions of tongue force in an asymptomatic population. This could be a new, more accessible tool to consider and add to the assessment and treatment of different clinical conditions in which a deficit in tongue force could be found

A Sytematic review

ReviewTo perform a systematic review of the literature to investigate the influence of psychosocial factors on pain and functional outcomes after knee arthroplasty from 6 months after surgery. Methods: Studies were included if they were prospective cohort observational studies. The subjects had to be middle aged or aged (mean age: 45 years) and have undergone total or unilateral knee arthroplasty. Studies should have recorded the influence of different psychosocial factors and the surgery outcomes had to be evaluated according to pain and/or function variables regardless of the tools used to measure them. In addition, outcome measures had to be recorded in the medium term (6 months) or the long term (12 months). Two reviewers assessed independently the MEDLINE, PsycINFO, and CINAHL databases to select observational studies. Results: Twenty-two studies with a total of 7156 patients (5349 females) were included in this review and the mean age was 67.92 years. Twenty-two studies included in this review showed a good average methodological quality (mean +/- SD: 7.22 +/- 0.92) on the Newcastle-Ottawa Scale for cohort studies. Conclusion: The evidence suggests that catastrophizing, kinesiophobia, anxiety, self-efficacy, and mental health are predictors of postoperative functional outcomes at 6 and 12 months after surgery. There is conflicting evidence on whether or not catastrophizing, anxiety, and depression are predictors of postoperative pain at 6 and 12 months after surgery