App-Mohedo®: a mobile app for the management of chronic pelvic pain. A design and development study

Background Chronic Pelvic Pain (CPP) has been described as a public health priority worldwide, and it is among the most prevalent and costly healthcare problems. Graded motor imagery (GMI) is a therapeutic tool that has been successfully used to improve pain in several chronic conditions. GMI therapy is divided into three stages: laterality training (LRJT, Left Right Judgement Task), imagined movements, and mirror therapy. No tool that allows working with LRJT in pelvic floor has been developed to date. Objective This research aims to describe the process followed for the development of a highly usable, multi-language and multi-platform mobile application using GMI with LRJT to improve the treatment of patients with CPP. In addition, this will require achieving two other goals: firstly, to generate 550 pelvic floor images and, subsequently, to carry out an empirical study to objectively classify them into different difficulty levels of. This will allow the app to properly organize and plan the different therapy sessions to be followed by each patient. Methodology For the design, evaluation and development of the app, an open methodology of user-centered design (MPIu + a) was applied. Furthermore, to classify and establish the pelvic floor images of the app in different difficulty levels, an observational, cross-sectional study was conducted with 132 volunteers through non-probabilistic sampling. Results On one hand, applying MPIu+a, a total of 5 phases were required to generate an easy-to-use mobile application. On the other hand, the 550 pelvic floor images were classified into 3 difficulty levels (based on the percentage of correct answers and response time used by the participants in the classification process of each image): Level 1 (191 images with Accuracy = 100 % and RT = [0–2.5] seconds); Level 2 (208 images with Accuracy = 75–100 % and RT = [2.5–5] seconds); and Level 3 (151 images with Accuracy = 50–75 % and RT > 5 s)...Funding for open access charge: Universidad de Malaga/CBUA

Characteristics of Frailty in Perimenopausal Women with Long COVID-19

The aim of this study was to compare the prevalence of risk factors for frailty between perimenopausal women with long COVID-19 syndrome, women having successfully recovered from COVID-19, and controls from the community. Women with a diagnosis of long COVID-19 and at least one symptom related to the perimenopausal period, women who had successfully recovered from COVID-19, and healthy women of comparable age were included in this study. Symptom severity and functional disability were assessed with the COVID-19 Yorkshire Rehabilitation Scale, and the presence of frailty was evaluated considering the Fried criteria. A total of 195 women were included in the study, distributed over the three groups. The long COVID-19 group showed a higher prevalence of perimenopausal symptoms and impact of COVID-19. Statistically significant differences were found between the long COVID-19 group and the other two groups for the frailty variables. When studying the associations between frailty variables and COVID-19 symptom impact, significant positive correlations were found. Perimenopausal women with long COVID-19 syndrome present more frailty-related factors and experience a higher range of debilitating ongoing symptoms. A significant relationship is shown to exist between long COVID-19 syndrome-related disability and symptoms and frailty variables, resulting in an increased chance of presenting disability.Formación Profesorado Universitario (FPU) grant (FPU: 19/02609) from the Spanish Ministry of EducationFPU grant (FPU: 21/00451) for the training of university faculty from the University of GranadaCollege of Physiotherapists of Andalucia, (Project Ref: 06195/21D/MA

Neurophysiological pain education for patients with symptomatic knee osteoarthritis: A systematic review and meta-analysis

Objective To evaluate the effectiveness of neurophysiological pain education in patients with symptomatic knee osteoarthritis considering pain-related variables. Methods A systematic review and meta-analysis was carried out according to the PRISMA guidelines. A search was conducted in PubMed, PEDro Database, Cochrane Library, Scopus, and Web of Science. Only randomized controlled trials enrolling patients ≥ 18 years of age with symptomatic knee osteoarthritis were included. The Downs and Black quality assessment tool was used to assess the quality of the articles, and the risk of bias was evaluated with the Cochrane Risk of Bias Assessment Tool. Results A total of 7 studies were included in the study. Most of the studies were rated as “fair” on the Downs and Black quality assessment tool, and in the category of “some concerns” according to the Cochrane Risk of Bias Assessment Tool. Neurophysiological pain education was conducted alone or combined with exercise, joint mobilizations, or self-management programs. The number of sessions ranged from 1 to 10. The meta-analysis results showed significant differences in favor of the intervention group in pain (MD = −0.49; 95% CI = −0.66; −0.32; p < 0.001) and catastrophization (MD = −1.81; 95% CI = −3.31, −0.3; p = 0.02). Conclusion, practice implications Neurophysiological pain education interventions in isolation or combined with exercise, joint mobilizations, or self-management programs have proven to significantly improve pain and catastrophization in patients with symptomatic knee osteoarthritis. These findings could provide clinicians with more information regarding the management of patients with symptomatic knee osteoarthritis.Spanish Ministry of Education through a grant for the training of uni- versity faculty (code FPU:19/02609,FPU: 20/01670 and FPU: 21/ 00451, respectively)

Post-COVID Patients With New-Onset Chronic Pain 2 Years After Infection: Cross-Sectional Study

Background: Although pain is common in non-hospitalized post-COVID-19 syndrome, only a few studies have provided information on the pain experience of these patients. Aim: To identify the clinical and psychosocial profile associated with pain in non-hospitalized patients with post-COVID-19 syndrome. Method: In this study there were three groups: healthy control group, successfully recovered group, and post-COVID syndrome group. Pain-related clinical profile and pain-related psychosocial variables were collected. Pain-related clinical profile included: pain intensity and interference (Brief Pain Inventory), central sensitization (Central Sensitization Scale), insomnia severity (Insomnia Severity Index), and pain treatment. Pain-related psychosocial variables were: fear of movement and (re)injury (Tampa Scale for Kinesiophobia), catastrophizing (Pain Catastrophizing Scale), depression, anxiety and stress (Depression, Anxiety and Stress Scale), and fear-avoidance beliefs (Fear Avoidance Beliefs Questionnaire). Results: In all, 170 participants were included in the study (healthy control group n = 58, successfully recovered group n = 57, and post-COVID syndrome group n = 55). Post-COVID syndrome group obtained significantly worse punctuation in pain-related clinical profile and psychosocial variables than the other two groups (p < .05). Conclusions: In conclusion, patients with post-COVID-19 syndrome have experienced high pain intensity and interference, central sensitization, increased insomnia severity, fear of movement, catastrophizing, fear-avoidance beliefs, depression, anxiety, and stres

Barriers and applied activity, quality of life and self‑efficacy in prostate cancer survivors 1 year after completing radiotherapy

Purpose The aims of the study were to assess self-reported physical activity (PA) levels, barriers to PA, quality of life and self-efficacy to manage chronic disease of prostate cancer survivor 1 year after radiotherapy treatment. Methods A cross-sectional case–control study was performed. Prostate cancer survivor patients treated with radiotherapy were recruited from the Radiation Oncology Service of the “Complejo Hospitalario Universitario” (Granada) and compared with age-matched healthy men. Outcomes included were perception of benefits for physical activity and potential barriers (Exercise Benefits/Barriers Scale), physical activity levels assessed by the International Physical Activity Questionnaire (IPAQ), quality of life (EuroQol five-dimension three-levels) and self-efficacy (Self-Efficacy to Manage Chronic Disease). Results A total of 120 patients were included in our study. Significant differences were found between groups with worse results for the prostate cancer patient group in the variable perception of the benefit of physical activity, potential barriers, and physical activity. Regarding quality of life and self-efficacy, significant differences were also observed between groups with a greater score in the control group. Conclusion In conclusion, the results of this study reveal that self-reported PA levels, as measured using the IPAQ, were low in prostate cancer survivors after treatment. Results also showed worse perception of benefits for PA and potential barriers by the cancer survivors. Similarly, the quality of life and self-efficacy to manage chronic disease of prostate cancer survivors was lower.Universidad de Granada/ CBUAThe Spanish Ministry of Education (Grant numbers FPU:20/ 01670, FPU:19/02609, FPU:17/00408)

Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis

This research was funded by Ministerio de Ciencia, Innovacion y Universidades, grant number FPU: 19/02609, FPU: 17/00408 and FPU: 16/01531 and by University of Granada, grant number FPU: PP20/05.Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = -1.26, 95% CI = -1.65, -0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.University of Granada FPU: PP20/05Spanish Government FPU: 19/02609 FPU: 17/00408 FPU: 16/0153

Early Effects of a Pain-Informed Movement Program in Patients with Post-COVID-19 Condition Experiencing Persistent Pain: Protocol for a Randomized Controlled Trial

(1) Background: The COVID-19 pandemic has generated 771 million confirmed cases. Of these patients, 60% have developed persistent symptoms including pain. This pain is a complex symptom that needs comprehensive therapeutic strategies to address it holistically. The main objective of this study will be to evaluate the early impact of the Pain Informed Movement (PIM) program in patients with post-COVID-19 conditions experiencing new-onset persistent pain. (2) Methods: A randomized, single-blind clinical trial will be performed. Patients will be randomly assigned (1:1) to the experimental or control group. The experimental group will undergo a PIM program consisting of low-intensity functional exercises, pain neuroscience education, and relaxation techniques. The control group will receive no intervention. (3) Results: The results will be published as a peerreviewed article. (4) Conclusions: This study will provide a basis for future research to support the implementation of comprehensive therapeutic approaches in the care of patients with post-COVID-19 persistent pain.Spanish Ministry of Education (Grant numbers FPU: 21/00451, FPU 20/01670, and FPU 19/02609)College of Physiotherapists of Andalucia, Proyect Ref: 06195/21D/M

Efficacy in urinary symptom burden, psychological distress, and self‑efficacy of education‑enhanced interventions in prostate cancer patients: a systematic review and meta‑analyses

Background Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. Purpose The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. Methods A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). Results A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. Conclusion Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and selfefficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.Universidad de Granada/ CBUAFPU (Formación Profesorado Universitario)The Spanish Ministry of Education (Spain) (FPU: 21/00451, FPU 20/01670, and FPU 19/02609)

Effects of the COVID-19 Pandemic on Physical Activity in Chronic Diseases: A Systematic Review and Meta-Analysis

This work was supported by the Spanish Ministry of Education by a FPU ("Formacion Profesorado Universitario") grant for the authors Andres Calvache-Mateo and Laura Lopez-Lopez (grant number, FPU:19/02609, FPU:17/00408).The management of chronic diseases (CD) includes physical activity (PA). It is necessary to determine the effects of COVID-19 restrictions in CD. The aim was to review the research related to PA levels before and during the COVID-19 pandemic in people with CD. This review was designed according to PRISMA guidelines and registered in PROSPERO: CRD42020218825. The search was performed in CINAHL, Medline, Scopus, and Web of Science up to January 2021. The PICOS recommendations were applied. The search was conducted by two reviewers, who completed the data extraction of included articles. Methodological quality was assessed using the STROBE checklist, and a meta-analysis was conducted. The literature search strategy identified 227 articles. Five studies remained and were included. Only three studies were included in the meta-analysis. Two articles used accelerometers to objectively compare PA levels before and during the pandemic. Three studies made this comparison using an online survey. All articles showed a decrease in PA levels during the COVID-19 pandemic. The meta-analysis showed a significant reduction in PA levels during pandemic. PA levels during the COVID-19 pandemic have been reduced with respect to previous levels of PA in patients with CD.German Research Foundation (DFG) FPU:19/02609 FPU:17/0040

Musculoskeletal, Functional and Performance Impairment in Female Overhead Athletes with a Previous Shoulder Injury

Background: Shoulder injuries are substantial problems in overhead athletes, and more studies are necessary to deepen the knowledge on this type of injury. The objective of this study was to compare the overall function and performance of female overhead athletes with and without a previous history of shoulder injuries. Methods: In this cross-sectional study, female overhead athletes with and without a previous shoulder injury were included. Muscular impairment, the stability of the shoulder, strength, scapular dyskinesia, functionality and sports performance were evaluated. A total of 50 females were included. Results: There were significant differences in strength (p = 0.046) and stability (p = 0.039) between groups, with a poorer score in the group with a history of shoulder injury. Regarding scapular dyskinesia, significant differences were also observed between groups (p = 0.048), with higher levels of dyskinesia in the group with previous shoulder injury. Also, muscular impairment showed significant differences between groups for the three muscles evaluated (p < 0.005). Additionally, the group without a previous shoulder injury presented with a significantly greater score in functionality (p = 0.046) and sports performance (p = 0.004). Conclusion: In conclusion, previous shoulder injuries are an important factor to take into account in female overhead athletes. Players with a history of shoulder injury present clinical impairments during the game, leading to poorer functional status and performance in sport.Spanish Ministry of Education through a grant for the training of university lecturers (FPU: 21/00451; FPU:20/01670; FPU: 19/02609