Efectos de la aplicación de un protocolo de entrenamiento de fuerza previo, a la cirugía de artroplastía total de rodilla en pacientes mayores de 60 años con artrosis de rodilla

La indicación mas frecuente para implantar una prótesis total de rodilla es eliminar el dolor y restaurar la movilidad causada por una gran destrucción articular en el cartílago, como ocurre con la osteoartritis. La cirugía de reemplazo de articulaciones es una intervención eficaz utilizada cada vez más para osteoartritis de cadera y de rodilla. Los pacientes diagnosticados de osteoartritis primaria avanzada que son susceptibles de recibir una prótesis total de rodilla, debido al dolor y la rigidez articular evitan utilizar la articulación durante las actividades de la vida diaria, como caminar y subir escaleras, de forma que adoptan una actitud sedentaria, afectando a la musculatura implicada en la rodilla, contribuyendo de esta forma a dificultar la movilidad de la misma. Esta situación de sedentarismo hace que el paciente afronte la cirugía con unas peores condiciones físicas que cuando fue diagnosticado e incluido en lista de espera para prótesis total de rodilla. Esta situación repercutirá en el proceso de postrehabilitación siendo este más duradero y costoso. Actualmente existen programas para mejorar los resultados físicos después de la cirugía y por otro lado aparecen otros diseñados para mejorar la función física y minimizar la ansiedad del paciente antes de la cirugía. Este tipo de actuaciones previas a la cirugía son conocidos como programas de prehabilitación. La mayoría de estos programas emplean una metodología con bastantes carencias metodológicas que hacer entender la escasa evidencia por la falta de resultados obtenidos. El objetivo principal de este trabajo es analizar los efectos que produce en el periodo postoperatorio, el entrenamiento de fuerza empleando altas intensidades sobre pacientes con gonartrosis severa que están en lista de espera para la cirugía de prótesis total de rodilla. De forma más concreta se pretende conocer que efectos produce este tipo de entrenamiento en diversas variables al mes y a los tres meses tras la cirugía. Las variables estudiadas son dolor, rango de movilidad, fuerza isométrica máxima, equilibrio, circumetría del muslo, percepción subjetiva de calidad, test timed up and go y test de la escalera, así como conocer el grado de satisfacción percibido por los pacientes tras el programa propuesto. En el siguiente estudio participaron un total de 50 pacientes mayores de 60 años con gonartrosis severa y en lista de espera quirúrgica para ATR, el 80% de los sujetos fueron mujeres. Esta muestra se dividió en dos grupos de 25 sujetos y de forma aleatorizada se asignó a cada uno de ellos. Un grupo control (GC) y un grupo prehabilitación (GPH), que realizó el entrenamiento de fuerza durante 8 semanas, con una frecuencia de 3 días a la semana supervisado por un fisioterapeuta. Tras una semana de familiarización, se llevo a cabo el entrenamiento de fuerza con una intensidad de 10RM sobre la musculatura abductora de cadera, extensora y flexora de rodilla, junto con un trabajo de equilibrio en diferentes apoyos. Los resultados obtenidos mostraron una mejoría significativa en todas las variables pre y postoperatorias. También se registró que el GPH tras el programa de fortalecimiento mostró un alto grado de satisfacción. Este trabajo concluye afirmando que el programa de fuerza empleando altas intensidades, es un método adecuado para mejorar la fuerza preoperatoria de sujetos mayores de 60 años que están en lista de espera, repercutiendo positivamente en la mejora de la capacidad funcional postoperatoria

Effect of a common exercise programme with an individualised progression criterion based on the measurement of neuromuscular capacity versus current best practice for lower limb Tendinopathies (malaga trial) : a protocol for a randomised clinical trial

High-load resistance training has shown positive effects in pain and function in lower limb tendinopathies. However, some authors suggest that current exercise programmes produce an increase in tolerance to load and exercise in general but without fixing some existing issues in tendinopathy. This may indicate the need to include training aspects not currently taken into account in the current programmes. The main objective of this study will be to compare the effect of a common exercise protocol for the three predominant lower limb tendinopathies (Achilles, patellar and gluteal), based on an individualised control of the dose and training of specific aspects of the neuromuscular system versus the current best practice for each location

Short-term effects of kinesio taping in the treatment of latent and active upper trapezius trigger points: two prospective, randomized, sham-controlled trials

The presence of myofascial trigger points (MTrPs) is one of the most common causes of musculoskeletal problems and may lead to limited professional activity. Among the various treatment methods proposed for MTrPs, Kinesio Taping (KT) is a non-invasive, painless, and less time-consuming method with fewer side efects that has become widely used as a therapeutic tool in a variety of prevention and rehabilitation protocols. The aim of the study was to evaluate the immediate and short-term efcacy of the space correction KT technique in patients with latent or active MTrPs in the upper trapezius muscle. Two parallel randomized sham-controlled trials were simultaneously executed: in trial A, ninety-seven participants with latent MTrPs were randomly assigned to either the KT (n=51) or sham (n=46) group; in trial B, thirty-seven participants with active MTrPs were assigned to the KT (n=20) or sham (n=17) group. The primary outcome was pressure pain threshold (PPT) in the upper trapezius muscle, measured with algometry. Secondary outcomes included the active range of motion (ROM) of the cervical spine (lateral fexion and rotation), measured with a cervical ROM goniometer. In each trial, two-way ANOVA tests were used to compare the study efects on the outcome measures between the groups, with time serving as the intra-group factor (baseline, immediately, and 72h after the application) and the intervention type (KT and sham) as the between-group factor. At 72h, participants receiving KT did not show signifcant diferences in PPT (trial A: mean diference −1.8N; 95% CI: [−8.1, 4.4], trial B: mean diference −1.2N; 95% CI: [−7.4, 5.1]), cervical lateral fexion (trial A: mean diference 0.2 degrees; 95% CI: [−2.7, 3.1], trial B: mean diference −2.4 degrees; 95% CI: [−8.4, 3.6]), and cervical rotation (trial A: mean diference 3.7 degrees; 95% CI: [−0.1, 7.5], trial B: mean diference 1.4 degrees; 95% CI: [−5.7, 8.4]), compared to the sham groups. Thus, the results of this study do not support the use of the space correction KT technique to treat patients with latent or active myofascial trigger points in the upper trapezius muscle

Impact of hip abductor and adductor strength on dynamic balance and ankle biomechanics in young elite female Basketball players

This study aimed to evaluate, in an isolated and relative manner, hip abductor (ABD) and adductor (AD) strength and to study the extent to which these factors are related to balance and ankle dorsiflexion mobility in young elite female basketball players. Sixty trainee-level elite female basketball players (13-18 years old), who voluntarily agreed to participate in the study, were divided into three subgroups based on competition age divisions (U14, U16, U18). Isometric hip ABD and AD strength in each leg was evaluated using the ForceFrame Strength Testing System, also calculating the strength ratio and imbalance between legs. Y Balance Test (YBT) and ankle dorsiflexion mobility were also assessed. ANOVA was used for between-group differences analysis. Likewise, the impact of hip strength on balance and ankle mobility was analyzed using Pearson's correlation coefficient. A linear regression model for dependent variables was created with all variables that exhibited significant correlations. A between-group comparison analysis for the three competition age subgroups (U14, U16, U18) revealed non-significant differences (p > 0.005) for the hip strength variables except for hip ABD strength. The correlation study showed low-moderate effect sizes for hip ABD (in both the contralateral and homolateral limb) and AD strength (only the homolateral limb) with YBT and ankle dorsiflexion. However, when performing a regression model, only right hip ABD significantly predicted right limb YBT scores (β = 0.592, p = 0.048). The present study indicated that, although both hip ABD and AD strength correlate with balance and ankle mobility with low-moderate effect sizes, only hip ABD strength was found to significantly predict YBT scores. Therefore, the potential role of hip ABD strength in particular, but also hip AD strength, for monitoring and enhancing balance and ankle mobility outcomes, should be taken into consideration when designing and implementing preventive strategies for lower-limb injuries

Review of the quality of youTube videos recommending exercises for the COVID-19 Lockdown

Background: The world is experiencing a pandemic caused by COVID-19. Insufficient physical activity can increase the risk of illness. Trying to replicate a normal search that any user/patient could do in YouTube, the objective of this study was to evaluate the quality of YouTube videos related to home exercises during lockdown and their adherence to World Health Organization (WHO) recommendations. Methods: A simple search was carried out on YouTube. The first 150 videos were selected. After applying exclusion criteria, 68 videos were analyzed and evaluated. Two statistical analyses based on machine learning techniques were carried out. Videos were classified according to principal component analysis (PCA) models as 'Relevant' and 'Non-Relevant'. Popularity was assessed using the video power index (VPI). Information's quality and accuracy were gauged using the DISCERN scale and global quality score (GQS). Reliability and credibility of information that can be found on health-related websites was assessed using the Health On the Net Code (HONCode). Exercises were evaluated according to WHO recommendations. Results: DISCERN, HONCode, and GQS scored a mean of 2.29, 58.95, and 2.32, respectively. The PCA calculation allowed videos to auto-classify into high- and low-quality videos. Conclusions: The quality of YouTube videos recommending exercises during lockdown is low and doesn't reflect WHO recommendations. Effective strategies and tools capable of indicating the quality of this information are needed to filter out erroneous or non-rigorous information that may affect people's health. These tools should help any user/viewer to distinguish videos of high and low quality

Pain neuroscience education in persistent painful tendinopathies: A scoping review from the Tendon PNE Network

Objective To conduct and report a scoping review of the available evidence of the effects and content of pain neuroscience education for patients with persistent painful tendinopathies. Methods PubMed, Embase, Web of Science, CINAHL, SPORTDiscus, and grey literature databases were searched from database inception to May 2022. Randomised and non-randomised controlled trials, non-controlled clinical trials, cohort studies, case series, case studies including people with persistent painful tendinopathy aged ≥18 years, a pain education intervention, and in English were included. Studies were excluded if they were cross-sectional studies, reviews, editorials, abstracts, or full-text not available or if included heterogeneous study cohorts, patients with tendon rupture, or patients with systemic diseases. Results five studies (n = 164) were included. Pain neuroscience education entailed face-to-face discussion sessions or educational materials including videos, brochures, paper drawings, and review questions. All studies used pain neuroscience education in conjunction with other interventions, obtaining significant benefits in outcomes related to pain, physical performance, or self-reported function, among others. Conclusions The application of pain neuroscience education in conjunction with other interventions seemed to improve several outcomes. However, considering the current knowledge about tendon pain and the scarcity of well-designed trials studying pain neuroscience education in tendinopathy, additional research is needed.Funding for open acces charge: Universidad de Málaga / CBU

Implementation of Online Behavior Modification Techniques in the Management of Chronic Musculoskeletal Pain : A Systematic Review and Meta-Analysis.

Purpose: The main aim of this systematic review and meta-analysis (MA) was to assess the effectiveness of online behavior modification techniques (e-BMT) in the management of chronic musculoskeletal pain. Methods: We conducted a search of Medline (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioral Collections, from inception to the 30 August 2021. The main outcome measures were pain intensity, pain interference, kinesiophobia, pain catastrophizing and self-efficacy. The statistical analysis was conducted using RStudio software. To compare the outcomes reported by the studies, we calculated the standardized mean difference (SMD) over time and the corresponding 95% confidence interval (CI) for the continuous variables. Results: Regarding pain intensity (vs. usual care/waiting list), we found a statistically significant trivial effect size in favor of e-BMT (n = 5337; SMD = −0.17; 95% CI −0.26, −0.09). With regard to pain intensity (vs. in-person BMT) we found a statistically significant small effect size in favor of in-person BMT (n = 486; SMD = 0.21; 95%CI 0.15, 0.27). With respect to pain interference (vs. usual care/waiting list) a statistically significant small effect size of e-BMT was found (n = 1642; SMD = −0.24; 95%CI −0.44, −0.05). Finally, the same results were found in kinesiophobia, catastrophizing, and self-efficacy (vs. usual care/waiting list) where we found a statistically significant small effect size in favor of e-BMT. Conclusions: e-BMT seems to be an effective option for the management of patients with musculoskeletal conditions although it does not appear superior to in-person BMT in terms of improving pain intensity

Impact of hip abductor and adductor strength on dynamic balance and ankle biomechanics in young elite female basketball players

This study aimed to evaluate, in an isolated and relative manner, hip abductor (ABD) and adductor (AD) strength and to study the extent to which these factors are related to balance and ankle dorsiflexion mobility in young elite female basketball players. Sixty trainee-level elite female basketball players (13–18 years old), who voluntarily agreed to participate in the study, were divided into three subgroups based on competition age divisions (U14, U16, U18). Isometric hip ABD and AD strength in each leg was evaluated using the ForceFrame Strength Testing System, also calculating the strength ratio and imbalance between legs. Y Balance Test (YBT) and ankle dorsiflexion mobility were also assessed. ANOVA was used for between-group differences analysis. Likewise, the impact of hip strength on balance and ankle mobility was analyzed using Pearson's correlation coefficient. A linear regression model for dependent variables was created with all variables that exhibited significant correlations. A between-group comparison analysis for the three competition age subgroups (U14, U16, U18) revealed non-significant differences (p > 0.005) for the hip strength variables except for hip ABD strength. The correlation study showed low-moderate effect sizes for hip ABD (in both the contralateral and homolateral limb) and AD strength (only the homolateral limb) with YBT and ankle dorsiflexion. However, when performing a regression model, only right hip ABD significantly predicted right limb YBT scores (β = 0.592, p = 0.048). The present study indicated that, although both hip ABD and AD strength correlate with balance and ankle mobility with low-moderate effect sizes, only hip ABD strength was found to significantly predict YBT scores. Therefore, the potential role of hip ABD strength in particular, but also hip AD strength, for monitoring and enhancing balance and ankle mobility outcomes, should be taken into consideration when designing and implementing preventive strategies for lower-limb injuries.Sin financiación4.996 JCR (2021) Q1, 19/73 Multidisciplinary Science1.005 SJR (2021) Q1, 11/138 MultidisciplinaryNo data IDR 2020UE

Dynamic balance and explosive strength appears to better explain single leg hop test results among young elite female basketball athletes

To analyze the impact of balance, lower-limb explosive strength and anthropometric variables on the result of the hop test in young elite female basketball athletes. Ninety young elite female basketball athletes (13–17 years), without current or recent lower-limb injury, were assessed in the off-season period of July 2021. Single leg hop test, countermovement jump, Y balance test and anthropometric outcomes were assessed. A correlation study and a regression model were performed to investigate the influence of such outcomes and the value of their participation on the hop test results. It was found a low-to-moderate correlation effect size for both countermovement jump (distance and power flight) and Y balance test values (except interlimb outcomes) with the single leg hop test results. Anthropometric outcomes did not show significant correlation (p > 0.05). Regression model revealed that for right hop test, countermovement jump values exhibited an adjusted determination coefficient of 0.408, (β = 0.249, p = 0.013), For left hop test, again the countermovement jump values (β = 0.229, p = 0.025), and left Y balance test values (β = 0.331, p = 0.011) jointly obtained an adjusted determination coefficient of 0.263 significant predictive value for countermovement jump outcomes in both right (β = 0.249, p = 0.013; β = 0.301; p = 0.031) and left leg (β = 0.229, p = 0.025; β = 0.365, p = 0.040), as well as certain Y balance outcomes values. Explosive strength, and dynamic balance although to a lesser extent, appear to be the most relevant physical-functional factors influencing the single leg hop test results among young elite female basketball athletes. These findings may a serve as a basis to implement targeted interventions, such as plyometric and balance training, for an enhancement on functional rehabilitation and reducing the risk of injury related to the hop test results.Sin financiación4.997 Q2 JCR 20210.973 Q1 SJR 2022No data IDR 2021UE

Effects of resistance training on patients with End‑Stage Renal Disease: an umbrella review with meta‑analysis of the pooled findings

Objectives This umbrella review aimed to review the effects of resistance training on patients with end-stage renal disease and assess the methodological quality of the available literature. Methods An umbrella review and meta-meta-analysis was performed. A systematic search was conducted until May 2022. Article selection, quality assessment, and risk of bias assessment were performed by two independent reviewers. The meta-metaanalyses were performed with a random-effects model and the summary statistics were presented in the form of a forest plot with a weighted compilation of all standardized mean differences and corresponding 95% confidence interval. Twenty-four reviews were eventually included. The protocol was registered in the international registry PROSPERO (CRD42022321702). Results Resistance training showed positive effects on functional capacity (g = 0.614), aerobic capacity (g = 0.587), healthrelated quality of life (g = 0.429), and peak force (g = 0.621). Fifteen of the included studies (63%) presented low risk of bias, and the remaining studies (37%) showed unclear risk of bias. Conclusion Resistance training in patients undergoing hemodialysis is an intervention that shows positive results regarding physical and functional outcomes. The quality level of the literature is inconclusive, but the included studies present low risk of bias.Sin Financiación3.4 Q2 JCR 20220.843 Q1 SJR 2023No data IDR 2023UE