Pràctica FNP: facilitació neuromuscular propioceptiva

El document forma part dels materials docents programats mitjançant l'ajut del Servei de Política Lingüística de la Universitat de ValènciaMaterial d'estudi del tema de facilitació neuromuscular propioceptiva de l'assignatura Fisioteràpia de especialitats clíniques IV

Buenas prácticas docentes en la Facultat de Fisioteràpia. Libro de resúmenes

Conocer, desarrollar y compartir experiencias de buenas prácticas docentes constituye un elemento fundamental para mejorar los procesos de enseñanza-aprendizaje en contextos universitarios. Esto es especialmente relevante si consideramos la situación actual generada por los cambios sobrevenidos por la COVID-19, en la que la implantación de la docencia y de la evaluación a distancia adquiere un papel destacado en la docencia universitaria. Por todo ello, desde una de las acciones del Plan de Innovación de Centro de la Facultat de Fisioteràpia de la Universitat de Valencia, se plantearon estas jornadas. Su objetivo era compartir las experiencias de innovación docente de los últimos cursos desarrolladas por el profesorado del centro con el propósito de mejorar la calidad de la enseñanza en nuestra titulación y potenciar el aprendizaje significativo del estudiantado. Estas jornadas estuvieron dirigidas tanto al profesorado de nuestro centro, como al estudiantado. Para el profesorado pretendía ser un foro de intercambio de experiencias innovadoras, donde se tuvo la oportunidad de presentar las metodologías y los resultados de las técnicas de innovación desarrolladas. La participación de las y los estudiantes pretendió conocer su perspectiva sobre estas experiencias formativas innovadoras. A través de comunicaciones orales, así como mediante el desarrollo de distintas mesas redondas, se intercambió, analizó y discutió las experiencias de innovación desarrolladas en los últimos cursos académicos por el profesorado del centro, agrupadas en tres categorías diferentes relativas a buenas prácticas docentes: a) Materiales docentes innovadores; b) Buenas prácticas en las herramientas de evaluación; y c) Aspectos transversales de la innovación docente en fisioterapia. Además, contamos con la participación de la profesora Mª Luisa Benítez Lugo, de la Facultad de Facultad de Enfermería, Fisioterapia y Podología de la Universidad de Sevilla, quien nos mostró su experiencia en innovación docente, además de presentarnos los resultados obtenidos por la Conferencia Nacional de Decanos de Facultades de Fisioterapia sobre metodologías docentes utilizadas por el profesorado de Fisioterapia a nivel nacional. Con estas jornadas se facilitó el encuentro del profesorado y se intercambió, discutió y promovió el desarrollo de buenas prácticas de docencia y evaluación en el centro, permitiendo establecer criterios de actuación y de buenas prácticas en la docencia y evaluación en Fisioterapia. El fluido clima de diálogo, las aportaciones de los asistentes y la discusión y debate que se estableció en las mesas redondas hicieron que las jornadas fueran muy fructíferas. Esperamos que el año que viene podamos celebrar la segunda edición con la misma satisfacción que este año

Functional and emotional impact of COVID-19 lockdown on older adults with sarcopenia living in a nursing home: A 15-month follow-up

This study aimed to detect the functional and emotional impact of COVID-19 lockdown on institutionalized older adults with sarcopenia during a 15-month follow-up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC-F questionnaire were included. Assessments were performed pre-lockdown (T1), 12 months (T2) after, and at a 15-month follow-up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up-and-Go test. Emotional assessments included Short-Form Health Survey, Geriatric Depression Scale-Short Form, and the Mini-Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducte

Frailty and Sarcopenia in Acute-on-Chronic Liver Failure

In patients with cirrhosis, sarcopenia is a critical reduction in skeletal muscle mass and frailty represents a status of global physical dysfunction caused by under nutrition, muscle wasting, and functional impairment. Both are prevalent conditions in liver transplant candidates and have shown to be independent predictors of adverse outcome. Evidence supports their incorporation into clinical practice both as a prognostic factor guiding clinical decision making and as a tool to identify candidates for physical and nutritional interventions. The wide heterogeneity of instruments used for sarcopenia and frailty measurement, the absence of a single suitable instrument for sarcopenia and frailty assessment in the outpatient versus inpatient acute- on-chronic clinical scenario, and the lack of strong evidence showing a beneficial effect of sarcopenia and frailty improvement on outcomes before and after transplantation are some of the questions that remain unanswere

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

Effectiveness of a heart disease blended learning program in physiotherapy students: a prospective study

Background: In recent years, novel teachingmethodologies have been emerging with the aim of improving student learning. One of them is known as Blended Learning. BL allows educators to integrate elements of traditional face-to-face teachingwith tailored online learning modalities, integrating the distinct strengths of both methodologies. Purpose: To determine the effectiveness of a heart disease blended learning program in undergraduate physiotherapy students. Methods: 124 participants (average age 21.20 ± 4.67 years, 58.87% female) performed an 8-week heart disease blended learning program that included face-to-face classes and online resources. Knowledge was assessed at baseline, at 4, 8, 12 and 20 weeks. Motivation and engagement were assessed at 4 and 8 weeks. Design of the instructions and learning behaviors were measured at 8 weeks. Finally, 108 subjects completed the study Results: Knowledge significantly increased mid-program (p = 0.02), at the end of the program (p < 0.001), at 12 weeks (p < 0.001) and 20 weeks (p=0.001). After the intervention, a high intrinsic motivation was shown (5.60±0.80)) over 7), whilst extrinsic motivation scored 4.24 ± 0.97 over 7.Finally, engagement (3.98 ± 0.52) over 5), design of the instructions (4.15 ± 0.62) over 5) and learning behaviors (70.51 ± 36.08) downloads, 28.97 ± 16.09) topics visited, and online questionnaires scored 7.67 ± 1.60) over 10) reported adequate scores. Conclusion: This program seems to be an appropriate methodology in future physiotherapists, since it improved knowledge and participants exhibited a high motivation and an adequate engagement, design of the program instructions and learning behaviors

Functional and Clinical Characteristics for Predicting Sarcopenia in Institutionalised Older Adults: Identifying Tools for Clinical Screening

Background: Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. Methods: A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson's Comorbidity Index (ACCI), number of medications, hospital stays and falls. Results: Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke's R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). Conclusion: BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach

Using the Updated EWGSOP2 Definition in Diagnosing Sarcopenia in Spanish Older Adults : Clinical Approach

Recently the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated diagnostic criteria for sarcopenia, which consist of one or more measures of muscle strength, muscle mass, and physical performance, plus an initial screening test called SARC-F. The main objective was to compare the number of cases of sarcopenia, using the different measurements and screening options. A cross-sectional study was conducted on Spanish older adults (n = 272, 72% women). Combining the different measures proposed by the steps described in the EWGSOP2 algorithm, 12 options were obtained (A-L). These options were studied in each of the three models: (1) using SARC-F as initial screening; (2) not using SARC-F; and (3) using SARC-CalF instead of SARC-F. A χ2 independence test was statistically significant (χ2(6) = 88.41, p < 0.001), and the association between the algorithm used and the classification of sarcopenia was moderate (Cramer's V = 0.226). We conclude that the different EWGSOP2 measurement options imply case-finding differences in the studied population. Moreover, when applying the SARC-F, the number of people classified as sarcopenic decreases. Finally, when SARC-CalF is used as screening, case finding of sarcopenic people decreases. Thus, clinical settings should consider these outcomes, since these steps can make preventive and therapeutic interventions on sarcopenia vary widely

Students' perceptions of instructional rubrics in neurological physical therapy and their effects on students' engagement and course satisfaction

One of the main challenges faced by physical therapy (PT) students is to learn the practical skills involved in neurological physical therapy (PT). To help them to acquire these skills, a set of rubrics were designed for formative purposes. This paper presents the process followed in the creation of these rubrics and their application in the classroom, noting that students perceived them as valid, reliable, and highly useful for learning. The perception of the validity and usefulness of the rubrics has different closely related dimensions, showing homogeneous values across the students´ sociodemographic and educational variables, with the exception of dedication to studying, which showed a significant relationship with schoolwork engagement and course satisfaction. The adequacy of the hypothesized structural model of the relationships among the variables was confirmed. Direct effects of the perception of the rubrics' validity and engagement on course satisfaction were found, as well as direct effects of the assessment of the usefulness of the rubrics on schoolwork engagement and indirect effects on course satisfaction through this latter variable. The results are discussed taking into account the conclusions of previous research and different instructional implications

Vídeos Facilitación neuromuscular propioceptiva: diagonal pélvica de descenso anterior- elevación posterior

Vídeo Facilitación neuromuscular propioceptiva: diagonal pélvica de descenso anterior- elevación posterio