Narrative review of the use and applications of radiofrequency for the treatment of musculoskeletal pain

Objetivos: La radiofrecuencia se define como una modalidad de terapia física, que consiste en la administración de ondas, consiguiendo múltiples efectos a nivel tisular y celular. Se trata de una terapia no invasiva, segura y eficaz, que provoca una disminución rápida del dolor en pacientes. En las patologías dolorosas del pie, como la fascitis plantar o el neuroma de Morton, las alternativas terapéuticas que conocemos actualmente no son efectivas en todos los casos. Por ese motivo, el uso de las nuevas tecnologías permite al podólogo añadir un nuevo tratamiento a su protocolo de actuación para conseguir analgesia, consiguiendo una mayor efectividad en sus tratamientos y mejorando la calidad de vida de sus pacientes de forma rápida, eficaz y segura. Material y métodos: Se realizó una búsqueda bibliográfica en las bases de datos de Pubmed, Scopus, Biblioteca de Salud de la Universidad de Sevilla y Google Scholar. Se obtuvieron 27 artículos y 1 libro. Resultados: En los artículos revisados, los pacientes mejoraron su sintomatología dolorosa tras la aplicación de la radiofrecuencia. No existe un único mecanismo de acción, depende de las diferentes formas de aplicación. Conclusiones: La radiofrecuencia puede administrarse tanto en patologías inflamatorias como mecánicas. Su mecanismo de acción depende de si se usa una corriente eléctrica de forma continua o pulsada, y mediante un electrodo invasivo o no invasivo.Objectives: Radiofrequency is defined as a modality of physical therapy, which consists of the administration of waves, achieving multiple effects at the tissue and cellular levels. It is a non-invasive, safe and effective therapy, which causes a rapid decrease in pain in patients. In painful foot disorders, such as plantar fasciitis or Morton’s neuroma, the therapeutic alternatives we use are not effective in all cases. For this reason, the use of new technologies allows the podiatrist to add a new treatment to its protocol of action to achieve analgesia, achieving greater effectiveness in its treatments and improving the quality of life of its patients in a quickly, effective and safe way. Material and methods: A bibliographic search was conducted in the databases of Pubmed, Scopus, Health Library of the University of Seville and Google Scholar. 27 articles and 1 book were obtained. Results: In the articles reviewed, patients improved their painful symptoms after radiofrequency application. There is no single mechanism for action, depending on the different forms of implementation. Conclusions: Radiofrequency can be administered in both inflammatory and mechanical pathologies. Its mechanism of action depends on whether an electric current is used continuously or pulsed, and through an invasive or non-invasive electrode

Static range of motion of the first metatarsal in the sagittal and frontal planes

The first metatarsal and medial cuneiform form an important functional unit in the foot, called “first ray”. The first ray normal range of motion (ROM) is difficult to quantify due to the number of joints that are involved. Several methods have previously been proposed. Controversy exists related to normal movement of the first ray frontal plane accompanying that in the sagittal plane. The objective of this study was to investigate the ROM of the first ray in the sagittal and frontal planes in normal feet. Anterior-posterior radiographs were done of the feet of 40 healthy participants with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. They were digitalized and the distance between the tibial malleolus and the intersesamoid crest in the three positions mentioned was measured. The rotation of the first ray in these three positions was measured. A polynomic function that fits a curve describing the movement observed in the first ray was obtained using the least squares method. ROM of the first ray in the sagittal plane was 6.47 (SD 2.59) mm of dorsiflexion and 6.12 (SD 2.55) mm of plantarflexion. ROM in the frontal plane was 2.69 (SD 4.03) degrees of inversion during the dorsiflexion and 2.97 (SD 2.72) degrees during the plantarflexion. A second-degree equation was obtained, which represents the movement of the first ray. Passive dorsiflexion and plantarflexion of the first ray were accompanied by movements in the frontal plane: 0.45 degrees of movement were produced in the frontal plane for each millimeter of displacement in the sagittal plane. These findings might be useful for the future design of instruments for clinically quantifying first ray mobility

How susceptible are our Achilles Tendons? Sonoanatomical assessment. A cross-sectional study

Objective: the aim of this study is to observe whether there are ultrasound changes between men and women in the Achilles tendon at rest, at maximum passive force is applied and during walking. Material and methods: it was a cross-sectional study involving 27 healthy young participants recruited as vol-unteers between April to July 2022. A variety of data was recorded: (age, Body Mass Index, sex, smoking, current injury status, allergies, medications, previous surgeries, type of sport, and number of weekly workouts) and ultrasound measurements at rest and at passive force (Cross Sectional Area Achilles Tendon length, tendon thickness, Cross Sectional Area and pennation angle of the soleus muscle to the Achilles Tendon). Results: women demonstrated a statistically significant lower proximal and median thickness both at rest (4.5 vs 5.1 mm with p < 0.001 for proximal thickness; 4.4 vs 5.3 mm with p < 0.001 for median thickness) as well as during maximum eccentric contraction (4.3 vs 4.8 mm with p=<0.001 for proximal thickness; 4.1 vs 4.8 mm with p < 0.001 for median thickness). Conclusion: there are significant sonoanatomical differences in vivo Achilles tendon between men and women.Funding for opoen access charge: Universidad de Málaga / CBU

Bipartite hallucal sesamoid bones: relationship with hallux valgus and metatarsal index

Objective. To relate the incidence of the partition of the hallucal sesamoid bones with the size of the first metatarsal and the hallux valgus deformity. Materials and Methods. In a sample of 474 radiographs, the frequency of appearance of bipartite sesamoids was studied. The length and relative protrusion of the first metatarsal, and the hallux abductus angle, were measured and compared between the feet with and without sesamoid partition. Results. The results showed that 14.6% of the feet studied had at least one partite sesamoid, that the sesamoid most frequently divided was the medial, and that unilateral partition was the most common. No difference was found in the incidence of partite sesamoids between men and women, or between left and right feet. Conclusion. Protrusion and length of the first metatarsal are higher in feet with partite sesamoids than in feet without this condition. A significantly higher incidence of bipartite medial sesamoid was obtained in feet with hallux valgus compared with normal feet

Medial deviation of the first metatarsal in incipient hallux valgus deformity

The intermetatarsal angle between metatarsals I and II (IMA 1-2) has been radiographicaly studied in 49 normal feet and in 49 feet with a mild hallux valgus (HV) deformity. The aim of the study is to know whether an excessive medial deviation of the first metatarsal with respect to II (IMA 1-2 over normal values reported by some authors) is present in the initial phase of HV. The results demonstrate that the difference in the mean intermetatarsal angle between the two groups is statistically significant (8.76º in normal feet; 9.98º in affected feet). However, the authors think it is not clinically significant. Other authors, comparing the IMA 1-2 in patients with more advanced HV and without HV, report greater differences than those obtained in this study,. The authors conclude that the excessive medial deviation of the first metatarsal is not a causal factor, but a consequence, in the HV deformity

La efectividad de los materiales de amortiguación usados en las ortesis plantares para el tratamiento de las sobrecargas metatarsales.

Objetivo: Para el tratamiento de la dolencia metatarsal por sobrecarga, se emplean soportes planta- res de distintos materiales con el fin de amortiguar las presiones plantares que se producen en esta región durante el periodo propulsivo de la marcha. El propósito de este estudio consistió en determinar las modificaciones de las presiones plantares en las cabezas metatarsales usando como amortiguación metatarsal palmillas de los siguientes materiales: Pedilastik®, Poron Medical®, Jogtene® y Confortene®, habitualmente usados en el tratamiento ortopodológico conservador de las sobrecargas metatarsales. Método: Los valores de presión máxima de los metatarsianos se midieron en dinámica, usando el sis- tema de Rs-Scan Insole System® dentro del calzado, con los sujetos sin palmilla, y usando palmillas de diferentes materiales. La muestra de este estudio fueron 16 pies. Resultados: La mayoría de los valores de presión plantar experimentaron un ligero incremento en sus valores con la aplicación de diferentes palmillas, con todos los materiales usados en el presente estudio. Así, aunque no se obtuvieron diferencias significativas (p > 0.05) en las diferentes mediciones, ni los resultados de la máxima presión plantar en cada cabeza metatarsal (excepto en el 5. o ) ni los resultados de la máxima presión plantar en la zona de antepié, mostraron un decrecimiento en sus valores con el uso de diferentes materiales ensayados en este estudio. Conclusiones: El uso de almohadillas con materiales tradicionalmente usados seleccionados en este estu- dio tiene un ligero efecto negativo en la presión máxima plantar en la cabezas metatarsales y la presión máxima plantar en la zona de antepié durante la fase propulsiva.Objective: For treatment of the metatarsal overload condition, plantar supports of different materials in order to reduce plantar pressures which occur in this region during the gait period propulsive are used. The purpose of this study has to determine the changes of plantar pressure under the metatarsal heads using as metatarsal cushioning soles of the following materials: Pedilastik®, Poron Medical®, Jogtene® y Confortene®, habitually in the conservative treatment orthopodiatric of the metatarsal overload. Method: The values of maximum pressure of the metatarsal heads were obtained in dynamics conditions, using the Rs-Scan Insole System ® inside the shoe. Measurements were taken without any cushioning insole, and using insoles of different materials. The sample used for this study was a set of 16 feet. Results: The majority of the variables of plantar pressure experienced a slight increase in their values with the application of different insoles, with all the materials used in the present study. Thus, although no significant differences (P > .05) during the propulsive phase were found with respect to the control group, neither in the maximum pressure at each metatarsal head (except for 5th) nor in the maximum plantar pressure at forefoot area, the results found have shown that no decrease in the values of the plantar pressures was reached with the use of the different materials tested in this study. Conclusions: The use of pads with the traditional materials used in the present study has a slight negative effect on the Maximum plantar pressure at the metatarsal heads and the maximum plantar pressure at the forefoot area during the propulsive phase

用于衡量小学教育学生数字能力的工具的设计和验证

Introduction: Recent technological advances have transformed the ways of interaction and participation in society. Therefore, digital skills are necessary for citizens of the digital age. This paper describes the design and validation of an instrument to analyze and describe the digital competence of elementary school students; because the subject has not been sufficiently studied in such population. Method: An instrument comprised of 5 sections was designed and it was applied in a pilot test to 143 students of 4th, 5th, and 6th grades. The validity of content was analyzed by expert judgment and different statistical tests were performed with the data. The construct validity was analyzed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was analyzed with measures of internal consistency through Cronbach’s alpha and McDonald’s omega. Results: The reliability of the instrument is evidenced by an internal consistency of .946. Appropriate adjustments were made analysis thanks to the answers given by the judges both to the structure and items of the instrument, and the results of the EFA and CFA identified a structure that was consistent with the proposal for this instrument. Conclusions: Evidence showed that the instrument has high levels of reliability and validity to analyze the digital skills of this population.Introducción: Los avances tecnológicos de los últimos años han trasformado las formas de interacción y participación en la sociedad, ante esto las competencias digitales resultan indispensables para los ciudadanos de la era digital. El presente artículo describe el diseño y validación de un instrumento que permite analizar y describir la competencia digital del alumnado de educación primaria; población poco estudiada en el tema. Método: Por ello se diseña este instrumento compuesto de 5 secciones, el cual fue aplicado en una prueba piloto a 143 estudiantes de 4to, 5to y 6to de primaria. La validez de contenido se analizó mediante juicio de expertos, con los datos obtenidos se realizaron diferentes pruebas estadísticas, también a través del análisis factorial exploratorio (AFE) y confirmatorio (AFC) se analizó la validez de constructo. La confiablidad se analizó con medidas de consistencia interna a través del alfa de Cronbach y el omega de McDonald. Resultados: La confiabilidad del instrumento se evidencia obteniendo una consistencia interna de .946. El análisis de las respuestas emitidas por los jueces permitió realizar las adecuaciones pertinentes a la estructura e ítems del instrumento, asimismo, los resultados del AFE y AFC identifican una estructura consistente con la propuesta para este instrumento. Conclusiones: Por tanto, se concluye que, con la evidencia proporcionada, el instrumento pose altos niveles de confiabilidad y validez para analizar las competencias digitales de esta población.Технологический прогресс последних лет изменил формы взаимодействия и участия в жизни общества, сделав цифровые компетенции необходимыми для граждан цифровой эпохи. В данной статье описывается разработка и валидация инструмента, позволяющего проанализировать и описать цифровую компетентность учащихся начальной школы - малоизученной группы населения. Метод: Для этого был разработан инструмент, состоящий из 5 разделов, который был применен в пилотном тестировании к 143 учащимся 4, 5 и 6 классов начальной школы. Валидность содержания была проанализирована с помощью экспертной оценки, с полученными данными были проведены различные статистические анализы, а валидность конструкции была проанализирована с помощью эксплоративного факторного анализа (EFA) и конфирматорного факторного анализа (CFA). Надежность анализировалась с помощью показателей внутренней согласованности через альфа Кронбаха и омега Макдональда. Результаты: надежность инструмента подтверждается получением внутренней согласованности на уровне .946. Анализ ответов судей позволил внести соответствующие коррективы в структуру и пункты инструмента. Аналогичным образом, результаты AFE и AFC выявили структуру, соответствующую предложенной для данного инструмента. Выводы: Таким образом, можно сделать вывод, что с учетом представленных данных инструмент обладает высоким уровнем надежности и валидности для анализа цифровых компетенций данной группы населения.简介：近年来的技术进步改变了社会互动和参与的形式，因此，数字技能对于数字时代的公民来说至关重要。本文介绍了对一种工具的设计和验证，该工具可以分析和描述很少被研究的小学生的数字能力。 方法：为此，我们设计了由5个部分组成的仪器，对四、五、六年级的143名学生进行了试点测试。通过专家判断分析内容效度，对获得的数据进行不同的统计检验，并通过探索性因素分析（EFA）和验证性因素分析（AFC）对结构效度进行分析。通过 Cronbach’s alpha 和 McDonald’s omega 的内部一致性测量来分析可靠性。 结果：仪器的可靠性通过获得 0.946 的内部一致性得到证明。对评判员给出的答复进行分析，以便对该工具的结构和项目进行针对性的调整。同样，EFA和CFA的结果确定了与该工具提案一致的结构。 结论：因此，可以得出结论，根据所提供的证据，该工具在分析该人群的数字技能方面具有高水平的信度和效度

Psychosocial Influence of Ehlers–Danlos Syndrome in Daily Life of Patients: A Qualitative Study

Ehlers–Danlos syndrome is a heterogeneous group of connective tissue disorders causing pain, fatigue, and disabilities; it has several implications for patients who suffer from this disease. The major clinical manifestations of EDS include joint hypermobility, skin hyperextensibility, and generalized conjunctive tissue fragility. This research aims to explore their perceptions and experiences about the phycological and social spheres. (2) Methods: Semistructured interviews were carried out. Participants were encouraged to talk about issues related to their disease by asking open-ended questions in one to one interview. The interview guide included questions to identify the syndrome’s influence on the social and psychological life of patients All interviews were audio recorded, fully transcribed, and analyzed using the phenomenological theoretical framework. The method of analysis was the thematic interpreting of perspectives and approaches. (3) Results: 31 individuals were proposed to participate in this study. Five patients refused to participate, so a total of 26 interviews were performed. Six themes ((1) Pain and its consequences on a daily basis; (2) The need to name the problem: the diagnosis; (3) Restructuring leisure and social relationships; (4) Limitations due to economic conditions; (5) Psychological impact of the disease situation; (6) Professional limitations) and four subthemes ((1) The value of partner support; (2) The weather influence on social plans; (3) Physical exercise and illness; (4) Support groups) emerged from the data. (4) Conclusions: This study revealed the impact of the syndrome on the social and daily life of patients, and not only in a physical level, but also in a psychological and social approach. These findings allow healthcare providers to know more about this disease in order to support and give advice to patients about the changes they will have to make.University of Seville “VI PLAN PROPIO DE INVESTIGACIÓN Y TRANSFERENCIA—US 2018

Effectiveness of the Ponseti method in the treatment of clubfoot: a systematic review

Clubfoot is a common congenital deformity of the lower limbs. It should be treated as soon as possible so that its correction is more easily achieved. The objective of this systematic review was to assess the effectiveness of the Ponseti method in the treatment of clubfoot. A bibliographic search was carried out in different databases, including PubMed and SciELO. Filters such as full text and randomized controlled trial were selected to find those articles that best matched our search. Among the results, we selected the ones that interested us, and the rest were discarded, either because they did not meet the requirements for our work or because they were repeated. In total, we collected 19 articles, but after using the critical evaluation instrument CASPe, 7 of them were eliminated, leaving us with a total of 12 articles for our systematic review. After analyzing the results obtained in the selected articles, we concluded that the Ponseti method is effective in the treatment of clubfoot, presenting a high success rate.Partial funding for open access charge: Universidad de Málag

Custom-made foot orthoses reduce pain and fatigue in patients with Ehlers-Danlos Syndrome. A pilot study

Background: Pain and fatigue are major clinical manifestations in patients with Ehlers-Danlos Syndrome (EDS). The aim of this study is to measure change of the effects of custom-made foot orthotics on some manifestations related to EDS, such as foot pain, foot functionality, fatigue, and quality of life. Methods: Thirty-six patients with EDS wore foot orthoses for three months. Foot pain, foot-related disability, foot functionality, fatigue, and quality of life were measured using the 11-point Numeric Rating Scale, the Manchester Foot Pain and Disability Index, the Foot Function Index, the Fatigue Severity Score, and the 12-Item Short Form Health Survey questionnaires, respectively, at the beginning and after 3 months. Results: Participants demonstrated significantly improved foot pain (p = 0.002), disability related to foot pain (p < 0.001), foot functionality (p = 0.001), fatigue (p < 0.007), and mental health-related quality of life (p = 0.016). The physical health-related quality of life did not show significant changes. Conclusions: The use of custom-made foot orthoses help in the management of the symptoms by participants. This study could contribute to the foot specialists being considered as an additional member in multidisciplinary teams that are trying to develop an approach for patients with EDS