Influence of shoulder pain on muscle function: implications for the assessment and therapy of shoulder disorders

Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly emphasizes an incomplete understanding of the nature of shoulder pain. Indeed, the effective diagnosis and treatment of shoulder pain should not only rely upon a detailed knowledge of the peripheral pathologies that may be present in the shoulder, but also on current knowledge of pain neurophysiology. To assess and treat shoulder pain, a comprehensive understanding of the way in which pain is processed is essential. This review reflects modern pain neurophysiology to the shoulder and aims to answer the following questions: why does my shoulder hurt? What is the impact of shoulder pain on muscle function? What are the implications for the clinical examination of the shoulder? And finally, what are the clinical implications for therapy? Despite the increasing amount of research in this area, an in-depth understanding of the bidirectional nociception-motor interaction is still far from being achieved. Many questions remain, especially related to the treatment of nociception-motor interactions

El impacto de la gran recesión en la Comunidad Valenciana

La gran recesión ha tenido un impacto importante sobre la estructura de la pobreza y la privación en la población de la Comunidad Valenciana. Exceptuando el grupo de las personas de más edad, todos los demás se han visto afectados por esta crisis en mayor o menor medida. No solo ha crecido el porcentaje de familias que está por debajo del umbral de la pobreza o que están privadas de algunos bienes o servicios básicos, sino que también ha aumentado la intensidad de estos fenómenos pudiendo afirmarse que las personas pobres y privadas de bienes lo son ahora con mayor intensidad que antes de la crisis. El presente artículo expone de una manera resumida los principales datos del estudio realizado por Eduardo Esteve Pérez: “Pobreza y privación en la Comunidad Valenciana y España: El impacto de la Gran Recesión” en el marco de los trabajos del Observatorio de Investigación sobre Pobreza y Exclusión en la Comunidad Valenciana. (ver http://www.uchceu.es/vida_universitaria/documentos/catedra_solidaridad/informe_pobreza_y_privacion_en_la_cv_y_espanya.pdf)The Great Recession has had a significant impact on the structure of poverty and privation throughout the Community of Valencia. Except for the group of population of older age, the rest of groups have been affected by the crisis to a greater or lesser extent. The percentage of families that are living under the poverty line or that have lost some basic services or goods has increased, as well as the intensity of these phenomena; therefore, we are able to establish that the status of people usually poor and deprived from their basic goods is now even worse than before the crisis started. This article briefly expounds the main data obtained from the study “Pobreza y privación en la Comunidad Valenciana y España: El impacto de la Gran Recesión” [«Poverty and Privation in the Community of Valencia and Spain: The Impact of the Great Recession»] carried out by Eduardo Esteve Pérez within the framework of the works developed by the Observatory of Poverty and Social Exclusion of the Community of Valencia

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In conclusion, it is key for physical therapists to acknowledge that an important subgroup of patients with OA develop hyperexcitability of the central nervous system and that CS plays a crucial role in the pain reported by these patients. Recent studies published in wellrespected journals support our argument

Effect of neuroscience education on subjects with chronic knee pain related to osteoarthritis: a randomized controlled trial

In this PhD study, the evidence for the role of central pain mechanisms in people with OA was investigated by means of a narrative and a systematic review of the existent literature. In addition, clinical criteria for recognizing central sensitization in subjects with knee OA are discussed as well as the rationale for a comprehensive integrative treatment program including pain neuroscience education and manual therapy for this population. Clinicians may find some practical problems when combining biomechanical approaches with more brain targeted approaches in a clinical setting, especially in a specific population like OA, where patients are often a bit older and tend to stick with pure biomechanical illness perceptions in line with the earlier understanding of OA. In this PhD dissertation, the rationale and tips and tricks to target the brain without ignoring the joints in patients with knee OA has been first provided in a narrative paper and afterwards tested by means of a randomized controlled trial. General conclusions achieved after this Doctoral Thesis are: -Substantial scientific evidence indicates a role for central sensitization in osteoarthritis pain including those with knee osteoarthritis, yet it is necessary to develop strategies to allow reliable and systematic recognition of patients with osteoarthritis whose pain has a (predominant) central sensitization component. -Optimum treatment for people with knee osteoarthritis pain requires a biopsychosocial approach and determination of how peripheral and central factors are contributing to pain in each patient in order to enable individualization of treatment strategies. Physical therapists are well positioned to deliver an individualized intervention because they are cognizant of the need for a biopsychosocial approach to management. -The area of pain reported by individuals with knee osteoarthritis pain is associated with some measures of central sensitization. Clinicians should be attentive for individuals with knee osteoarthritis showing extended areas of pain as this may be an indicator of altered nociceptive processing mechanisms. Pain drawings may constitute an easy and cheap way for the early identification of central sensitization in people with knee osteoarthritis pain. -Sound scientific rationale and practical guidelines have been developed for the application of a combined manual therapy and pain neuroscience education approach in patients with chronic osteoarthritis-related pain and central sensitization as their dominant pain mechanism. -In subjects with knee osteoarthritis waiting for knee joint replacement, pre-operative pain neuroscience education combined with knee joint mobilization did not produce any additional benefits over time in knee pain and disability and central sensitization measures compared with biomedical education with knee joint mobilization. Superior effects in the pain neuroscience education with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia.In this PhD study, the evidence for the role of central pain mechanisms in people with OA was investigated by means of a narrative and a systematic review of the existent literature. In addition, clinical criteria for recognizing central sensitization in subjects with knee OA are discussed as well as the rationale for a comprehensive integrative treatment program including pain neuroscience education and manual therapy for this population. Clinicians may find some practical problems when combining biomechanical approaches with more brain targeted approaches in a clinical setting, especially in a specific population like OA, where patients are often a bit older and tend to stick with pure biomechanical illness perceptions in line with the earlier understanding of OA. In this PhD dissertation, the rationale and tips and tricks to target the brain without ignoring the joints in patients with knee OA has been first provided in a narrative paper and afterwards tested by means of a randomized controlled trial. General conclusions achieved after this Doctoral Thesis are: -Substantial scientific evidence indicates a role for central sensitization in osteoarthritis pain including those with knee osteoarthritis, yet it is necessary to develop strategies to allow reliable and systematic recognition of patients with osteoarthritis whose pain has a (predominant) central sensitization component. -Optimum treatment for people with knee osteoarthritis pain requires a biopsychosocial approach and determination of how peripheral and central factors are contributing to pain in each patient in order to enable individualization of treatment strategies. Physical therapists are well positioned to deliver an individualized intervention because they are cognizant of the need for a biopsychosocial approach to management. -The area of pain reported by individuals with knee osteoarthritis pain is associated with some measures of central sensitization. Clinicians should be attentive for individuals with knee osteoarthritis showing extended areas of pain as this may be an indicator of altered nociceptive processing mechanisms. Pain drawings may constitute an easy and cheap way for the early identification of central sensitization in people with knee osteoarthritis pain. -Sound scientific rationale and practical guidelines have been developed for the application of a combined manual therapy and pain neuroscience education approach in patients with chronic osteoarthritis-related pain and central sensitization as their dominant pain mechanism. -In subjects with knee osteoarthritis waiting for knee joint replacement, pre-operative pain neuroscience education combined with knee joint mobilization did not produce any additional benefits over time in knee pain and disability and central sensitization measures compared with biomedical education with knee joint mobilization. Superior effects in the pain neuroscience education with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia

Heterotheca subaxilaris (Compositae), nuevo xenófito para la flora ibérica

Se cita por primera vez en la Península Ibérica Heterotheca subaxillaris (Lam.) Britton & Rusby (Compositae), planta originaria de Norteamérica. Localizada en la mediana de la autovía CV-10 en la Pobla Tornesa, provincia de Castellón (España)A first reference on the presence of Heterotheca subaxillaris (Lam.) Britton & Rusby (Compositae), native of North America, in the iberian flora is provided. This species has been located at the CV-10 highway, in la Pobla Tornesa, Castellón province (Spain

Pain Treatment for patients with osteoarthritis and central sensitization

Osteoarthritis is one of the most frequent, disabling, and costly pathologies of modern society. Among the main aims of osteoarthritis management are pain control and functional ability improvement. The exact cause of osteoarthritis pain remains unclear. In addition to the pathological changes in articular structures, changes in central pain processing or central sensitization appear to be involved in osteoarthritis pain. The latter calls for a broader approach to the management of patients with osteoarthritis. Yet, the scientific literature offers scant information addressing the treatment of central sensitization, specifically in patients with osteoarthritis. Inter-ventions such as cognitive-behavioral therapy and neuroscience education potentially target cognitive-emotional sensitization (and descending facilitation), and centrally acting drugs and exercise therapy can improve endogenous analgesia (descending inhibition) in patients with osteoarthritis. Future studies should assess these new treatment avenues

Profiling and Association over Time between Disability and Pain Features in Patients with Chronic Nonspecific Neck Pain:A Longitudinal Study

Objectives: To longitudinally investigate the relationships between neck/arm disability and pain profile measures in individuals with chronic nonspecific neck pain (NSNP) at baseline, one month, and six months after a standardized physiotherapy intervention. A secondary aim was to compare pain sensitivity of individuals with chronic NSNP at baseline to healthy controls. Methods: A total of sixty-eight individuals with chronic NSNP and healthy controls were recruited. Neck disability index (NDI), the 11-item disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), temporal summation (TS), pressure pain thresholds (PPTs), pain intensity and pain extent were assessed in individuals with chronic NSNP. For the cross-sectional assessment, TS and PPTs were compared to healthy controls. Results: After following a standardized physiotherapy intervention, local and distal PPTs to the neck region decreased at one and six month follow-ups, respectively. Pain extent decreased at one and six months. Furthermore, a positive correlation between neck/arm disability and pain intensity was found at baseline, whereas moderate positive correlations (e.g., between NDI and pain extent) at baseline, one and six month follow-ups and negative correlations at six months (e.g., between arm disability and PPTs) were found. Discussion: Overall, these findings indicate that pain sensitivity can worsen following treatment despite reduced pain extent and unchanged neck disability and pain intensity scores over a six-month period in individuals with chronic NSNP

El desarrollo desde una visión humanista cristiana

ABSTRACT This article reviews the christian humanist concept of development and contrast with the main ideas about what is called human development. The article exposes the principal points where the two ways to understanding de development are converging and shows those aspects in which Christian humanism can make original contributions to the concept of human development.El artículo revisa la concepción del desarrollo que tiene el humanismo cristiano comparándola con las ideas principales de lo que se ha venido a denominar desarrollo humano. Desarrolla los puntos en los que ambos son convergentes y aporta cuáles son aquellos aspectos en los que el humanismo cristiano puede realizar aportaciones originales que sean clave a la hora de hacer realidad la concepción de desarrollo humano.ABSTRACTThis article reviews the christian humanist concept of development and contrast with the main ideas about what is called human development. The article exposes the principal points where the two ways to understanding de development are converging and shows those aspects in which Christian humanism can make original contributions to the concept of human development.   &nbsp

El Pardalero : : semanari festiu, pare de la grasia, chermá de la juerga y cosí del bon humor: Año I Número 1

Microfilme. Valencia : BV, ca. 199