Análisis neurofisiológico y abordaje fisioterápico multimodal en pacientes con dolor lumbar crónico inespecífico

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 11-11-202

Psychological, pain, and disability factors influencing the perception of improvement/recovery from physiotherapy in patients with chronic musculoskeletal pain: a cross-sectional study

13 p.Objectives: The aim of this study was to identify the possible relationships between psychological, pain, and disability variables with respect to the perception of change/recovery from physiotherapy in patients with chronic musculoskeletal pain (CMP). Methods: A cross-sectional observational study was performed with 150 patients. All patients completed a series of self-administered questionnaires and a series of self-reports to quantify the perception of change with respect to the physiotherapy they underwent, the level of disability and pain intensity, the level of fear of movement, the level of catastrophism, the degree of self-efficacy, the level of therapeutic alliance and their adherence to the physiotherapy. Results: The strongest correlations were between the subjective perception of change and the number of sessions, treatment beliefs, self-efficacy, pain intensity, collaboration, and bonding. The linear regression model showed that the number of sessions, treatment beliefs, self-efficacy, compliance, pain intensity, and bonding were predictors of subjective perception of improvement, with 50% of the variance. Conclusions: Treatment beliefs, therapeutic alliance, degree of self-efficacy, and pain intensity have been shown to be predictors of a subjective perception of improvement in patients with CMP. In turn, multimodal treatments had the greatest positive impact on the subjective perception of improvement

Evaluación de los aspectos sensoriomotores y cognitivo-afectivos de los pacientes con síndrome post- COVID-19 persistente y las posibles diferencias con los que presentan dolor musculoesquelético asociado

11 p.Introducción: Entre los síntomas más frecuentes que aparecen en pacientes con síndrome de post-COVID persistente destaca la presencia de dolor musculoesquelético, pero actualmente existe una falta de evidencia sobre el impacto de la presencia de este síntoma sobre otras variables cognitivas, afectivas, funcionales y de discapacidad. En base a ello, el objetivo principal del proyecto es comparar la capacidad funcional y el grado de discapacidad entre pacientes con síndrome post-COVID-19 persistente que sufren dolor y pacientes con dicho síndrome que no sufren dolor. Métodos: Se llevará a cabo un estudio descriptivo transversal. Los pacientes serán reclutados y evaluados en el Centro XXXXX de Valladolid, España. Se recogerán datos mediante cuestionarios autoadministrados para determinadas variables de carácter cognitivo o afectivo y se realizarán pruebas de carácter físico/funcional como la prueba del escalón para evaluar la resistencia cardiorrespiratoria o la dinamometría para evaluar la fuerza muscular, entre otras. Para analizar los datos, se empleará la prueba estadística t de student para estudiar la comparación entre las variables continuas. Las relaciones entre las variables de las dimensiones capacidad física, sensorial, cognitiva y afectiva-motivacional, se examinarán mediante el coeficiente de correlación de Pearson. Ética y difusión: El estudio se realizará atendiendo a la legislación nacional para la protección de datos de los voluntarios según la LOPD y la declaración de Helsinki. Una vez se analicen los datos obtenidos, los resultados serán publicados en una revista de impacto y se difundirán en congresos científicos.Colegio Profesional de Fisioterapeutas de la Comunidad de Madri

Combining motor imagery with action observation training does not lead to a greater autonomic nervous system response than motor imagery alone during simple and functional movements: a randomized controlled trial

Both motor imagery (MI) and action observation (AO) trigger the activation of the neurocognitive mechanisms that underlie the planning and execution of voluntary movements in a manner that resembles how the action is performed in a real way. The main objective of the present study was to compare the autonomic nervous system (ANS) response in an isolated MI group compared to a combined MI + AO group. The mental tasks were based on two simple movements that are recorded in the revised movement imagery questionnaire in third-person perspective. The secondary objective of the study was to test if there was any relationship between the ANS variables and the ability to generate mental motor imagery, the mental chronometry and the level of physical activity. The main outcomes that were measured were heart rate, respiratory rate and electrodermal activity. A Biopac MP150 system, a measurement device of autonomic changes, was used for the quantification and evaluation of autonomic variables. Forty five asymptomatic subjects were selected and randomized in three groups: isolated MI, MI + AO and control group (CG). In regards to the activation of the sympathetic nervous system (SNS), no differences were observed between MI and MI + AO groups (p > .05), although some differences were found between both groups when compared to the CG (p < .05). Additionally, even though no associations were reported between the ANS variables and the ability to generate mental motor imagery, moderate-strong positive associations were found in mental chronometry and the level of physical activity. Our results suggest that MI and MI + AO, lead to an activation of the SNS, although there are no significant differences between the two groups. Based on results obtained, we suggest that tasks of low complexity, providing a visual input through the AO does not facilitates their subsequent motor imagination. A higher level of physical activity as well as a longer time to perform mental task, seem to be associated with a greater increase in the ANS response

Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma

Producción CientíficaObjective:The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness. Methods:RO and spirometry were performed in 154 children (6 to 14-year-old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25-75 for spirometry, and R5, AX and R5-19 for RO, were converted into z-scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values. Results:There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427). Conclusion:RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.Junta de Castilla y León (Gerencia Regional de Salud - Grant/Award Number: 2191/A/2020

CiTiEs (Ciudades: Tiempo + Espacio). Implementación de itinerarios didácticos para la enseñanza virtual y presencial del Patrimonio cultural de Madrid a través del aprendizaje cooperativo

Retomando los itinerarios didácticos diseñados en un PID anterior (2019/20, nº 363), se implementarán materiales digitales para la Educación patrimonial de Madrid. Se utilizarán técnicas de aprendizaje cooperativo y recursos para la enseñanza virtual.Depto. de Didáctica de las Ciencias Experimentales , Sociales y MatemáticasFac. de EducaciónFALSEsubmitte

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Somatosensory and Motor Differences between Physically Active Patients with Chronic Low Back Pain and Asymptomatic Individuals

Background and Objectives: Chronic low back pain (CLBP) is the most common occupational disorder due to its associated disability and high risk of recurrence and chronicity. However, the mechanisms underlying physical and psychological variables in patients with CLBP remain unclear. The main objective of this study was to assess whether there were differences between physically active patients with nonspecific CLBP compared with asymptomatic individuals in sensorimotor and psychological variables. Materials and Methods: This was an observational cross-sectional design with a nonprobabilistic sample. The sample was divided into two groups: individuals with nonspecific CLBP (n = 30) and asymptomatic individuals as a control (n = 30). The psychological variables assessed were low back disability, fear of movement, pain catastrophizing, and self-efficacy. The sensorimotor variables assessed were two-point discrimination, pressure pain threshold, lumbopelvic stability, lumbar flexion active range of motion, and isometric leg and back strength. Results: Statistically significant differences between the groups in terms of catastrophizing levels (p = 0.026) and fear of movement (p = 0.001) were found, but no statistically significant differences between groups were found in self-efficacy (p &gt; 0.05). No statistically significant differences between the groups in any of the sensorimotor variables were found (p &gt; 0.05). Conclusion: No sensorimotor differences were found between patients with asymptomatic and chronic low back pain, but differences were found in the psychological variables of catastrophizing and fear of movement

Psychosocial and Somatosensory Factors in Women with Chronic Migraine and Painful Temporomandibular Disorders

Introduction. Psychosocial and somatosensory factors are involved in the pathophysiology of chronic migraine (CM) and chronic temporomandibular disorders (TMD). Objective. To compare and assess the relationship between pain catastrophizing and kinesiophobia in patients with CM or chronic TMD. Method. Cross-sectional study of 20 women with CM, 19 with chronic TMD, and 20 healthy volunteers. Pain catastrophizing and kinesiophobia were assessed. The level of education, pain intensity, and magnitude of temporal summation of stimuli in the masseter (STM) and tibialis (STT) muscles were also evaluated. Results. There were significant differences between the CM and chronic TMD groups, compared with the group of asymptomatic subjects, for all variables (p<.05) except kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r=0.46; p<.01) were obtained, and the strongest association was between kinesiophobia and magnification (r=0.52; p<.01). The strongest associations among physical variables were found between the STM on both sides (r=0.93; p<.01) and between the left and right STT (r=0.76; p<.01). Conclusion. No differences were observed in pain catastrophizing and kinesiophobia between women with CM and with chronic TMD. Women with CM or chronic TMD showed higher levels of pain catastrophizing than asymptomatic subjects