Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta‐analysis

[EN] Background: Numerous interventions to reduce perineal trauma during childbirth have been studied in recent years, including perineal massage. Objective: To determine the efficacy of perineal massage during the second stage of labor to prevent perineal damage. Search Strategy: Systematic search in PubMed, Pedro, Scopus, Web of Science, ScienceDirect, BioMed, SpringerLink, EBSCOhost, CINAHL, and MEDLINE with the terms Massage, Second labor stage, Obstetric delivery, and Parturition. Selection Criteria: The articles must have been published in the last 10 years; the perineal massage was administered to the study sample; and the experimental design consisted of randomized controlled trial. Data Collection and Analysis: Tables were used to describe both the studies' characteristics and the extracted data. The PEDro and Jadad scales were used to assess the quality of studies. Main Results: Of the 1172 total results identified, nine were selected. Seven studies were included in the meta-analysis and indicated a statistically significant decreased number of episiotomies in perineal massage. Conclusions: Massage during the second stage of labor appears to be effective in preventing episiotomies and reducing the duration of the second stage of labor. However, it does not appear to be effective in reducing the incidence and severity of perineal tears.S

Do Spanish minors, in their free time, prefer electronic devices or physical activity?

Las nuevas generaciones viven expuestos diariamente a estímulos provenientes de dispositivos electrónicos y diversos instrumentos de ocio que llevan asociado su uso al mantenimiento de una conducta sedentaria. Hasta el momento no se han explorado las posibles relaciones existentes entre los diferentes componentes del estilo de vida en una muestra representativa de la población de menores españoles. Por ello, se diseñó la presente investigación con los objetivos de examinar el grado de exposición a pantallas de los niños españoles e identificar posibles relaciones en su estilo de vida entre dicho aspecto y otros hábitos como la práctica de ejercicio y las horas de descanso, así como, determinar si alguno de ellos influye en su salud mental. Los resultados obtenidos mostraron que la exposición a pantallas de los niños españoles es de 15 horas semanales, y que su estilo de vida, aunque mejorable, entra dentro de los estándares de salud en cuanto a horas de descanso y hábitos de actividad física. Las políticas preventivas de abuso de dispositivos electrónicos en menores en España deberían poner especial énfasis en el sector que peores resultados en las variables de salud mental obtuvieron en la presente investigación: niños menores de 7 años y con malos hábitos de descanso nocturno y/o más horas de exposición a pantallas.The new generations live exposed daily to stimuli from electronic devices that are associated with maintaining sedentary behavior. So far, the possible relationships between the different components of lifestyle have not been explored in a representative sample of the population of Spanish minors. For this reason, this research was designed with the objectives of examining the degree of exposure to screens of Spanish children and identifying possible relationships in their lifestyle and other habits such as exercising and resting hours, as well as determining whether some of them influence your mental health. The results obtained showed that the exposure of Spanish children to screens is 15 hours a week, and that their lifestyle, although it could be improved, falls within health standards in terms of hours of rest and physical activity habits. The preventive policies of abuse of electronic devices in minors in Spain should place special emphasis on the sector with the worst results in the variables of mental health obtained in the present investigation: children under 7 years of age and with poor night-time rest habits and / or more hours of exposure to screens

Compliance with the recommendations of the World Health Organization on the practice of physical activity in people over 65 years in Spain

Purpose: Identifying whether the recommendations of the WHO regarding the amount of weekly time dedicated to the practice of PA in its different modalities are being met in the population of people over 65 in Spain. Method: This study has used data provided by 1317 interviewees aged 65 to 69 years old included in the Spanish Health Survey. Results: 19.1% of the sample said to not walk any day of the week at least 10 minutes, being the 84.2% those who did, at least, 150 minutes per week. Concerning the accomplishment of intense and moderate physical activity generally, the general or optimal recommendations for the weekly time were not satisfied. The proportion of individuals that comply the recommendations, general and optimal, of physical activity moderate were 17.4% in both cases. Those percentages, regarding intense exercise, the percentage of individuals that comply with the recommendations are reduced to 6.6% and 2.4%, for general and optimal recommendations, respectively. Conclusion: The practice of moderate and intense exercise is not within the frequent habits of people over 65 years of age, and this phenomenon could be one of the causes of the increasing health demand in this country (regardless of whether it is of a sensitive sector to get sick from the ageing process)

Prevalence of Perineal Tear Peripartum after Two Antepartum Perineal Massage Techniques: A Non-Randomised Controlled Trial

[EN] Perineal massage increases elasticity of myofascial perineal tissue and decreases the burn-ing and perineal pain during labour, thus optimising child birth, although an application protocol has not been standardised yet. The objective of this study is to determine the efficiency of massage in perineal tear prevention and identification of possible differences in massage application. Total of 90 pregnant participants were divided into three groups: perineal massage and EPI-NO® device group, applied by an expert physiotherapist, self-massage group, where women were instructed to apply perineal massage in domestic household, and a control group, which received ordinary obstetric attention. Results: The results showed significant differences among the control group and the two perineal massage groups in perineal postpartum pain. Correlations in perineal postpartum pain, labour duration and the baby’s weight were not statistically significant. Lithotomy posture was significantly less prevalent in the massage group than in the other two; this variable is known to have a direct effect on episiotomy incidence and could act as a causal covariate of the different incidence of episiotomy in the groups. Perineal massage reduces postpartum perineal pain, prevalence and severity of perineal tear during delivery.S

Satisfaction Of Spanish Primary School Teachers Regarding Anti-Covid Protocols

After the closure of the Spanish Primary Education Centres in March 2020, academic and educational institutions began the 2020-2021 academic year with the obligation to abide by the anti-Coronavirus protocols. Consequently, students of all academic levels, and especially school-age children, have experienced, to a greater or lesser degree, a learning crisis. For this reason, this research was carried out with the objective of analysing the perception of Spanish Primary Education teachers. Cross-sectional descriptive study in a representative sample of Spanish Primary Education teachers (n = 263). The research instrument consisted of a closed questionnaire designed ad hoc with a total of ten questions related to the object of study and other questions related to sociodemographic variables. Cohen\u27s t-test and d statistic were used to determine differences between sexes and the ANOVA test, and all statistical analyses were performed with Stata version 12 (StataCorp., United States) with a p value < .05. 76.4% of those surveyed did not identify the protocols established by the state administration as sufficient and correct, and 84% did not consider the resources provided by the administration of their region sufficient. Spanish teachers are not satisfied or in agreement with the protocols implemented by the governments of each Spanish region

Perineal Massage during Pregnancy for the Prevention of Postpartum Urinary Incontinence: Controlled Clinical Trial

[EN] Background and objectives: Urinary incontinence is any involuntary loss of urine. It may result in anxiety, depression, low self-esteem and social isolation. Perineal massage has spread as a prophylactic technique for treating complications during labor. Acknowledged effects of perineal massage are reduction of incidence and severity of perineal tear and use of equipment directly related to the intrapartum perineal trauma. The aim of this study was to determine the effectiveness of massage in urinary incontinence prevention and identification of possible differences in its form of application (self-massage or by a physiotherapist), with the previous assumption that it is effective and that there are differences between the different forms of application. Materials and Methods: A controlled clinical trial with a sample of 81 pregnant women was conducted. The participants were divided into three groups: a group that received the massage applied by a specialized physiotherapist, another group that applied the massage to themselves, and a control group that only received ordinary obstetric care. Results: No differences were identified in the incidence or severity of urinary incontinence among the three groups. The severity of the incontinence was only affected by the body mass index and the weight of the baby at the time of delivery. Conclusions: A relationship between perineal massage interventions and development of urinary incontinence has not been observed.S

Comparison of the portuguese version of the Pregnancy Physical Activity Questionnaire (PPAQ) with accelerometry for classifying physical activity among pregnant women with obesity

In recent years, the number of pregnant women with obesity has increased exponentially; thus, it is important to evaluate and characterize the physical activity levels of this specific group. The aim of this study is to evaluate the reliability and validity of the Portuguese version of the Physical Activity and Pregnancy Questionnaire and Pregnancy Questionnaire in pregnant women with obesity and to classify physical activity using the Physical Activity and Pregnancy Questionnaire and accelerometry. An analytical observational study was carried out between May and August of 2019 at the University Hospital Center of São João, with a sample of 31 pregnant women with obesity (30.9 ± 4.6 years 36.5 ± 4.6 kg/m2 of BMI and 21.5 ± 9 gestational weeks). The physical activity of participants was evaluated using an accelerometer and Physical Activity and Pregnancy Questionnaire at two time points (the first visit at the moment of consultation and the second seven days after, with accelerometer retest), the interclass correlation coefficient was used to test reliability between the Physical Activity and Pregnancy Questionnaire filled out at visit1 and the Physical Activity and Pregnancy Questionnaire filled out at visit2, and Pearson’s correlation was used to determine validity between the Physical Activity and Pregnancy Questionnaire and accelerometry. The interclass correlation coefficient values for total activity were 0.95, 0.97 for moderate and 0.58 for vigorous intensities. It ranged from 0.74 for sports/exercise to 0.96 for domestic activities. The Pearson’s correlations showed that the Physical Activity and Pregnancy Questionnaire is moderately valid for moderate intensity (r = 0.435). A total of 67.7% of the pregnant women complied with international physical activity recommendations.info:eu-repo/semantics/publishedVersio

Effects of a back school-based intervention on non-specific low back pain in adults: a randomized controlled trial

Background. Non-specific low back pain is a common condition with significant global prevalence and socio-economic impact. Back School programs, which combine exercise and educational interventions, have been used to address back pain. This study aimed to investigate the effects of a Back School-based intervention on non-specific low back pain in adults. Secondary objectives included evaluating the impact of the program on disability, quality of life, and kinesiophobia. Methods. A randomized controlled trial was conducted involving 40 participants with non-specific low back pain, who were divided into two groups. The experimental group underwent an 8-week Back School-based program. The program comprised 14 practical sessions focusing on strengthening and flexibility exercises, along with two theoretical sessions covering anatomy and concepts related to a healthy lifestyle. The control group maintained their usual lifestyle. Assessment instruments included the Visual Analogue Scale, Roland Morris disability questionnaire, Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia. Results. The experimental group showed significant improvements in the Visual Analogue Scale, Roland Morris disability questionnaire, physical components of the Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia. However, there were no significant improvements in the psychosocial components of the Short-Form Health Survey-36. In contrast, the control group did not show significant results in any of the study variables. Conclusions. The Back School-based program has positive effects on pain, low back disability, physical components of quality of life, and kinesiophobia in adults with non-specific low back pain. However, it does not appear to improve the participants' psychosocial components of quality of life. Healthcare professionals can consider implementing this program to help reduce the significant socio-economic impact of non-specific low back pain worldwide.Colegio Profesional de Fisioterapeutas de Castilla y León | Ref. INV2023-3

The effects of back schools on non-specific back pain: a systematic review and meta-analysis

Background: Non-specific back pain is a global concern. Exercise and health education are crucial components in its management. The Back School is a theoretical practical program that integrates both elements. The objective of this study is to determine if Back School-based programs are effective in reducing pain, disability, and kinesiophobia in patients with non-specific back pain. Methods: A systematic review of research involving participants with non-specific back pain was carried out on databases such as PubMed, Scopus, Web of Science, and Medline. Results: In total, 25 papers were chosen for review. All of these papers focused on the effects on the lumbar area, with the exception of one paper that specifically targeted the cervical region. The pain variable showed statistically significant results with standardized mean differences of −1.01 (950 confidence interval = −1.39 to −0.63; p < 0.001), and the disability variable had standardized mean differences of −0.98 (95% confidence interval = −1.38 to −0.58; p < 0.001), and only one study analysed the kinesiophobia variable and concluded that Back School programs have a positive effect on kinesiophobia between the baseline and post-intervention levels. Conclusions: Back School programs have shown effectiveness in reducing non-specific back pain and lowering disability rates

Protective effects of exercise on cardiotoxicity induced by breast cancer treatments: A systematic review and meta-analysis

[EN] Objective Currently, one of the main causes of death in women with breast cancer is cardiovascular disease caused by the oncologic therapies. Exercise has demonstrated positive effects on cardiovascular fitness in individuals without cancer. Therefore, the aim of this study was to evaluate the cardioprotective effects of exercise in women with breast cancer, during and after the application of their treatments. Methods Systematic search was done in PubMed, Scopus, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and PEDro. The articles must have been published in the last ten years; the intervention to be evaluated was to consist of an exercise program; the sample had to comprise women who were undergoing breast cancer treatment or who had completed it at the time of the intervention; and the outcome variables had to include at least one parameter for the assessment of cardiac function and/or structure. Results Of the 28 articles identified, nine reported non-randomized controlled studies, 16 randomized clinical trials and three quasi-experimental studies. The effects of exercise on left ventricular ejection fraction, global longitudinal strain and the E/A waveforms ratio were not significant. However, its effect on VO2max was significant. Conclusions Exercise does not seem to be effective in avoiding the cardiotoxic effects of oncological treatment for breast cancer. Although exercise seems to mitigate the symptomatology, reflected in improved functional capacity, more long-term studies are needed.S