Aplicación de metodologías activas en el aula para la mejora del estado anímico del estudiantado de Ciencias de la Salud

Debido a los múltiples componentes externos que pueden generar un aumento de la percepción de estrés en el estudiantado universitario, tanto su motivación, memoria y recursos cognitivos, entre otros, pueden verse afectados. Desde el ámbito universitario, actualmente se han incluido nuevos métodos de enseñanza docente, que fomenten el aprendizaje y así el rendimiento académico. En concreto, los objetivos de este proyecto de innovación docente han sido el de evaluar si las metodologías docentes activas mejoran el estado anímico del alumnado de Ciencias de la Salud, además de otros objetivos secundarios como conocer si el uso de estas metodologías mejora el rendimiento académico frente a las metodologías clásicas o si existe una correlación entre la mejora del rendimiento académico y la mejora del estado de ánimo. Para ello, se llevó a cabo un estudio comparativo entre las metodologías docentes activas y las metodologías clásicas llevadas a cabo en clases teóricas de asignaturas del ámbito de las Ciencias de la Salud. Se evaluaron, antes y después de la intervención, el estado de ánimo de los participantes (a través del cuestionario Evaluación del Estado de Ánimo, EVEA) y los conocimientos sobre el temario impartido (a través de 6 preguntas tipo test relacionadas con el contenido a impartir durante la clase teórica). Además, se recogieron datos sociodemográficos para caracterizar a la muestra (edad, sexo, grado al que pertenecían, curso en el que estaban matriculados y si repetían o no asignatura). Todos estos datos se recogieron a través de un formulario mediante la herramienta “Google Form”, previo consentimiento informado de los participantes. Por último, los datos obtenidos se volcaron en una base de datos para su posterior análisis estadístico: se calcularon las diferencias de medias entre los valores obtenidos antes y después de cada intervención, y se compararon los resultados de la metodología clásica (lección magistral) frente a la metodología activa (gamificación) Las intervenciones que se llevaron a cabo fueron las siguientes: a) Lección magistral: Antes y después de la explicación del contenido de clase, los alumnos completaban el cuestionario EVEA y los conocimientos del contenido a impartir, a través de 6 preguntas tipo test. La clase se desarrollaba mediante una lección magistral, en la que el profesor exponía el temario y respondía a las dudas que surgieran durante la clase. b) Metodología activa: Antes y después de la explicación del contenido de clase, los alumnos completaban el cuestionario EVEA y los conocimientos del contenido a impartir, a través de 6 preguntas tipo test. Previamente a la clase, el profesor había preparado un “Kahoot” con 6 preguntas tipo test, con un tiempo de 2 minutos para responder a cada pregunta. Entre pregunta y pregunta, se discutían las razones por las que una de las opciones era la correcta y las otras eran falsas, para facilitar la asimilación de los conceptos. En total, participaron 154 alumnos, pertenecientes a los campus de Granada y Melilla, de los grados de Fisioterapia y de Terapia Ocupacional de la Universidad de Granada. El proyecto se desarrolló en 8 asignaturas diferentes, 7 del grado de Fisioterapia y 1 del grado de Terapia Ocupacional. Tras analizar los datos, observamos que, como planteamos en nuestra hipótesis inicial, la metodología activa (en nuestro caso, realizada a través de gamificación), mejoró el estado de ánimo de los participantes, en comparación a la metodología clásica realizada (es decir, frente a la lección magistral). Además, también observamos que el rendimiento académico se vio mejorado tras el uso de las metodologías activas: se obtuvo una puntuación más alta de los conocimientos evaluados después de la intervención de gamificación frente a la metodología clásica. Creemos que, debido a que la intervención llevada a cabo no supone ningún coste extra, su aplicación resulta bastante viable, si bien es cierto que es necesario un conocimiento previo de las herramientas informáticas que se utilizan

Swallowing after Oral Oncological Treatment: A Five-Year Prospective Study

Background: Swallowing rehabilitation in curative treated patients with oral cancer is still a challenge. Different factors may influence these patients’ swallowing function. The aim of this study was to identify factors associated with swallowing function up to 5 years after cancer treatment. Methods: Swallowing duration and frequency of 5 mL water and 15 mL applesauce were measured in 123 patients treated for oral cancer. Mixed model analyses were performed to identify associated factors. Results: Age influenced all measured swallowing outcomes. Assessment moment, gender, tumor location, maximum tongue force, and tactile sensory function of the tongue were associated with both water and applesauce swallowing duration, tumor classification was associated with water swallowing duration, and alcohol consumption was associated with applesauce swallowing duration. Assessment moment, cancer treatment, maximum tongue force, and tactile sensory function of the tongue were associated with water and applesauce swallowing frequency. Conclusion: Patients who are older at diagnosis, women, and patients who regularly consume alcohol before their treatment may have poorer swallow functioning after curative oral cancer treatment. Patients that fit these criteria should have their swallowing evaluated during clinical follow-ups and sent to swallowing therapy when needed. During this therapy, optimizing tongue function needs attention to maintain an optimal swallowing function

Effect of Myofascial Therapy on Pain and Functionality of the Upper Extremities in Breast Cancer Survivors: A Systematic Review and Meta-Analysis

(1) Objective: The purpose was to analyze the effectiveness of myofascial therapy on musculoskeletal pain and functionality of the upper extremities in female breast cancer survivors, and to evaluate the changes in range of motion, quality of life, and mood state of these patients. (2) Methods: Systematic searches were performed on the MEDLINE/PubMed, Web of Science, Scopus, and Physiotherapy Evidence Databases for articles published until October 2020, in order to identify randomized controlled trials which analyzed the effectiveness of myofascial therapy as compared to a control group, passive treatment, placebo, or another intervention, and allowed co-interventions on female breast cancer survivors. Two reviewers examined the sources individually, calculated the risk of bias and extracted the data (PROSPERO number CRD42020215823). (3) Results: A total of eight RCTs were included. The results suggested that myofascial therapy does not have a greater statistically significant immediate effect on pain intensity (SMD: -0.15; 95% CI -0.48, 0.19), functionality (SMD: -0.17; 95% CI -0.43, 0.09) and range of motion in flexion (SMD: 0.30; 95% CI -0.13, 0.74) than an inactive, passive treatment or another intervention. However, a statistically significant result was observed for the abduction shoulder in favor of the experimental group (SMD: 0.46; 95% CI 0.05, 0.87; p = 0.03). (4) Conclusion: In general, although we found greater overall effects in support of the intervention with myofascial therapy than other control groups/types of interventions, the subgroup analysis revealed inconsistent results supporting myofascial therapy applied to breast cancer survivors

Myofascial Induction Therapy Improves the Sequelae of Medical Treatment in Head and Neck Cancer Survivors: A Single-Blind, Placebo-Controlled, Randomized Cross-Over Study

Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than 60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single 30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy (placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual analogue scale) and range of motion (cervical range of motion device and goniometer), maximum mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test) were measured before and after the treatment and placebo sessions. A single session of MIT improved cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and cervical muscle function. The associated effect sizes ranged from moderate to large. The present study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension: 12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affectedside lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening (3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.European Regional Development Fund (ERDF) and the “University of Granada, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES)” programUniversity of Granada: “Proyectos de Investigación Precompetitivos para Jóvenes Investigadores. Plan Propio 2020” Code: PPJIA2020.15

Effect of mHealth plus occupational therapy on cognitive function, mood and physical function in people after cancer: Secondary analysis of a randomized controlled trial

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.rehab.2022.101681Spanish Ministry of Economy and Competitiveness (Plan Estatal de I+D+I 2013-2016)Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI14/01627)Fondos Estructurales de la Unión Europea (FEDER)Spanish Ministry of Education (FPU14/01069 and FPU18/03575)University of Granada, Plan Propio de Investigación 2016, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES)Funding for open access charge: Universidad de Granada/CBU

Upper body motor function and swallowing impairments and its association in survivors of head and neck cancer: A cross-sectional study

Background Upper body motor function and swallowing may be affected after curative treatment for head and neck cancer. The aims of this study are to compare maximum mouth opening (MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of motion (AROM) and strength, and swallowing difficulty between survivors of head and neck cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations between these outcomes in sHNC. Methods Thirty-two sHNC and 32 HMC participated on the study. MMO, TMD, cervical and shoulder AROM, cervical and shoulder strength, the SPADI shoulder pain and disability indices, the Eating Assessment Tool (EAT-10) score, swallowing difficulty as determined using a visual analogue scale (VAS), and the location of disturbances in swallowing, were recorded. Results MMO and cervical and shoulder AROM and strength were significantly lower in sHNC, whereas FAI, SPADI score, EAT-10 and VAS were higher. The MMO, TMD, cervical and shoulder AROM, and cervical shoulder strength values showed significant correlations (some direct, others inverse) with one another. Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength. Conclusion Compared with controls, sHNC present smaller MMO, lower cervical and shoulder AROM, lower cervical and shoulder strength and higher perception of TMD, shoulder pain and disability and swallowing difficulty. sHNC suffer impaired swallowing related to lower MMO, presence of TMD, cervical AROM and shoulder strength values. Improving these variables via physiotherapy may reduce the difficulty in swallowing experienced by some sHNC.Fondos Estructurales de la Union Europea (FEDER)Unit of Excellence on Exercise and Health (UCEES), University of Granad

Effects of a Single Myofascial Induction Session on Neural Mechanosensitivity in Breast Cancer Survivors: A Secondary Analysis of a Crossover Study

Objectives: The purpose of this study was to investigate the short-term effects of myofascial induction on mechanosensitivity of upper limb nerves. Methods: In this secondary analysis of a randomized, single-blind, placebo-controlled crossover study, 21 breast cancer survivors with stage I-IIIA cancer were randomly allocated to an experimental group (30 minutes of myofascial induction session) or placebo control group (unplugged pulsed 30 minutes of shortwave therapy), with a 4-week washout period between sessions that occurred in a physical therapy laboratory in the Health Science Faculty (University of Granada, Spain). Range of motion (universal goniometry), structural differentiation, symptoms (yes/no), and pressure pain thresholds (electronic algometry) were assessed during neurodynamic tests and attitude toward massage scale as covariate. Results: An analysis of covariance revealed significant time × group interactions for range of motion in affected upper limb nerves (median, P .05). An analysis of covariance revealed no significant interactions on pressure pain thresholds over the nerves for affected (all P > .05) and nonaffected (all P > .05) upper limb nerves. Conclusion: A single myofascial induction session may partially improve mechanosensitivity of median, radial, and ulnar nerves and yield positive effects on symptom mechanosensitivity, especially regarding the ulnar nerve in breast cancer survivors

The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial

Purpose We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of HNC (sHNC). Methods We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions, 3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction, cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness were assessed. Results Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05). Conclusion A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.Fondos Estructurales de la Union Europea (FEDER)University of Granada, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES)Junta de Andalucia PI-0171-2020 CSy

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross‑sectional study

Purpose To evaluate the prevalence of dysphagia in survivors of head and neck cancer (sHNC) and to identify the predictors contributing to the development of dysphagia. Methods We enrolled 62 sHNC in a cross-sectional study to check the prevalence of dysphagia in sHNC and to evaluate which factors were influencing the presence of this side effect. Besides dysphagia, sociodemographic and clinical characteristics, oral symptoms, maximal mouth opening (MMO), sleep quality and physical condition were evaluated, and a linear regression analysis was performed to verify which of these outcomes impact dysphagia. Results Among all the sHNC, 85.5% presented dysphagia. The linear regression analysis confirmed that 44.9% of the variance in dysphagia was determined by coughing, MMO and sleep quality, being MMO the most powerful predictor, followed by coughing and sleep quality. Conclusion Dysphagia affected the great majority of sHNC. Moreover, symptoms as coughing, reduced MMO and sleep disorders may act as predictors contributing to the development of dysphagia. Our results emphasize the importance of an early and proper identification of the symptoms as well as an adequate treatment strategy to address the cluster of symptoms that sHNC undergo.Funding for open access publishing: Universidad de Granada/CBUA.Consejería de Salud, Junta de Andalucía (PI-0187–2021 and PI-0171–2020)European Regional Development Fund (ERDF-FEDER

Therapeutic Benefits of Balneotherapy on Quality of Life of Patients with Rheumatoid Arthritis: A Systematic Review

This paper has external funding for publication from the "Catedra Hammam Al Andalus I + D + I en Bienestar Humano" (Hammam Al Andalus Chair in Human Well-being), University of Granada, Spain.Background: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease. RA symptoms make the disease disabling and strongly impact the quality of life of patients. Among the available forms of treatment, balneotherapy seems to be one of the most common forms of nonpharmacological treatment for rheumatic disease. The aim was to explore the effectiveness of balneotherapy for improving the quality of life of patients with RA. Methods: Pubmed, Scopus, Web of Science and The Cochrane library were searched for randomized or clinical controlled trials published in English or Spanish until May 2021. Risk of bias of included articles were assessed using the Cochrane tool. A total 535 records were retrieved, and seven met the inclusion criteria. All the included studies showed statistically significant improvements in the quality of life of patients who received balneotherapy treatment despite differences in treatment administration. Sessions should be approximately 20 min long and use natural mineral waters enriched with elements, or mud, at a water temperature between 35–38ºC. Conclusions: Balneotherapy benefits the quality of life of people with RA. The obtained results show positive effects for both mineral bathing and immersion in sand or mud on the quality of life of people who suffer from RA."Catedra Hammam Al Andalus I + D + I en Bienestar Humano" (Hammam Al Andalus Chair in Human Wellbeing), University of Granada, Spai