Fibromyalgia and therapeutic exercise: Qualitative systematic review

Objetivos: El objetivo de esta revisión es determinar qué ejercicio es más eficaz para reducir la sintomatología de la fibromialgia. Estrategia de búsqueda: Se realizaron búsquedas en las principales bases de datos de las ciencias de la salud: PEDro, PubMed, Cochrane Plus, ISI (Web of Knowledge), y PsycINFO, y en las revistas no indexadas del área, entre marzo y octubre de 2013. Resultados: Se analizó el nivel de evidencia y se aplicaron criterios de exclusión e inclusión para obtener 32 artículos en la revisión, clasificados en 5 categorías en función del tipo de ejercicio. Todos ellos eran ensayos clínicos aleatorios. Conclusiones: El ejercicio terapéutico es eficaz para reducir la sintomatología de la fibromialgia. El ejercicio acuático, el combinado y las actividades alternativas parecen más eficaces para el tratamiento de puntos sensibles, de la depresión, y tiene mayores niveles de adherencia terapéutica. Para el tratamiento del resto de síntomas, todos los tipos de ejercicio tienen similares resultadosObjective: The goal of this review is to determine which exercise is the best to reduce the symptomatology of fibromyalgia. Search Strategy: Intervention studies in fibromyalgia were retrieved through searches in the main health-science databases: PEDro, PubMed, Cochrane Plus, ISI (Web of Knowledge), y PsycINFO, and in in publications of the field, Fisioterapia y Cuestiones de Fisioterapia, between March and October 2013. Results: After applying inclusion and exclusion criteria, and analyze the level of evidence, 32 publications were accepted in this review, classified in 5 different categories, depending on the type of activity. They were all randomized clinical trials. Conclusions: Exercise is effective for reducing symptomatology of fibromyalgia. Aquatic and combined exercise, and alternative activities seem to be more accurate in the treatment of tender points, depression, and they have higher levels of adherence. Relating to the rest of the symptoms, every other type of exercise has similar resul

Shoulder pain prevalence in competitive swimmers: A pilot study

Objetivos: conocer la prevalencia de dolor de hombro en nadadores de competición, sus características y su relación con factores antropométricos y deportivos. Métodos: estudio de prevalencia. Ciento cuarenta nadadores/as entre 12 y 24 años cumplimentaron un cuestionario durante una fase de entrenamiento específico. Resultados: el 25,7% revelaron padecer dolor de hombro. Se hallaron relaciones estadísticamente significativas entre el dolor de hombro y episodios previos de dolor (p<0,001), experiencia superior a tres años (p=0,014), Índice de Masa Corporal (p=0,015) y la especialidad estilo (p=0,008) y distancia (p=0,011). El dolor fue significativamente más intenso durante la actividad que en reposo (p<0,001). Conclusiones: el dolor de hombro en nadadores de competición entre 12 y 24 años parece ser un problema frecuente mayor Índice de Masa Corporal y a la especialidad del nadadorObjectives: to investigate the prevalence of shoulder pain in competitive swimmers and find out the characteristics of pain as well as its relation to anthropometric and sports factors. Methods: prevalence study. A hundred and forty competitive swimmers between 12 and 24 years old completed a questionnaire in a high intensity training phase. Results: 25.7% swimmers reported shoulder pain. There were significant statistical correlations between shoulder pain and previous episodes of pain (p<0.001), more than three years of experience (p=0.014), Body Mass Index (p=0.015) and stroke (p=0.008) and distance (p=0.011) specialty. Pain was statistically correlated with activity (p<0.001). Conclusions: shoulder pain seems to be a frequent and repetitive problem in competitive swimmers between 12 and 24 years old, which increases with years of practice. Furthermore, it seems to be associated with the activity, a higher Body Mass Index and the swimmers’ specialty

Fatigue and functional capacity post COVID-19

Background: We explored if fatigue influenced the long-term functional capacity of patients post COVID-19. Methods: People after COVID -19, grouped by treatment setting (home - H, hospital ward - HW or intensive care unit – ICU), were studied 12 months after discharge. Fatigue-Functional Chronic Illness Assessment Questionnaire Fatigue Subscale, FACIT-F and functional capacity-6min walk test, 6MWD and 1min sit-to-stand test, 1minSTS were assessed. Groups were compared with one-way ANOVA or Kruskal-Wallis H test. Spearman’s ρ and multiple regression analyses were performed between fatigue-functional tests. Results: 148 subjects (H, n=44; HW, n=60; ICU, n=44) participated. Fatigue was clinically relevant at 12 months although not significantly different among groups [H: 41(35-49); HW: 42(33-50); ICU; 42(32-48) points; p=.979). Functional capacity was significantly higher in those treated at home (6MWD: H,626 114m, HW: 527 146m, ICU: 528 129m, p<.001; 1minSTS: H,29 11reps, HW: 23 8reps, ICU: 24 8reps, p<.002). Fatigue was significantly correlated with functional tests within each group (FACIT-F-6MWD,.317<ρ≤.550, p<.01; FACIT-F-1minSTS, .364<ρ≤.485, p<.01). Each point of FACIT-F could change 6MWD by 5-6m and 1minSTS by. 3-.5reps, explaining between 12-33% of change in 6MWD and 17-22% of change in 1minSTS (Table 1). Conclusions: Fatigue seems to influence functional capacity of patients post COVID-19. Early management of this symptom seems important for their long-term management.publishe

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).The study was funded by the Spanish 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) and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D. Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain

Actividad física en sujetos post covid-19 1 año tras el alta

Introducción: Tras su fase aguda, la COVID-19 afecta a los pacientes mediante síntomas residuales que pueden comprometer su actividad física (AF), conocido predictor de morbimortalidad. Los efectos a largo plazo aún se desconocen, por ende, conocer la AF de sujetos pos-CO-VID-19 1 año tras el alta cobra especial interés.Material y métodos: Estudio observacional transversal de una cohor-te de sujetos pos-COVID-19 12 meses tras el alta, tratados en domici-lio (H), planta hospitalaria (HW) y UCI (ICU). Se valoraron datos de-mográficos y clínicos (espirometría, síntomas persistentes) y AF (International Physical Activity Questionnaire – IPAQ). Para comparar características y síntomas, se empleó el ANOVA de un factor (post hoc, test de Tukey) para variables cuantitativas y el chi-cuadrado de Pearson para variables categóricas (fuerza de asociación, V de Cra-mer). Para estudiar los patrones de AF, se usó la prueba H de Kruskal-Wallis (post hoc, test de Dunn).Resultados: Se reclutaron 148 sujetos pos-COVID-19 (H, n = 44; HW, n = 60; ICU, n = 44) (tabla). Se evidenciaron diferencias significativas inter-grupos en edad, IMC, FEV1, FVC. El grupo H se caracterizó por menor edad e IMC (p < 0,01), y mayores valores FEV1 y FVC (p < 0,01) que los grupos HW-ICU. No se estimaron otras diferencias respecto a estos parámetros. Además, se destacaron diferencias inter-grupos en sexo, fatiga y otros síntomas, cuya fuerza de asociación resultó débil. De hecho, fatiga (p = 0,049, V = 0,2) y otros síntomas (p = 0,006, V = 0,3) resultaron más prevalentes en el grupo ICU. No hubo diferencias en disnea, dolor o ausencia de síntomas. Finalmente, se detectaron diferencias significativas inter-grupos en AF vigorosa, andar ≥ 10 min y sedentarismo. El grupo H empleó más tiempo en AF vigorosa que los grupos HW-ICU (p = 0,025), mientras el grupo ICU dedicó más tiempo en andar ≥ 10min (p = 0,029), pese a ser más sedentario (p = 0,089) (fig.).Conclusiones: Doce meses tras el alta, las personas pos-COVID-19 siguen con síntomas de fatiga u otros (calambres, parestesias), en par-ticular aquellas tratadas en UCI. El nivel de AF, independientemente de la severidad de la COVID-19 en fase aguda, es moderado. Los suje-tos tratados en domicilio resultan dedicar más tiempo a AF vigorosa, mientras que los ingresados en UCI emplean más tiempo en andar, pese a ser más sedentarios. Edad, función pulmonar y síntomas (fati-ga u otros) podrían influir en su AF, pero es necesario un análisis in-tegral y longitudinal para entender su impactopublishe