Is Cycling Practice Related to Men’s Pelvic Floor Dysfunctions? A Hypothesis-Generating Observational Study

Background: There is a lack of consensus with regards to the consequences of cycling practice on urogenital and sexual problems in men. The aim of the study was to analyse the relationship between intensity of cycling practice and urinary tract symptoms, erectile dysfunction, and urinary incontinence. Methods: Observational hypothesis-generating design. Cyclists, men, between 25 and 70 years who had been cycling for more than one year were included. During the statistical analysis, a multiple linear regression model, partial correlation and Spearman’s correlation were carried out. Results: Fifty-eight men participated in the study. Results showed that there is a correlation between years of cycling and prostate symptoms (p = 0.041), and between age and erectile dysfunction (p = 0.001). The multiple linear regression model and the partial correlation analysis showed a correlation between the years of cycling and prostate symptoms (p = 0.007 and p = 0.018). Conclusions: The results have shown that there is a slight correlation between the years of cycling and the presence of lower urinary tract symptoms, independently of the man’s age. Therefore, the results display that high-intensity cycling practice might impact negatively in some men’s pelvic floor functions. Further research is needed to analyse the impact of cycling on urogenital problems in this population group

Estudio y abordaje de los factores de riesgo psicosociales asociados al dolor postquirúrgico tras una artroplastia de rodilla

Programa de Doctorat en Medicina i Recerca Translacional[spa] INTRODUCCIÓN: La artroplastia de rodilla (AR) se considera una intervención quirúrgica altamente exitosa para la mejora del dolor y la función, en sujetos que se encuentran en una fase avanzada de artrosis, una vez el tratamiento no quirúrgico ha fracasado. A pesar de ello, aproximadamente un 20% de los pacientes continúan experimentando altos niveles de dolor, discapacidad y una reducción significativa en su calidad de vida. Al tratarse de una intervención tan prevalente y debido a su creciente popularidad, numerosos investigadores han dedicado sus recursos y esfuerzos en la identificación de factores de riesgo capaces de predecir los resultados obtenidos tras una AR. La identificación de los factores de riesgo es un paso clave para el desarrollo de nuevas y mejores intervenciones pre- y perioperatorias para mejorar los resultados obtenidos tras la intervención. Gracias a investigaciones previas, factores clínicos como la intensidad del dolor preoperatorio y los factores psicosociales como: el catastrofismo ante el dolor, la kinesiofobia, la ansiedad y la depresión, emergen como predictores significativos de los resultados postoperatorios tras una AR. Al tratarse de factores modificables, numerosos autores recomiendan la evaluación y tratamiento de dichos factores con el objetivo de mejorar los resultados tras una AR. A pesar de ello, la influencia que ejercen estos factores todavía no está del todo clara por lo que es necesario continuar investigando la influencia de estos. HIPÓTESIS: Los factores psicosociales son factores predictores de los resultados obtenidos tras una AR. La fisioterapia es un tratamiento eficaz para la reducción de los factores de riesgo psicosociales antes de una AR. OBJETIVOS: Investigar la influencia de los factores psicosociales sobre los resultados obtenidos tras una AR. Investigar la efectividad de la fisioterapia multimodal sobre la reducción del catastrofismo ante el dolor y la intensidad del dolor en sujetos con artrosis sintomática de rodilla, pendientes de una AR y que presenten altos niveles de catastrofismo

Estudio y abordaje de los factores de riesgo psicosociales asociados al dolor postquirúrgico tras una artroplastia de rodilla

[spa] INTRODUCCIÓN: La artroplastia de rodilla (AR) se considera una intervención quirúrgica altamente exitosa para la mejora del dolor y la función, en sujetos que se encuentran en una fase avanzada de artrosis, una vez el tratamiento no quirúrgico ha fracasado. A pesar de ello, aproximadamente un 20% de los pacientes continúan experimentando altos niveles de dolor, discapacidad y una reducción significativa en su calidad de vida. Al tratarse de una intervención tan prevalente y debido a su creciente popularidad, numerosos investigadores han dedicado sus recursos y esfuerzos en la identificación de factores de riesgo capaces de predecir los resultados obtenidos tras una AR. La identificación de los factores de riesgo es un paso clave para el desarrollo de nuevas y mejores intervenciones pre- y perioperatorias para mejorar los resultados obtenidos tras la intervención. Gracias a investigaciones previas, factores clínicos como la intensidad del dolor preoperatorio y los factores psicosociales como: el catastrofismo ante el dolor, la kinesiofobia, la ansiedad y la depresión, emergen como predictores significativos de los resultados postoperatorios tras una AR. Al tratarse de factores modificables, numerosos autores recomiendan la evaluación y tratamiento de dichos factores con el objetivo de mejorar los resultados tras una AR. A pesar de ello, la influencia que ejercen estos factores todavía no está del todo clara por lo que es necesario continuar investigando la influencia de estos. HIPÓTESIS: Los factores psicosociales son factores predictores de los resultados obtenidos tras una AR. La fisioterapia es un tratamiento eficaz para la reducción de los factores de riesgo psicosociales antes de una AR. OBJETIVOS: Investigar la influencia de los factores psicosociales sobre los resultados obtenidos tras una AR. Investigar la efectividad de la fisioterapia multimodal sobre la reducción del catastrofismo ante el dolor y la intensidad del dolor en sujetos con artrosis sintomática de rodilla, pendientes de una AR y que presenten altos niveles de catastrofismo

Postoperative Psychological Predictors for Chronic Postsurgical Pain After a Knee Arthroplasty: A Prospective Observational Study

Objective Chronic postsurgical pain is a significant adverse effect shown in around 20% of people who had undergone a knee arthroplasty. Psychological risk factors emerged as significant and potentially modifiable risk factors for its development. However, there is still little evidence when assessing these factors during the acute postoperative period. This study aimed to assess the predictive value of postoperative pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes in developing chronic postsurgical pain after knee arthroplasty. Methods A 6-month follow-up prospective observational study design was used. The study sample comprised 115 people who underwent a knee arthroplasty due to painful primary osteoarthritis. Measures of pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes were obtained 1 week after surgery. Chronic postsurgical pain was set at an intensity of ≥30 using a 100-mm visual analog scale 3 and 6 months after surgery. Results Analysis revealed that baseline pain intensity, pain catastrophizing, pain-related fear of movement, anxiety, depression, and maladaptive pain attitudes were significant predictors of chronic pain at 3 and 6 months after surgery in a univariate analysis. However, at 3 months after surgery, only pain intensity and pain catastrophizing were predictors in the final multivariate model forecasting disturbing pain. Moreover, 6 months after surgery, pain intensity and distrust in medical procedures remained independent predictors. Most of the psychological factors can be grouped into a single dimension defined as pain-related psychological distress. Conclusion The results suggest that postoperative pain intensity, pain catastrophizing, and pain attitudes are independent predictors for chronic postsurgical pain after knee arthroplasty. Impact Postoperative cognitive and emotional factors should be considered alongside pain intensity during postoperative rehabilitation after knee arthroplasty since they could influence the development of chronic postsurgical pain

Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Knee arthroplasty (KA) is a typically successful surgical procedure commonly performed to alleviate pain in participants with end-stage knee osteoarthritis. Despite its beneficial effects, a significant proportion of individuals with KA continue experiencing persistent pain and functional limitations. The purpose of this study was to assess the postoperative outcomes after KA in relation to postoperative pain catastrophizing. Methods. Participants were recruited at a domiciliary physiotherapy service, using a prospective, observational, hypothesis-generating cohort design. Participants were divided into two groups based on their Pain Catastrophizing Scale (PCS) total score (50th percentile), which resulted in high and low PCS groups. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, quality of life, walking speed, physical performance, range of motion, and pain were measured. Outcome measures were collected at baseline (1 week postoperatively) and at follow-up (1, 3, and 6 months postoperatively). Results. A total of 60 participants (21 total KA and 39 unicompartmental KA) were recruited. Individuals with a higher degree of pain catastrophizing showed significantly higher WOMAC total scores at every follow-up, indicating poorer health functioning (p 0.05). Conclusion. The results of the present study suggest that participants with high postoperative pain catastrophizing might have poorer outcomes during the rehabilitation process after KA. Future work should seek to clarify if this relationship is causal

Effectiveness of Virtual Reality on Postoperative Pain, Disability and Range of Movement after Knee Replacement: A Systematic Review and Meta-Analysis

Postoperative pain after knee arthroplasty (TKA) is a reality that continues to be experienced today. Recently, virtual reality (VR) has demonstrated effectiveness in the management of pain. Our aim was to review the original controlled trials evaluating the effectiveness of VR for pain management and quality of life after TKA. Six databases were searched for articles published from inception to September 2023, following (PRISMA) guidelines. The methodological quality was assessed using the Risk of Bias tool for Randomized Trials (ROB2). Five RCTs were included in the systematic review, and four of them in the meta-analysis. The effectiveness of VR for short term pain relief was superior compared to the control (MD = −0.8 cm; CI 95%: −1.3 to −0.4; p p p = 0.049). However, no differences were found in the effect on the ROM between groups (MD = 3.4 grades; CI 95%: −6.0 to 12.8, p = 0.48). Our findings suggest that the use of virtual reality during the postoperative period could be an effective non-pharmacological therapy in relieving acute pain, compared to a control intervention, with a very low degree of certainty according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). However, the low methodological quality of the articles limits our findings

Effectiveness of virtual reality on functional mobility during treadmill training in children with cerebral palsy: a single-blind, two-arm parallel group randomised clinical trial (VirtWalkCP Project)

IntroductionTreadmill training and virtual reality have been investigated in children with cerebral palsy. However, few studies have assessed the effectiveness of the combination of both treatments on children's functional and balance activities. The project aims to compare the effects of treadmill training with and without virtual reality on walking endurance and speed, static and dynamic balance, gross motor function, functional independence, quality of life and occupational participation in children with spastic cerebral palsy between the ages of 4 and 12 years classified at levels I, II and III of the Gross Motor Function Classification System. Methods and analysisThis study is a single-blind, two-arm parallel group, randomised, controlled clinical trial. Participants will be recruited at the Pediatric Department of the Vic Hospital Consortium, and the research will be conducted at the University of Vic - Central University of Catalonia. The participants will be randomly allocated into two groups: (1) the experimental group, which will receive the treadmill training at the same time as the virtual reality; and (2) the control group, which will undertake treadmill gait training alone. The training will be provided in 10 sessions over 2 weeks with 30min for each session. Assessments will be performed on three occasions: 1week before the intervention, 1week following the intervention and 1month after the end of the intervention. The evaluations will involve the 6min walk test, stabilometry, the Berg Balance Scale, the 10 m walk test, the Gross Motor Function Measure, the Functional Independence Measure, the paediatric quality of life inventory and the Children Participation Questionnaire. For between-within group comparison, a mixed-effect linear model will be used. Ethics and disseminationThe study has been approved by the Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (2021061). Results will be published in peer-reviewed journals and presented at international conferences. Trial registration numberNCT05131724

A feasibility study of home-based preoperative multimodal physiotherapy for patients scheduled for a total knee arthroplasty who catastrophize about their pain

Background Preoperative pain catastrophizing (PC) and pain are both risk factors for poor outcomes after a total knee arthroplasty (TKA). Despite that, there is limited evidence about physiotherapy interventions' effectiveness on addressing such factors. Purpose To evaluate the feasibility and clinical impact of a home-based multimodal physiotherapy intervention in reducing pain and PC, in patients scheduled for a TKA who present preoperative moderate-to-severe pain and PC. Methods Three-armed parallel-group randomized controlled feasibility study. Subjects with symptomatic osteoarthritis and a score of >= 20 on the Pain Catastrophizing Scale (PCS) were recruited. The control group received usual care. Both experimental groups received pain neuroscience education, coping skills training and therapeutic exercise, but differ in the number of sessions, dosage, hands-on approach, and grade of supervision. All outcomes were measured before and after the intervention. Results A total of 33,7% were eligible for inclusion, and 97,1% agreed to participate. Every participant completed the treatment. Treatment compliance was higher in the group with additional supervision. Both groups showed significant effects in PC and pain reduction. A total of 33 patients would be required for a full trial. Conclusion Preoperative physiotherapy is a feasible and effective treatment in reducing pain intensity and PC in high PCS osteoarthritis subjects scheduled for a TKA.Part of Hector Beltran-Alacreu'ssalary is financed by the European Regional Development Fund (2020/5154)

A Sytematic review

ReviewTo perform a systematic review of the literature to investigate the influence of psychosocial factors on pain and functional outcomes after knee arthroplasty from 6 months after surgery. Methods: Studies were included if they were prospective cohort observational studies. The subjects had to be middle aged or aged (mean age: 45 years) and have undergone total or unilateral knee arthroplasty. Studies should have recorded the influence of different psychosocial factors and the surgery outcomes had to be evaluated according to pain and/or function variables regardless of the tools used to measure them. In addition, outcome measures had to be recorded in the medium term (6 months) or the long term (12 months). Two reviewers assessed independently the MEDLINE, PsycINFO, and CINAHL databases to select observational studies. Results: Twenty-two studies with a total of 7156 patients (5349 females) were included in this review and the mean age was 67.92 years. Twenty-two studies included in this review showed a good average methodological quality (mean +/- SD: 7.22 +/- 0.92) on the Newcastle-Ottawa Scale for cohort studies. Conclusion: The evidence suggests that catastrophizing, kinesiophobia, anxiety, self-efficacy, and mental health are predictors of postoperative functional outcomes at 6 and 12 months after surgery. There is conflicting evidence on whether or not catastrophizing, anxiety, and depression are predictors of postoperative pain at 6 and 12 months after surgery

Postoperative psychosocial factors in health functioning and health-related quality of life after knee arthroplasty: A 6- month follow up prospective observational study

Knee arthroplasty (KA) is an effective and cost-effective treatment for end-stage knee osteoarthritis. Despite high surgical success rates, as many as 25% of patients report compromised postoperative functioning, persistent pain, and reduced quality of life. The purpose of this study was to assess the predictive value of psychological factors in health functioning and quality of life, during a 6-month period after KA. Design. A prospective observational study. Setting. Surgery at two hospitals and follow-up was carried out through the domiciliary rehabilitation service. Subjects. In total, 89 patients (age 70.2767.99 years) met the inclusion criteria. Method. A test battery composed of Health functioning associated with osteoarthritis (WOMAC), Health-related quality of life (EQ-5D-5L), Anxiety and Depression (HADS), Pain attitudes (SOPA-B), Pain catastrophizing (PCS), and Fear of Movement (TSK11) was assessed at 1 week, and 1, 3, and 6 months after surgery. A mixed effects linear model was used to estimate the effect of time and covariates. An exploratory factor analysis was used to identify the number of dimensions underlying the group of psychological measurements. Results. In WOMAC model, anxiety level (F - 120.8), PCS (F - 103.9), depression level (F - 93.6) and pain score (F - 72.8) were the most influential variables. Regarding EQ5D-5L model, anxiety level (F = 98.5), PCS (F - 79.8), depression level (F - 78.3) and pain score (F - 45) were the most influential variables. Pain score and the psychosocial variables of PCS, TSK, HADS-A, HADS-D, SOPA-B Emotion, SOPA-B Harm and SOPA-B Disability loaded in one single dimension. Conclusions. Postoperative acute pain and psychosocial factors of pain catastrophizing, anxiety, depression, and pain attitudes might influence health functioning and quality of life during KA rehabilitation. Such factors could be gathered into one single dimension defined as pain-related psychologic distress