The Effect of Proprioception Training on Pain Intensity in Thumb Basal Joint Osteoarthritis: A Randomized Controlled Trial

A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) postintervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance.His research was partially funded by University of Málaga Spain. Partial funding for open access charge: Universidad de Málag

Validation of pain catastrophizing scale on breast cancer survivor

Introduction: Pain catastrophizing scale (PCS) is the most used scale to measure pain catastrophizing. In breast cancer survivors (BCS), pain catastrophizing is related to upper-limbs dysfunction and disability. This study aimed to assess the internal consistency, internal structure, and convergent validity of the Spanish version of the PCS in Spanish BCS. Material and Methods: Breast cancer survivors were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The psychometric properties were evaluated with analysis factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). Results: Factor structure was three-dimensional, and one item was removed due to cross-loading. The new 12-item PCS showed a high internal consistency for the total score (α = 0.91) and a good homogeneity, and CFA revealed a satisfactory fit. PCS showed an acceptable correlation with FACS (r =0.53, p <0.01). Conclusion: Pain catastrophizing scale is a valid and reliable instrument to evaluate pain catastrophizing in Spanish BCS. This tool may help clinicians in the management of pain by assessing pain and by measuring the effect of interventions.This work was partially supported by Novartis Oncology [Contract N° PS16060 in IBIMA between Novartis-IBIMA, (Translation Research in Cancer B-01 & Clinimetric F-14)]. Funding for open access charge: Universidad de Málaga / CBU

Tratamientos psicológicos empíricamente apoyados para adultos: Una revisión selectiva

Antecedentes: los tratamientos psicológicos han mostrado su eficacia, efectividad y eficiencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científico generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda. Background: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help

Analisis clinimétrico de la actividad y la condición física en terapia ocupacional en poblaciones especiales

La tesis aborda un análisis clinimétrico tanto de la actividad como de la condición física en poblaciones especiales seleccionando para ello adultos con discapacidad intelectual debido a los bajos niveles de actividad física encontrados en esta población y a la gran cantidad de problemas a los que debe hacer frente esta población a la hora de realizar actividad física, y por otro lado se seleccionaron personas que habían sufrido un accidente cerebrovascular ya que en estas personas la pérdida de equilibrio es una de las secuelas principales con las que tienen que convivir día a día. La presente tesis doctoral es dividirá en tres partes para representar mejor los resultados; siendo estas: resultados de las variables objetivas, resultados de las variables subjetivas e investigación clínica. En la primera parte se analiza el test de equilibrio estático en personas que han sufrido accidente cerebrovascular con la ayuda de sensores inerciales y estos datos son comparados con poblaciones sanas de diferentes edades utilizando la misma metodología. En la segunda parte se llevó a cabo diferentes análisis para conocer la correlación y la concordancia en la medición de la actividad física con diferentes herramientas como son las escalas autoadministradas y los acelerómetros en adultos con discapacidad intelectual. En el último capítulo son analizados los cambios que fueron encontrados en una población con discapacidad intelectual tras llevar a cabo una intervención multimodal que combinó actividad física y educación y posteriormente una intervención para teléfonos móviles cuya función era actuar a modo recordatorio para la realización de actividad física

Intervención de la terapia ocupacional en rizartrosis: revisión bibliográfica

Objective: This review aims to identify the effects of different occupational therapy interventions in patients suffering from osteoarthritis of first carpometacarpal joint, to know the types of treatments available for occupational therapists, and to establish various tests and standardized scales that can be applied in the assessment of this condition. Methods: A literature review was carried out using five databases. Articles related to our study, which had been published in the last ten years (June 2007- June 2017) in English or Spanish, were examined. An additional criterion was selecting samples with patients aged between 18 and 65. Results: A total of eight articles were assessed in which occupational therapy has proved to have beneficial effects on maintaining the dynamic stability of the trapeziometacarpal joint, using different techniques such as joint protection, orthotic treatment, treatment of fine motor skills and manual exercises with the aim to improve joint range and muscle strength. Conclusion: There are some discrepancies about which method of treatment is the most appropriate as well as a consensus regarding the application of these therapies. In addition, the assessment tools for this pathology have been tested, these being the Visual Analog Scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH), the Australian Canadian Osteoarthritis Hand Index (AUSCAN), the Purdue Pegboard and the O’Connor test.Objetivos: conocer los efectos de diferentes intervenciones de terapia ocupacional en las personas con rizartrosis, averiguar los tipos de tratamiento que puede realizar un terapeuta ocupacional con personas que sufren rizartrosis e identificar los diferentes tests y escalas estandarizadas que un Terapeuta Ocupacional puede utilizar para conocer la valoración de la mano con rizartrosis. Métodos: se realizó una revisión bibliográfica utilizando 5 bases de datos. Fueron seleccionados aquellos artículos relacionados con nuestra pregunta de estudio (tratamiento de la rizartrosis desde la terapia ocupacional) y que habían sido publicados en los últimos diez años (junio 2007-julio 2017) en inglés o en español y los sujetos comprendían una edad entre 18-65 años. Resultados: fueron evaluados un total de 8 artículos en los cuales la terapia ocupacional ha mostrado efectos beneficiosos en el mantenimiento de la estabilidad dinámica de la articulación trapeciometacarpiana, utilizando diferentes técnicas como protección articular, tratamiento ortésico, tratamiento en habilidades motoras finas y ejercicios manuales con el fin de mejorar rango articular y fuerza muscular. Conclusión: existen discrepancias sobre qué método de tratamiento es el adecuado así como un consenso en cuanto a la aplicación de dichas terapias. Además de ello, se han analizado las herramientas para la evaluación de dicha patología, siendo estas, la Escala Visual Analógica (EVA), el DASH (Disabilities of the arm, shoulder and hand), el AUSCAN (Australian Canadian Osteoarthritis Hand Index) , el Purdue Pegboard y la prueba de O´Connor

Comunicación en terapia ocupacional

In the following critical review, an opinion article by anthropologist Gregory Bateson, which aims to show how important is both the treatment modality and the professional's ability to communicate in a positive way in the intrinsic change of the person. Through its reading, other reflections can be detected, such as the identity of the profession, the birth of the profession and its context, the paradigms throughout its history, all the changes that have occurred and its causes and, above all, the moment in which that we are and where we are heading without losing the essence of occupational therapy, which differentiates us from other professionals, instead of getting closer and closer to them.En la siguiente recesión se presenta un artículo del antropólogo Gregory Bateson, que pretende mostrar cuán importante es tanto la modalidad del tratamiento como la capacidad de comunicación del profesional para incidir de manera positiva en el cambio intrínseco de la persona. A través de su lectura se pueden extraer otras reflexiones como son la identidad de la profesión, el nacimiento de la misma y su contexto, los paradigmas a lo largo de su historia, todos los cambios acontecido y sus causas y sobre todo el momento en el que estamos y hacia donde queremos dirigirnos sin perder la esencia de la terapia ocupacional, lo que nos diferencia del resto de profesionales, en vez de acercarnos cada vez más a ellos

Calidad de vida y autonomía en las actividades de la vida diaria en personas con lesión medular

Objective: The aim is to evaluate the autonomy and quality of life, as well as factors that may affect these components. Methods: An Observational, cross-sectional study were performed. The Barthel index and the EQ-D scale were used to assess the dependence and the quality of life. Pain and sociodemographic data were evaluated too. Descriptive statistics Student's t test and one-way ANOVA were carried out Results: 99 participants were included in the study, 42.1% had tetraplegia and 57.9% paraplegia which 53.1% were incomplete. Significant differences were found between paraplegia and tetraplegia in Barthel Index and quality of life and between the level of injury. Conclusions: The spinal cord injury level affects the independence of patients, which is a key factor in their quality of life. Nevertheless, the self-perception of their quality of life is not seemed to be affected by the independence, level of the injury or pain.Objetivos: el objetivo de este estudio es evaluar la autonomía y la calidad de vida. Métodos: estudio observacional, trasversal, analítico. Se evaluó en nivel de dependencia con el Índice de Barthel y la calidad de vida con la escala EQ-5D, así como el dolor, y datos sociodemográficos. Se realizaron estadísticos descriptivos, prueba tStudent y ANOVA de un factor. Resultados: un total de 99 participaron, un 42’1% presentaron tetraplejia y un 57’9% paraplejia, un 53,1% fueron lesiones incompletas. Se encontraron diferencias significativas entre paraplejia y tetraplejia en Índice de Barthel y calidad de vida, así como una relación entre las mismas y el nivel de lesión. Conclusiones: el nivel de la lesión afecta a la independencia de las personas con lesión medular, y esto a su vez es un factor clave en su calidad de vida, sin embargo, la independencia, nivel o dolor parece no afectar a la autopercepción de su calidad de vida

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: The role of gender (EMITRAL study).

BACKGROUND AND OBJECTIVES: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. METHOD: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. RESULTS: Vitamin D deficiency (25OHD3<15ng/ml) was more common in female recipients at CKD-T stages I-III (29.6% vs 44.4%; p=0.003). The inverse and significant correlation between 25OHD3 and PTH was gender-specific and women exhibited a steeper slope than men (p=0.01). Vertebral fractures (VFx) with deformity grade ≥2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01-1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6-6.3); in females, age (OR 1.07; 95% CI: 1.03-1.12) and PTH levels (OR per 100pg/ml increase: 1.27; 95% CI: 1.043-1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. CONCLUSIONS: Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: the role of gender (EMITRAL study)

Background and objectives: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. Method: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. Results: Vitamin D deficiency (250HD(3) = 2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01-1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6-6.3); in females, age (OR 1.07; 95% CI: 1.03-1.12) and PTH levels (OR per 100 pg/ml increase: 1.27; 95% CI: 1.043-1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. Conclusions: Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients. (C) 2016 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: the role of gender (EMITRAL study)

Background and objectives: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. Method: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. Results: Vitamin D deficiency (250HD(3) = 2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01-1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6-6.3); in females, age (OR 1.07; 95% CI: 1.03-1.12) and PTH levels (OR per 100 pg/ml increase: 1.27; 95% CI: 1.043-1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. Conclusions: Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients. (C) 2016 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U