Comparison between Three Therapeutic Options for the Treatment of Balance and Gait in Stroke: A Randomized Controlled Trial

Stroke patients are more likely to be at risk of falling, which leads to limitation in their abilities to perform daily living activities and participate in society. The aim was to compare the relative effectiveness of three different treatment groups for improvements in postural control and for improvements in balance. Forty-five participants diagnosed with acquired brain injury, with over one year’s evolution, were divided into a dry land therapy group (control group), an experimental group (Ai Chi aquatic therapy), and a combined group (therapy on dry land and aquatic therapy with Ai Chi). The Berg balance scale, tandem stance, the timed up and go test, and the five times sit-to-stand test were used. After twelve weeks of treatment, the results improved significantly for the combined therapy group (p < 0.01), and were significantly higher compared to the dry land therapy group (p < 0.01). In addition, improvements were also found in the aquatic Ai Chi therapy group. In conclusion, aquatic Ai Chi and/or the combination of aquatic therapy with dry land therapy is effective for the improvement of static and dynamic balance and for enhancing functional capacity, therefore, increasing the quality of life of acquired brain injury patients

Protocol of Action in Injuries of the Long Head of the Biceps Tendon. Joint Reference Values and Recommended Training Weight for the Recovery of Joint Range and Strength

Daily and sports activities can be affected by joint injury. The objectives of physical therapy are to help patients regain range of motion (ROM), mobility, strength, and function. The purpose of this study was to examine the optimal joint range of elbow flexion and recommended training weight for the recovery of biceps brachii muscle strength. It was a prospective study with a sample of 157 healthy young adult volunteers from two institutions. The Hawk goniometer was used for measurements. Participants performed a flexion-extension movement of the elbow in standing, in series, with progressive loads. The ROM in males was found to be higher than in females. Nevertheless, the joint values of the dominant and non-dominant arm indicate that there are differences between both arms, regardless of gender. In relation to the force used during the performance of the activity, the weight used by the women was lower than that of the men, whereas, during the execution, women showed greater stability throughout the test, compared to men. Normative values have been established for the ROM and weights to be used in the recovery process of injuries to the long tendon of the biceps brachii muscle

Use of a Portable Inertial Measurement Unit as an Evaluation Method for Supraspinatus Muscle: Proposed Normative Values

Treatment protocols do not specify an appropriate weight for rehabilitating the shoulder joint. The purpose of this study was to establish normative values for the shoulder abduction range of motion and recommended weights to be used in the rehabilitation process after injury to the supraspinatus muscle. Fifty-eight volunteers were assessed using the DyCare system. A test was conducted by lifting the arm to a 90° angle and having the participants lift different weights. The range of motion was similar for both sexes, suggesting that sex had no influence on this variable. Regarding the use of weights, men did not show as much stability in their movement execution, with a high dispersion seen in values between zero and three kilograms of weight, reaching a maximum weight of six kilograms. However, women showed good joint stability from the beginning of the test, with values that remained constant as weight increased up to a maximum of five kilograms. In conclusion, no major differences were observed in supraspinatus muscle injury recovery according to sex. However, differences were observed in the amount of weight that was necessary and appropriate to allow the participants to recover their muscular strength and avoid relapses

Influence of an Aquatic Therapy Program on Perceived Pain, Stress, and Quality of Life in Chronic Stroke Patients: A Randomized Trial

Pain and depressive states may have a negative impact on the quality of life of individuals with stroke. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression, and quality of life in a sample of people with stroke. Forty-five participants received physiotherapy treatment on dry land (control group), an experimental group received aquatic Ai Chi therapy, and a combined therapy group received alternating sessions of physiotherapy on dry land and aquatic Ai Chi therapy. The Visual Analog Scale (VAS) scale for pain, the resilience scale, and the SF-36 quality of life scale were used as outcome measures. Statistically significant differences were found in the experimental group and the combined intervention group for post treatment pain and resilience (p < 0.001). Concerning the SF-36, statistically significant changes (p < 0.01) were found in the experimental group and the combined therapy group for all items except general health, vitality, and social function, where no between group differences were observed (p = 0.001). In conclusion, physical exercise performed in water has positive effects on several factors that contribute towards improving the mood and quality of life of people with acquired brain injury

Validation and Application of a Spanish Version of the ALR-RSI Scale (Ankle Ligament Reconstruction—Return to Sport after Injury) in an Active Non-Athlete Population

The most recent scale to quantify psychological readiness before returning to sport is the ALR-RSI (Ankle Ligament Reconstruction—Return to Sport after Injury) scale. The aim of this study was the cross-cultural adaptation to Spanish and application of the ALR-RSI scale in a sample of active people who were not professional athletes, and to carry out an initial psychometric analysis of the functioning of the instrument in this sample. The sample consisted of 257 participants (161 men and 96 women) aged between 18 and 50 years. The adequacy of the model obtained in the exploratory study was confirmed, obtaining a model composed of one factor and 12 indicators in total. The estimated parameters were statistically significant (p < 0.05), and the factor loadings presented values higher than 0.5; thus, all indicators revealed a satisfactory saturation in the latent variable (convergent validity). Regarding internal consistency, the Cronbach’s alpha value was 0.886 (excellent internal consistency). This study demonstrated that the ALR-RSI in Spanish is a valid and reproducible scale for evaluating psychological readiness to return to non-professional physical activity after ankle ligament reconstruction in the Spanish population

Effect of an Aquatic Balance-Training Program in Patients with Chronic Stroke: A Single-Group Experimental Pilot Study

Background and Objectives: Stroke survivors face severe problems affecting their mobility, such as balance impairments and an increased risk of falls. The principal aim of this study was to quantify the effects of 12 sessions of Halliwick aquatic therapy for the treatment of balance in patients with chronic stroke. Materials and Methods: Twenty-nine people with stroke participated in this single-group experimental pilot study. Sessions were performed three times a week for a total of 12 sessions. A stabilometric assessment was conducted using a computerized platform. The evaluations were performed at baseline, at four weeks, and one month after completing the aquatic program. Results: The results obtained revealed significant differences for postural stability values (p < 0.001) and single-leg stabilometry. However, in the case of values within the limits of stability, such as forward (F = 0.339, p = 0.676), backward (F = 0.449, p = 0.644), forward right oscillations (F = 1.637, p = 0.21), and the anterior/posterior instability index (F = 0.614, p = 0.55), no significant differences were found. Conclusions: These findings suggest that Halliwick therapy may potentially improve stroke balance impairments. The main limitations of the study were the sample size, the lack of a control group, and the study not being blind

Parents’ Perceptions Regarding the Implementation of a Physical Therapy Stimulation Program for Children with Disabilities in Bolivia: A Qualitative Study

The purpose of this study was to explore how parents of children with neuromotor disorders in the department of Chuquisaca (Bolivia) perceive attendance to a physical therapy stimulation program and the expectations they place on the therapy and professional care provided to their children. Semi-structured interviews were conducted with the parents, related to their role in supporting the recommended exercise program for the child, generating topics such as benefits of the therapy for the child, impact on the family, and role of the project in terms of therapy and the physical therapists providing treatment, including both positive and negative aspects of the overall process. This study revealed the importance of understanding the feelings of families receiving intervention under a pioneering program in Bolivia for the detection and treatment of children with neuromotor disorders. Being able to access these types of services provides them with extensive personal, social, and economic support. Knowing their concerns, desires, and demands will allow us to continue to improve and offer the best care for children and families. The professionals involved should also be encouraged to develop effective teaching techniques to promote the inclusion of parents in the stimulation program

Formación continua transdisciplinaria para la detección y atención al riesgo de trastornos del neurodesarrollo en menores de cinco años

Continuous education is important in order to improve health practices and infant education. The goal of this paper was to evaluate the impact of a trans disciplinary continuous formation model in order to detect neurodevelopment and psychosocial disorders in five and under year old living in Sucre and Chuquisaca provinces. 458 health professionals, technicians, and medical interns were interviewed for this purpose. A survey was made after twenty-five sections of formation during 2016-2017. The questions of the survey were related to topics referred to such a formation section. The findings show the importance of the new topics, the necessity of more formation regarding the diagnosis scales and the knowledge on family and community therapies, this aspect was detected mostly in rural areas, which have less possibilities of accessing to continuous formation. To finish, it is important to point out that the trans disciplinary cyclical formation model allowed refreshing knowledge, sharing experiences, to dialogue different kinds of knowledge, and to integrate collaborative work among peers, so the health service among 5 years old would be optimized.La formación continua es fundamental para la mejora de las buenas prácticas en salud y educación infantiles, el objetivo de la investigación fue evaluar el impacto de un programa de formación continua transdisciplinaria para la detección y atención del riesgo en los trastornos del neurodesarrollo en menores de 5 años de edad en Chuquisaca, Bolivia. Metodología. Siguiendo un enfoque cualitativo se aplicó encuestas luego de la participación en veinticinco ciclos de formación continua durante las gestiones 2017 y 2018 en el marco de un proyecto de cooperación interuniversitaria a una muestra de 458 profesionales, técnicos de los municipios del departamento y estudiantes universitarios. El instrumento contenía preguntas referidas a las temáticas expuestas en los ciclos tomando en cuenta las variables de novedad, aplicabilidad, profundidad, importancia de conocimientos teóricos, conocimientos prácticos, estudios de caso y demandas de formación en su campo de trabajo. Los resultados muestran respuesta favorable en cuanto a la novedad de los temas, profundidad en el manejo de escalas de diagnóstico y conocimientos en terapia, trabajo con familia e intervención comunitaria con énfasis en los entornos rurales donde los profesionales tienen menor acceso a recibir educación continua. Las conclusiones muestran que el programa de ciclos de formación continua tuvo un impacto favorable en cuanto a la actualidad, la practicidad y la revisión de estudios de caso como puntos fuertes en la mejora de los niveles de atención primaria en salud en menores en situación de riesgo

Factors and Beliefs that Condition the Attitude of Health Science Students towards End of Life in Spain and Bolivia: A Multicenter Study

Health Science students in Spain and Bolivia should be trained in the management of the processes of death and dying of patients. The aim of this study was to examine the degree of training, self-perceived safety and preferences in relation to the care of terminal and non-terminal patients. It was a descriptive, cross-sectional, multicenter study with students of Medicine, Nursing and Physiotherapy in Spain and Bolivia. The following variables were evaluated: care preparation and emotional preparation to caring for terminally ill and non-terminally ill patients, the Death Attitude Profile Revised (PAM-R) and the Bugen Scale for Facing Death. The self-perceived preparation of students for caring for terminally ill patients can be considered “fair” (mean 2.15, SD 0.756), and this was also the case for their perceived emotional preparation (mean 2.19, SD 0.827). In contrast, the score obtained for their preparedness for treating non-terminal patients was higher (mean 2.99 and 3.16, respectively). Working with terminally ill patients, including terminal or geriatric cancer patients, was the least preferred option among future health professionals. The results obtained show a limited preference for end-of-life care and treatment, highlighting a lack of preparation and motivation among health science students in Spain and Bolivia for working with these patients

Study of Psychomotor Development and Environmental Quality at Shelter Homes for Children Aged 0 to 2 in the Department of Chuquisaca (Bolivia)

Children in situations of destitution who become institutionalized commonly display developmental disorders, including delayed growth. The aim was to evaluate the environmental quality of the casas cuna of the Department of Chuquisaca (Plurinational state of Bolivia) in children aged 0 to 2 years old after receiving an early stimulation program based on psychomotor therapy. Thirty-six children who were institutionalized at shelter homes in the Department of Chuquisaca were selected to receive sessions of psychomotricity over a five-month period. The Infant/Toddler Home Observation for Measurement of the Environment (IT-HOME) scale and the Attachment During Stress Scale (ADS) were used. The adult−child relationship with factors of responsiveness (−0.89; p = 0.037), acceptance (0.57; p = 0.024), organization (−1.03; p < 0.001), learning material (−2.57; p < 0.001) and involvement (−1.92; p < 0.001) scored below expectations, showing that environmental indicators are a poor stimulation for children growing up in shelter homes. Improvements were found in the children’s development after receiving this therapy. In conclusion, an early stimulation program based on psychomotor therapy over five months provided favorable results for the acquisition of skills for communication, motor development and social skills, which positively affect the psychomotor development