Actividad física a través de la telerehabilitación en el cáncer de mama: Una revisión de la literatura

Cartel presentado en el 3er Congreso Internacional de Comunicación en Salud (3ICHC), celebrado los días 19 y 20 de octubre de 2017 en la Universidad Carlos III de Madrid.En 2015, los nuevos casos de cáncer de mama (CM) representaron un 29%, mientras que las mortalidades asociadas al cáncer representaron un 15% de todos los cánceres en mujeres 1. Por otro lado, se sabe que la inactividad física está asociada con un aumento de probabilidad de desarrollo de CM 2,3, mientras que la actividad física mejora la fatiga y la función física 4,5 en pacientes, y reduce el riesgo de recurrencia en supervivientes 3,6. Actualmente, se sabe que a través de la telerehabilitación se pueden obtener resultados comparables con los programas de rehabilitación tradicionales 7. Por tanto, el objetivo es revisar la bibliografía presente en la literatura científica sobre telerehabilitación para incentivar o promocionar la actividad física en pacientes o supervivientes de CM

Efecto del entrenamiento de fuerza en linfedema asociado al cáncer de mama (LACM): Una revisión de la literatura

Comunicación oral presentada en el 3er Congreso Internacional de Comunicación en Salud (3ICHC), celebrado los días 19 y 20 de octubre de 2017 en la Universidad Carlos III de Madrid.El objetivo de este trabajo es revisar la bibliografía de la literatura científica que se centre en el entrenamiento de fuerza en pacientes con LACM para presentar los hallazgos principales a los profesionales sanitarios del ámbito clínico, facilitando la consecuente comunicación a los pacientes de la evidencia actual sobre el tema

Estudio de la cinemática del miembro superior e inferior mediante sensores inerciales.

A través del conjunto de artículos recogidos en la presente Tesis se describe y analiza las variables relacionadas con el movimiento humano en distintas regiones corporales. Para el estudio del complejo articular del hombro, se eligió estudiar la abducción y flexión del hombro a través de los distintos segmentos corporales que lo conforman. Los dispositivos empleados para la medición de las variables cinemáticas fueron los sensores inerciales y el Smartphone. Por un lado, en el artículo I, se pudieron describir valores de referencia de movilidad en segmentos corporales y articulaciones en sujetos jóvenes sanos. En el artículo II, se pudieron observar diferencias entre sujetos sanos de distinto rango etario. Posteriormente el artículo III, con los sensores inerciales se pudo establecer diferencias cinemáticas entre sujetos asintomáticos y aquellos que presentan patología del hombro. En línea con el Smartphone, en el Artículo IV se obtuvieron valores descriptivos de la cinemática del húmero con el sensor embebido en un Smartphone. En el Artículo V, se validó una aplicación basada en imagen para medir el ángulo de abducción del brazo en sujetos sanos y patológicos, mostrando ser válida y fiable. La funcionalidad del complejo lumbo-pélvico-femoral se estudió a través de la prueba o Test “Sit-to-Stand” (STS), que representa el movimiento de levantarse de una silla. En el artículo VI, se profundizó en la actividad muscular y la fatiga durante la prueba STS a través de distintas variantes del test. Los resultados de este estudio permitieron establecer valores de referencia en sujetos sanos y analizar cómo varían las variables electromiográficas cuando se modifican las características de STS. Se demostró que la velocidad modifica la actividad muscular, y que se produce más fatiga a mayor número de repeticiones y velocidad. Por tanto, posteriormente los estudios se centraron en la variante más exigente de este test: 30-STS, levantarse tan rápido como sea posible el mayor número de veces durante 30 segundos. En el artículo VII, se buscó correlacionar la fatiga medida con electromiografía con la fatiga a través de la cinemática medida en el tronco con un Smartphone, no habiendo una correlación evidente. Posteriormente, en el artículo VIII, se decidió analizar la fatiga durante la prueba 30-STS a través de la aceleración como única variable proporcionada por un Smartphone situado en el esternón. Para ello, se analizaron esta vez los datos de aceleración, encontrándose un aumento del porcentaje de energía en el segundo 19 del test. Por tanto, de los resultados obtenidos en los estudios sobre el complejo articular del hombro y el complejo lumbopélvico-femoral en la presente Tesis se puede resumir que la cinemática del movimiento humano a través de variables inerciales ofrece al fisioterapeuta una potente herramienta aplicable al ámbito de evaluativo, diagnóstico y de tratamiento transferibles a la clínica a través de dispositivos de bajo coste como el Smartphone y, que, en conjunto con otras herramientas tales como cuestionarios auto-informados y electromiografía, permite abarcar más dimensiones dentro de la complejidad del movimiento humano

Three-Dimensional Kinematics during Shoulder Scaption in Asymptomatic and Symptomatic Subjects by Inertial Sensors: A Cross-Sectional Study

Shoulder kinematics is a measure of interest in the clinical setting for diagnosis, evaluating treatment, and quantifying possible changes. The aim was to compare shoulder scaption kinematics between symptomatic and asymptomatic subjects by inertial sensors. Methods: Scaption kinematics of 27 subjects with shoulder symptomatology and 16 asymptomatic subjects were evaluated using four inertial sensors placed on the humerus, scapula, forearm, and sternum. Mobility, velocity, and acceleration were obtained from each sensor and the vector norm was calculated from the three spatial axis (x,y,Z). Shoulder function was measured by Upper Limb Functional Index and Disabilities of the Arm, Shoulder, and Hand questionnaires. One way ANOVA was calculated to test differences between the two groups. Effect size was calculated by Cohen’s d with 95% coefficient Intervals. Pearson’s correlation analysis was performed between the vector norms humerus and scapula kinematics against DASH and ULFI results in symptomatic subjects. Results: The asymptomatic group showed higher kinematic values, especially in the humerus and forearm. Symptomatic subjects showed significantly lower values of mobility for scapular protraction-retraction (Cohen’s d 2.654 (1.819–3.489) and anteriorisation-posteriorisation (Cohen’s d 1.195 (0.527–1.863). Values were also lower in symptomatic subjects for velocity in all scapular planes of motion. Negative correlation showed that subjects with higher scores in ULFI or DASH had lower kinematics values. Conclusion: Asymptomatic subjects tend to present greater kinematics in terms of mobility, velocity, and linear acceleration of the upper limb, and lower humerus and scapula kinematics in symptomatic subjects is associated with lower levels of functionThis research received no external funding. Partial funding for open access charge: Universidad de Málag

Thermal Characterization of Conductive Filaments in Unipolar Resistive Memories

A methodology to estimate the device temperature in resistive random access memories (RRAMs) is presented. Unipolar devices, which are known to be highly influenced by thermal effects in their resistive switching operation, are employed to develop the technique. A 3D RRAM simulator is used to fit experimental data and obtain the maximum and average temperatures of the conductive filaments (CFs) that are responsible for the switching behavior. It is found that the experimental CFs temperature corresponds to the maximum simulated temperatures obtained at the narrowest sections of the CFs. These temperature values can be used to improve compact models for circuit simulation purposesConsejería de Conocimiento, Investigación y Universidad, Junta de Andalucía (Spain)FEDER B-TIC-624-UGR20. M.B.GRamón y Cajal RYC2020-030150-

Variability and power enhancement of current controlled resistive switching devices

characterized using both current and voltage sweeps, with the device resistance and its cycle-to-cycle variability being analysed in each case. Experimental measurements indicate a clear improvement on resistance states stability when using current sweeps to induce both set and reset processes. Moreover, it has been found that using current to induce these transitions is more efficient than using voltage sweeps, as seen when analysing the device power consumption. The same results are obtained for devices with a Ni top electrode and a bilayer or pentalayer of HfO2/Al2O3 as dielectric. Finally, kinetic Monte Carlo and compact modelling simulation studies are performed to shed light on the experimental resultsConsejería de Conocimiento, Investigaci´on y Universidad, Junta de Andalucía (Spain)FEDER program for the project B-TIC-624-UGR20Spanish Consejo Superior de Investigaciones Científicas (CSIC) for the intramural project 20225AT012Ramón y Cajal grant No. RYC2020-030150-I

Feasibility Study of a Proton Irradiation Facility for Radiobiological Measurements at an 18 MeV Cyclotron

A feasibility study of an experimental setup for the irradiation of biological samples at the cyclotron facility installed at the National Centre of Accelerators (Seville, Spain) is presented. This cyclotron, which counts on an external beam line for interdisciplinary research purposes, produces an 18 MeV proton beam, which is suitable for the irradiation of mono-layer cultures for the measurement of proton cell damages and Relative Biological Effectiveness (RBE) at energies below the beam nominal value. Measurements of this kind are of interest for proton therapy, since the variation of proton RBE at the distal edge of the Bragg curve may have implications in clinical proton therapy treatments. In the following, the characteristics of the beam line and the solutions implemented for the irradiation of biological samples are described. When dealing with the irradiation of cell cultures, low beam intensities and broad homogeneous irradiation fields are required, in order to assure that all the cells receive the same dose with a suitable dose rate. At the cyclotron, these constraints have been achieved by completely defocusing the beam, intercepting the beam path with tungsten scattering foils and varying the exit-window-to-sample distance. The properties of the proton beam thus obtained have been analysed and compared with Monte Carlo simulations. The results of this comparison, as well as the experimental measurement of the lateral dose profiles expected at the position of samples are presented. Meaningful dose rates of about 2–3 Gy/min have been obtained. Homogeneous lateral dose profiles, with maximum deviations of 5%, have been measured at a distance of approximately 50 cm in air from the exit window, placing a tungsten scattering foil of 200 μm in the beam path

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

Validation of the upper limb functional index on breast cancer survivor

Breast cancer survivors (BCS) may face functional alterations after surgical intervention. Upper Limb Disorders (ULDs) are highly prevalent even years after a diagnosis. Clinicians may assess the upper limbs after breast cancer. The Upper Limb Functional Index (ULFI) has been validated across different populations and languages. This study aimed to assess the psychometric properties of the Upper Limb Functional Index Spanish version (ULFI-Sp) in the BCS. Methods: A psychometric validation study of the ULFI-Sp was conducted on 216 voluntary breast cancer survivors. The psychometric properties were as follows: analysis of the factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). Results: The factor structure was one-dimensional. ULFI-Sp showed a high internal consistency for the total score (α = 0.916) and the regression score obtained from MLE (α = 0.996). CFA revealed a poor fit, and a new 14-item model (short version) was further tested. The developed short version of the ULFI-SP is preferable to assess upper limb function in Spanish BCS. Conclusions: Given the high prevalence of ULD in this population and the broader versions of ULFI across different languages, this study’s results may be transferred to clinical practice and integrated as part of upper limb assessment after breast cancer.Partial funding for open access charge: Universidad de Málag