Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: a cross-sectional study

[EN] Study design: Cross-sectional study. Objectives: To determine the prevalence of, and factors associated with, spinal pain among wheelchair users. Setting: Four Spanish hospitals specialized in providing care for wheelchair users. Methods: Persons who had used a wheelchair for a median (IRQ) of 10 (5;19) years, 27% of them due to reasons other than spinal cord injury, were recruited consecutively (n = 750). Data on 43 demographic, psychosocial, ergonomic, and clinical variables were collected, and analyzed. Main outcome measures were: Point prevalence of neck (NP), thoracic (TP), low back pain (LBP), and pain at any spinal level (PASL); and factors associated with them. Results: Point prevalence was 56% for NP, 54% for TP, 45% for LBP, and 76% for PSAL. PASL was associated with a lower quality of life (OR (95% CI) 0.91 (0.86; 0.97)). Multivariable regression models showed that the main factors associated with significant pain (≥1.5 VAS points) were: (a) For NP: Cervical spinal injury and wheelchair seat cushion thickness, (b) For TP: Thoracic spinal injury and sagittal index, (c) For LBP: Thoracic or lumbar spinal injury, with some sensitivity remaining, (d) For PASL: Being female, living alone, and using a non-power wheelchair. Discrimination (AUC) of these models ranged between 0.638 and 0.818. p-values in the Hosmer-Lemeshow test ranged between 0.420 and 0.701. Conclusions: Prevalence of spinal pain among wheelchair users is high. It is associated with a lower quality of life. Future studies should assess whether using a power wheelchair affects PASL, and if the thickness of seat cushion affects NP. Sponsorship: Spanish Back Pain Research NetworkS

The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial

[EN] Background: The relationship between fragility and neurological diseases is extensive and affects many patients with multiple sclerosis (MS), whose risk factors are related to fragility. Objective: To study the effects of exercise and transcranial direct current stimulation (tDCS) in MS patients with fatigue from four dimensions: functional mobility, balance, fatigue, and depression. Methods: A total of 12 patients who belonged to two associations of people with physical disabilities participated. Functional mobility, depression, balance, and fatigue were assessed before and after the intervention. Transcranial direct current stimulation and the exercise program were carried out over a 4-week period with a wash-out period of 5 months. Results: After the application of tDCS, we found significant improvements in balance (p < 0.05, g = 0.632), depression (p < 0.05, g = 0.402), functional mobility (p < 0.05, g = 0.297), and fatigue (p < 0.05, g = 0.526). After the exercise program, significant improvements were shown in balance (p < 0.01, g = 0.418), depression (p < 0.001, g = 0.540), functional mobility (p < 0.01, g = 0.262), and fatigue (p < 0.01, g = 0.742). Two-way mixed-measures ANOVA showed that all variables improved in both groups, with significant differences over time but not between groups. Secondary analysis showed significant correlations between balance and functional mobility (r = 0.671, p = 0.017), depression and fatigue (r = 0.586, p = 0.044) and between intensity of rehabilitation and balance (r = 0.622, p = 0.031). CONCLUSION: Participating in an exercise program and receiving tDCS separately improved the variables of depression, balance, mobility, and fatigue.S

Might exogenous circular RNAs act as protein-coding transcripts in plants?

[EN] Circular RNAs (circRNAs) are regulatory molecules involved in the modulation of gene expression. Although originally assumed as non-coding RNAs, recent studies have evidenced that animal circRNAs can act as translatable transcripts. The study of plant-circRNAs is incipient, and no autonomous coding plant-circRNA has been described yet. Viroids are the smallest plant-pathogenic circRNAs known to date. Since their discovery 50 years ago, viroids have been considered valuable systems for the study of the structure-function relationships in RNA, essentially because they have not been shown to have coding capacity. We used two pathogenic circRNAs (Hop stunt viroid and Eggplant latent viroid) as experimental tools to explore the coding potential of plant-circRNAs. Our work supports that the analysed viroids contain putative ORFs able to encode peptides carrying subcellular localization signals coincident with the corresponding replication-specific organelle. Bioassays in well-established hosts revealed that mutations in these ORFs diminish their biological efficiency. Interestingly, circular forms of HSVd and ELVd were found to co-sediment with polysomes, revealing their physical interaction with the translational machinery of the plant cell. Based on this evidence we hypothesize about the possibility that plant circRNAs in general, and viroids in particular, can act, under certain cellular conditions, as non-canonical translatable transcripts.This work was supported by the Spanish Ministry of Economy and Competitiveness (co-supported by FEDER) PID2020-115571RB-I00VP) and AGL2016-79825-R (GG), and by the Spanish Ministry of Science and Innovation (co-supported by FEDER) Grant PID2019104126RB-I00 (GG). JMM was the recipient of a predoctoral contract supported by the Conselleria d ' Educacio, Investigacio, Cultura i Esport Generalitat Valenciana -ACIF Programme (ACIF-2017-114). The funders had no role in the experiment design, data analysis, decision to publish, or preparation of the manuscript;Conselleria d'Educacio, Investigacio, Cultura i Esport [ACIF-2017-114];Ministerio de Economia, Industria y Competitividad, Gobierno de Espana [AGL201679825-R];Ministerio de Econom?a, Industria y Competitividad, Gobierno de Espana [PID2020-115571RB-I00];Ministerio de Ciencia, Innovacion y Universidades [PID2019-104126RB-I00].Márquez-Molins, J.; Navarro Bohigues, JA.; Cervera Seco, L.; Pallás Benet, V.; Gomez, GG. (2021). Might exogenous circular RNAs act as protein-coding transcripts in plants?. RNA Biology. 18:98-107. https://doi.org/10.1080/15476286.2021.1962670S981071

Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

[EN] The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9–12 years) (n = 17) and teen (13–18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 3.83% vs. teen: 14.33 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.S

Effect of hip muscle strengthening exercises on pain and disability in patients with non-specific low back pain—a systematic review

Low back pain (LBP) is a health problem that affects 70–80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of this study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from the PubMed, PEDro, and Scopus databases published up to September 2022. Based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASP and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating interacted with LBP, effectively improving pain and disability

Physician-Related Variability in the Outcomes of an Invasive Treatment for Neck and Back Pain: A Multi-Level Analysis of Data Gathered in Routine Clinical Practice

[EN] Neuro-reflexotherapy (NRT) is a proven effective, invasive treatment for neck and back pain. To assess physician-related variability in results, data from post-implementation surveillance of 9023 patients treated within the Spanish National Health Service by 12 physicians were analyzed. Separate multi-level logistic regression models were developed for spinal pain (SP), referred pain (RP), and disability. The models included all patient-related variables predicting response to NRT and physician-related variables. The Intraclass Correlation Coefficient (ICC) and the Median Odds Ratio (MOR) were calculated. Adjusted MOR (95% CI) was 1.70 (1.47; 2.09) for SP, 1.60 (1.38; 1.99) for RP, and 1.65 (1.42; 2.03) for disability. Adjusted ICC (95%CI) values were 0.08 (0.05; 0.15) for SP, 0.07 (0.03; 0.14) for RP, and 0.08 (0.04; 0.14) for disability. In the sensitivity analysis, in which the 6920 patients treated during the physicians’ training period were excluded, adjusted MOR was 1.38 (1.17; 1.98) for SP, 1.37 (1.12; 2.31) for RP, and 1.25 (1.09; 1.79) for disability, while ICCs were 0.03 (0.01; 0.14) for SP, 0.03 (0.00; 0.19) for RP, and 0.02 (0.00; 0.10) for disability. In conclusion, the variability in results obtained by different NRT-certified specialists is reasonable. This suggests that current training standards are appropriateS

Duchenne de Boulogne: el camino de la ciencia al arte

The work of Guillaume Benjamin Amand Duchenne (1806-1871) has been widely collected and analyzed. Most of his biographers highlight an extraordinary scientific and clinician, who revolutionized the field of neurology and electrotherapy. It is considered though that his most important contribution has not been sufficiently highlighted: he was the nexus of union between two fields independent until then, electrophysiology and artistic photograph. The culmination of this symbiosis is the publication of Mécanisme De La Physionomie Humaine: Où, Analyse Électro-Physiologique De L’expression Des Passions published in 1862. To the authors of the present study, the goal of Duchenne’s work was not only that of a scientific and clinician but also that of an artist, determined to reflect and unravel the mechanisms of emotion and feeling. He even intended to establish an aesthetic canon in painting and sculpture in facial expression, reflecting his ideal of beauty. His work had important repercussions in neurology and electrotherapy, in medical photography and in the development of a new scenic space: the representation of body movement provoked by electric currents, named Electric Performance Art.La obra de Guillaume Benjamín Amand Duchenne (1806-1871) ha sido ampliamente recogida y analizada. La mayoría de sus biógrafos destacan a un extraordinario científico y clínico, que revolucionó el campo de la neurología y la electroterapia. Sin embargo, se considera que no ha sido suficientemente destacada su mayor aportación: ser el nexo entre dos campos que habían sido independientes hasta ese momento, la electrofisiología y la fotografía artística. La culminación de esta simbiosis sería la publicación de&nbsp;Mécanisme De La Physionomie Humaine: Où, Analyse Électro-Physiologique De L’expression Des Passions, publicada en 1862. Para los autores del presente trabajo, el objetivo final de la obra de Duchenne no fue solo el de un científico y clínico, fue también el de un artista, empeñado en reflejar y desentrañar los mecanismos de la emoción y del sentimiento. Incluso, pretendió establecer un canon estético en la pintura y escultura en la expresión facial, que reflejase su ideal de belleza. Su obra, tuvo importantes repercusiones en la neurología y la electroterapia, en la fotografía médica y en el desarrollo de un nuevo espacio escénico: la representación del movimiento corporal provocado por corrientes eléctricas, el denominado&nbsp;Electric Performance Art

The Role of Hip Joint Clearance Discrepancy as Other Clinical Predictor of Reinjury and Injury Severity in Hamstring Tears in Elite Athletes

[EN] Hamstring tear injuries (HTI) are the most prevalent injuries in athletes, with high reinjury rates. To prevent reinjury and reduce the severity of injuries, it is essential to identify potential risk factors. Hip characteristics are fundamental to optimal hamstring function. We sought to investigate the role of hip joint clearance discrepancy (JCD) as a risk factor for HTI and a clinical predictor of risk of reinjury and injury severity. A cross-sectional, retrospective study was performed with elite athletes (n = 100) who did (n = 50) and did not (n = 50) have a history of injury. X-rays were taken to assess JCD. We reviewed muscular lesions historial, and health records for the previous 5 years. Significant differences were found in injury severity (p = 0.026; ŋ2p = 0.105) and a number of injuries (p = 0.003; ŋ2p = 0.172). The multivariate analysis data indicated that JCD was significantly associated with the number of injuries and their severity (p &lt; 0.05). In the stepwise regression model, JCD variability explained 60.1% of the number of injuries (R2 0.601) and 10.5% of injury severity (R2 0.0105). These results suggest that JCD could play an important role as a risk factor for HTI and also as a clinical predictor of reinjury and injury severityS

Therapeutic Exercise Intervention Using Vibration Platforms for Glycemic Control in Type 2 Diabetes: A Pilot Study

[EN] Diabetes generates a great impact on society, as well as a concern for health professionals due to its high and increasing prevalence; there are several studies that demonstrate the effectiveness of vibration platforms and their benefits at a physiological level. The aim of this study will be to analyze the decrease in glycosylated hemoglobin and glycemia levels after the use of whole-body vibration platforms and the possible inclusion of this therapeutic option within the usual treatments. This is a double-blind, randomized controlled trial with parallel group design in a 1:1 ratio. The sample will be composed of people diagnosed with type 2 diabetes mellitus in in the Plasencia area (Cáceres, Extremadura). Participants will be randomly assigned to the intervention or control group using a randomization list and will follow the inclusion criteria: type 2 diabetics between 50 and 60 years of age and not taking diabetes medication. All participants will undergo a determination of glycosylated hemoglobin, blood pressure, lipid profile, weight and height, and different functional tests such as Time Up and Go, 10 Meters Walk Test, and 5 Sit To Stand. The experimental group will perform a whole-body vibration intervention on an oscillating platform for 12 weeks with a weekly frequency of three nonconsecutive days and a duration of 12 min. The exercises will consist of 60 s of work and 60 s with rest. The control group will carry out their normal life insisting on the importance of glycemic controls before and after their daily physical exercise. This study has been registered at clinical.trial.org, ID: NCT 05968222. Whole-body vibration platforms have demonstrated their effectiveness in different pathologies such as stroke, fibromyalgia, sclerosis multiple, or Parkinson’s. For that reason, an improvement in glycemic and lipid values and body composition are expected in people with diabetes after a whole-body vibration intervention for 12 weeks’ duration. In addition, whole-body vibration platforms could be postulated as an alternative to usual treatments.SIUniversity of Salamanc