Application of induced movement therapy in patients restriction after stroke: a systematic review.

Introducción: La terapia de movimiento inducido por restricción (TMIR) es un enfoque actual en la rehabilitación tras un ictus que implica la restricción de la extremidad superior menos afecta, combinado con la realización de tareas funcionales repetitivas de progresiva dificultad con la extremidad superior más afecta. Objetivo: Conocer y describir los resultados clínicos de la aplicación de la TMIR (tradicional o modi cada) cuando comparadas con terapia convencional y/o placebo e identificar las diferencias entre las dos modalidades. Adicionalmente, describir los resultados clínicos obtenidos según la evolución temporal del ictus (agudo, subagudo o crónico). Material y métodos: Revisión bibliográfica de ensayos clínicos controlados en las bases de datos PUBMED, PEDro (physiotherapy Evidence Database) y MEDLINE realizados en los últimos 10 años. Estos ensayos clínicos debían incluir pacientes adultos con diagnóstico de ictus y con paresia de una extremidad superior. De los 223 artículos identificados, se incluyeron 24 artículos para análisis en esta revisión. Resultados: Los estudios revelaron mejoras importantes en la función motora y el deterioro motor del miembro superior, además de en la independencia funcional y calidad de vida de los pacientes, tras la aplicación de la TMIR (tradicional o modificada) cuando fue comparada con terapia convencional y/o placebo. Estos resultados han sido obtenidos principalmente cuando la terapia fue aplicada a pacientes subagudos y crónicos. Conclusiones: Los estudios incluidos en esta revisión demostraron que la TMIR tanto la modalidad tradicional como la modificada fueron una terapia eficaz para el tratamiento del miembro superior de pacientes tras un ictus, especialmente en pacientes en fase subaguda o crónica.Terapia y Rehabilitació

Continuidad de cuidados implicada en la fisioterapia del paciente hospitalizado : magnitud, factores asociados e impacto sobre la salud y satisfacción / Silvana Loana de Oliveira Sousa; directores, Francesc Medina i Mirapeix, Pilar Escolar Reina.

Tesis-Universidad de Murcia.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M. 3755

Physical frailty characteristics have a differential impact on symptoms as measured by the CAT score: an observational study

Abstract Background The physical frailty status affects the health status of patients with chronic obstructive pulmonary disease (COPD). The objective was to determine if the individual physical frailty characteristics have a differential impact on the CAT score. Methods This observational study included 137 patients with stable COPD. Physical frailty was measured with unintentional weight loss, low physical activity, exhaustion, slow walking speed and low grip strength and health status assessed with the COPD Assessment test (CAT). The following variables were evaluated as potential determinants of CAT: sex, age, body mass index, smoking, dyspnea, exacerbations, comorbidities, %FEV1, %FVC, anxiety and depression. Results The prevalence of characteristics for individual frailty was as follows: low grip strength, 60.6%; low physical activity, 27.0%; exhaustion, 19.7%; slow walking speed, 9.5%; and unintentional weight loss, 7.3%. A total of 17.5% of the patients were non-frail, 73.7% were pre-frail and only 8.7% were frail. One of the five frailty characteristics, exhaustion (adjusted β coefficient 5.12 [standard error = 1.27], p = 0.001) was an independent determinant of CAT score in the final regression model which was adjusted by other independent determinants of CAT (dyspnea, exacerbations and anxiety). Conclusions Due to the fact that exhaustion is a frequent and relevant psychological symptom on CAT score of patients with COPD, interventions should reduce that stress. Future research should explore how exhaustion persists or remits over time

The Type of Conservative Management Could Be Related to the Strength of the Inspiratory Muscles of Adolescents with Idiopathic Scoliosis—A Case Series

Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine with a Cobb angle of at least 10° with an unknown etiology. It is recognized that AIS may affect respiratory function. This study aims to describe and compare respiratory function in a case series of patients with scoliosis who underwent different types of therapeutic management: no intervention, orthotic brace, and global postural reeducation (GPR). Fifteen AIS patients were included in this study (seven no intervention, four orthotic brace and four GPR). Lung function and inspiratory muscle strength were measured and analyzed, as well as sociodemographic, clinical, and anthropometric variables. Significant correlations were observed between height (cm) and maximum inspiratory pressure (MIP) reference (cmH2O) and forced vital capacity (FVC) (liters) (r = 0.650 and r = 0.673, respectively; p < 0.01); weight (Kg) and MIP reference (cmH2O) (r = 0.727; p < 0.01); and Main curve degrees (Cobb angle) and FVC% (r = −0.648; p < 0.01). The AIS cases that underwent GPR treatment presented a greater MIP (% predictive) compared to the no intervention and brace cases (201.1% versus 126.1% and 78.4%, respectively; p < 0.05). The results of this case series show a possible relation whereby patients undergoing treatment with the GPR method have greater inspiratory muscle strength compared to the no intervention and brace cases. Studies with larger samples and prospective designs must be performed to corroborate these results

Case Report: Conservative Treatment of Adolescent Idiopathic Scoliosis Can Alter the Perception of Verticality. A Preliminary Study.

Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine of at least 10° Cobb's angle of unknown etiology. Some studies have found that patients with AIS have a Visual Verticality (VV) perception similar to healthy controls. This study aimed to analyze VV perception and postural balance differences in patients with AIS depending on the management, either based on observation or conservative treatment. Eighteen patients with AIS were included in this study. Nine patients were managed based on observation. The other nine underwent conservative treatment, such as bracing or exercise. Subjective Visual Vertical (SVV) and posturographic parameters were measured and analyzed. In the SVV test, patients who underwent treatment showed poor constant error in absolute values and mean absolute error, with statistically significant differences (

Does Inspiratory Muscle Training Affect Static Balance in Soccer Players? A Pilot Randomized Controlled Clinical Trial

Inspiratory muscle training (IMT) is effective in improving postural stability and balance in different clinical populations. However, there is no evidence of these effects in soccer players. A single-blind, two-arm (1:1), randomized, placebo-controlled pilot study on 14 soccer players was performed with the main aim of assessing the effect of IMT on static balance, and secondarily, of examining changes in the respiratory muscle function. The experimental group (EG) received an IMT program with progressive intensity, from 20% to 80%, of the maximal inspiratory pressure (MIP). The sham group (SG) performed the same program with a fixed load of 20% of the MIP. Static balance and respiratory muscle function variables were assessed. A two-factor analysis of variance for repeated measures was used to assess differences after training. Statistical significance was set at p p = 0.012) and eyes closed (from 3166.2 ± 641.3 to 4173.3 ± 390.8 mm, p = 0.004). A significant increase in the maximal voluntary ventilation was observed for both groups (EG p = 0.005; SG p = 0.000). No significant differences existed between the groups. IMT did not improve the static balance in a sample of soccer players. Conducting a high-scale study is feasible and could refine the results and conclusions stemming from the current pilot study

Relationship between Respiratory Muscle Function and Postural Stability in Male Soccer Players: A Case-Control Study.

The important role of postural stability in exercise performance has been determined by several authors. Despite this, few studies have analyzed the relationship between respiratory muscles' strength and postural stability in athletes. For this reason, the aim of this study was to investigate the relationship between postural stability and respiratory muscles' function in male soccer players. A case-control study was conducted over twenty-eight healthy men (18 soccer players; 10 non-athletes). Inspiratory muscle strength (MIP) and respiratory resistance (MVV) were obtained through a digital spirometer. Stability variables were obtained in standing position on a stabilometric platform and in open and closed eyes conditions. The area and length of the center of pressures and displacements in the X and Y range were analyzed. Pearson's coefficient was used to measure the linear correlation between MIP, MVV and stabilometric variables. In the soccer players' group, MIP and MIP % predictive were inversely correlated with length (r = -0.535 and r = -0.585;

Relationship between Respiratory Muscle Function and Postural Stability in Male Soccer Players: A Case-Control Study

The important role of postural stability in exercise performance has been determined by several authors. Despite this, few studies have analyzed the relationship between respiratory muscles’ strength and postural stability in athletes. For this reason, the aim of this study was to investigate the relationship between postural stability and respiratory muscles’ function in male soccer players. A case-control study was conducted over twenty-eight healthy men (18 soccer players; 10 non-athletes). Inspiratory muscle strength (MIP) and respiratory resistance (MVV) were obtained through a digital spirometer. Stability variables were obtained in standing position on a stabilometric platform and in open and closed eyes conditions. The area and length of the center of pressures and displacements in the X and Y range were analyzed. Pearson’s coefficient was used to measure the linear correlation between MIP, MVV and stabilometric variables. In the soccer players’ group, MIP and MIP % predictive were inversely correlated with length (r = −0.535 and r = −0.585; p < 0.05) and X range (r = −0.527 and r = −0.560; p < 0.05), whereas MVV was directly correlated with length (r = 0.606; p < 0.01) and Y range (r = 0.558; p < 0.05). Our results show that the greater the inspiratory muscle strength, the less displacement of the pressure center, while at higher respiratory rates there is greater displacement