Efectividad de un protocolo de manipulación tracción en posición de reposo de la columna cervical superior en pacients con mareo cervicogénico

Teniendo en cuenta la evidencia científica disponible que muestra que la fisioterapia manual tiene una evidencia moderada en tratamiento de pacientes con mareo cervicogénico y la insuficiente evidencia científica que avale el uso de metodologías de manipulación que satisfagan las recomendaciones de la Federación internacional de terapia manual ortopédica de seguridad y efectividad en el tratamiento de la hipomovilidad de la columna cervical superior, se decidió profundizar con la realización de la siguiente tesis. Este estudio se plantea disminuir la intensidad de mareo y dolor, mejorar la función cervical, la estabilidad corporal y la discapacidad autopercibida en sujetos con mareo cervicogénico, utilizando técnicas de manipulación tracción en posición de reposo de la columna cervical superior y comparar los resultados con un grupo control.Para alcanzar los objetivos del estudio, el trabajo realizado es un estudio analítico, longitudinal, prospectivo, experimental. Se trata de un ensayo clínico controlado en paralelo, aleatorio, con dos grupos.El trabajo ha encontrado que:1. El mareo cervicogénico se caracteriza por una intensidad de mareo media-moderada, dolor o rigidez de cuello medio-moderado, cinestesia cervical disminuida, rango de movimiento activo disminuido, rango de movimiento de la columna cervical superior disminuida tanto en el plano sagital como en el transverso, inestabilidad y provocadiscapacidad y disminución de la calidad de vida.2. Una sesión del protocolo de manipulación tracción en posición de reposo de la columna cervical superior produce una reducción de la intensidad del mareo actual y habitual, una reducción intensidad del dolor cervical actual, aumenta el rango de movimiento hacia la extensión cervical superior, aumenta el test de flexión rotación hacia la derecha y hacia la izquierda y aumenta el test de flexión rotación hacia el lado más y menos restringido en pacientes con mareo cervicogénico.3. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una reducción de la intensidad del mareo a corto plazo y tras un mes de seguimiento en pacientes con mareo cervicogénico.4. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior no modifican la frecuencia y duración del mareo tras un mes de seguimiento en pacientes con mareo cervicogénico.5. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una reducción de la intensidad de dolor cervical a corto plazo y tras un mes de seguimiento en pacientes con mareo cervicogénico.6. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una mejora en la cinestesia cervical en todas las direcciones sin mostrar diferencias estadísticamente significativas entre grupos en pacientes con mareo cervicogénico.7. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una mejora inmediata en el rango de movimiento activo hacia la extensión y una mejora de la inclinación derecha y rotación derecha tras un mes de seguimiento en pacientes con mareo cervicogénico.8. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una mejora en el rango de movimiento de la columna cervical superior hacia la flexión, extensión, test flexión rotación derecha e izquierda, test flexión rotación lado más y menos restringido a corto plazo y tras un mesde seguimiento en pacientes con mareo cervicogénico.9. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una mejora en la estabilidad corporal registrada con la estabilometría para la longitud con ojos cerrados y en suelo blando y para la superficie con ojos cerrados y suelo duro al mes de seguimiento en pacientes con mareo cervicogénico.10. Tres sesiones del protocolo de manipulación tracción en posición de reposo de la columna cervical superior producen una apreciación subjetiva de mejoría clínica relevante y estadísticamente significativa a corto plazo y tras un mes de seguimiento en pacientes con mareo cervicogénico.<br /

Propuesta de un programa de intervención fisioterápica para prevenir esguinces en jugadoras de baloncesto. A propósito de una serie de casos

Introducción: El esguince lateral de tobillo es una de las lesiones más comunes ocurridas en baloncesto y, sus secuelas afectan al rendimiento deportivo. La afectación de la estabilidad postural, así como una disminución en la flexión dorsal del tobillo son dos consecuencias frecuentes y, a su vez, dos de los principales factores de riesgo que aumentan la recurrencia de esta lesión. Por ello, se propone un programa de entrenamiento propioceptivo y mejora del rango articular para prevenir futuras lesiones. Metodología: se propone un estudio de intervención analítico de serie de casos (n=13), con medición pre y post-intervención de las siguientes variables: balance postural estático (estabilometría en plataforma de presiones) y dinámico (Star Excusion Balance Test) y rango de movilidad en flexión dorsal de tobillo en carga (Lunge Test). Se estableció un programa de entrenamiento propioceptivo y de ejercicios destinados a mejorar la dorsiflexión para jugadoras de baloncesto (17,3 ± 0,64 años) de 2 meses de duración. Resultados: por el COVID-19 no se pudo realizar la valoración final, por lo que los resultados se limitan a un análisis estadístico comparativo de la valoración inicial en función de la historia previa de esguinces. Se obtuvo una disminución en la flexión dorsal en tobillos lesionados (p=0,017), así como valores medios en los alcances del SEBT y en el desplazamiento y velocidad media de excursión del centro de presiones, que indicaban una tendencia a un peor control postural en sujetos con antecedentes lesiónales. Conclusiones: tobillos con historia previa de esguinces de tobillo presentan déficits en la flexión dorsal así como una tendencia a un peor balance postural tanto estático como dinámico. <br /

The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis

The Schroth method is one of the most common physiotherapeutic scoliosis-specific exercises intervention applied in adolescent idiopathic scoliosis (AIS). This method consists of three-dimensional correction of the specific curve pattern of the patient using a combination of sensorimotor, postural, and corrective breathing exercises. The aim of this systematic review and meta-analysis was to analyse the effects of the Schroth method in isolation on Cobb angle, quality of life, and trunk rotation angle compared to no intervention or other conservative treatments in patients with AIS

Factors associated with depression and anxiety in adults =60 years old during the CPVID-19 pandemic: a systematic review

COVID-19 represents a threat to public health and the mental health of the aged population. Prevalence and risk factors of depression and anxiety have been reported in previous reviews in other populations; however, a systematic review on the factors associated with depression and anxiety in older adults is not currently present in the literature. We searched PubMed, Embase, Scopus, ProQuest Psychology Database, Science Direct, Cochrane Library and SciELO databases (23 February 2021). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to COVID-19, elderly, depression and anxiety in the databases. A total of 11 studies were included in the systematic review. Female gender, loneliness, poor sleep quality and poor motor function were identified as factors associated with both depression and anxiety. Aspects related to having a stable and high monthly income represent protective factors for both depression and anxiety, and exercising was described as protective for depression. This study synthesised information and analysed the main factors associated with depression and anxiety in the older population during the COVID-19 pandemic. However, the cross-sectional design of most of the included studies does not allow a causal relationship between the factors analysed and depression or anxiety

Systematic review and meta-analysis showed that complementary and alternative medicines were not effective for infantile colic

Aim: Osteopathy and chiropractic techniques are used for babies for different rea-sons, but it is unclear how effective they are. The aim of this study was to evaluate their effectiveness in reducing crying time and increasing sleeping time in babies with infantile colic.Methods: A systematic review and meta-analysis was conducted on infantile colic studies that used complementary and alternative medicine techniques as interven-tions. The outcome measures were hours spent crying and/or sleeping. We used the PubMed, Physiotherapy Evidence Database, Cochrane Library, Embase, Web of Science, Scopus, Osteopathic Medicine Digital Database and Google Scholar data-bases from inception to 11 November 2022.Results: The methodological quality of the randomised control trials ranged from fair to high. We focused on five studies with 422 babies. Complementary treatments failed to decrease the crying time (mean difference −1.08, 95% CI: −2.17 to 0.01, I2= 92%) and to increase sleeping time (mean difference 1.11, 95% CI: −0.20 to 2.41; I2: 91%), compared with no intervention. The quality of the evidence was rated as very low for both outcome measures.Conclusion: Osteopathy and chiropractic treatment failed to reduce the crying time and increase sleeping time in babies with infantile colic, compared with no additional intervention

A computer vision-based application for the assessment of head posture: A validation and reliability study

As its name implies, the forward head position (FHP) is when the head is further forward of the trunk than normal. This can cause neck and shoulder tension, as well as headaches. The craniovertebral angle (CVA) measured with 2D systems such as Kinovea software is often used to assess the FHP. Computer vision applications have proven to be reliable in different areas of daily life. The aim of this study is to analyze the test-retest and inter-rater reliability and the concurrent validity of a smartphone application based on computer vision for the measurement of the CVA. Methods: The CVAs of fourteen healthy volunteers, fourteen neck pain patients, and fourteen tension-type headache patients were assessed. The assessment was carried out twice, with a week of rest between sessions. Each examiner took a lateral photo in a standing position with the smartphone app based on computer vision. The test-retest reliability was calculated with the assessment of the CVA measured by the smartphone application, and the inter-rater reliability was also calculated. A third examiner assessed the CVA using 2D Kinovea software to calculate its concurrent validity. Results: The CVA in healthy volunteers was 54.65 (7.00); in patients with neck pain, 57.67 (5.72); and in patients with tension-type headaches, 54.63 (6.48). The test-retest reliability was excellent, showing an Intraclass Correlation Coefficient (ICC) of 0.92 (0.86–0.95) for the whole sample. The inter-rater reliability was excellent, with an ICC of 0.91 (0.84–0.95) for the whole sample. The standard error of the measurement with the app was stated as 1.83°, and the minimum detectable change was stated as 5.07°. The concurrent validity was high: r = 0.94, p < 0.001. Conclusion: The computer-based smartphone app showed excellent test-retest and inter-rater reliability and strong concurrent validity compared to Kinovea software for the measurement of CVA.Postprint (published version

Clinical and psychological variables in female patients with cervical syndromes: A cross-sectional and correlational study

Producción CientíficaBackground: The objectives of this study were: (1) to compare the pain intensity, cervical range of motion (ROM), psychological distress and kinesiophobia in patients with cervicogenic dizziness (CGD), tension-type headache (TTH), and mechanical chronic neck pain (MCNP); and (2) to investigate the relationships between pain intensity and cervical ROM and between psychological distress and kinesiophobia. Methods: a cross-sectional and correlational study was designed. In total, 109 patients (32 patients with CGD, 33 with TTH and 44 with MCNP) were included. Pain intensity, cervical ROM, psychological distress and kinesiophobia were assessed. Results: Statistically significant differences were found between the groups in pain intensity, psychological distress and kinesiophobia. The patients with MCNP showed higher pain intensity compared to the other groups (p 0.05). The CGD and MCNP groups found a moderate positive correlation between psychological distress and kinesiophobia (p < 0.05). The patients with TTH and MCNP showed a moderate positive correlation between pain intensity, psychological distress and kinesiophobia (p < 0.05). Conclusion: Pain intensity, psychological distress and kinesiophobia should be considered in the three groups. Psychological distress was correlated with kinesiophobia in the CGD and MCNP groups. The MCNP group showed a correlation between pain intensity, psychological distress and kinesiophobia

Efectividad de un protocolo de entrenamiento con el dispositivo de facilitación de movimiento cervical en sujetos con déficit de fuerza de la musculatura profunda cervical. Estudio piloto

Neck pain is one of the major public health problems, which has a great impact on the quality of people's lives, with a high prevalence and recurrence rate. The deep cervical muscles play a key role in neck stability. Deficits in deep cervical muscle strength are related to different clinical conditions: cervicogenic dizziness, cervical radiculopathy, chronic mechanical neck pain, cervical pain, and cervical instability. Training protocols can help to improve pain, cervical function, posture, and cross-sectional area. However, there are no training protocols in subjects with strength deficit in deep cervical muscles, including deep neck extensor and flexor muscles. The cervical device treatment (CDAT) allows us to train the cervical flexor and extensor muscle in a simple and comfortable way. The purpose of this study is to evaluate the clinical results in upper cervical range of motion, endurance, and self-perceived functional capacity by a training protocol with the new device for cervical treatment (GD) and the conventional training protocol (GH) versus a control group (GC) in subjects with cervical deep muscle strength deficit

Hip range of motion and strength in male athletes with stage 1 osteitis pubis: A cross-sectional and correlational study

Producción CientíficaBackground: The objectives of this study were: (1) to determine whether athletes with stage 1 osteitis pubis (OP) present differences in hip range of motion (ROM) and muscle strength, between both sides and compared with healthy athletes; (2) to investigate the relationship between the internal rotation (IR) ROM and pain intensity and physical function. Methods: a cross-sectional and correlational study was designed, in which 30 athletes (15 athletes with stage 1 OP and 15 healthy athletes) were included. Pain intensity, physical function, hip ROM and hip muscle strength were assessed. Results: The ROM assessment reported significant differences between both groups in the IR, external rotation (ER) and adduction (ADD) ROM of the painful side (PS) (p 0.05). A strong negative correlation between pain intensity and IR ROM (r = −0.640) and a strong positive correlation between physical function and IR ROM (r = 0.563) were found in the OP group. Conclusions: Male athletes with stage 1 OP present a hip IR, ER and ADD ROM limitation in the PS compared to non-PS and to healthy athletes. IR ROM is correlated to pain intensity and physical function in athletes with stage 1 OP

Restriction of Mouth Opening, Reduction in Pressure Pain Thresholds and Activation of Myofascial Trigger Points in Mandibular and Cervical Regions after Root Canal Therapy: A Quasi-Experimental Study

Background: In daily clinical practice, patients often refer temporomandibular or cervical complaints after different oral procedures, especially in lengthy procedures that can result in iatrogenic postures or trauma that can affect the temporomandibular joint (TMJ). This study aimed to evaluate the clinical and functional changes of the temporomandibular joint (TMJ) and cervical region immediately after a session of root canal therapy. Methods: Twenty-nine subjects who received a session of root canal therapy were included. Clinical assessments included mouth opening, cervical mobility, pain intensity, pressure pain thresholds (PPTs), and myofascial trigger points (MTrPs) of the jaw and neck muscles. Results: After the intervention, a significant reduction in mouth opening (41.90 mm; SD = 6.21) was observed compared to baseline (46.28 mm; SD = 6.17) (p p p = 0.002–0.026) were demonstrated after the intervention. Conclusions: A session of root canal therapy can produce an immediate significant reduction in mouth opening, PPTs, and cervical mobility, and an increase in MTrPs. The risk can be higher if there is a previous TMJ limitation