Effectiveness of Motor Imagery on Motor Recovery in Patients with Multiple Sclerosis: Systematic Review

The effects of motor imagery (MI) on functional recovery of patients with neurological pathologies, such as stroke, has been recently proven. The aim of this study is to evaluate the effectiveness of MI on motor recovery and quality of life (QOL) in patients with multiple sclerosis (pwMS). A search was carried out in the following scientific databases: PubMed, CINAHL, PEDro, Scopus, Cochrane and Web of Science, up to November 2020. The grey literature and reference lists of potentially relevant articles were also searched. The Checklist for Measuring Quality and The Cochrane collaboration's tool were used to assess the methodological quality and risk of bias of the studies. Five studies were included in the systematic review. Findings showed that pwMS using MI had significant improvements in walking speed and distance, fatigue and QOL. In addition, several benefits were also found in dynamic balance and perceived walking ability. Although the evidence is limited, rehabilitation using MI with the application of musical and verbal guides (compared to non-intervention or other interventions), can produce benefits on gait, fatigue and QOL in pwMS with a low score in the Expanded Disability Status Scale.Department of Nursing and Physiotherapy (University of Cadiz, Spain

Effectiveness of Mechanical Horse-Riding Simulators on Postural Balance in Neurological Rehabilitation: Systematic Review and Meta-Analysis

Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down). The main objective of this study is to analyze the effectiveness of mechanical horse-riding simulators to improve postural balance in subjects with neurological disorders. The search was conducted during January-March 2019 in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane, Web of Science, CINAHL, and Scopus. The methodological quality of the studies was evaluated through the PEDro scale. A total of seven articles were included in this systematic review, of which four contributed information to the meta-analysis. Statistical analysis showed favorable results for balance in stroke patients, measured by the Berg Balance Scale (standardized mean difference (SMD) = 3.24; 95%; confidence interval (CI): 1.66-4.83). Not conclusive results were found in sitting postural balance, measured using the Gross Motor Function Measure-66 (GMFM-66) Sitting Dimension, in patients with cerebral palsy. Most studies have shown beneficial effects on postural balance compared with conventional physical therapy. However, due to the limited number of articles and their low methodological quality, no solid conclusions can be drawn about the effectiveness of this therapy

Health economics: identifying leading producers, countries relative specialization and themes

El área de investigación en economía de la salud tuvo una gran evolución a partir de la década de 1960 y está en constante crecimiento. Actualmente, el gasto en salud es un tema clave en todo el mundo. La bibliometría proporciona varios métodos para explorar el impacto y la evolución de la investigación. Así pues, el principal objetivo del presente estudio es comprender la situación actual de la investigación en materia de economía de la salud para el período 2010-2019. Se analizaron tres aspectos diferentes: la producción de los países, el índice de prioridad relativa y los temas principales. El conjunto de datos se obtuvo a partir de los documentos indizados en la base de datos Web of Science de 2010 a 2019. Se utilizó el software SciMAT para obtener el análisis temático mediante el análisis de mapas de la ciencia. Las revistas Health economics, Value in Health, Journal of Health Economics y European Journal of Health Economics son los principales productoras. Estados Unidos, Inglaterra y Alemania son los que tienen una mayor producción; los Países Bajos, Inglaterra y Australia son los que tienen el índice de prioridad relativa más alto. Los años de vida ajustados en función de la calidad y la desigualdad en materia de salud son los temas con mayor número de documentos y medidas de impacto. Este estudio es un marco útil basado en ciencia que servirá de base para futuras acciones de investigación.Health economics research area was a high evolution from the 1960s and it is constantly growing. Currently, the health expenditure is a key issue worldwide. Bibliometrics provides several methods to explore the impact and evolution of the research. Thus, the main aim of the present study is to understand the current status of the research in health economics for the period 2010-2019. Three different aspects were analyzed: countries production, relative priority index and main themes. The dataset was obtained from the documents indexed in the Web of Science database from 2010 to 2019. SciMAT software was used to obtain the thematic analysis by means of science mapping analysis. The journals Health economics, Value in Health, Journal of Health Economics, and European Journal of Health Economics are the main producers. USA, England and Germany are those with highest production; Netherlands, England and Australia are those with the highest relative priority index. Quality adjusted life years and Health inequality are the themes with the highest number of documents and impact measures. This study is a useful evidence-based framework on which to base future research actions

Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis

Spasticity is one of the most frequent and disabling clinical manifestations of patients with stroke. In clinical practice, stretching is the most widely used physiotherapeutic intervention for this population. However, there is no solid evidence for its effectiveness. The aim of this study was to evaluate the effectiveness of different types of stretching in reducing post-stroke spasticity. Research was carried out until March 2021 in the following scientific databases: PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and PEDro. The PEDro scale and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Eight articles were selected for qualitative analysis; six of them contributed information to the meta-analysis. No conclusive evidence was obtained on the effectiveness of stretching in terms of treating spasticity and range of motion in patients with stroke. Further research is necessary in order to determine the effectiveness of the use of stretching in this population, considering the different types of stretching (static and dynamic), the time of application, the measurement of the different components of spasticity, and the extrapolation of functional results.Erasmus+ Strategic Partnership for Higher Education Program (Key Action 203) grant number 2018-1-PL01-KA203-05105

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

This study aims to analyze the effects of Dry Needling (DN) for the release of myofascial trigger points (MTrPs) in the triceps surae muscles (TSM). A systematic review was performed up to February 2022 in PubMed, PEDro, Scopus, CENTRAL, and Web of Science. Selection criteria were studies involving subjects older than 18 years presenting MTrPs in the TSM, without any concomitant acute or chronic musculoskeletal conditions; DN interventions applied to the MTrPs of the TSM; and results on pain, range of motion (ROM), muscle strength, muscle stiffness, and functional outcomes. The PEDro scale was used to assess the methodological quality of the studies, and the Risk of Bias Tool 2.0 to assess risk of bias. A total of 12 studies were included in the systematic review, involving 426 participants. These results suggest that DN of MTrPs in TSM could have a positive impact on muscle stiffness and functional outcomes. There are inconclusive findings on musculoskeletal pain, ROM, and muscle strength. Significant results were obtained in favor of the control groups on pressure pain thresholds. Despite the benefits obtained on muscle stiffness and functional performance, the evidence for the use of DN of MTrPs in the TSM remains inconclusive

Virtual and Augmented Reality versus Traditional Methods for Teaching Physiotherapy: A Systematic Review

The use of virtual worlds in health-related education is increasingly popular, but an overview of their use in physiotherapy education is still needed. The aim of this review was to analyse the use of virtual and augmented reality (VR/AR) compared to traditional methods for teaching physiotherapy. A systematic review was performed up to October 2022 in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo. The quality appraisal and risk of bias were assessed by the Joana Briggs Institute checklist and the Cochrane Collaboration’s RoB Tool 2.0, respectively. A total of seven randomised and non-randomised controlled studies were included, involving 737 students. VR/AR-based teaching approaches included simulation and virtual worlds, and were conducted through immersive head-mounted displays, AR-based applications, and 3D visualisations. Three studies were focused on teaching anatomy content, two on clinical decision making skills, and the rest were focused on pathology, physiotherapy tasks or exercise performance, and movement analysis of lower limbs. Inconclusive results were found in terms of learning satisfaction and academic performance, showing VR/AR-based teaching models to be equally effective as traditional methods for teaching physiotherapy. We encourage researchers and teachers to include games in their VR/AR-based teaching approaches to enhance interaction and active learning in physiotherapy education

Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis

Spasticity is one of the most frequent and disabling clinical manifestations of patients with stroke. In clinical practice, stretching is the most widely used physiotherapeutic intervention for this population. However, there is no solid evidence for its effectiveness. The aim of this study was to evaluate the effectiveness of different types of stretching in reducing post-stroke spasticity. Research was carried out until March 2021 in the following scientific databases: PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and PEDro. The PEDro scale and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Eight articles were selected for qualitative analysis; six of them contributed information to the meta-analysis. No conclusive evidence was obtained on the effectiveness of stretching in terms of treating spasticity and range of motion in patients with stroke. Further research is necessary in order to determine the effectiveness of the use of stretching in this population, considering the different types of stretching (static and dynamic), the time of application, the measurement of the different components of spasticity, and the extrapolation of functional results

Descriptive analysis of post-stroke patients in a neurological physical therapy unit

Introduction: Physical therapy (PT) is the mainstay treatment in functional recovery after suering a stroke. It is important in the acute phase of hospitalization after a stroke and later in the ambulatory phase. Patients and methods: The present study aimed to analyze the data provided by the clinical history (CH) of people with stroke (pwS) who received PT treatment in order to establish a “preferential patient profile” (PPP) that may benefit more from an early PT treatment. This was an observational, descriptive, and cross-sectional study. A total of 137 pwS who had been treated with PT were selected. Information provided age, gender, stroke type and localization, and start and end dates of the dierent PT treatments. A descriptive analysis of the variables was conducted using absolute frequencies and percentages for the qualitative variables. Student’s t-test or the Mann–Whitney U-test was used to determine the relationship between the time and variables “stroke type,” “outpatient,” and “occupational therapy.” The Kruskal–Wallis H-test was applied for the “localization” variable. Results: Of the entire sample, 57.7% were men, 65% had an ischemic stroke, and 48.9% had a stroke on the left side. The patients with hemorrhagic stroke had an increased number of hospital PT sessions (p = 0.01) and were younger (59.58 years) than patients with ischemic stroke (65.90 years) (p = 0.04). Discussion and conclusion: Our results do not show significant dierences between the persons <65 years and the number of outpatient physiotherapy sessions performed, although the resulting values are close to significance. Our results suggest that the PPP is a young person, with a hemorrhagic and left or bilateral stro