Discovering Rehabilitation trends in Spain: A bibliometric analysis

The main purpose of this study is to offer an overview of the rehabilitation research area in Spain from 1970 to 2018 through a bibliometric analysis. Analysis of performance and a co-word science mapping analysis were conducted to highlight the topics covered. The software tool SciMAT was used to analyse the themes concerning their performance and impact measures. A total of 3,564 documents from the Web of Science were retrieved. Univ Deusto, Univ Rey Juan Carlos and Basque Foundation for Science are the institutions with highest relative priority. The most important research themes are IntellectualDisability, Neck-Pain and Pain

Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Parkinson's disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson's disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson's disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject

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.Departamento de Enfermería y Fisioterapia. Universidad de Cádiz; Ilustre Colegio Profesional de Fisioterapeutas de Andaluci

Effectiveness of Virtual Reality on Functional Performance after Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

A spinal cord injury (SCI) usually results in a significant limitation in the functional outcomes, implying a challenge to the performance of activities of daily living. The main aim of this study is to analyze the effectiveness of virtual reality to improve functional performance in patients with SCI. The search was performed between October and December 2019 in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, Web of Science, and Embase. The methodological quality of the studies was evaluated through the PEDro scale, and the risk of bias was evaluated with the Cochrane collaboration's tool. Seven articles were included in this systematic review, and five of them in the meta-analysis. Statistical analysis showed favorable results for functional performance in control group performing conventional therapy, measured by the functional independence measure (standardized mean difference (SMD)= -0.70; 95% confidence interval: -1.25 to -0.15). Results were inconclusive for other outcomes. Most studies have not shown beneficial effects on functional performance compared with conventional physical therapy. The results obtained showed that virtual reality may not be more effective than conventional physical therapy in improving functional performance in patients with SCI

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

Anthropometric, Cardiopulmonary and Metabolic Benefits of the High-Intensity Interval Training Versus Moderate, Low-Intensity or Control for Type 2 Diabetes: Systematic Review and Meta-Analysis

This study aims to evaluate the effectiveness of high-intensity interval training compared with no intervention and other types of training interventions for people with Type 2 diabetes. A systematic review and meta-analysis of randomized controlled trials that used high-interval intensity training to improve anthropometric, cardiopulmonary and metabolic conditions were conducted. The search was performed during October-December 2017 using the databases PubMed, Web of Science and Physiotherapy Evidence Database (PEDro). The methodological quality of the studies was evaluated using the PEDro scale. A total of 10 articles were included in this meta-analysis. After statistical analysis, favorable results were obtained for high-Intensity Interval Training compared with control (non-intervention): [Weight: Standardized mean difference (SMD) = -2.09; confidence interval (CI) 95%: (-3.41; -0.78); body-mass index: SMD = -3.73; CI 95%: (-5.53; -1.93); systolic blood pressure: SMD = -4.55; CI 95%: (-8.44; -0.65); VO2max: SMD = 12.20; CI 95%: (0.26; 24.14); HbA(1c): SMD = -3.72; CI 95%: (-7.34; -0.10)], moderate intensity continuous training: [body-mass index: SMD = -0.41; CI 95%: (-0.80; -0.03); VO2max: SMD = 1.91; CI 95%: (0.18; 3.64)], and low intensity training: [Weight: SMD = -2.06; CI 95%: (-2.80; -1.31); body-mass index: SMD = -3.04; CI 95%: (-5.16; -0.92); systolic blood pressure: SMD = -2.17; CI 95%: (-3.93; -0.41); HbA(1c): SMD = -1.58; CI 95%: (-1.84; -1.33)]. The results show that high-intensity interval training can be a useful strategy in order to improve anthropometric, cardiopulmonary and metabolic parameters in people with Type 2 diabetes. Despite this, it could be essential to clarify and unify criteria in the intervention protocols, being necessary new lines of research

Commercial mobile applications in the therapeutic approach to stroke: Review in main application repositories and scientific evidence

Fundamentos: El ictus es la principal causa de discapacidad física en la población adulta. La tecnología al servicio de la medicina aporta nuevas soluciones para la valoración, tratamiento y seguimiento de sujetos con afectaciones neurológicas. El objetivo del presente estudio fue realizar una revisión sobre el uso de aplicaciones móviles comerciales en el abordaje terapéutico de sujetos que han sufrido ictus, así como analizar si existe evidencia científica sobre el uso de dichas apps. Métodos: Se llevó a cabo una búsqueda de apps útiles para el abordaje terapéutico del ictus y de sus posibles secuelas clínicas, en los principales repositorios de aplicaciones: “Google Play” y “App Store”. Se analizó la posible evidencia científica de cada app obtenida, en las siguientes bases de datos: Web Of Science, Pubmed, ScienceDirect, Scopus y Google Scholar. Resultados: Se obtuvieron 45 apps que cumplían los criterios de selección. Éstas se subdividieron en diferentes categorías: herramientas de valoración (13), programa de ejercicio terapéutico (8) percepción de la lateralidad y esquema corporal (7), manejo de trastornos secundarios (7), movilidad, destreza y coordinación manual (5) y corrección postural y ergonomía (5). De las 45 apps obtenidas, solo 10 de ellas habían sido utilizadas en estudios incluidos en las bases de datos científicas consultadas. Conclusiones: Existe amplia variedad de apps móviles comerciales de gran utilidad y bajo coste, aplicables en la valoración y tratamiento de sujetos que han sufrido ictus, existiendo evidencia científica, aunque escasa, sobre la validez de dichas apps

Economía de la Salud: identificación de los principales productores, la especialización relativa de los países y temas

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

Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis

Background: Patients with spinal cord injury (SCI) usually present with different motor impairments, including a deterioration of upper limb motor function (ULMF), that limit their performance of activities of daily living and reduce their quality of life. Virtual reality (VR) is being used in neurological rehabilitation for the assessment and treatment of the physical impairments of this condition. Objective: A systematic review and meta-analysis was conducted to evaluate the effectiveness of VR on ULMF in patients with SCI compared with conventional physical therapy. Methods: The search was performed from October to December 2019 in Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and Cochrane Central Register of Controlled Trials. The inclusion criteria of selected studies were as follows: (1) comprised adults with SCI, (2) included an intervention with VR, (3) compared VR intervention with conventional physical therapy, (4) reported outcomes related to ULMF, and (5) was a controlled clinical trial. The Cochrane Collaboration's tool was used to evaluate the risk of bias. The RevMan 5.3 statistical software was used to obtain the meta-analysis according to the standardized mean difference (SMD) and 95% CIs. Results: Six articles were included in this systematic review. Four of them contributed information to the meta-analysis. A total of 105 subjects were analyzed. All of the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed nonsignificant results for the Nine-Hole Peg Test (SMD -0.93, 95% CI -1.95 to 0.09), muscle balance test (SMD -0.27, 95% CI -0.82 to 0.27), Motricity Index (SMD 0.16, 95% CI -0.37 to 0.68), Jebsen-Taylor Hand Function Test (JTHFT) subtests (writing, SMD -0.10, 95% CI -4.01 to 3.82; simulated page turning, SMD -0.99, 95% CI -2.01 to 0.02; simulated feeding, SMD -0.64, 95% CI -1.61 to 0.32; stacking checkers, SMD 0.99, 95% CI -0.02 to 2.00; picking up large light objects, SMD -0.42, 95% CI -1.37 to 0.54; and picking up large heavy objects, SMD 0.52, 95% CI -0.44 to 1.49), range of motion of shoulder abduction/adduction (SMD -0.23, 95% CI -1.48 to 1.03), shoulder flexion/extension (SMD 0.56, 95% CI -1.24 to 2.36), elbow flexion (SMD -0.36, 95% CI -1.14 to 0.42), elbow extension (SMD -0.21, 95% CI -0.99 to 0.57), wrist extension (SMD 1.44, 95% CI -2.19 to 5.06), and elbow supination (SMD -0.18, 95% CI -1.80 to 1.44). Favorable results were found for the JTHFT subtest picking up small common objects (SMD -1.33, 95% CI -2.42 to -0.24). Conclusions: The current evidence for VR interventions to improve ULMF in patients with SCI is limited. Future studies employing immersive systems to identify the key aspects that increase the clinical impact of VR interventions are needed, as well as research to prove the benefits of the use of VR in the rehabilitation of patients with SCI in the clinical setting

Effectiveness of Dry Needling versus Placebo on Gait Performance, Spasticity, Electromyographic Activity, Pain, Range-of-Movement and Quality of Life in Patients with Multiple Sclerosis: A Randomized Controlled Trial Protocol

Dry needling (DN) is an emerging technique commonly used in neurological and musculoskeletal pain conditions, but there have been no previous studies in patients with multiple sclerosis (pwMS). This trial aims to assess the efficacy of deep DN, compared with sham placebo DN, on gait performance, spasticity level, pain, electromyographic activity, range-of-movement (ROM) and quality of life in pwMS. Forty adults with MS were randomly assigned to one study group. The DN group will undergo 2 sessions (once per week) using DN over the rectus femoris (RF) and gastrocnemius medialis (GM) muscles at the lower extremity with higher spasticity. The placebo group will receive the same protocol using a sham placebo needle (Dong Bang needle). Outcome measures will include gait performance, using the GaitRite(R) system, spasticity level with the Modified Ashworth Scale, superficial electromyographic activity of RF and GM, pain (pressure algometer), ROM (goniometer), and quality of life (Musiqol). This study is the first investigating the short-term effect of DN, compared with placebo, in pwMS, and taking into account the possible changes in the electromyographic activity of the lower limb. Therefore, the results may help to understand the suitability of using this technique in the clinical setting for this population. Trial registration: ACTRN12619000880145