Effectiveness of physical therapy in axillary web syndrome after breast cancer: a systematic review and meta-analysis

The axillary web syndrome (AWS) is a surgical breast cancer sequel that limits the functionality of the patient and delays the protocol times of application of cancer treatments. This implies a long period of discomfort and limitations for the user. Objective: To investigate the different physiotherapy treatments for the AWS and how effective they are. Methods: A systematic review based on PRISMA protocol and registered in PROSPERO (CRD42021281354) was conducted. The research was performed using PubMed, Scopus, CINAHL, PEDro, and Web of Science databases during January 2022 and March 2022. All randomized controlled trials and controlled clinical trials were included in this review. Results: A total of 188 articles were identified, with 9 studies selected for the systematic review. These studies basically propose treatments based on exercises and stretching, manual therapy, and the combination of manual therapy and exercises. Conclusions: Exercise and stretching are the most effective therapies within the field of physiotherapy for the rehabilitation of axillary web syndrome. They restore range of motion faster, reduce pain, improve quality of life, and reduce disabilities. Manual therapy, scar massage, and myofascial release could help improve outcomes but with worse results. The meta-analysis conclusion is that pain is the only outcome with a significant reduction after the application of physiotherapy treatments − 0.82 [− 1.67; 0.03]. This conclusion is drawn from the only three studies with small sample sizesFunding for open access publishing: Universidad de Cádiz/CBUA This study was funded by the University of Málaga through a predoctoral grant support to JBGR, a PhD student at the university

Randomised clinical trial of a manual therapy programme to reduce the evolution time of axillary web syndrome in women affected by breast cancer: study protocol

Introduction Breast cancer is the most common malignant tumour in women, with more than 2 million new cases annually worldwide. One of the most frequent and well-known surgical and post-actinic sequelae is post-mastectomy lymphoedema. The axillary web syndrome is another sequela that limits the functionality of the patient and delays the protocol time of administering cancer treatments; and in many cases, this sequela is misdiagnosed. This surgical sequela usually disappears spontaneously after the third month of appearance, but this implies a long period of discomfort and limitations for the patient, at the same time, it may delay the application of radiotherapy within the indicated protocol deadline (due to a need for body posture). Methods and analysis With the present quasi-experimental study, we intend to show the application of physiotherapy and stretching from the beginning of the appearance of the axillary cord, in a controlled and scheduled way by the physiotherapist. It is possible to reduce the time in which the lymphatic thrombus is present and, therefore, recover functionality and mobility, reduce pain and be able to apply treatments within the established deadline. We intend to apply this therapy into the intervention group and compare thrombus evolution time with the control group. Ethics and dissemination This trial has the approval of the Andalucia Ethics Committee (PEIBA code 1909-N1-21, reg. number 171.21)

Aprendizaje colaborativo y evaluación por pares a través de rúbricas en las asignaturas de “Métodos específicos de intervención en Fisioterapia I y II”

Artículo dentro de la convocatoria de Innovación Docente 18-19La docencia siempre es un reto para cualquier profesor y es necesario poseer herramientas que motiven al alumnado para participar en el proceso de aprendizaje. El objetivo principal de este proyecto de innovación docente es integrar el uso de recursos audiovisuales para mejorar el aprendizaje mediante el trabajo en grupo, así como involucrar al alumnado en el proceso de evaluación mediante la utilización de rúbricas. Metodología: Este proyecto se llevó a cabo en dos asignaturas del tercer curso del Grado de Fisioterapia con la colaboración del Centro de Recursos Digitales de la UCA. Se basó en la organización de los alumnos por equipos, y cada grupo debía realizar un power point y un vídeo sobre una determinada técnica de Fisioterapia. Fueron 12 trabajos en total por cada asignatura involucrada. Posteriormente a su visualización por el profesorado y el alumnado, se debían valorar mediante una rúbrica consensuada Finalmente se elaboraron dos encuestas (una de expectativas y otra de satisfacción) que los alumnos debían realizar al inicio y al final del proyecto. Resultados y Conclusiones: Ante los resultados obtenidos podemos concluir que el trabajo colaborativo ha sido beneficioso, aunque les suponga una inversión de tiempo extra. No se han encontrado diferencias relevantes en las encuestas las encuestas al comparar ambas asignaturas. En cuanto a la evaluación por rúbricas, las notas realizadas por el docente y los compañeros han variado, siendo inferiores las calificaciones de los profesores.6 página

Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: a randomized, single-blind, controlled trial

Background: The best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial induction (MI) is a therapeutic approach in which the aim is to release fascial tension and regain mobility that has been presented as a possible option in other musculoskeletal pathologies, although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization. Methods: Patients were randomly assigned to a control group, which received conventional kinesitherapy, or to the intervention group, which received a myofascial therapy protocol. Both groups completed a therapeutic exercise program based on specific mobilization and strengthening exercises. Main Outcome Measures: The QuickDash questionnaire was the primary outcome, Visual Analog Scale and the Passive Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3) Results: 44 participants were included. Comparative analysis revealed no statistically significant differences at 12 weeks between the two therapies in any of the variables explored. Significant improvement was observed in functionality measured with the QuickDash scale and in range of motion measurements in both groups (p<0.05). Only myofascial therapy achieved a clinically and statistically significant reduction (VAS improvement >or= 2) at 12 weeks, [GC: -1.568 (3.626) p=0.055; MG: -2.091 (3.715) p=0.015]. Conclusions: Both, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain Trial registration: Trial registration: ClinicalTrials.gov NCT04944446. Registered 29 june 2021 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT049444

Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research

Background: There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. Methods: The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. Results: Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I-2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. Conclusions: The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results.This research was funded by the Department of Nursing and Physiotherapy (University of Cadiz)

Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis

Background: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. Objective: This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. Methods: A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta - Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation The Cochrane Collaboration tool was used to evaluate the risk of bias. Results: In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI -0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change -1.211, 95% CI -3.2005 to 0.7768; z=1.194; P=.23). Conclusions: AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed

Self-management in heart failure using mHealth: A content validation.

AIM: To describe the development of a mobile health application -mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity. METHODS: Critical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed. RESULTS: The developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI≥0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851. CONCLUSIONS: mICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation

The Influence of Therapeutic Exercise on Survival and the Quality of Life in Survivorship of Women with Ovarian Cancer

Background: Ovarian cancer is the most difficult of all gynaecological cancers to treat, mainly due to its late diagnosis. Although exercise interventions have been reported to be safe and beneficial for ovarian cancer, treatment does not include it and is usually a combination of chemotherapy and surgery. It is increasingly common to include exercise as a tool to increase survival in the cancer population. The aim of this study was to determine the influence of therapeutic exercise on survival and the quality of life in survivorship in women with ovarian cancer. Methods: Literature review of clinical trials, reviews and pilot studies compiled in three databases collected in PubMed, PEDro and Scopus. Results: Of the 44 articles found, 10 were selected. Improvements in survival, quality of life and comorbidities associated with ovarian cancer were found with exercise interventions as a treatment tool. Conclusions: Through the application of therapeutic exercise, improvements in survival and quality of life were observed, as well as in the general symptomatology of ovarian cancer. No adverse effects have been found with its use, but future studies with larger sample sizes with more detailed and individualised interventions combined with conventional treatment are needed

Pulmonary auscultation sequence.

En el vídeo se explica los requisitos a tener en cuenta en una secuencia de auscultación pulmonar, así como la secuencia posterior y anterior. Está dentro de los contenidos docentes de la asignatura Métodos Específicos de Intervención en Fisioterapia II, en la parte de Fisioterapia Respiratoria.La duración es de 8 minutos y 14 segundo

Lung segment learning and lung auscultation sequence through Augmented Reality

Se trata de un instrumento docente innovador que sirve de guía para conseguir el aprendizaje de la anatomía pulmonar y de la secuencia de auscultación pulmonar a través de unos marcadores que deberán ser visualizados a través de Realidad Aumentada mejorando la atención del alumnado.It is an innovative teaching tool that serves as a guide to achieve learning of lung anatomy and the sequence of lung auscultation through markers that should be visualized through Augmented Reality improving the attention of students.3 páginas con la explicación de su visualización y el orden a seguir