Relación de factores del comercio internacional de Colombia, del ejercicio productivo de sus zonas francas y del indicador de desarrollo económico en los últimos 13 años

Para llevar a cabo el presente estudio, inicialmente se establece el panorama general de la incidencia comportamental del crecimiento económico de Colombia considerando particularidades de la región latinoamericana, para seguidamente relacionar estas consideraciones con las conceptualizaciones teóricas que aclaran los elementos a tratar desde el punto de vista estadístico. Definidas las variables a relacionar se calculan los correspondientes coeficientes de correlación y de determinación, visualizando la interacción gráfica. Para terminar, se analizan los datos y resultados sistematizados para sacar las conclusiones que aportan y justifican los objetivos propuestos.To carry out this study, initially sets the overview of the behavioral impact of economic growth of Colombia considering particularities of the Latin American region, and then relate these observations with theoretical conceptualizations that clarify the elements to treat from a statistical point of view. Defined the variables to relate are calculated the corresponding coefficients of correlation and determination, by viewing the graphical interaction. In conclusion, the data is analyzed and systematized results to draw conclusions that provide and justify the proposed objectives

Efectividad del abordaje específico de la región suboccipital en pacientes con cervicalgia mecánica crónica con déficit de rotación

Introducción: La cervicalgia mecánica es la tipología más frecuente de dolor cervical. La mayoría tiene su origen en factores mecánicos: movimientos repetitivos, ausencias de pausas en el trabajo, cargas estáticas y posturas mantenidas con la cabeza y/o los brazos. La incidencia anual de episodios de cervicalgia mecánica atendidos por los médicos de Atención Primaria se calcula en 12 por cada 1.000 sujetos que acuden a la consulta, y constituye uno de los principales problemas de salud atendidos en las unidades de fisioterapia de Atención Primaria. Las dos tecnicás manuales de la región suboccipital de este estudio, presenta una buena evidencia clínica, pero no se han realizado estudios en la cervicalgia mecánica crónica,Objetivo: Evaluar la efectividad de la técnica de inhibición suboccipital por presión mantenida (TISPM) y la movilización de deslizamiento translatorio dorsal de la articulación occipito-atloidea en grado III (MDTD), produce una mejoría adicional en la sintomatología en comparación con el tratamiento fisioterápico convencional, en sujetos con cervicalgia mecánica crónica y déficit de la rotación cervical superior.Material y Métodos: Se diseño un estudio Ensayo clínico aleatorizado, doble ciego. El estudio fue aprobado por el CEIC del IDIAP Jordi Gol, llevado a cabo en un servicio público de Atención Primaria. Registrado previamente en Clinicaltrials NCT02832232. Se reclutaron 78 pacientes con cervicalgia mecánica crónica que se repartieron en tres grupos. Grupo Control con tratamiento protocolizado consistente en IR, autotracciones, autoestiramientos y flexibilización de la columna dorsal, más charlas educativas; Grupo TISPM con tratamiento protocolizado más técnica de inhibición suboccipital por presión mantenida y Grupo MDTD con tratamiento protocolizado más técnica de movilización de deslizamiento translatorio dorsal de la articulación occipito-atloidea en grado III. Se valoró Intensidad de dolor, Rango de movilidad columna cervical global, Rango de movilidad columna cervical superior, discapacidad cervical, intensidad de cefaleas, evaluación palpatoria de los músculos suboccipitales y la apreciación subjetiva del cambio clínico. Las valoraciones se realizaron al inicio, final de tratamiento y 3 meses postratamiento.Resultados: Los grupos eran homogéneos al inicio. En la movilidad de la columna cervical global el grupo MDTD ofrece mejores resultados a corto plazo y el Grupo TISPM ofrece mejores resultados a medio plazo, en la variable de la movilidad de la columna cervical superior a corto y medio plazo el grupo MDTD es el que ofrece mejores resultados. En la variable intensidad del dolor el grupo MDTD ofrece mejores resultados a corto y medio plazo siendo el grupo TISPM el de mayor ganancia, en la intensidad de la cefalea ambos grupos de la técnica manual presentan diferencias estadísticamente significativas a corto y medio plazo siendo el grupo TISPM el de mayor ganancia, en la variable discapacidad cervical el grupo MDTD ofrece mejores resultados a corto y medio plazo, en la evaluación palpatoria el grupo MDTD ofrece mejores resultados a corto y medio plazo y el grupo TISPM a medio plazo. Los dos grupos de las técnicas manuales ofrece más caso de mejoría clínica siendo el grupo MDTD el que presentaba mas caso a corto y medio plazo más del 50%, el 69,2% a corto plazo y el 81% a medio plazo dejaron de tener un test de flexión rotación restringido en el grupo MDTD.Conclusiones: Añadir 6 sesiones de 5 minutos, con la MDTD, al protocolo de fisioterapia de Atención Primaria propuesto; produce mayor ganancia en discapacidad cervical y en el umbral de dolor a la presión a corto y medio plazo, y a corto plazo en la intensidad del dolor; mientras que añadir la TISPM al tratamiento de fisioterapia presenta mejores resultados en la intensidad del dolor a medio plazo y en la intensidad de la cefalea tanto a corto como medio plazo, en sujetos con cervicalgia mecánica crónica y déficit de rotación cervical superior.Añadir 6 sesiones de 5 minutos, con la MDTD, al protocolo de fisioterapia de Atención Primaria propuesto; produce mayor ganancia en la movilidad de la columna cervical global a corto plazo, mientras que a medio plazo añadir la TISPM al tratamiento de fisioterapia, presenta mejores resultados en sujetos con cervicalgia mecánica crónica y déficit de rotación cervical superior.Añadir 6 sesiones de 5 minutos, con la técnica de movilización de deslizamiento translatorio dorsal de la articulación occipito-atloidea, al protocolo de fisioterapia de Atención Primaria propuesto; produce mayor ganancia en la movilidad de la columna cervical superior tanto a corto como medio plazo en sujetos con cervicalgia mecánica crónica y déficit de rotación cervical superior.<br /

Effect of scapular fixation on lateral movement and scapular rotation during glenohumeral lateral distraction mobilisation

Background: Glenohumeral lateral distraction mobilisation (GLDM) is used in patients with shoulder mobility dysfunction. No one has examined the effect of scapular fixation during GLDM. The aim was to measure and compare the lateral movement of the humeral head and the rotational movement of the scapula when three different magnitudes of forces were applied during GLDM, with and without scapular fixation. Methods: Seventeen volunteers were recruited (n = 25 shoulders). Three magnitudes of GLDM force (low, medium, and high) were applied under fixation and non-fixation scapular conditions in the open-packed position. Lateral movement of the humeral head was assessed with ultrasound, and a universal goniometer assessed scapular rotation. Results: The most significant increase in the distance between the coracoid and the humeral head occurred in the scapular fixation condition at all three high-force magnitudes (3.72 mm; p &lt; 0.001). More significant scapular rotation was observed in the non-scapular fixation condition (12.71°). A difference in scapula rotation (10.1°) was observed between scapular fixation and non-scapular fixation during high-force application. Conclusions: Scapular fixation resulted in more significant lateral movement of the humeral head than in the non-scapular fixation condition during three intensities of GLDM forces. The scapular position did not change during GLDM with the scapular fixation condition

Changes over time in the strain on the inferior iliofemoral ligament during a sustained 5-minute high-force long-axis distraction mobilization: a cadaveric study

Objective To analyze the changes over time in the strain on the inferior iliofemoral (IIF) ligament when a constant high-force long-axis distraction mobilization (LADM) was applied over 5 minutes. Design A cross-sectional laboratory cadaveric study. Setting Anatomy laboratory. Participants Thirteen hip joints from 9 fresh-frozen cadavers (mean age, 75.6±7.8 years; N=13). Interventions High-force LADM in open-packed position was sustained for a period of 5 minutes. Main Outcome Measure(s) Strain on IFF ligament was measured over time with a microminiature differential variable reluctance transducer. Strain measurements were taken at every 15 seconds for the first 3 minutes and every 30 seconds for the next 2 minutes. Results Major changes in strain occurred in the first minute of high-force LADM application. The greatest increase in strain on the IFF ligament occurred at the first 15 seconds (7.3±7.2%). At 30 seconds, the increase in strain was 10.1±9.6%, the half of the total increase at the end of the 5-minute high-force LADM (20.2±8.5%). Significant changes in strain measures were shown to occur at 45 seconds of high-force LADM (F=18.11; P<.001). Conclusions When a 5-minute high-force LADM was applied, the major changes in the strain on IIF ligament occurred in the first minute of the mobilization. A high-force LADM mobilization should be sustained at least 45 seconds to produce a significant change in the strain of capsular–ligament tissue

Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

Background: Stretching techniques for hamstring muscles have been described both to increase muscle length and to evaluate nerve mechanosensitivity. Aim: We sought to evaluate the short-term effects of three types of hamstring stretching on hamstring length and report the type of response (neural or muscular) produced by ankle dorsiflexion and perceived sense of effort in asymptomatic subjects. Methods: A randomised cross-over clinical trial was conducted. A total of 35 subjects were recruited (15 women, 20 men; mean age 24.60 ± 6.49 years). Straight leg raises (SLR), passive knee extensions (PKE), and maximal hip flexion (MHF) were performed on dominant and non-dominant limbs. In addition, the intensity of the applied force, the type and location of the response to structural differentiation, and the perceived sensation of effort were assessed. Results: All stretching techniques increased hamstring length with no differences between limbs in the time*stretch interaction (p &lt; 0.05). The perceived sensation of effort was similar between all types of stretching except MHF between limbs (p = 0.047). The type of response was mostly musculoskeletal for MHF and the area of more neural response was the posterior knee with SLR stretch. Conclusions: All stretching techniques increased hamstring length. The highest percentage of neural responses was observed in the SLR stretching, which produced a greater increase in overall flexibility

Thermal and non-thermal effects off capacitive-resistive electric transfer application on the achilles tendon and musculotendinous junction of the gastrocnemius muscle: a cadaveric study

Background Calf muscle strain and Achilles tendon injuries are common in many sports. For the treatment of muscular and tendinous injuries, one of the newer approaches in sports medicine is capacitive-resistive electric transfer therapy. Our objective was to analyze this in vitro, using invasive temperature measurements in cadaveric specimens. Methods A cross-sectional study designed with five fresh frozen cadavers (10 legs) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) was performed for 5¿min each by a diathermy “T-Plus” device. Achilles tendon, musculotendinous junction and superficial temperatures were recorded at 1-min intervals and 5¿min after treatment. Results With the low-power capacitive protocol, at 5¿min, there was a 25.21% increase in superficial temperature, a 17.50% increase in Achilles tendon temperature and an 11.27% increase in musculotendinous junction temperature, with a current flow of 0.039 A¿±¿0.02. With the low-power resistive protocol, there was a 1.14% increase in superficial temperature, a 28.13% increase in Achilles tendon temperature and an 11.67% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.063 A¿±¿0.02. With the high-power capacitive protocol there was an 88.52% increase in superficial temperature, a 53.35% increase in Achilles tendon temperature and a 39.30% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.095 A¿±¿0.03. With the high-power resistive protocol, there was a 21.34% increase in superficial temperature, a 109.70% increase in Achilles tendon temperature and an 81.49% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.120 A¿±¿0.03. Conclusion The low-power protocols resulted in only a very slight thermal effect at the Achilles tendon and musculotendinous junction, but current flow was observed. The high-power protocols resulted in a greater temperature increase at the Achilles tendon and musculotendinous junction and a greater current flow than the low-power protocols. The high-power resistive protocol gave the greatest increase in Achilles tendon and musculotendinous junction temperature. Capacitive treatments (low- and high-power) achieved a greater increase in superficial temperature

Comparison of resistive capacitive energy transfer therapy on cadaveric molars and incisors with and without implants.

Capacitive-resistive energy transfer therapy (CRet) is used to improve the rehabilitation of different injuries. This study aimed to evaluate and compare the changes in temperature and current flow during different CRet applications on upper and lower molars and incisors, with and without implants, on ten cryopreserved corpses. Temperatures were taken on molars and incisors with invasive devices and skin temperature was taken with a digital thermometer at the beginning and after treatments. Four interventions: 15 VA capacitive hypothermic (CAPH), 8 watts resistive (RES8), 20 watts resistive (RES20) and 75 VA capacitive (CAP75) were performed for 5 min each. All treatments in this study generated current flow (more than 0.00005 A/m2) and did not generate a significant temperature increase (p > 0.05). However, RES20 application slightly increased surface temperature on incisors without implants (p = 0.010), and molar with (p = 0.001) and without implant (p = 0.008). Also, CAP75 application increased surface temperature on molars with implant (p = 0.002) and upper incisor with implant (p = 0.001). In conclusion, RES8 and CAPH applications seem to be the best options to achieve current flow without an increase in temperature on molars and incisors with and without implants

Thermal and non-thermal effects of capacitive–resistive electric transfer application on different structures of the knee: A cadaveric study

Capacitive–resistive electric transfer therapy is used in physical rehabilitation and sports medicine to treat muscle, bone, ligament and tendon injuries. The purpose is to analyze the temperature change and transmission of electric current in superficial and deep knee tissues when applying different protocols of capacitive–resistive electric transfer therapy. Five fresh frozen cadavers (10 legs) were included in this study. Four interventions (high/low power) were performed for 5 min by a physiotherapist with experience. Dynamic movements were performed to the posterior region of the knee. Capsular, intra-articular and superficial temperature were recorded at 1-min intervals and 5 min after the treatment, using thermocouples placed with ultrasound guidance. The low-power protocols had only slight capsular and intra-capsular thermal effects, but electric current flow was observed. The high-power protocols achieved a greater increase in capsular and intra-articular temperature and a greater current flow than the low-power protocols. The information obtained in this in vitro study could serve as basic science data to hypothesize capsular and intra-articular knee recovery in living subjects. The current flow without increasing the temperature in inflammatory processes and increasing the temperature of the tissues in chronic processes with capacitive–resistive electric transfer therapy could be useful for real patients

Precision of ultrasound-guided versus anatomical palpation-guided needle placement of the ulnar nerve at the cubital tunnel: a cadaveric study

Percutaneous electrical stimulation has been performed for years with only the assistance of anatomical landmarks. The development of real-time ultrasonography guidance has improved the precision and safety of these percutaneous interventions. Despite ultrasound-guided and palpation-guided procedures being performed routinely for targeting nerve tissues in the upper extremity, the precision and safety of these techniques are unknown. The aim of this cadaveric study was to determine and compare the precision and safety of ultrasound-guided versus palpation-guided needling procedure with and without the handpiece of the ulnar nerve on a cadaveric model. Five physical therapists performed a series of 20 needle insertion tasks each (n = 100), 10 palpation-guided (n = 50) and 10 ultrasound-guided (n = 50) on cryopreserved specimens. The purpose of the procedure was to place the needle in proximity to the ulnar nerve at the cubital tunnel. The distance to target, time performance, accurate rate, number of passes, and unintentional puncture of surrounding structures were compared. The ultrasound-guided procedure was associated with higher accuracy (66% vs. 96%), lower distance from needle to the target (0.48 ± 1.37 vs. 2.01 ± 2.41 mm), and a lower frequency of perineurium puncture (0% vs. 20%) when compared with the palpation-guided procedure. However, the ultrasound-guided procedure required more time (38.33 ± 23.19 vs. 24.57 ± 17.84 s) than the palpation-guided procedure (all, p &lt; 0.001). Our results support the assumption that ultrasound guidance improves the accuracy of needling procedures on the ulnar nerve at the cubital tunnel when compared with palpation guidance

Vacuna emocional en la Covid-19: programa de autocuidado para personas mayores

The group of elderly people is one of the most affected by this pandemic. It is considered a risk group and age is a relevant factor in the body’s response to COVID-19. To face this situation and disease, it is important that people take care of themselves at a biopsychosocial level. The aim of this paper is to present a self-care and psychological activation program: “Emotional Vaccine for COVID-19”. It is aimed at elderly people without or with mild cognitive impairment, individually or in groups, in different environments: residential, home, day center, etc., assessing the effect of this program in the improvement of their quality of life, distinguishing between rural and urban contexts. The program consists of 10 sessions of one hour and a half, held twice a week. In each session, a self-care guideline is worked on through a message in the form of a saying that facilitates mnesic activation. From the Acceptance and Commitment Therapy and following the paradigm of the Attention Centered on what is Important for the Person, emotional management, cognitive stimulation and behavioral activation are addressed in order to produce better coping strategies for the current situation. The life project of each participant is emphasized through orientation to values. Using a quasi-experimental pre-post design with a control group, the following instruments are used: behavioral records, scales and questionnaires that measure quality of life, anxiety, depression and experiential avoidance. An improvement in health and well-being through psychological activation is expected in the target sample with respect to the control group. The need for this type of psychological intervention in the gerontological field is highlighted due to its feasibility, efficacy and social demand.El colectivo de personas mayores es uno de los más afectados por esta pandemia. Es considerado grupo de riesgo y la edad es un factor relevante en la respuesta que da el organismo frente a la Covid-19. Para afrontar esta situación y esta enfermedad es importante que las personas se cuiden a nivel biopsicosocial. El presente trabajo tiene como fin exponer un programa de autocuidado y de activación psicológica: “Vacuna Emocional para la COVID-19”. Dirigido a personas mayores sin o con deterioro cognitivo leve, de manera individual o grupal, en diferentes entornos: residencial, domiciliario, centro de día, etc., valorando el efecto de este programa en la mejora de su calidad de vida, distinguiendo entre contextos rurales y urbanos. El programa consta de 10 sesiones de una hora y media de duración aplicándose dos sesiones semanales. En cada sesión se trabaja una pauta de autocuidado a través de un mensaje con forma de refrán que facilita la activación mnésica. Desde la Terapia de Aceptación y Compromiso y siguiendo el paradigma de la Atención Centrada en lo Importante para la Persona, se aborda la gestión emocional, la estimulación cognitiva y la activación conductual de manera que se produzca un mejor afrontamiento de la situación actual. Se enfatiza el proyecto de vida de cada participante a través de la orientación en valores. Utilizando un diseño cuasiexperimental pre-post con grupo control, se emplean los instrumentos: registros conductuales, escalas y cuestionarios que midan calidad de vida, ansiedad, depresión y evitación experiencial. Se espera una mejora en la salud y bienestar a través de la activación psicológica en la muestra diana respecto al grupo control. Se destaca la necesidad de este tipo de intervención psicológica en el ámbito gerontológico por su viabilidad, eficacia y demanda social.