Person: Baño Alcaraz, Aitor
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Relación entre el sexo, edad e índice de masa corporal y el Foot Function Index en pacientes con fascitis plantar
La fascitis plantar es una de las patologías de miembro inferior que más impacto causan en la persona produciendo dolor, discapacidad y limitación funcional. Una serie de factores incrementan el riesgo de sufrir fascitis plantar tales como predominio del sexo femenino, edad avanzada y un índice de masa corporal (IMC) elevado. El impacto que produce la fascitis plantar en la persona ser cuantificado por escalas para darnos información en la clínica acerca del estado de nuestros pacientes. Métodos y objetivos: Se realizó un estudio observacional transversal con 28 participantes que sufrían fascitis plantar y se les administra la encuesta FFI-sp con el propósito de determinar la relación entre las subescalas incluidas en el FFI-sp con el sexo, edad e IMC en pacientes con fascitis plantar. Resultados: No se han obtenido resultados significativos que indiquen relación del sexo, edad e IMC con las subescalas incluidas en el FFI-sp. Conclusión: No se ha encontrado relación entre FFI-sp y las variables sexo, edad e IMC.
Clinical practice guidelines in fibromyalgia. Physiotherapists’ adherence in Denmark: a cross-sectional web-based survey study
Fibromyalgia is a widespread chronic condition. Although Clinical Practice Guidelines for fibromyalgia currently exist, their application in diagnostic and therapeutic settings faces significant implementation challenges across healthcare systems. This has led to a persistent gap between knowledge and clinical practice, a phenomenon yet to be explored in the Danish context. A cross-sectional study was conducted to investigate the level of knowledge and adherence to Clinical Practice Guidelines for fibromyalgia among Danish physical therapists, throughout a questionnaire consisting in the selection of the elements that they would consider for the adequate assessment, treatment, and expected duration of the therapeutic approach, to classify professionals as adherent, partially adherent, or non-adherent based on their selection of assessment and treatment components, and to evaluate their responses to 24 statements on a 5-point Likert scale reflecting their alignment with recommendations from Clinical Practice Guidelines. A total of 149 physiotherapists (mean age 39.26 ± 11.50, and gender-balanced) participated, amongst which 35 (23.49%) were classified as ‘adherent’, and 46 subjects (30.87%) were labelled as ‘partially adherent’ to Clinical Practice Guidelines. Participants’ assessment and therapeutic tools selection was generally aligned with the Clinical Practice Guidelines’ extolled recommendations, except for tender points examination and massage therapy. A number of 14 out of the 24 statements exceeded the predefined 70% agreement threshold. The current study reflects an adequate level of knowledge and adherence amongst physiotherapists in Denmark. Further research and targeted implementation strategies are needed to reduce the evidence-to-practice gap
A complementary technique that improves flexibility without compromising strength: the role of ultrasound-guided nerve stimulation
Background Hamstring flexibility is a key determinant of musculoskeletal function and physical performance; however, conventional interventions such as static stretching may negatively affect muscle strength. Ultrasound-guided peripheral nerve stimulation has emerged as a potential neuromodulatory technique, although its effects on flexibility and strength remain insufficiently explored. Objective To evaluate the effects of ultrasound-guided electrical stimulation of the sciatic nerve on hamstring flexibility and muscle strength. Methods A randomized, double-blind, placebo-controlled clinical trial was conducted in 40participants. Participants were allocated to either an experimental group receiving ultrasound-guided peripheral nerve stimulation or a control group undergoing a sham intervention. Hamstring flexibility was assessed using the popliteal angle, toe-touch, and fingertip-to-floor tests, and muscle strength was measured with a digital dynamometer. Assessments were performed before and immediately after the intervention. Results Significant improvements in all flexibility measures were observed in the experimental group (p < 0.05), whereas no significant changes were detected in the control group (p > 0.05). Between-group comparisons demonstrated significantly greater improvements in flexibility in the experimental group (p < 0.05). No statistically significant differences were found in muscle strength between groups (p > 0.05). Conclusion Ultrasound-guided peripheral nerve stimulation improved immediate hamstring flexibility without evidence of an acute reduction in the measured strength outcomes in this exploratory sample.. This technique may represent a promising alternative for both clinical rehabilitation and performance optimization, although further studies are required to confirm the durability of its effects.
Relationship between low back mobility test and low back pain in amateur paddle tennis players
L'attuale letteratura scientifica non offre una quantità di studi sufficiente a determinare se il deficit di mobilità lombare possa essere correlato al dolore avvertito a livello della regione lombare, nei giocatori di paddle tennis. METODI: Il disegno di studio impiegato è osservazionale, analitico e trasversale. Il range di mobilità lombare è stato valutato in un campione di 34 giocatori di paddle tennis per mezzo del test di Schöber modificato-modificato (Modified- Modified Schöber Test, MMST), del test Toe touch (TTT), dell’analisi dei punteggi FMS® relativi al gesto motorio dello squat profondo (Deep Squat, DS) e alla misurazione della flessione lombare nella posizione finale dello squat profondo (lumbar flexion measurement in the final position of the deep squat, LBM in FMS® DS). RISULTATI: Sono state riscontrate differenze significative nella LBM in FMS® DS (P=0,014) in relazione alla pre-esistenza/ assenza di dolore localizzato a livello della regione lombare. È stata inoltre osservata una moderata correlazione positiva tra TTT e LBM in FMS® DS (0,517) nel gruppo non affetto da lombalgia, mentre nel gruppo che presentava lombalgia è stata evidenziata una ragguardevole correlazione negativa tra TTT e LBM in FMS® DS (-0,592). Una correlazione positiva “elevata” (0,721) è parimenti emersa tra tra MMST e LBM in FMS® DS. Infine abbiamo riscontrato anche una “considerevole” correlazione negativa (-0,672) tra TTT e LBM nella FMS® DS. CONCLUSIONI: Il test di mobilità lombare e il dolore lombare sono correlati nei giocatori di paddle tennis amatoriali.
Physiotherapists' adherence to Clinical Practice Guidelines in fibromyalgia: a cross-sectional online survey
To evaluate the level of knowledge and adherence to Clinical Practice Guidelines on fibromyalgia of physiotherapists in Spain. A cross-sectional study using an ad-hoc online survey was implemented to assess aspects on the assessment, treatment, and decision of the length of the therapeutic approach on fibromyalgia. Based on the results, professionals were classified as adherent, partially adherent, or non-adherent. The level of agreement with several statements on the condition was also evaluated across the professionals surveyed to evaluate the potential consensus. A total of 240 physiotherapists met inclusion criteria, amongst which 68 (28.33%) were adherent. The academic level of studies (Chi-square = 48.601, p-value = 0.001) and having had previous training in fibromyalgia (Chi-square = 151.011, p-value = 0.001) displayed statistically significant differences across adherence-based groups. Consensus was reached for 15 out of 24 statements. Our findings highlight the presence of an acceptable level of knowledge and adherence to clinical practice guidelines in the field of fibromyalgia among physiotherapists in Spain.Practice implicationsOur results also reveal the existence of an evidence-to-practice gap in the field, with potential room for improvement: further efforts on promoting and reinforcing the importance of evidence-based therapies are needed, from university teaching plans to clinical updates for daily practice.
Effectiveness of a cervical treatment in wind-instrument musicians with temporomandibular dysfunction: a randomized clinical trial
Aims To compare the effectiveness of a combined treatment involving manual therapy and postural exercises in wind musicians with temporomandibular dysfunction (TMD). Methods: A randomized controlled clinical trial was conducted among a sample of TMD-affected wind-instrument musician students (NCT05893251), who were assigned to an experimental group (EG) or a control group (CG). Both groups underwent an active cervical postural treatment for 4 weeks, with the experimental group (EG) additionally receiving a cervical therapy protocol. Participants were assessed through the craniofacial pain and disability inventory (CF-PDI) test and maximum mouth opening (MMO). Results The treatment administered to the experimental group (EG) demonstrated higher efficacy compared to the control group (CG) in terms of MMO and CF-PDI scores (p < 0.05). Conclusion A therapeutic program including manual therapy at a cervical level and a program of active postural exercises results to be more effective than solely performing postural exercises on wind musicians with DTM.
Addition of tDCS and TENS to an education and exercise program in subjects with knee osteoarthritis: a study protocol
BACKGROUND: Knee osteoarthritis often leads to chronic pain that frequently becomes disabling.Osteoarthritis has been linked to maladaptive plasticity in the brain, which can contribute to chronic pain. Therapies including neuromodulation and peripheral electrical stimulation are used to counteract the maladaptive plasticity of the brain. OBJECTIVE: To determine the efficacy of the addition of tDCS and TENS to an education and exercise program in reducing pain. METHODS: Over a 2-week study period, 60 participants will complete an exercise and educational intervention. Eligible participants accepting to participate will be subsequently randomized into one of the three treatment groups: 1) Active Transcranial Direct Current Stimulation (tDCS) and active Transcutaneous Electrical Nerve Stimulation (TENS); 2) Active tDCS and sham TENS; 3) Sham tDCS and sham TENS. RESULTS: The primary outcome will be subjective pain intensity. Secondary outcomes: quality of life, physical function, central sensitization, and pain adjuvants (uncertainty, catastrophizing kinesiophobia, adverse events). CONCLUSION: This clinical trial will provide data on the effect that the addition of tDCS and/or TENS to an education and exercise program may have to counteract maladaptive plastic changes and improve the benefits of exercises, and whether the combination of both neuromodulator techniques may have a higher magnitude of effect.
Coexistence of neck pain and low back pain, and their association with demographic, occupational, and spine MRI-based morphological factors in dentists
Background The prevalence of musculoskeletal pain, particularly low back pain (LBP) and neck pain (NP), is notably high among dentists. Several studies have examined associated factors such as age, gender, long working hours, non-ergonomic postures, and repetitive movements. Magnetic resonance imaging (MRI) is considered the gold standard for detecting spinal morphological changes; however, evidence shows that MRI findings do not always correlate with the presence or severity of LBP or NP. Purpose This study aimed to compare the relative frequency of coexisting versus isolated NP and LBP and to assess their association with demographic, occupational, and MRI-based morphological factors. Methods A descriptive cross-sectional study was conducted among actively practicing dentists affiliated with the Professional College of Dentists and Stomatologists of Murcia. Data were collected during a single visit at an authorized radiology unit, including pain types, demographic and occupational data, and MRI measurements. Results A total of 57 dentists participated. LBP was reported by 66.7% of participants, while NP was present in 70%; notably, 47.4% experienced both simultaneously. MRI findings revealed that the most common lumbar alterations were disc bulging (84.2%) and facet joint degeneration (66.7%), while cervical changes included disc bulging (66.7%) and herniated disc (54.4%). A significant association (p = 0.010) was found between younger dentists and the coexistence of both pain types, as well as between middle-aged dentists (40–49 years) and isolated LBP. Conclusion Nearly half of dentists experience coexisting NP and LBP, with coexistence strongly linked to individuals under 40 years of age.
Knowledge and attitudes towards patient safety among students in physical therapy in Spain: a longitudinal study
Background: Patient safety is a discipline of health care management aiming to prevent and reduce errors and harm to patients. The assessment of knowledge and attitudes on patient safety among students in physical therapy is still scarce; no studies have yet explored the changes that internship periods may produce. Objectives: 1. to determine the attitudes and knowledge of students in physical therapy with respect to patient safety in a Spanish University; and 2. to explore changes following a practical internship period. (2) Methods: Longitudinal study. Data from the Attitudes to Patient Safety Questionnaire III (APSQ-III) before and after the internship period were obtained from an initial sample of 125 students and average positive response rates were compared. (3) Results: “Team functioning”, “Importance of patient safety in the curriculum”, and “Error inevitability” displayed the highest scores, in accordance with the current literature. After the internship period, the dimensions “Patient safety training received” (p = 0.001), “Error reporting confidence” (p = 0.044), and “Professional incompetence as an error cause” (p = 0.027) showed significant changes. (4) Conclusions: The current study, highlighting areas of strengths and weaknesses in the knowledge and attitudes of students in physical therapy towards patient safety, may be a foundation to adopt tailored programs to enhance students’ competencies in patient safety
Effects of a Self-Management Program for Temporomandibular Myalgia in Patients With Fibromyalgia: A Single-Arm Study
Purpose Myogenic temporomandibular disorder frequently co-occurs with fibromyalgia and is associated with pain, disability, and maladaptive pain cognitions. This study evaluated the short- and long-term effects of an online Pain Neuroscience Education-informed self-management program in individuals with fibromyalgia and myogenic temporomandibular disorder. Design Prospective single-arm clinical study. Methods Adults with fibromyalgia and myogenic temporomandibular disorder participated in a therapist-led online group self-management program consisting of three sessions integrating Pain Neuroscience Education, temporomandibular exercises, self-care strategies, and mindfulness. Assessments were conducted at baseline, post-treatment (4 weeks), and 12-month follow-up. Pain intensity at rest and during maximum mouth opening were predefined as primary outcomes. Secondary outcomes included pain-related cognitions, pain neurophysiology knowledge, psychological symptoms, central sensitization, jaw function, oral health-related quality of life, and oral habits. Changes over time were analysed using repeated-measures analysis of variance. Results A total of 107 participants were enrolled. Significant and sustained reductions were observed in temporomandibular pain during maximum mouth opening, whereas pain at rest did not change significantly. Significant, large, and sustained improvements were found in kinesiophobia, pain catastrophizing, and pain neurophysiology knowledge. Moderate short-term reductions were observed in anxiety, depression, and insomnia, but these were not maintained at 12 months. No significant changes were found in central sensitization, jaw functional limitation, oral health-related quality of life, or oral habits. Conclusions A brief online Pain Neuroscience Education-informed self-management program was associated with durable improvements in movement-evoked temporomandibular pain and pain-related cognitions in individuals with fibromyalgia and myogenic temporomandibular disorder. Clinical Implications A brief online self-management program incorporating Pain Neuroscience Education appears feasible for this population and may contribute to improvements in movement-evoked pain and pain-related cognitions. Controlled studies are needed to determine its clinical effectiveness.