Fisioterapia

Obra que desde la fisioterapia se encarga de recoger la evidencia científica disponible para profundizar en el tratamiento de las patologías temporomandibulares, convirtiéndose así en una referencia en la materia para fisioterapeutas y terapeutas manuales. El enfoque de la obra es eminentemente visual, logrando además un perfecto equilibrio entre la información teórica y el abordaje práctico. Para ello, el contenido se complementa con una selección de diez vídeos en los que se muestra cómo realizar pruebas, movilizaciones y manipulaciones vinculadas al área temporomandibular. Se trata de un manual pionero en español centrado exclusivamente en el tratamiento fisioterapéutico del trastorno temporomandibular. Una de las claves de la obra es que presenta e interpreta la evidencia científica disponible sobre la materia con el objetivo de que el lector pueda aplicarla con eficacia en su labor clínica. Su contenido incluye aspectos que van desde la valoración diagnóstica del paciente hasta cuestiones más específicas como el tratamiento basado en terapia física, ejercicio terapéutico o la integración de áreas afines en el tratamiento de las patologías de origen temporomandibular, vinculando así la odontología, la cirugía maxilofacial o la logoterapia a la labor realizada por los fisioterapeutas y otros profesionales vinculados a la terapia manual.

El objetivo de este estudio fue analizar la presencia de alteraciones genéticas y polimorfismos en el gen SCN5A codificante para el canal de sodio cardiaco NaV1.5 en individuos sanos menores de 30 años y deportistas.

The purpose of the study was to determine if an intensive preseason training program modifies the inflammatory status in professional soccer players and if this inflammatory profile may be associated with the physical state. We compared plasma protein biomarkers, using proteomics, and the physiological state and cardiac function in 12 professional soccer players and 9 recreational soccer players. Reduced cardiac low frequency [LF] after the pre-season training program previous competition with respect to recreational soccer players was found. No differences were found in cardiac high frequency, cardiac high frequency/ low frequency ratio, tension index and oxygen volume consumption. Alpha-1-antitrypsin isotype-3, fibrinogen-gamma isotypes-1, 2 and 3 and vitamin-D-binding protein isotype-1 were reduced in professionals players compared with those in recreational players. However, an increased content of alpha-1- antitrypsin isotype-6 and alpha-1-antichymotrypsin 1 and 4 were found in professional soccer players. Spearman´s analysis showed a positive correlation between LF and fibrinogengamma chain isotype 3; but LF was negatively correlated with alpha-antichymotrypsin isotype 4. Professional soccer players submitted to an intensive training showed differences in the content of plasma proteins associated with inflammatory/ oxidative stress and thrombosis with respect to recreational soccer players. Proteomics analysis in combination with the analysis of cardiac function assessment may be useful to know more in depth molecular processes associated with sport and intensive exercise.

Jugador profesional de tenis de 26 años (188 cm ,82 kg) que durante el transcurso de un partido de un torneo Máster Series sufre dolor en zona abdominal al realizar un servicio. Los problemas de la musculatura abdominal constituyen una de las lesiones características del jugador de tenis. Son lesiones muy frecuentes al punto que una gran parte de los tenistas profesionales han sufrido este tipo de problemas en algún momento de su carrera. Se presentan en jugadores de todos los niveles y, por su naturaleza incapacitante para la ejecución del servicio y su tendencia a la recidiva, han de ser consideradas lesiones potencialmente graves, en especial, para el tenista de alta competición. La gran mayoría de las lesiones de la pared abdominal involucran al músculo recto mayor contralateral al brazo dominante (el que se utiliza para sacar). El músculo recto abdominal y las fibras laterales del oblicuo externo son considerados los movilizadores primarios de la flexión del tronco. Durante la fase de preparación del servicio de tenis, el jugador aleja la raqueta del cuerpo, principalmente, mediante la abducción-rotación externa del hombro y la hiperextensión de la columna lumbar, con el objetivo de aumentar el recorrido y velocidad de la raqueta. Durante esa fase del lanzamiento, el recto abdominal contralateral ha mostrado una elevada actividad electromiográfica predisponiendo a su lesión por estiramiento.

La articulación escapulotorácica y la acromioclavicular (AC) están íntimamente interrelacionadas formando el complejo suspensorio del hombro. Por lo tanto, las luxaciones AC de cualquier grado pueden afectar al ritmo escapular y a su biomecánica. En este artículo se revisa el concepto de disquinesis, cuáles son los criterios para su evaluación y las diferentes clasificaciones. Además, se profundiza en la relación entre la luxación AC y la disquinesis. Los aspectos anatómicos, la presencia aumentada de la disquinesis en el contexto de las diferentes lesiones de la AC y las hipótesis sobre sus causas. Finalmente se comentan los resultados del tratamiento conservador y quirúrgico en el contexto de la luxación AC grado 3 en cuanto a la disquinesis.

Shoulder pain is one of the most frequent causes of disability in overhead sports and often forces athletes andworkers to stop their activities. Scapular dyskinesis is not an injury or a musculoskeletal diagnosis, but rather analteration of the normal position or motion of the scapula during coupled scapulohumeral movements. Theunderlying pathology can be multifactorial in nature, and understanding the various contributing factors is importantin order to properly diagnose and treat the patient. An additional goal should be the prevention of further pathologyor symptoms. In the present article the concept of scapular dyskinesis is reviewed along with a review of theliterature regarding related pathology and our observations. Scapular dyskinesis can exist in asymptomaticindividuals. In symptomatic patients with shoulder pain the scapular rhythm should be evaluated and treated. Someof the associated pathologies could be subacromial impingement, internal impingement, chronic acromioclaviculardislocations grade III, chronic neck pain. Physical therapy is usually the preferred treatment of choice and effectiveto treat these patients.

Background. The medial longitudinal arch of the foot is a variable structure, and a decrease in its height could affect several functions and increase the risk of injuries in the lower limbs. There are many different techniques for evaluating it. Objective. The objective of this study was to evaluate the correlations of the Navicular Drop Test, several footprint parameters, and the Foot Posture Index-6 in people with a low medial longitudinal arch. Intrarater reliability and interrater reliability were also estimated. Design. This was a repeated-measures, observational descriptive study. Methods. Seventy-one participants (53.5% women; mean age = 24.13 years; SD = 3.41) were included. All of the parameters were collected from the dominant foot. The correlation coefficients were calculated. The reliability was also calculated using the intraclass correlation coefficient, 95% CI, and kappa coefficient. Results. Statistically significant correlations were obtained between the Navicular Drop Test and the footprint parameters, with r absolute values ranging from 0.722 to 0.788. The Navicular Drop Test and the Foot Posture Index-6 showed an excellent correlation (Spearman correlation coefficient = 0.8), and good correlations (Spearman correlation coefficient = |0.663–0.703|) were obtained between the footprint parameters and the Foot Posture Index-6. Excellent intrarater reliability and interrater reliability were obtained for all of the parameters. Limitations. Radiographic parameters, the gold standard for evaluating the medial longitudinal arch height, were not used. In addition, the results of this research cannot be generalized to people with normal and high medial longitudinal arches. Conclusions. In participants with a low medial longitudinal arch, the Navicular Drop Test showed significant correlations with footprint parameters; correlations were good for the arch angle and Chippaux-Smirnak Index, and excellent for the Staheli Index. The Foot Posture Index-6 showed an excellent correlation with the Navicular Drop Test and a good correlation with the footprint parameters evaluated. All of the parameters showed high reliability

Objectives: To evaluate the reliability of the used diagnostic criteria of latent trigger points (LTrPs) and pressure pain thresholds and to evaluate the prevalence of LTrPs in several muscles of the lower limb in subjects with a lower medial longitudinal arch (MLA) compared with controls. Design: Cross-sectional study. Setting: University campus. Participants: Subjects with a lower limb MLA (nZ82) and controls (nZ82) (NZ164). Interventions: Not applicable. Main Outcome Measures: The navicular drop test was used to classify subjects with a lower MLA ( 10mm) and controls (5e9mm). The Simons et al recommended specific diagnostic criteria and pressure pain thresholds were used to evaluate the prevalence of LTrPs in several muscles of the lower limb, which was compared between the 2 groups. The reliability was evaluated using Cohen’s kappa and intraclass correlation coefficient. The unpaired Student t test and chi-square test were used to evaluate the difference in the LTrP prevalence between the 2 groups. Results: The intrarater reliability of the navicular drop test and the diagnosis of LTrPs was excellent, with the taut band and tender spot being the most reliable diagnostic criteria. In the lower MLA group, 60 subjects (73%) presented at least 1 LTrP whereas 57 controls (70%) presented at least 1 LTrP. The lower MLA group showed more LTrPs (4.464.10) than did controls (3.323.24) (P<.05). There were significantly (P<.05) more subjects with LTrPs in the flexor digitorum longus, tibialis anterior, and vastus medialis in the lower MLA group than in the control group. Conclusions: LTrPs are common in the lower limb muscles in both controls and subjects with a lower MLA. A lower MLA is associated with a higher prevalence of LTrPs, which are significant in the flexor digitorum longus, tibialis anterior, and vastus medialis. Archives of Physical Medicine and Rehabilitation 2015;96:1123-30

Objective: The purpose of this study was to evaluate the correlation among the navicular drop test, the arch angle, the Staheli index and the Chippaux-Smirak index. The reliability and the correlation among the footprint parameters were also estimated. Methods: A cross-sectional study (n = 86; 59.3% women; 27.8 years, standard deviation: 4.8 years) was carried out. The navicular drop test was evaluated and footprint parameters using a plantar pressure platform were recorded in the dominant foot. Pearson correlation coefficients, intraclass correlation coefficient, standard error of measurement, and minimum detectable change were calculated. Results: Both intrarater and interrater reliability were excellent for all the parameters evaluated (intraclass correlation coefficients N 0.880). Statistically significant correlations existed between the navicular drop test and footprints parameters (arch angle = 0,643; Staheli index = 0.633; Chippaux-Smirak index = 0.614). The footprint parameters had excellent correlation with each other (0.838-0.881). The navicular drop test and the footprint parameters studied were reproducible and thus had excellent reliability. Conclusion: The correlations obtained between the navicular drop test and the footprint parameters evaluated were good. The navicular drop test appears to be a reproducible, valid, and simple test for evaluating medial longitudinal arch height, having fewer disadvantages than using footprint parameters.