Dpto. Enfermería y Fisioterapia
Permanent URI for this collectionhttps://hdl.handle.net/10637/10413
Search Results
- Effectiveness of telematic behavioral techniques to manage anxiety, stress and depressive symptoms in patients with chronic musculoskeletal pain a systematic review and meta-analysis
2022-03-09 Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL),Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = 0.35; 95% CI 0.46, 0.24) and anxiety (n = 2578; SMD = 0.32; 95% CI 0.42, 0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.
- Effectiveness of virtual reality on balance and risk of falls in people with multiple sclerosis a systematic review and meta-analysis
2022-10-30 The aim of this study was to systematically review the scientific evidence related to the physiotherapy interventions in neurorehabilitation that utilize virtual reality (VR) for balance training and risk of falls in people with multiple sclerosis (MS). A search was conducted in Medline (PubMed), PEDro, and Google Scholar to identify all the relevant studies. Clinical trials assessing the effects of VR in people with MS were included. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and PEDro scale. Qualitative analysis was performed according to the GRADE. In total, 16 studies (n = 663) were included. The meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for balance, with a moderate clinical effect in eight studies (SMD: 0.63; 95% CI 0.34–0.92; p < 0.05). In addition, the meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for risk of falls, with a small clinical effect in six studies (SMD: 0.55; 95% CI 1.07–0.04; p < 0.05). VR-based treatments are more effective than non-intervention in improving balance and fall risk in people with MS, with a very low certainty of evidence. In addition, they also show to be more effective than conventional rehabilitation, with a very low certainty of evidence.
- Alexithymia and facial emotion recognition in patients with craniofacial pain and association of alexithymia with anxiety and depression : a systematic review with meta-analysis
2021-11-29 Background: We aimed to determine the presence of alexithymia in patients with craniofacial pain (CFP) compared with asymptomatic individuals. Our secondary aims were to assess the relationship of alexithymia with anxiety and depression levels, as well as to assess the presence of facial emotion recognition deficit. Methods: Medline, Scielo and Google Scholar were searched, with the last search performed in 8 September 2021. Standardized mean differences (SMDs) and 95% CIs were calculated for relevant outcomes and were pooled in a meta-analysis using the random effects model. In addition, meta-analyses of correlations and a metaregression of alexithymia with depression and anxiety were performed. Results: Regarding alexithymia, assessed through the Toronto Alexithymia Scale (TAS), the results showed significant differences, with higher values in patients compared with asymptomatic individuals, with a large clinical effect (SMD 0.46; 95% CI [0.22–0.71]; heterogeneity-Q 66.86; p < 0.001; inconsistency (I2) = 81%). We found statistically significant correlations with a small clinical effect of alexithymia with anxiety and depression. The meta-regression showed no significant association between the TAS and anxiety or depression. With respect to facial emotion recognition, the results showed statistically significant differences, with greater recognition difficulty in patients compared with asymptomatic individuals, with a large clinical effect (SMD −1.17; 95% CI [−2.01 to −0.33]; heterogeneity-Q 2.97; p = 0.080; I2 = 66%). Conclusions: Patients with CFP showed alexithymia with moderate evidence. There was also moderate evidence indicating that these patients had significant deficits in facial emotion recognition compared with asymptomatic individuals. Furthermore, alexithymia showed statistically significant correlations with anxiety and depression levels.
- Are psychosocial factors determinant in the pain and social participation of patients with early knee osteoarthritis? : a cross-sectional study
2021-04-26 The main objective of this research is to determine the psychosocial differences between patients with knee pain or early osteoarthritis (EOA) and healthy subjects at risk of developing osteoarthritis. The secondary objective is to determine how psychosocial factors might influence pain and social participation in patients with EOA. A cross-sectional study was performed. Participants were divided according to the presence of pain or EOA. Pain intensity both at rest and walking, psychological variables such as anxiety and depression, and social participation were evaluated. A total of 105 participants were included (64 with knee pain and 41 without pain), with a mean age of 51.42 5.92 (35 men and 70 women). Patients with knee pain had higher levels of anxiety (MD = 2.35; p < 0.01; d = 0.66) and depression (MD = 2.45; p < 0.01; d = 0.87), regardless of the presence of EOA. In addition, patients with higher depression levels had lower levels of social participation. The results revealed a relationship between the psychological variables, anxiety and depression, with knee pain and the onset of symptomatic OA, as well as an influence of depression levels on social participation. Improving these psychological characteristics may be useful in delaying the onset of symptomatic OA and enhancing social participation.
- The role of movement representation techniques in the motor learning process : a neurophysiological hypothesis and a narrative review
2020-01-02 We present a neurophysiological hypothesis for the role of motor imagery (MI) and action observation (AO) training in the motor learning process. The e ects of movement representation in the brain and those of the cortical–subcortical networks related to planning, executing, adjusting, and automating real movements share a similar neurophysiological activity. Coupled with the influence of certain variables related to the movement representation process, this neurophysiological activity is a key component of the present hypothesis. These variables can be classified into four domains: physical, cognitive–evaluative, motivational–emotional, and direct-modulation. The neurophysiological activity underlying the creation and consolidation of mnemonic representations of motor gestures as a prerequisite to motor learning might di er between AO and MI. Together with variations in cognitive loads, these di erences might explain the di ering results in motor learning. The mirror neuron system appears to function more e ciently through AO training than MI, and AO is less demanding in terms of cognitive load than MI. AO might be less susceptible to the influence of variables related to movement representation.
- Assessing anxiety, depression and quality of life in patients with peripheral facial palsy : a systematic review
2020-12-01 Objective: Peripheral facial palsy (PFP) is predominantly a unilateral disorder of the facial nerve, which can lead to psychological disorders that can result in decreased quality of life. The aim of this systematic review was to assess anxiety, depression and quality of life symptoms associated with PFP. Data sources: We searched the Medline, PEDro, CINAHL and Google Scholar databases to conduct this systematic review while following Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The search was performed by two independent reviewers, and differences between the two reviewers were resolved by consensus. Study Selection: The search terms used were derived from the combination of the following MeSH terms: “facial paralysis”, “bell palsy”, “anxiety”, “anxiety disorders”, “depression”, “depressive disorders”, “quality of life” and not MeSH: “facial palsy”, “hemifacial paralysis”, “facial paresis”, “Peripheral Facial Paralysis”, using the combination of different Boolean operators (AND/OR). Data Extraction: On November 1st (2019). Data Synthesis: In total, 18 cross-sectional articles and two case-control studies were selected. Conclusions: The cross-sectional articles showed low methodological quality, while the case-control studies showed acceptable methodological quality. Limited evidence suggests that patients with PFP might have increased levels of anxiety and depressive symptoms. A qualitative analysis also showed limited evidence that quality of life might be diminished in patients with PFP.
- Effects of movement representation techniques on motor learning of thumb-opposition tasks
2020-07-23 The present work is the first study that assess long run change after motor learning. The study’s main objective was to evaluate the short to medium-term impact of motor imagery (MI) and action observation (AO) on motor learning of a sequence of thumb-opposition tasks of increasing complexity. We randomly assigned 45 participants to an AO, MI, or placebo observation (PO) group. A sequence of 12 thumb-opposition tasks was taught for 3 consecutive days (4 per day). The primary outcome was accuracy. The secondary outcomes were required time and perfect positioning. The outcomes were assessed immediately after the intervention and at 1 week, 1 month and 4 months postintervention. Regarding the primary outcome, AO group had significantly higher accuracy than the MI or PO group until at least 4 months (p < 0.01, d > 0.80). However, in the bimanual positions, AO was not superior to MI at 1 week postintervention. Regarding secondary outcomes, AO group required less time than the MI group to remember and perform the left-hand and both-hand gestures, with a large effect size (p < 0.01, d > 0.80). In terms of percentage of perfect positions, AO group achieved significantly better results than the MI group until at least 4 months after the intervention in the unimanual gestures (p < 0.01, d > 0.80) and up to 1 month postintervention in the bimanual gestures (p = 0.012, d = 1.29). AO training resulted in greater and longer term motor learning than MI and placebo intervention. If the goal is to learn some motor skills for whatever reason (e.g., following surgery or immobilization.), AO training should be considered clinically.
- Mental practice in isolation improves cervical joint position sense in patients with chronic neck pain : a randomized single-blind placebo trial
2019-09-12 Objective. The main objective of this trial was to assess whether action observation (AO) training and motor imagery (MI) produced changes in the cervical joint position sense (CJPS) both at the end of the intervention and 10 min postintervention compared with a placebo intervention in patients with nonspecific chronic neck pain (NSCNP). Methods. A single-blind placebo clinical trial was designed. A total of 30 patients with NSCNP were randomly assigned to the AO group, MI group or placebo observation (PO) group. CJPS in flexion, extension and rotation movements in both planes were the main variables. Results. The results obtained in the vertical plane showed that the AO group obtained greater impr ovements than the PO group in the CJPS in terms of cervical extension movement both at the end of the intervention and 10 min postintervention (p = .001, d = 1.81 and p = .004, d = 1.74, respectively), and also in cervical flexion movement, although only at 10 min after the intervention (p = .035, d = 0.72). In addition, the AO group obtained greater improvements than the MI group in the CJPS only at the end of the intervention in cervical extension movement (p = .041, d = 1.17). Regarding the left rotation cervical movement, both the MI and AO groups were superior to the PO group in both planes at the end of the intervention (p < .05, d > 0.80). Conclusions. Although both AO and MI could be a useful strategy for CJPS improvement, the AO group showed the strongest results. The therapeutic potential of the application of mental practice in a clinical context in the early stages of rehabilitation of NSCNP should be considered.
- Somatosensory and motor differences between physically active patients with chronic low back pain and asymptomatic individuals
2019-08-23 Background and Objectives: Chronic low back pain (CLBP) is the most common occupationaldisorder due to its associated disability and high risk of recurrence and chronicity. However,the mechanisms underlying physical and psychological variables in patients with CLBP remain unclear.The main objective of this study was to assess whether there were differences between physicallyactive patients with nonspecific CLBP compared with asymptomatic individuals in sensorimotor andpsychological variables.Materials and Methods: This was an observational cross-sectional design with anonprobabilistic sample. The sample was divided into two groups: individuals with nonspecific CLBP(n=30) and asymptomatic individuals as a control (n=30). The psychological variables assessedwere low back disability, fear of movement, pain catastrophizing, and self-efficacy. The sensorimotorvariables assessed were two-point discrimination, pressure pain threshold, lumbopelvic stability,lumbar flexion active range of motion, and isometric leg and back strength.Results: Statisticallysignificant differences between the groups in terms of catastrophizing levels (p=0.026) and fear ofmovement (p=0.001) were found, but no statistically significant differences between groups werefound in self-efficacy (p>0.05). No statistically significant differences between the groups in anyof the sensorimotor variables were found (p>0.05).Conclusion: No sensorimotor differences werefound between patients with asymptomatic and chronic low back pain, but differences were found inthe psychological variables of catastrophizing and fear of movement.
- Therapeutic exercise based on biobehavioral approach for the rehabilitation of a radial nerve injury after surgical removal of a schwannoma : a case report
2019-08-28 Schwannoma is a benign tumor located in the Schwann cells of the nerves. A 36-year-old white man underwent surgery after being diag-nosed with radial nerve schwannoma of the upper right extremity be-tween the triceps brachii muscle and brachioradialis muscle, after which a complete axonotmesis of the aforementioned nerve trunk oc-curred. The symptomatology presented by the patient included a loss of both motor and sensory function of the fingers, hand, and right forearm. The treatment was a biobehavioral physiotherapy approach that includ-ed therapeutic exercise, neuro-orthopedic manual physical therapy, therapeutic education, and sensitivity retraining. The biobehavioral ap-proach in physiotherapy includes a multimodal approach that encom-passes biological aspects, along with cognitive-evaluating and motiva-tional-affective components. Two weekly sessions were held for 6 months, resulting in a total of 48 sessions. Using multimodal physiother-apy based on a biobehavioral approach, after 6 months of treatment, the symptoms improved. The motor function of the upper limb improved considerably due to the recovery of increased activity of the superficial musculature dependent on the radial nerve. However, the functions de-pendent on deep forearm and hand musculature recovered to a lesser extent. At the sensory level, the retraining of sensitivity allowed the pa-tient to regain an important sensitivity. This case report explains the treatment used and the findings obtained, given a large percentage of the functionality that had been lost was recovered.