1. Investigación

The aim of the present clinical trial is to evaluate the efficacy of kinesio taping on patients with chronic low back pain, when the exploration identifies skin/fascia mobilization as a factor that could modify the treatment effect. This study is a randomized controlled trial with intention-totreat analysis. Sixty-two participants with chronic low back pain were therefore recruited from a tertiary referral hospital. Targeted kinesio taping, according to skin/fascia mobility exploration, was applied in the experimental group (17 female/13 male; 49.47 ± 11.15 years) once a week for four sessions. The control group (17 female/14 male; 48.87 ± 9.09 years) underwent a placebo taping application. At post-treatment time there was a statistically significant reduction both in disability (Roland-Morris Disability Questionnaire) and pain (Numeric Pain Rating Scale) in the experimental group (disability: −2.88, 95% confidence interval [CI] −4.56 to −1.21, P < .001; pain: −1.58, 95% CI −2.67 to −0.54 P = .001) and the control group (disability: −1.82, 95% CI −3.46 to −0.17 P = .025; pain: −1.30, 95% CI −2.32 to −0.28 P = .008). However, at six months, these changes only remained significant in the experimental group (disability: −2.95, 95% CI −4.72 to −1.18, P < .001; pain: −1.06, 95% CI −2.07 to −0.04, P < .05). As a conclusion, the application of targeted kinesio taping produced a significant reduction in pain and disability, at 4 weeks and at 6 moths follow-up, although there were no differences between groups at any measurement time point.

The aim of the present clinical trial is to evaluate the effectiveness of neuromuscular versus classical strength-resistance training as part of a cardiac rehabilitation programme in patients following acute coronary syndrome. The study is designed as a double-blinded, randomised, and controlled clinical trial. Thirty participants suffering from acute coronary syndrome who meet our inclusion criteria will be recruited by a private tertiary hospital. The intervention group will follow 20 sessions of a cardiac rehabilitation programme divided into two parts: aerobic training and neuromuscular strength-resistance training. The control group will complete the same aerobic training as well as a classical strength-resistance training workout programme. The primary outcome of the study will be the mean difference in change from baseline in the Incremental Shuttle Walking Test. The secondary outcomes will be the cardiorespiratory fitness of the patients (assessed by means of the Chester Step Test), lower-limb performance (assessed with the 30-Second Chair Stand Test and Single- Leg Squat Test), lower-limb strength (hip flexor handheld dynamometry), sexual dysfunction assessment (Sex Health Inventory for Men) and quality of life (EQ-5D-5L). This work will provide evidence for the effectiveness of a neuromuscular versus a classic strength-training programme in terms of cardiorespiratory fitness, lower-limb performance capacities and quality of life, in cardiac patients. The data obtained could lead to more effective and functional workouts which, in turn, may enhance the speed at which these patients can return to their everyday activities of life and improve the efficiency of their movement patterns and heart responses. Furthermore, patients may find neuromuscular workout routines more motivating and engaging, thus encouraging them to adopt healthier lifestyle patterns.

Background: Flexion-relaxation response of the lumbar erector spinae has been previously studied after different interventions such as exercise programs or spinal manipulation, in subjects with chronic low back pain. The objective of the study was to investigate the effects of an isolate myofascial release protocol on erector spinae myoelectric activity and lumbar spine kinematics in chronic low back pain. Methods: Thirty-six participants, with nonspecific chronic low back pain, were randomized to myofascial release group (n=18) receiving four sessions of myofascial treatment, each lasting 40 minutes, and to control group (n=18) receiving a sham myofascial release. Electromyographic and kinematic variables as well as pain and disability questionnaires were analyzed. Findings: There was a bilateral reduction of the flexion relaxation ratio in individuals receiving myofascial release and who did not show myoelectric silence at baseline (right difference M = .34, 95% CI [0.16, 0.33], p ≤ .05 and left difference M = .45, 95% CI [0.16, 0.73], p ≤ .05). There was also a significant reduction in pain in the myofascial release group (difference M = −9.1, 95% CI [−16.3, −1.8], p ≤ .05) and disability (difference M = −5.6, 95% CI [−9.1, −2.1], p ≤ .05), compared with control group. No significant differences between groups were found for the kinematic variables. Interpretation: The myofascial release protocol contributed to the normalization of the flexion- relaxation response in individuals who did not show myoelectric silence before the intervention, and also showed a significant reduction in pain and disability compared with the sham group.

The purpose of this study is to investigate whether implementing a myofascial release (MFR) protocol designed to restore the myofascial properties of the diaphragm has any efect on the symptoms, quality of life, and consumption of proton pump inhibitors (PPI) drugs by patients with non-erosive gastroesophageal refux disease (GERD). We randomized 30 patients with GERD into a MFR group or a sham group. Changes in symptomatology and quality of life were measured with the Refux Disease Questionnaire and the Gastrointestinal Quality of Life Index. Need of PPIs was measured as the milligrams of drug intake over the 7 days prior to each assessment. All variables were assessed at baseline, one week and 4 weeks after the end of the treatment. At week 4, patients receiving MFR showed signifcant improvements in symptomatology (mean diference-1.1; 95% CI: −1.7 to −0.5), gastrointestinal quality of life (mean diference 18.1; 95% CI: 4.8 to 31.5), and PPIs use (mean diference-97mg; 95% CI: −162 to −32), compared to the sham group. These preliminary fndings indicate that the application of the MFR protocol we used in this study decreased the symptoms and PPIs usage and increased the quality of life of patients with non-erosive GERD up to four weeks after the end of the treatment.

Unstable shoe was developed as a walking device to strengthen the lower extremity muscles and reduce joint loading. A large number of studies have reported in asymptomatic adults increased electromyography (EMG) activity throughout the gait cycle in most of the lower limb muscles. However, no previous studies have explored the effects of wearing unstable shoes on trunk muscle activity in patients with chronic low back pain (CLBP). Therefore, the aim of the present study was to compare trunk muscle activity during gait using an unstable shoe and a conventional flat control shoe in patients with CLBP. Thirty-five CLBP patients (51.1±12.4 yrs.; 26±3.8 kg/m2; 9.3±5.2 Roland Morris Disability Questionnaire score) were recruited from the Orthopedic Surgery Service at the Hospital to participate in this cross-sectional study. All participants underwent gait analysis by simultaneously collecting surface electromyography (EMG) data from erector spinae (ES), rectus abdominis (RA), obliquus internus (OI) and obliquus externus (OE) muscles, while walking on a treadmill with flat control shoes and experimental unstable shoes. The results showed significantly higher %EMG activity in ES (mean difference: 1.8%; 95% confidence interval [CI] 1.3 to 2.2), RA (mean difference: 1.5%; 95% CI 0.3 to 2.7), and OI (mean difference: 1.5%; 95% CI 0.2 to 2.8) in the unstable shoes condition compared to the flat shoes condition. Based on these findings, the use of unstable shoes may have potential implications in promoting spine stability, particularly in improving neuromuscular control of trunk muscles in CLBP treatment.