Facultad de Ciencias de la Salud

Study design: Double-blind, randomized parallel sham-controlled trial with concealed allocation and intention-to treat analysis. Objective: To investigate the effects of an isolate myofascial release (MFR) protocol on pain, disability, and fear-avoidance beliefs in patients with chronic low back pain (CLBP). Summary of background data: MFR is a form of manual medicine widely used by physiotherapists in the management of different musculoskeletal pathologies. Up to this moment, no previous studies have reported the effects of an isolated MFR treatment in patients with CLBP. Methods: Fifty-four participants, with nonspecific CLBP, were randomized to MFR group (n = 27) receiving four sessions of myofascial treatment, each lasting 40 minutes, and to control group (n = 27) receiving a sham MFR. Variables studied were pain measured by means Short Form McGill Pain Questionnaire (SF-MPQ) and visual analog scale (VAS), disability measured with Roland Morris Questionnaire, and fear-avoidance beliefs measured with Fear-Avoidance Beliefs Questionnaire. Results: Subjects receiving MFR displayed significant improvements in pain (SF-MPQ) (mean difference -7.8; 95% confidence interval [CI]: -14.5 to -1.1, P = 0.023) and sensory SF-MPQ subscale (mean difference -6.1; 95% CI: -10.8 to -1.5, P = 0.011) compared to the sham group, but no differences were found in VAS between groups. Disability and the Fear-Avoidance Beliefs Questionnaire score also displayed a significant decrease in the MFR group (P < 0.05) as compared to sham MFR. Conclusion: MFR therapy produced a significant improvement in both pain and disability. Because the minimal clinically important differences in pain and disability are, however, included in the 95% CI, we cannot know whether this improvement is clinically relevant.

Purpose: Many patients with acute coronary syndrome experience problematic or altered sexual function. This aspect of the disease is frequently ignored or overlooked by the healthcare community even though it can strongly influence health-related patient quality of life (HRQoL). Thus, the aim of this study was to compare the effects of a specific cardiac rehabilitation programme focused on aerobic and neuromuscular strength-resistance training to those of a classic rehabilitation programme, both in terms of HRQoL and erectile dysfunction in patients with acute coronary syndrome. Methods: This study reports both secondary and unregistered outcomes from a double-blinded, randomised, and controlled clinical trial. The proposed intervention was based on the completion of a 20-session (10-week) cardiac rehabilitation programme for patients with cardiovascular disease. The patient cohort had been diagnosed with acute coronary syndrome and was recruited at the Cardiology Service of a private tertiary hospital. The outcomes assessed in this study were HRQoL and erectile disfunction assessed at baseline, after the intervention, and at a 6-month follow-up. Results: A total of 30 participants were randomly allocated to each study arm. The results of the two-way mixed ANOVAs showed significant group × time interactions for all the outcome measures (EQ-5D_index, p = 0.004; EQ-5D_VAS, p = 0.017; QLMI-Q, p ≤ 0.001; and IIEF-5, p = 0.001). Conclusion: The neuromuscular strength training programme was more effective than the classic strength training programme in terms of increasing the HRQoL and improving erectile dysfunction in patients following acute coronary syndrome, with differences still remaining between these groups at the 6-month follow-up.

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.