Daniel Catalan-Matamoros

Systematic Review of the Benefits of Physical Therapy Within a Multidisciplinary Care Approach for People With Schizophrenia

Background Although schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown. Purpose The purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia. Data Sources EMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used. Study Selection Two reviewers independently determined study eligibility on the basis of inclusion criteria. Data Extraction Reviewers rated study quality and extracted information about study methods, design, intervention, and results. Data Synthesis Ten RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress. Limitations The heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research. Conclusions Physical therapy offers added value in the multidisciplinary care of people with schizophrenia.

A systematic review on physical therapy interventions for patients with binge eating disorder

Abstract Purpose: Since a distorted body experience and a sedentary lifestyle are central in the course of binge eating disorder (BED), physical therapy might be an interesting add-on treatment. The aim of this study was to systematically review randomised controlled trials (RCTs) evaluating physical therapy on binge eating and physical and mental health in BED patients. Method: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Library were searched from their inception until 15 August 2012 for relevant RCTs comparing physical therapy with a placebo condition, control intervention or standard care. Results: Three RCTs involving 211 female community patients (age range: 25–63 years) met all selection criteria. Review data demonstrate that aerobic and yoga exercises reduce the number of binges and the body mass index (BMI) of BED patients. Aerobic exercise also reduces depressive symptoms. Only combining cognitive behavioural therapy (CBT) with aerobic exercise and not CBT alone reduces BMI. Combining aerobic exercise with CBT is more effective in reducing depressive symptoms than CBT alone. Conclusions: The limited number of available studies and the heterogeneity of the interventions limit overall conclusions and highlight the need for further research. Implications for Rehabilitation Because of severe co-morbid psychiatric and physical conditions, binge eating disorder is one of the most difficult psychiatric conditions to treat. Both yoga and aerobic exercise have shown promise in reducing binge eating pathology and weight. Combining aerobic exercise with cognitive behavioural therapy seems more effective in reducing depressive symptoms than cognitive behavioural therapy alone.

A pilot study on the effect of Basic Body Awareness Therapy in patients with eating disorders: a randomized controlled trial

Objective: To analyse the feasibility of Basic Body Awareness Therapy in people with eating disorders. Design: A randomized controlled trial; the assessors were not blinded to the group allocation. Setting: The eating disorders department within a hospital setting. Subjects: Twenty-eight outpatients with eating disorders for less than five years. Intervention: All patients received standard outpatient treatment. The intervention group (n = 14) also received Basic Body Awareness Therapy for seven weeks. Main measures: Eating Disorder Inventory, Eating Attitude Test, Body Attitude Test and Quality of Life Scale SF-36. Results: Analysing the differences between both groups, significant differences were found in Eating Disorder Inventory (mean difference: 26.3; P = 0.015) and in its subscales ‘drive to thinness’ (P = 0.003), ‘body dissatisfaction’ (P = 0.025) and ‘ineffectiveness’ (P = 0.014). Also in Body Attitude Test (mean difference: 33.0; P = 0.012), Eating Attitude Test-40 (mean difference: 17.7; P = 0.039) and SF-36 in the section ‘mental health’ (mean difference: 13.0; P = 0.002). Conclusions: This study has shown some effectiveness of Basic Body Awareness Therapy in improving some symptoms in outpatients with eating disorders. Further studies should include larger samples, double-blinded and placebo methodologies, and should focus on questions such as which eating disorder diagnoses benefit most from physical therapy.

A systematic review of physical therapy interventions for patients with anorexia and bulemia nervosa.

Abstract Purpose: The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. Method: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. Results: Eight randomised controlled trials involving 213 patients (age range: 16–36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score≥3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. Conclusions: The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.

La comunicación y la satisfacción de las primíparas en un servicio público de salud

OBJECTIVE To analyze first-time mothers communication with health professionals, and to explore satisfaction, needs and expectation towards healthcare services. METHOD Qualitative design using in-deep interviews and phenomenology was used. First-time mothers from Huercal-Overa (Almería) were intentionally selected in 2010 and were included in the study. A hermeneutic analysis was performed. RESULTS Six meta-categories were obtained. Saturation of information was found with nine interviews. The meta-categories were the following: 1) Health professionals; 2) Pregnancy, partum and postpartum; 3) Communication; 4) Child nutrition; 5) Feelings; 6) Others. The mothers perceived as exciting this new experience and expressed feelings of fear, anguish and high sensitiveness. These feelings are increased by the information received from the family circle and the professionals which is referred low and contradictory. All professionals were positively considered, specially the midwife. The following negative experiences were identified: contractions, dilation and delivery. The end of the stay at the hospital was considered early and the time for consultation was short for the mothers. There is a demand about more information on breast feeding. Mothers wish health professionals to respect their decisions. CONCLUSIONS The study found some areas for improvement in the communication between firs-time mothers and health professionals which could be taken into account in satisfaction promotion plans in regards to healthcare services.

Análisis de las patologías con mayor prevalencia en las Unidades Móviles de Rehabilitación y Fisioterapia de la provincia de Almería

OBJECTIVES To describe the most prevalent disorders in 1753 patients referred to home rehabilitation and home physiotherapy units. METHOD We carried out a cross-sectional descriptive study. The variables analyzed were age, gender, main diagnosis, functional capacity (Barthel Index), physiotherapeutic objectives, the treatment applied and the number of sessions. RESULTS The main diagnoses were immobilization effects (29%), hip fracture (16.5%), stroke (13.7%), knee replacement (11.9%), hip replacement (4.7%), chronic obstructive pulmonary disease (2.6%), and Alzheimers disease (2.4%). The lowest Barthel Index was obtained in Alzheimers disease, stroke and immobilization effects and the highest in patients with knee replacement. The process requiring the highest number of sessions for complete recovery was stroke. CONCLUSIONS Significant improvements were confirmed in pre- and post- Barthel Index scores for each of the above-mentioned diagnoses, demonstrating greater functional independence among patients.

Considering the Role of Physical Therapists Within the Treatment and Rehabilitation of Individuals With Eating Disorders: An International Survey of Expert Clinicians

PURPOSE Recent research has demonstrated that physical therapy may benefit the physical and mental health of people with eating disorders (EDs). Because this is a new and developing field, this study aimed to investigate the experience, practices and knowledge of international physical therapy experts to inform clinical practice, education and research. METHODS An international cross-sectional survey design was undertaken with experienced physical therapists within the field of EDs. Physical therapist responses were analysed with descriptive statistics and thematic analysis as appropriate. RESULTS Twenty-eight international physical therapists participated. On average, participants had 6.9 years (95% confidence interval: 3.1-10.7, n = 27) of clinical experience working in ED settings and devoted approximately 39.3% (95% confidence interval: 23.8-54.8, n = 27) of their time to treating individuals with EDs. Participants reported that physical therapy interventions have a diverse range of benefits on the physical, mental and disease-specific factors (e.g. binges) in people with EDs. The key role of physical therapists includes improving body awareness, especially during physical activity combined with psycho-education about healthy doses of physical activity. Physical therapists were able to identify a range of barriers and facilitators to physical activity in people with EDs. DISCUSSION This paper provides a first step towards understanding the role and value of physical therapists working with individuals with EDs. Copyright

Effectiveness of pacemaker tele-monitoring on quality of life, functional capacity, event detection and workload: The PONIENTE trial.

The purpose of the present study was to assess the effectiveness of the remote monitoring (RM) of older adults with pacemakers on health‐related quality of life, functional capacity, feasibility, reliability and safety.

Considering the Role of Physical Therapists Within the Treatment and Rehabilitation of Individuals With Eating Disorders

PURPOSE Recent research has demonstrated that physical therapy may benefit the physical and mental health of people with eating disorders (EDs). Because this is a new and developing field, this study aimed to investigate the experience, practices and knowledge of international physical therapy experts to inform clinical practice, education and research. METHODS An international cross-sectional survey design was undertaken with experienced physical therapists within the field of EDs. Physical therapist responses were analysed with descriptive statistics and thematic analysis as appropriate. RESULTS Twenty-eight international physical therapists participated. On average, participants had 6.9 years (95% confidence interval: 3.1-10.7, n = 27) of clinical experience working in ED settings and devoted approximately 39.3% (95% confidence interval: 23.8-54.8, n = 27) of their time to treating individuals with EDs. Participants reported that physical therapy interventions have a diverse range of benefits on the physical, mental and disease-specific factors (e.g. binges) in people with EDs. The key role of physical therapists includes improving body awareness, especially during physical activity combined with psycho-education about healthy doses of physical activity. Physical therapists were able to identify a range of barriers and facilitators to physical activity in people with EDs. DISCUSSION This paper provides a first step towards understanding the role and value of physical therapists working with individuals with EDs. Copyright

Basic Body Awareness Therapy in patients suffering from fibromyalgia: A randomized clinical trial

ABSTRACT Introduction: The aim of this study is to assess whether Basic Body Awareness Therapy (BBAT) improves musculoskeletal pain, movement quality, psychological function, and quality of life. Methods: The effects of BBAT in addition to treatment as usual (TAU) were studied in a randomized controlled trial. Forty-one patients were randomly assigned to a control group (n = 21) and an intervention group (n = 20). Both groups received TAU including pharmacological therapy. The intervention group took part in 10 BBAT sessions. Outcome variables were measured regarding pain, movement quality, psychological function, and quality of life. Outcome measures were assessed before intervention, in posttest, and in follow-ups at 12 and 24 weeks. Results: The BBAT group showed significant improvement in ‘pain’ at posttest (p = 0.037) and in ‘movement quality’ from baseline to 24 weeks (p = 0.000). Intragroup analysis showed significant improvements in the SF-36 body pain subscale at 12 and 24 weeks (p = 0.001, p = 0.014), Hospital Anxiety Depression scale in anxiety subscale at 12 weeks (p = 0.019), State-Trait Anxiety Inventory anxiety questionnaire at 12 and 24 weeks (p = 0.012, p = 0.002), and STAI state at 12 and 24 weeks (p = 0.042, p = 0.004). Conclusion: This study showed that BBAT might be an effective intervention in patients suffering from fibromyalgia in relation to pain, movement quality, and anxiety.