Jesús Seco

A long‐term physical activity training program increases strength and flexibility, and improves balance in older adults

Purpose: Physical activity training programs in older adults have recognized health benefits. Evidence suggests that training should include a combination of progressive resistance, balance, and functional training. Our aim was to assess the effects of a simple physical activity program working on strength, flexibility, cardiovascular fitness, and balance in older adults, as well as the effects of a detraining period, at various different ages. Methods: This was longitudinal prospective study, including a convenience sample of 227 independent older adults (54 men, 173 women) who completed a simple 9‐month training program and 3‐month detraining follow‐up. The subjects were categorized into two age groups (65–74 [n = 180], and >74 years [n = 47]). At the beginning of the study (baseline), the end of the training period, and 3 months later (postdetraining), body mass index, body fat percentage, triceps skinfold thickness, hand grip strength, lower limb and trunk flexibility, resting heart rate, heart rate after exercise, and balance were measured, while VO2 max was estimated using the Rockport fitness test and/or measured directly. Results: Significant improvements in strength (p < .0001), flexibility (p < .0001), heart rate after exercise (p < .0001), and balance (p < .0001) were observed at the end of the training program. Flexibility and balance (p < .0001) improvements were maintained at the end of the detraining. Conclusion: A simple long‐term physical activity training program increases strength in both sexes, improves flexibility in women, and improves balance in older adults. The results also indicate the importance of beginning early in old age and maintaining long‐term training.

Anthropometric, physiological and maturational characteristics in selected elite and non-elite male adolescent basketball players

Abstract We investigated the anthropometric, physiological and maturation characteristics of young players (13–14 years old) associated with being successful in basketball. Body parameters were measured (stature, total body mass, skinfolds and lengths) and physiological capacities were assessed by endurance, sprint (20 m), jump and dribbling tests. Chronological age (CA) was recorded and maturity estimated using predicted age at peak height velocity (APHV). Anthropometric analysis indicated that elite players were taller, heavier and had a higher percentage of muscle. Further, physiological testing showed that these elite players perform better in jump, endurance, speed and agility tests (especially in the agility and ball tests). In addition, these skills are correlated with point average during the regular season. More basketball players born in the first semester of the year are selected and there is a predominance of early-maturing boys among those selected for the elite team. Those who are more mature have advantages in anthropometric characteristics and physiological test results. In conclusion, around puberty, physical and physiological parameters associated with maturity and CA are important in determining the success of basketball players. These findings should be taken into account by trainers and coaches, to avoid artificial bias in their selection choices.

The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review

BACKGROUND CONTEXT Shock wave and especially ultrasound are commonly used to treat low back pain (LBP) in routine practice. PURPOSE To assess the evidence on the efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and shock wave to treat LBP. STUDY DESIGN Systematic review. METHODS An electronic search was performed in MEDLINE, EMBASE, and the Cochrane Library databases up to July 2009 to identify randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP. No language restrictions were applied. Additional data were requested from the authors of the original studies. The risk of bias of each study was assessed following the criteria recommended by the Cochrane Back Review Group. RESULTS Thirteen studies were identified. The four RCTs complying with the inclusion criteria included 252 patients. Two of the three RCTs on ultrasound had a high risk of bias. For acute patients with LBP and leg pain attributed to disc herniation, ultrasound, traction, and low-power laser obtained similar results. For chronic LBP patients without leg pain, ultrasound was less effective than spinal manipulation, whereas a shock wave device and transcutaneous electrical nerve stimulation led to similar results. Results from the only study comparing ultrasound versus a sham procedure are unreliable because of the inappropriateness of the sham procedure, low sample size, and lack of adjustment for potential confounders. No study assessed cost-effectiveness. No adverse events were reported. CONCLUSION The available evidence does not support the effectiveness of ultrasound or shock wave for treating LBP. High-quality RCTs are needed to assess their efficacy versus appropriate sham procedures, and their effectiveness and cost-effectiveness versus other procedures shown to be effective for LBP. In the absence of such evidence, the clinical use of these forms of treatment is not justified and should be discouraged.

Perioperative physiotherapy in patients undergoing lung cancer resection.

Physiotherapy is considered an important component of the perioperative period of lung resection surgery. A systematic review was conducted to assess evidence for the effectiveness of different physiotherapy interventions in patients undergoing lung cancer resection surgery. Online literature databases [Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, SCOPUS, PEDro and CINAHL] were searched up until June 2013. Studies were included if they were randomized controlled trials, compared 2 or more perioperative physiotherapy interventions or compared one intervention with no intervention, included only patients undergoing pulmonary resection for lung cancer and assessed at least 2 or more of the following variables: functional capacity parameters, postoperative pulmonary complications or length of hospital stay. Reviews and meta-analyses were excluded. Eight studies were selected for inclusion in this review. They included a total of 599 patients. Seven of the studies were identified as having a low risk of bias. Two studies assessed preoperative interventions, 4 postoperative interventions and the remaining 2 investigated the efficacy of interventions that were started preoperatively and then continued after surgery. The substantial heterogeneity in the interventions across the studies meant that it was not possible to conduct a meta-analysis. The most important finding of this systematic review is that presurgical interventions based on moderate-intense aerobic exercise in patients undergoing lung resection for lung cancer improve functional capacity and reduce postoperative morbidity, whereas interventions performed only during the postoperative period do not seem to reduce postoperative pulmonary complications or length of hospital stay. Nevertheless, no firm conclusions can be drawn because of the heterogeneity of the studies included. Further research into the efficacy and effectiveness of perioperative respiratory physiotherapy in this patient population is needed.

The correlation between pain, catastrophizing, and disability in subacute and chronic low back pain: a study in the routine clinical practice of the Spanish National Health Service.

Study Design. Correlation between variables measured with previously validated instruments. Objective. To explore the association between catastrophizing and disability in patients treated for subacute or chronic low back pain (LBP) within routine clinical practice in Spain. Summary of Background Data. The influence of psychological variables on LBP-related disability in Southern Europe is different to the one in the Anglo-Saxon and Northern European cultural environments. In Spanish LBP patients, the influence of fear avoidance beliefs on disability is negligible, and catastrophizing does not mediate the improvement of disability caused by active education. The association between catastrophizing and disability is unknown. Methods. Thirty-three clinicians working for the Spanish National Health Service in 6 primary care and 8 specialty centers, recruited 1461 patients seeking care for subacute and chronic LBP. Patients were assessed only once. A linear regression model was developed to assess the percentage of the variance of disability explained by gender, age, chronicity status, severity of LBP, severity of referred pain (referred pain down to the leg), catastrophizing, eligible for workers’ compensation (yes/no), failed back surgery (yes/no), radiologic findings, and treatments. Results. Correlations among LBP, referred pain down to the leg, disability, and catastrophizing were moderate, but significant. The strongest one was between disability and catastrophizing (r ∇ 0.520). Catastrophizing explained 28% of disability, whereas severity of LBP only 3%. Global adjusted R2 of the model was 0.387. There was an association between some radiologic findings and treatments, and slightly higher levels of disability. Conclusion. In Southern European subacute and chronic LBP patients, catastrophizing correlates with disability and explains approximately one-fourth of its variance. Further studies should assess its value as a prognostic factor in subacute and chronic patients.

Adaptive response in the antioxidant defence system in the course and outcome in first-episode schizophrenia patients: A 12-months follow-up study

Correlation of plasma antioxidant enzyme activity with the course and outcome in first-episode schizophrenia patients (n=49) was analyzed in order to assess the possible utility of peripheral markers of oxidative stress as prognostic factors. These markers were measured shortly after the onset of schizophrenia, and again 1, 6 and 12 months later. A decrease in catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD), and glutathione (GSH) levels and total antioxidant status (TAS), as well as an increase in thiobarbituric acid reactive substances (TBARS), were observed 1 month after (p<0.05). 6-Months later, there was a reduction in TAS, GSH, SOD and GPx, and a increase in TBARS (p<0.05), with a normalization of CAT levels, indicating a persistent alteration of the antioxidant system and the maintenance of oxidative stress. At 12-months, a considerable decrease was observed in TBARS. Additionally, while the level of GPx decreased (p<0.05) further, SOD and GSH levels and TAS were normalizing, indicating a partial regeneration of the antioxidant defence system. These results indicate the possible contribution of oxidative stress to the onset and pathophysiology of schizophrenia, suggesting the involvement of an adaptive response in the antioxidant defence system in the course and outcome in first-episode schizophrenia patients.

KiReS: A Kinect-based telerehabilitation system

The goal of this paper is to show the main features of KiReS, a telerehabilitation system based on Kinect for Windows, that offers, for both, users and physiotherapists some specific elements that make it more friendly to them. From the point of view of users, they can see in two 3D avatars how an exercise must be executed and how they execute it respectively. This feature can help them improve exercises performance. Moreover during the rehabilitation session they will always see an informative list that shows the exercises to be done in the session. From the point of view of physiotherapists the system allows them on the one hand, to define customized rehabilitation therapies. That can be done by defining different exercises that combine pre-defined movements. Moreover, they can add tests oriented to specific illnesses so that users themselves evaluate their physical state. On the other hand, they can create new exercises just performing those exercises in front of the system and recording them. Those features, not fully supported by already existing telerehabilitation systems, provide an added value that is well valued by both groups. Moreover, a prototype of KiReS is in operation, and allowed us to test its suitability from the point of view of real time performance as well as from the point of view of usability.

Predicting the evolution of low back pain patients in routine clinical practice: results from a registry within the Spanish National Health Service

BACKGROUND CONTEXT The Spanish National Health Service (SNHS) is a tax-funded public organization that provides free health care to every resident in Spain. PURPOSE To develop models for predicting the evolution of low back pain (LBP) in routine clinical practice within SNHS. STUDY DESIGN Analysis of a prospective registry in routine clinical practice, in 17 centers across SNHS. PATIENT SAMPLE Patient sample includes 4,477 acute and chronic LBP patients treated in primary and hospital care. OUTCOME MEASURES Pain and disability, measured through validated instruments. METHODS Patients treated for LBP were assessed at baseline and 3 months later. Data gathered were the following: sex, age, employment status, duration of pain, severity of LBP, pain down to the leg (LP) and disability, history of lumbar surgery, diagnostic procedures undertaken, imaging findings, and treatments used throughout the study period. Three separate multivariate logistic regression models were developed for predicting a clinically relevant improvement in LBP, LP, and disability at 3 months. RESULTS In total, 4,261 patients (95.2%) attended follow-up. For all the models, calibration was reasonable and the area under the receiver operating characteristic curve was ≥0.640. For LBP, LP, and disability, factors associated with a higher probability of improvement at 3 months were the following: not having undergone lumbar surgery, higher baseline scores for the corresponding variable, lower ones for the rest, and being treated with neuroreflexotherapy. Additional factors were the following: for LBP, shorter pain duration; for LP, not undergoing electromyography; and for disability, shorter pain duration, not being diagnosed with disc degeneration, and being treated with muscle relaxants and not opioids. CONCLUSIONS A prospective registry can be used for developing predictive models to quantify the odds that a given LBP patient will experience a clinically relevant improvement. This may empower patients for an informed shared decision making.

Basketball Performance Is Related to Maturity and Relative Age in Elite Adolescent Players.

Abstract Torres-Unda, J, Zarrazquin, I, Gravina, L, Zubero, J, Seco, J, Gil, SM, Gil, J, and Irazusta, J. Basketball performance is related to maturity and relative age in elite adolescent players. J Strength Cond Res 30(5): 1325–1332, 2016—During a national championship, the anthropometric, physiological, and maturation characteristics of 13- to 14-year-old players of elite basketball teams and their association with sport performance were analyzed. Body parameters (weight, height, skinfold thicknesses, and lengths) were measured and physiological capacities assessed by sprint (20 m) and jump tests (i.e., countermovement jump with arm swing). Chronological age (CA) and maturity offset (years from age at peak height velocity; YAPHV) were calculated, and then predicted age at peak height velocity, as the difference between CA and YAPHV. Game performance was assessed with point averages and the performance index rating (PIR). The birth-date distribution of players was biased, those born early in the selection year outnumbering those born later. Anthropometric analysis indicated that players who performed better had longer body lengths. Physiological testing showed that semi-finalists had better sprint performance than quarter-finalists and those players with greater jump capacity scored more points. Early maturation and advanced maturity status were also associated with better PIR and scored points per game. Multiple blockwise regression analysis showed that, among the factors analyzed, YAPHV was the best predictor of basketball performance. In conclusion, around puberty, physical and physiological parameters associated with maturity and CA are important in determining the success of elite basketball players. Consequently, boys who are born in the second half of the year and/or late maturing tend to be marginalized or totally excluded, and not given the chance to play under equal conditions; their careers may then be held back by the relative disadvantage associated with inexperience.

Spanish adaptation of the Quality of Life Index-Spinal Cord Injury version.

Study design:A cross-sectional, validation study.Objectives:To (a) develop the Spanish version of the Quality of Life Index-Spinal Cord Injury version (SV-QLI/SCI) and (b) assess its psychometric characteristics among permanent wheelchair users and specifically among those with SCI.Setting:Associations of wheelchair users in Mallorca (Spain).Methods:Two forward and backward translations of the QLI/SCI into Spanish were carried out separately. Seventy-seven subjects were randomly selected among the members of the associations. They completed the SV-QLI/SCI and validated instruments to measure depression and spinal pain upon recruitment and 14 days later. Assessments included comprehensibility, reproducibility, floor and ceiling effects and correlations between quality of life, pain and depression (Spearmans correlation coefficient). Analyses were repeated excluding data from subjects without SCI.Results:Three items of the SV-QLI/SCI required rephrasing. Reproducibility was ‘almost perfect’ for the entire questionnaire and its ‘Health and functioning’ subscale, ‘substantial’ for the ‘Social and economic’ and ‘Family’ subscales and ‘moderate’ for the ‘Psychological/spiritual’ subscale. Floor effect was not observed, and only for the ‘Family’ subscale >3% of the subjects reached the maximum possible score. The correlation between quality of life and depression was the strongest (r=−0.628). Results were virtually identical in the subsample with SCI.Conclusion:These results support the use of the SV-QLI/SCI among Spanish-speaking wheelchair users.