José-Jesús Jiménez-Rejano

Reliability and minimal detectable change of three functional tests: forward-lunge, step-up-over and sit-to-stand

[Purpose] To examine the intrasession and intersession reliability and the absolute reliability of three functional dynamic tests—forward-lunge, step-up-over and sit-to-stand tests—using computerized dynamic posturography. [Subjects and Methods] An intra-test and test-retest, repeated measure study was designed. Forty-five healthy subjects twice carried out the forward-lunge test, step-up-over test, and sit-to-stand test on two days, one week apart. The intrasession and intersession reliabilities as judged by the intraclass correlation coefficient (ICC) and the minimal detectable change of the three functional tests were calculated. [Results] Excellent to very good intrasession reliability of the forward-lunge test (ICC range of 0.9–0.8) was found. Very good to good intrasession reliability of the step-up-over test (ICC range of 0.9–0.5) was found and very good intrasession reliability of the sit-to-stand test (ICC range of 0.8–0.7) was found. The minimal detectable change at the 95% confidence level of most of the measures was lower than 30%. [Conclusion] The forward-lunge, step-up-over and sit-to-stand tests are reliable measurement tools.

Efficacy of Therapeutic Ultrasound in Pain and Joint Mobility in Whiplash Traumatic Acute and Subacute Phases

To determine if ultrasound (US) is effective in reducing pain and mobility limitation in the treatment of traumatic cervical sprain, we performed an experimental study. The sample comprised 54 diagnosed subjects with a mean age of 36.54 y (standard deviation = 12.245), assigned by simple random selection to an experimental group with ultrasound treatment and a control group with placebo ultrasound. Treatment consisted of 10 sessions of an ultrasound treatment protocol, followed by 15 sessions of a protocol identical for both groups without ultrasound. The variables assessed were pain and joint mobility. There was no significant difference (p > 0.05) between groups in the first 10 sessions of treatment. However, there was a statistically significant difference (p < 0.05) between groups on the pain variable, 20 days after completion of the US. High-active ultrasound treatment is more effective than placebo in reducing pain.

Pain, motion and function comparison of two exercise protocols for the rotator cuff and scapular stabilizers in patients with subacromial syndrome

Study Design: Randomized clinical trial. Introduction: Eccentric exercise (EE) was shown to be an effective treatment in tendinopathies. However, the evidence of its effectiveness in subacromial syndrome (SS) is scarce. Moreover, consensus has not been reached on whether best results for SS are obtained by means of EE with or without pain. Purpose of the Study: The purpose of this is to compare the effect on pain, active range of motion (AROM), and shoulder function of an exercise protocol performed with pain <40 mm Visual Analog Scale (VAS) and without pain, in patients with SS. Methods: Twenty‐two subjects (mean age: 59 years [Q1 = 48.50‐Q3 = 70], 54.5% women) were randomized into a not‐painful EE group (NPEE; G0: n = 11) and a painful EE group (PEE; G1: n = 11). The intervention lasted 4 weeks. Pain was recorded using VAS; AROM was measured using a goniometer; and shoulder function using the modified Constant‐Murley Score (CMS) before and after intervention. Results: All dependent variables improved significantly in both groups (P < .05): NPEE VAS median: pretest = 55.0 posttest = 28.0; CMS median: pretest = 36.0 posttest = 65.0. PEE VAS median: pretest = 37.0 posttest = 12.0; CMS median: pretest = 35.0 posttest = 59.0. The comparison between groups showed no significant differences, with small effect size values (VAS = 0.09; CMS = 0.21; AROM = 0.12–0.43). Discussion: In contrast to the previous findings, our results suggest that PEE do not add benefit in SS patients compared to NPEE. Conclusion: Our results suggest that both interventions are effective in terms of pain, function, and shoulder AROM. Furthermore, PEE does not provide greater benefits. Further studies are needed with long‐term follow‐up to reinforce these results. HIGHLIGHTS Findings Possibly, achieving improvements in pain, active ROM, and shoulder function does not rely on performing the exercise with or without pain, but other factors could be involved. Four weeks of intervention are sufficient to produce statistically significant improvements in these variables. Implications The findings suggest that patients with SS could benefit both with a painful exercise protocol and with a pain‐free exercise protocol. This could refocus the clinical practice for such patients. However, more research is needed in order to overcome the limitations of this study. Caution According to the clinical judgment of the authors, future studies with a larger sample size and medium long‐term monitoring are needed to confirm the results.

Is it possible to relate accommodative visual dysfunctions to neck pain

The aim of this study was to establish whether there is a relationship between conditions of accommodative visual dysfunctions and cervical complaints. Fifty‐two participants were included. Variables were accommodative amplitude, positive and negative relative accommodation (NRA), accommodative response, and accommodative facility. Subjects were classified as accommodative insufficiency, accommodative excess, or normal. Neck complaints were measured with the Neck Disability Index, the Visual Analogue Scale, and by cervical range of motion, deep flexor muscle activation score, and performance index. We found the following significant relationships: between NRA and both performance index and left‐side bending; accommodative amplitude right‐eye with right‐side bending and with left‐side bending; accommodative amplitude left‐eye with right‐side bending; and accommodative facility left‐eye with both performance index and left‐side bending. In accommodative amplitude right‐eye, aIl participants showed significant values and greater than those with accommodative excess. In both groups, performance index values were decreased. Greater pain and lower right‐rotation were found in participants with accommodative excess than in those with accommodative insufficiency. We conclude that accommodative dysfunctions are related to low performance index, decreased range of motion, as well as greater neck pain.